The Difference Between Alcohol Abuse and Alcohol Dependence

Binge Drinking Is Common for Those Who Abuse Alcohol

Alcohol abuse is any "harmful use" of alcohol but is that the same as alcohol dependence? These two terms are not the same. While some who abuses alcohol is prone to binge drinking, someone who is dependent on alcohol exhibits a variety of other symptoms.

Who Is an Alcohol Abuser?

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

Typically, you can help those drinkers diagnosed as alcohol abusers with a brief intervention, including education concerning the dangers of binge drinking and alcohol poisoning.

Who Is Alcohol Dependent?

If you are alcohol-dependent, you meet all of the criteria of alcohol abuse mentioned above, but you will also exhibit some or all of the following:

  • Narrowing of the drinking repertoire. For example, rather than consuming a variety or drinks, you drink only one specific brand or a certain type of alcoholic beverage, such as the same martinis every night.
  • Drink-seeking behavior. You only go to social events or places that will include drinking, or you only hang out with others who drink.
  • Alcohol tolerance. When you have 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 that feeling you're looking for.​
  • Withdrawal symptoms. When you have physical symptoms, such as insomnia, tremors, and mood swings 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 you 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).

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

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 may last for weeks, according to information from the National Institutes of Health.

Those with mild to moderate symptoms generally 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.

The treatment may involve intravenous fluids, sedation medication and monitoring of blood pressure, heart rate and other vital signs.

Symptoms of severe alcohol withdrawal include:

  • fever
  • hallucinations
  • seizures
  • severe confusion

How Do I Know if I'm Drinking 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 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.

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  1. National Institute on Alcohol Abuse and Alcoholism. Alcohol use disorder: A comparison between DSM–IV and DSM–5. Revised 2016.

  2. NIH MedlinePlus. Alcohol withdrawal. Updated January 1, 2019.