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Alcohol Abuse vs. Alcoholism: What’s the Difference?

Updated: Oct 10, 2020



Alcoholism and alcohol abuse are both used to describe ongoing issues with alcohol. Many people use these terms interchangeably, but they actually have very distinct meanings. When you’re struggling with alcohol problems or if you know someone who is, it’s important to know which kind you are dealing with.


The Difference Between Alcoholism and Alcohol Abuse


Switching these terms seems harmless. But for people who can’t say no to alcohol, knowing which is which can make all the difference in their recovery. Having a good grasp of what you (or a loved one) are going through will enable you to get appropriate help for your condition.


What is Alcohol Abuse?


Alcohol abuse is an umbrella term that denotes excessive drinking. And no, we’re not talking about that relative of yours who occasionally enjoys having one-too-many-drinks; or that friend who called you to hang out and ended up drunk that night. A person can be intoxicated at several points throughout their lifetime and not abuse alcohol.


In fact, data from the National Institute on Alcohol Abuse and Alcoholism (NIAAA) says that 86.4% of Americans aged 18 and above have consumed alcohol at least once in their life.


Someone who is legitimately suffering from alcohol abuse will drink regularly, even if there is no occasion that calls for it. There is no clear-cut definition on what makes an ‘abusive’ drinker other than the frequent, excessive intake of alcohol. A ‘light drinker’ like Jane who downs one bottle of red wine every week, can be just as much of an alcohol abuser as John, a ‘heavy drinker’ who drinks 1 to 2 packs of beer each day.


Signs of Alcohol Abuse


According to the Centers for Disease Control and Prevention, having more than one drink (if you’re a woman) or more than two drinks per day (if you’re a man) is considered heavy drinking. One drink, they say, is equivalent to 12 oz of beer, 8 oz of malt liquor, 5 oz of wine, or 1.5 oz of 80-proof liquor or distilled spirits.


But as mentioned earlier, it isn’t necessarily the amount of alcohol you consume that makes you an abusive drinker. Rather, it’s the frequency or how often you drink. If you find yourself drinking more often than usual, it could be a sign of alcohol abuse.


What is Alcoholism?


Alcoholism is a more serious form of alcohol abuse. It’s an outdated term as most medical professionals now refer to it as alcohol dependence or alcohol use disorder. Still, many people continue to use these terms interchangeably.


Alcoholism usually develops gradually over several months of heavy drinking. During which time, a person builds up tolerance to alcohol, causing them to drink more the longer they go. However, it can also develop quickly in the span of a few weeks. People who experience sudden, stressful situations – such as a breakup, the loss of a job or a loved one, and retirement – may resort to drinking as a coping mechanism. Eventually, this could lead to alcoholism.


Not everyone with alcohol abuse goes on to develop alcoholism. Unless you seek treatment however, there is always the risk that it would progress.


Signs of Alcoholism


Alcohol is a psychoactive substance. Like any drug, long-term exposure can directly impact your brain and negatively affect your mood, behavior, and cognitive ability.


People with alcoholism have no regard for the consequences of their behavior. They will continue to drink alcohol even if they are already failing in their responsibilities, or are under obvious danger – such as driving or working with heavy machinery. The common denominator here is the incessant urge to drink.


A person who has alcohol dependence will also find it difficult to function. In fact, the only time you feel ‘normal’ is when you’re inebriated or have had a few drinks. If you are unsure whether you or a loved one has alcoholism, you can watch out for these signs:


  • Making up excuses to drink

  • Choosing drinking over responsibilities

  • Isolating oneself from friends and family

  • Feeling guilt and shame when drinking in public

  • Changes in behavior and social circle


According to the National Library of Medicine, people with alcohol use disorder experience intense cravings, irritability, and anxiety whenever they’re sober. They also tend to have a high alcohol tolerance, which is why they don’t easily get drunk. People who struggle with alcoholism also spend a considerable amount of time drinking and recovering from a binge.


Alcoholism and Alcohol Withdrawal


The thing with alcohol is that it’s a “downer” with sedative and depressant effects. To compensate, the brain will try to balance it out by producing more natural stimulants like serotonin and norepinephrine. If you suddenly stop drinking, your brain will continue to produce these chemicals in high quantities. Only this time, there is no alcohol to counteract their stimulating effects, which could then result in withdrawal.


Alcohol withdrawal peaks within 24 to 48 hours of quitting. Signs include:


  • Shaking

  • Rapid pulse

  • Increased blood pressure

  • Fast breathing

  • Nausea and vomiting

  • Sweating

  • Anxiety

  • Irritability

  • Nightmares or vivid dreams

  • Difficulty sleeping

  • Hyperactive state

  • Hallucinations

  • Headache

  • Loss of appetite

  • Depression


About 5 to 10 percent of people with alcoholism may experience delirium tremens after 48 hours of quitting. It is an intense form of alcohol withdrawal characterized by these symptoms:


  • Irregular breathing

  • Unstable body temperature

  • Impaired circulation

  • Decreased blood flow to the brain

  • Increased heart rate

  • Dehydration

  • Confusion and disorientation

  • Seizures


Other Signs of Alcohol Abuse and Alcoholism


In addition to alcohol withdrawal and the symptoms associated with alcoholism, there are other signs you can look out for. For instance, long-term exposure to alcohol is known to cause health complications. These include:


  • Liver disease

  • Heart problems

  • Diabetes

  • Vision problems

  • Loss of bone density

  • Cognitive impairment


Left untreated, alcoholism can affect your personal life. It will cause your work, relationships, or studies to suffer. Some people also engage in risky behavior such as drinking and driving.


Treatment for Alcoholism vs Alcohol Abuse


Alcohol abuse and alcoholism are two different conditions that require different levels of care. But before you can get treated, medical professionals will have to evaluate you to see which kind you have.


Getting Help for Alcohol Abuse


The symptoms of alcohol abuse are not as intense, though it shouldn’t be taken any less seriously. Keep in mind that without treatment, it can still develop into alcoholism.


With alcohol abuse, the goal of treatment is to prevent it from getting worse. This is made possible with therapies that address underlying issues. More often than not, alcohol abuse can be resolved with outpatient rehab.


Getting Help for Alcoholism


If you have alcoholism, the biggest struggle you will have to overcome is the physical and psychological dependence you have for alcohol. Remember that unlike someone who only has alcohol abuse, you will be experiencing withdrawal symptoms which can make it difficult to quit.


Alcohol detoxification makes it possible for you to get past the withdrawal phase as safely and as comfortably as possible. By removing the influence of alcohol on your body, you can transition more easily into rehab. From here, doctors will likely recommend inpatient rehab, followed by outpatient treatment once you show signs of improvement.


Some centers may also provide additional therapies alongside their alcohol rehab programs. For instance, if you have mental health issues, you can benefit from dual diagnosis programs such as the ones we offer.


At Recovery Blvd Treatment Center, we can provide you or your loved one the comprehensive care you need to get past alcohol abuse and alcoholism. Call us at 503-897-1916 or visit our drug rehab center in Portland at 1316 SE 12th Avenue Portland, OR 97214.

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