Addiction Alcohol Use Binge Drinking The Difference Between Alcohol Abuse and Alcohol Dependence By Buddy T facebook twitter Buddy T is an anonymous writer and founding member of the Online Al-Anon Outreach Committee with decades of experience writing about alcoholism. Learn about our editorial process Buddy T Medically reviewed by Medically reviewed by Steven Gans, MD on April 25, 2020 Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Review Board Steven Gans, MD Updated on April 25, 2020 Print Until the publication of the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), substance issues were generally divided into abuse and dependence. The DSM-5 combines these categories into a single substance use disorder, measured on a continuum from mild to severe. This change was made to update the idea that abuse was a mild and early phase of the illness and dependence was a more severe manifestation. In reality, abuse can often be quite severe. Who Is an Alcohol Abuser? It is still sometimes useful to clarify the distinctions between abuse and dependence. Alcohol abusers can be defined as those who continue to drink despite recurrent social, interpersonal, health, and legal problems as a result of their alcohol use. An Overview of Alcohol Abuse and Misuse Who Is Alcohol Dependent? People who are alcohol-dependent exhibit some or all of the following characteristics. Alcohol tolerance: Needing to drink increasing amounts over time to achieve previous effects. For example, you used to drink three cocktails every night, but now you need five to get the feeling you're looking for. Withdrawal symptoms: Experiencing physical symptoms, such as insomnia, tremors, and mood swings. after going for a short period without drinking. Drinking to relieve or avoid withdrawal symptoms, such as drinking to stop the shakes or to "cure" a hangover. Awareness of the compulsion to drink or craving for alcohol, regardless of whether you admit it to others. Drinking larger amounts or over a longer period than intended and making unsuccessful efforts to cut down. Those with moderate to severe alcohol use disorders generally require outside help to stop drinking. This could include detoxification, medical treatment, professional rehab or counseling, and/or self-help group support. What Does Having an "Alcohol Problem" Mean? How Much Is Too Much? Are your drinking habits safe, risky, or harmful? Are you abusing alcohol or alcohol dependent? Looking at the aforementioned symptoms can give you an idea of how your drinking may fall into harmful patterns and indicate whether or not you have a drinking problem. If you or a loved one are struggling with substance use or addiction, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area. For more mental health resources, see our National Helpline Database. Alcohol Withdrawal Symptoms and Treatment If you are alcohol-dependent and decide to change your life and quit drinking, you can expect to experience withdrawal symptoms. These discomforts usually peak 24 to 72 hours after your last drink, but they may last for weeks, according to information from the National Institutes of Health. Those with mild to moderate symptoms may be able to receive treatment in an outpatient setting. You should ask a loved one to stay with you during this process and you may need to visit a clinician for daily monitoring. If you have moderate to severe symptoms of alcohol withdrawal, you may require inpatient treatment at a hospital or substance abuse facility. Symptoms of severe alcohol withdrawal include: Fever Hallucinations Seizures Severe confusion Unstable vital signs Was this page helpful? Thanks for your feedback! Learn the best ways to manage stress and negativity in your life. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. National Institute on Alcohol Abuse and Alcoholism. Alcohol use disorder: A comparison between DSM–IV and DSM–5. Revised 2016. U.S. National Library of Medicine. Alcohol withdrawal. Updated August 4, 2020.