
Alcohol abuse and alcoholism in adults is a significant societal issue. Alcohol use is such an accepted activity that it’s extremely easy to develop a dependency without even being aware of it. However, alcohol addiction goes beyond merely going out for a few nights, celebrating with friends, or having a couple cocktails with coworkers at Happy Hour.
When you notice a loved one who’s dangerously toeing the line between “having a good time” and dependency, it can be difficult to tell when harmless or occasional drinking has turned into a real problem. Maybe you’re noticing your partner coming home late after the bar multiple times per week. Or maybe you’re a parent having to pick up your grandkids more often from school because your child is often too inebriated to drive.
We’ve treated over 10,000 patients with substance use issues and heard concerns from countless families who just want to find the best ways to help a family member addicted to drugs. The lines between concern and misuse can blur often, and we know that you may wonder how to confront the behavior without overstepping boundaries or damaging relationships.
Over 29 million adults (almost 1 in 10 people) have an alcohol addiction, and your loved one may be one of them. That’s why it’s necessary to reflect on their behaviors and understand a crucial part of alcohol addiction: the difference between alcohol abuse and alcoholism.
By knowing this difference, you’ll be much better equipped to confront your loved one’s behaviors, be more confident in finding solutions, and have a better understanding of your loved one on a deeper level.
Aren’t Alcohol Abuse and Alcoholism the Same?
The simple answer is no, they’re not. While the two may seem very similar (and they are), they do have some differences. Let’s start with an overview of alcohol abuse and alcoholism first.
Alcohol Abuse is a Disruption of Daily Functions
When frequent drinking starts disrupting daily functions, the behavior may have crossed the line into alcohol abuse. This results when the pattern of drinking starts damaging your loved one’s health, relationships, or work. A few examples of alcohol abuse can include:
- Drinking in hazardous situations, such as driving or operating heavy machinery.
- The inability to complete responsibilities at home, work, or school.
- A noticeable deterioration in mental or physical health.
- Increasingly frequent episodes of drinking in inappropriate situations.
If drinking has negatively affected your loved one’s life often enough to become a consistent disruption, they may suffer from alcohol abuse, not alcoholism.
Alcoholism is a Chronic Disease
By contrast, alcoholism is a chronic mental disease comprised of specific behaviors and thought patterns, and is clinically known as Alcohol Use Disorder (AUD). It’s not just a disruption of daily life, but the uncontrollable inability to focus on anything else but drinking, putting the habit at the forefront of everything including family, friends, work, and overall health.
People who suffer from alcohol addiction may exhibit behaviors and thought patterns, such as:
- Alcohol usage surpassing a generally “negative” impact, reaching a level that severely impacts physical and mental health.
- Valuing alcohol above friends and family relationships, jobs, or physical health.
- Wanting to stop drinking but always go back to it.
- Feeling like they can’t function in daily life without drinking.
Another key difference in alcoholism is that trying to stop drinking can result in physical withdrawals. However, not everyone with alcoholism will experience withdrawal; it’s just a key indicator of the disease. Symptoms of alcohol withdrawal can include:
Alcoholism can vary in severity, but it boils down to going beyond just issues of daily functions; it’s an uncontrollable, physical dependency on the substance, and it’s an important distinction to know.
5 Differences Between Alcohol Abuse and Alcoholism
Now that we’ve established what alcohol abuse and alcoholism are, their main differences can be categorized into 5 main areas:
- Differences in behavior.
- Differences in tolerance level.
- Differences in frequency of alcohol consumption.
- Differences in level of control.
- Differences in treatment types.
1. Behavioral Differences: Disruption vs. Disease
Alcohol abuse is reckless overuse and misuse of alcohol, causing a behavioral pattern that disrupts daily life. However, an important distinction is that someone who abuses alcohol often can stop drinking through their own willpower, if given a good enough reason to do so, such as a health issue or potential loss of a relationship.
By contrast, alcoholism is a brain disease characterized by persistent use and often a physical addiction to alcohol. The person suffering from this disease will feel like they cannot cope with day-to-day life without drinking. They may have tried to stop on their own, but the physical, emotional, or mental discomfort they experience when they are not drinking is intolerable. An indicator of alcoholism is the physical dependence experienced that may cause withdrawal symptoms if they stop drinking suddenly.
In short, alcohol abuse just disrupts life, while alcoholism disrupts the person on deeper levels.
2. Tolerance Level: Low vs. High Alcohol Tolerance
The second difference is tolerance level. The concept of “building up tolerance” means that you need to drink more and more to feel the effects, and it’s dependent on a variety of factors. Regarding alcohol abuse and alcoholism, there’s a disparity between tolerance levels.
Someone experiencing alcohol abuse will not necessarily develop tolerance; the effects felt after one or two drinks won’t be noticeable until six or seven. However, with alcoholism, a significant symptom is a buildup of tolerance; there is no ceiling, meaning tolerance will just continue to grow.
Think about your loved one’s drinking patterns. When they drink, do they have a set number of drinks needed to get drunk? Or does it feel like their tolerance just keeps growing and growing, like there’s no stop to it? This is an important indicator that can help identify the type of drinking problem your loved one has.
3. Frequency of Drinking: Often vs. Chronic
It’s important to note that alcohol abuse doesn’t necessarily mean drinking alcohol every day. It can be binge-drinking episodes or occasional outings. The defining characteristic of alcohol abuse just refers to problematic drinking behaviors, and it doesn’t have to be a daily occurrence.
However, someone with alcoholism will not be able to consistently or reliably limit their intake. The person often can’t–or won’t–stop drinking even when it causes severe and detrimental health, social, and legal issues. They may not even drink every day, but when they do, they almost always lose control of when (or if) they stop. And, if they do stop because they pass out, their supply runs out, they get arrested, engage in a fight, or some other external factor interfering with their ability to continue drinking. Stopping does not come from an internal realization that they have had enough; it’s as if their “off switch” is broken.
When reflecting on your loved one’s drinking habits, think about how often they drink. Do they go on random binge-drinking episodes, or is it a daily routine for them? Do they have an “off switch” when drinking, or does it always get out of control? How deep do they go when they’re drinking?
4. Willpower to Change: Awareness vs. Physical Inability
With alcohol abuse, people can learn to associate the negative consequences of their drinking with the behavior itself. They’re able to realize and become aware of the direct line between their alcohol problem and problematic behaviors, often being able to change these habits on their own.
In contrast, a person with alcoholism cannot change on their own, and willpower typically is not enough to overcome dependence. Unfortunately, this is why many people with alcoholism drink to the point of isolation, unemployment, and homelessness. There is no level of negative consequences that will overcome the person’s need to drink because they are mentally and physically unable to make the change for themselves. This inability to change their thinking is also why remission from alcoholism requires very targeted addiction treatment.
Anyone can overcome alcohol abuse, but alcoholism takes effort on a greater scale beyond willpower, and it’s a crucial distinction to make.
5. Treatment: Willpower vs. Expert Intervention
Lastly, the treatments for alcohol abuse and alcoholism are different. A person can change their alcohol abuse patterns through therapy, willpower, and a mindful, intentional change in drinking habits. At its core, alcohol abuse is a behavioral habit, so the first step is always to see a specialist and learn what they recommend depending on how severe the alcohol use is.
On the other hand, alcoholism is a disease. A more regimented, intensive treatment plan created by trained professionals gives a person the best chance at achieving sobriety, not just simply changing their behavior. A treatment plan may include medication for stabilization, therapy services, or psychiatry, and a specialized program managed by addiction experts is needed. Due to the uncontrollable nature of the drinking problem, alcoholism requires intervention and effort beyond the person’s will.
How Can You Tell Which One?
Alcohol abuse and alcoholism are serious conditions that can be severely detrimental to one’s life if left unmanaged. So, how can you tell if your loved one is suffering from alcohol abuse or alcoholism? We recommend exploring the symptoms of alcoholism and asking yourself these questions to reflect on their behaviors:
- “Do I like the person they are when they drink?”
- “What would happen if they stopped drinking today; would they be okay, or would they have physical withdrawals?”
- “Can they stop drinking on their own, or does something need to intervene?”
- “Have they neglected any responsibilities so that they can drink?”
- “How many drinks are they having per day/per week?”
- “Have they listened when someone’s told them to stop before?”
Depending on the answers to these questions, it might be time to confront your loved one about your concerns. We also recommend reading our article, “Holding an Intervention: What You Need to Know” to get information on how to confront your loved one with a possible alcohol addiction.
Moving Forward: Get Support for You
We know it’s not easy coming to terms that your loved one may have an alcohol use problem, and we’re here to give you the support you need. With our Family & Friends Program, you’ll receive the most important pieces of support in helping you manage life when someone you love has an alcohol use problem.
Whether it’s alcohol abuse or alcoholism, this program is designed to give you the tools you need to identify an addiction, get information on finding alcohol rehab, support your loved one without enabling, and more. We offer a free library of resources, including a community group database and a downloadable e-book on the essentials of life with addiction, as well as group therapy for families to help you process your feelings.
Check out our Family & Friends Program today and get started on the path to your personal recovery journey.
About Master Center for Addiction Medicine
Master Center for Addiction Medicine is a groundbreaking addiction treatment program headquartered in Glen Allen, Va. Based on a vision of comprehensive outpatient care, Master Center was launched in 2016 and now includes locations throughout the Commonwealth.
Master Center offers a coordinated, multidisciplinary approach rarely seen in the outpatient setting, staffed by experienced addiction physicians, psychiatrists, counselors, therapists, and peer recovery coaches.
