Getting the Facts on Alcohol Abuse

Alcohol Abuse
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Alcohol abuse differs from alcoholism in that it does not include an extremely strong craving for alcohol, loss of control, or physical dependence. In addition, alcohol abuse is less likely than alcoholism to include tolerance (the need for increasing amounts of alcohol to get "high").

Alcohol abuse is defined as a pattern of drinking that is accompanied by one or more of the following situations within a 12-month period:

  • Failure to fulfill major work, school, or home responsibilities;
  • Drinking in situations that are physically dangerous, such as while driving a car or operating machinery;
  • Recurring alcohol-related legal problems, such as being arrested for driving under the influence of alcohol or for physically hurting someone while drunk;
  • Continued drinking despite having ongoing relationship problems that are caused or worsened by the effects of alcohol.

DSM-IV Definition of Alcohol Abuse

In the Diagnostic and Statistical Manual of Mental Disorders IV, alcohol abuse was defined as any harmful use of alcohol, meaning any physical or mental damage.

The DSM-IV provided separate diagnoses for alcohol abuse and alcohol dependence. Alcohol abuse was any drinking despite recurrent social, interpersonal, and legal problems as a result of alcohol use.

DSM-IV Definition of Alcohol Dependence

Alcohol dependence was the diagnosis if the drinker met all of the above criteria plus exhibited any or all of the following symptoms:

  • 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).

DSM5 and Alcohol Abuse Disorders

With the May 2013 publication of the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM–5) by the American Psychiatric Association, alcohol abuse and alcohol dependence were no longer diagnosed.

The new DSM5 combines those two disorders into one, called "alcohol use disorder," with sub-classifications of mild, moderate, and severe.

The DSM5 provides a list of 11 symptoms of alcohol abuse disorders. Alcohol use disorder is considered mild if the person exhibits 2 or 3 of those 11 symptoms, moderate if they display 4 or 5 symptoms, and severe if they display 6 or more symptoms on the list.

Although there is no longer an official diagnosis of "alcohol abuse," it is still a very real phenomenon and is defined in general has the continued use of alcohol despite negative consequences in the drinker's life.

While alcohol abuse may be considered a less severe disorder compared to alcoholism, it is important to note that many effects of alcohol abuse are also experienced by alcoholics.

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