Alcohol Abuse vs. Alcohol Dependence

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

Those who are alcohol dependent meet all of the criteria of alcohol abuse, but the will also exhibit some or all of the following:

* 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).

* 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 they 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).

Typically, those drinkers who are diagnosed as only alcohol abusers can be helped with a brief intervention, including education concerning the dangers of binge drinking and alcohol poisoning.

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