Alcoholism and Alcohol Abuse

Alcohol abuse and alcoholism have existed probably as long as alcohol itself has. In fiction, The Alcoholic is an often-used angst trope, as are other depictions of alcohol abuse and alcoholism. But what is alcohol abuse and alcoholism? What is the difference between the two, and how do you know if you are at risk for or are an alcoholic?

This article exists to give a short overview of alcohol abuse and alcoholism, and include ways you can find help for yourself and/or someone else if you or someone you know is an alcohol abuser or alcoholic.

Alcohol abuse is simply the regular use of alcohol to a dangerous or unhealthy degree, the regular overuse of alcohol, and/or the use of alcohol to a degree that it creates dangerous or problematic behavior on a regular basis. Almost all alcoholics are alcohol abusers, but not everyone who abuses alcohol is or will become a true alcoholic.

• Moderate and responsible drinking behavior is two or fewer alcoholic beverages over 24 hours (depending on height, weight, medications, and other factors, one or "half of one" per 24 hours may be more correct as moderate - more than two over 24 hours generally qualifies as overuse for anyone). Exceeding two drinks a day on a regular basis (as in, more than once within a six-month span) is a warning sign of alcohol abuse.
• Binge drinking is the consumption of five or more alcoholic beverages within a span of 24 hours, generally within the same drinking session (e.g. not four drinks over 10 hours, but four drinks in two hours). If one has binged more than once in a six-month period, this is generally a sign of ongoing alcohol abuse.
• Relational problems from the use of alcohol is a sign of alcohol abuse. If your use of alcohol causes you to get in fights, engage in violence, or be criticized for your drinking (and the people criticizing you are not The Fundamentalist), this is likely a warning sign that you need to monitor your alcohol usage.
• Legal problems are another warning sign of alcohol abuse. Not legal problems so much as in "I carried my beer outside the bar and got a ticket" or "someone opened a container in my car" as those aren't necessarily related to your personal usage, but if you get a DUI or drunk and disorderly conduct arrest, that is a major warning sign.
• Regret over one's actions while under the influence is another major warning sign of alcohol abuse. If your drinking causes you to lose control of your actions or emotions, it may definitely be alcohol abuse.
  • Alternatively loss of memory or blackouts are always a major warning sign of alcohol abuse, and a warning sign that alcohol abuse may be becoming alcoholism.
• Drinking regularly for Drowning My Sorrows is another warning sign of alcohol abuse, and one that should be taken with far more seriousness than even the others. There is a very important saying in the recovery community regarding this: "sorrow knows how to swim."

Alcoholism is far more serious than even the alcohol abuse that can become it and that is always a part of it. The difference between alcoholism and alcohol abuse is that alcoholism is a literal physical and emotional addiction to alcohol itself. Someone who is abusing alcohol but who is not addicted (yet) can, even if they drink problematically, manage their drinking. The Alcoholic cannot.

• The alcohol abuser may binge drink at every party and may even get busted for DUI leaving one - but he/she can go days without drinking with no ill effect, can drink moderately, and/or can just go "you know, I don't want to get plastered at this party." It is a want for alcohol, even at the expense of one's health or other consequences.
• The Alcoholic, on the other hand, needs to use alcohol or will go into a possibly fatal withdrawal syndrome called delirium tremens, cannot stop drinking once he or she begins to drink, even if the circumstances would demand moderation or sobriety. Alcoholic drinking is a need or compulsive behavior - an alcoholic may drink even when they do not want to do so.

• The Michigan Alcohol Screening Test can also help you determine whether you are an alcohol abuser or an alcoholic. This is the primary screening test for alcoholism.

Getting help

• Alcoholics Anonymous is often considered the best recovery program for those who are alcoholics or severe alcohol abusers.
• Smart Recovery and Rational Recovery both are alternatives to AA that take a slightly different approach than AA's traditional 12-step recovery with no focus on the idea of a higher power, whatever it may be.
• Moderation Management is a harm-reduction approach that allows for continued drinking but strictly controlled. It is at odds with much of the recovery community (which, often for very good reasons, demands total sobriety) and has somewhat less successful odds, and is probably more useful for problem drinkers/alcohol abusers than for true alcoholics.

There are also many others, including inpatient rehabs, outpatient rehab programs, one on one counseling, and more. There are programs specially for military members or ex-military (generally, you can find out about these in the US by contacting the Veterans Administration), programs for the LGBTQI community (there's generally meetings listed at community centers), for atheists or secularists who still want to do 12-step but without references to the "higher power," and alternatively, for devout religious believers who want to specify their higher power as their object of worship. And there's also harm reduction measures, listed above, whether via MM or via one's own ideas (e.g. thinking about what you can do to reduce alcohol intake or behave responsibly even if planning on getting drunk, for example, substituting a larger liquid volume drink for one with more alcohol, spacing out alcoholic drinks with nonalcoholic ones, making sure one is not driving or doing other hazardous things until sober) - which are especially valuable for alcohol abusers or overusers to prevent becoming alcoholics.