Alcohol Abuse vs. Alcohol Dependence

Q: What is the difference between alcohol abuse and alcohol dependence?

A: Alcohol abuse is described as any "harmful use" of alcohol.

The Diagnostic and Statistical Manual of Mental Disorders IV describes
alcohol abusers as those who drink despite recurrent social, interpersonal,
and legal problems as a result of alcohol use. Harmful use implies alcohol
use that causes either physical or mental damage.

Those who are alcohol dependent meet all of the criteria of alcohol abuse,
but the will also exhibit some or all of the following:

• Narrowing of the drinking repertoire (drinking only one brand or type of
  alcoholic beverage).

• Drink-seeking behavior (only going to social events that will include
  drinking, or only hanging out with others who drink).

• Alcohol tolerance (having to drink increasing amounts to achieve previous
  effects).

• Withdrawal symptoms (getting physical symptoms after going a short period
  without drinking).

• Drinking to relieve or avoid withdrawal symptoms (such as drinking to stop
  the shakes or to "cure" a hangover).

• Subjective awareness of the compulsion to drink or craving for alcohol
  (whether they admit it to others or not).

• A return to drinking after a period of abstinence (deciding to quit drinking
  and not being able to follow through).

Typically, those drinkers who are diagnosed as only alcohol abusers can be
helped with a brief intervention, including education concerning the dangers
of binge drinking and alcohol poisoning.

Those who have become alcohol dependent generally require outside help to
stop drinking, which could include detoxification, medical treatment,
counseling and/or self-help group support.