Alcohol Abuse vs. Dependence

A comparison of alcohol abuse and dependence, with the two terms defined in text and illustrated with different images. The background is blue.

When there are conversations about alcohol use, we often interchange some terms. For example, alcohol abuse may be used interchangeably with physical dependence and dependence with addiction. These are all different clinical scenarios, and below, we cover alcohol abuse vs. dependence and everything else to know on the topic.


What is Alcohol Abuse?

Anyone can abuse alcohol, even if they don’t have a diagnosable addiction. Alcohol abuse is any scenario where you’re drinking too much. Medically, if you’re a woman with more than three drinks on one occasion or more than seven drinks a week, this is excessive alcohol intake. 

For men, if you’re having more than four drinks on an occasion, or over 14 a week, then you are abusing alcohol.

For people older than 65, alcohol abuse or excessive drinking is more than three drinks on an occasion and seven in a week.

Any time you’re not just drinking a lot but taking risks with alcohol, we can also consider this abuse.

For example, if you drink any amount of alcohol and drive or operate machinery, it’s a risk. Mixing alcohol with prescription or over-the-counter medications and regularly drinking without telling your health care provider are signs of abuse.

Drinking while taking care of small children can be considered a sign of alcohol abuse.

Sometimes, we can describe alcohol abuse as problem drinking. Signs of problem drinking include:

  • Feeling like you should cut down
  • Irritation when people comment about your drinking
  • You feel guilty about drinking
  • You engage in binge drinking no matter the negative consequences 
  • You have to drink in the morning to feel normal or get rid of a hangover
  • Worrying about having an adequate supply of alcohol to get through the night or weekend
  • Buying from different stores or hiding alcohol, so people don’t know how much you’re drinking
  • Trying to sneak drinks or get “extra” when you’re at social events
  • Not living up to expectations at home or work because of drinking
  • Memory blackouts with heavy drinking 
  • An inability to stop drinking after you start
  • Dangerous drinking, leading to accidents or alcohol poisoning, along with other risky behaviors
  • Hurting someone else because of your drinking

Alcohol abuse and problem drinking don’t mean you’re an alcoholic, but they are progressive, so you are at risk for developing an alcohol use disorder. Alcohol abuse, to put it in more concise terms, is when you keep drinking despite ongoing interpersonal, health, legal or social problems stemming from alcohol use.

At the problem drinking stage, many people can stop drinking on their own without professional treatment or intervention.


Alcohol Abuse vs. Dependence

While many people in the United States drink to the point that’s considered excessive, most aren’t alcohol dependent. One study from the Centers for Disease Control and Prevention and the Substance Abuse and Mental Health Services Administration found that 9 in 10 adults who drink too much aren’t alcoholics or dependent on alcohol.

Alcohol dependence is a chronic medical condition. One of the defining characteristics of alcohol dependence is withdrawal symptoms if you stop drinking or cut back.

To avoid withdrawal symptoms, a person might keep drinking.

When a person is dependent on alcohol, they often have a tolerance. Alcohol tolerance means needing to drink increasing amounts to achieve the same effects. Maybe you used to have two glasses of wine every night to feel relaxed, and now you need four, for example.

Withdrawal symptoms that indicate alcohol dependence include tremors, insomnia, and mood swings.

If you wake up and experience shakes or hangovers and you’re alcohol dependent, you might drink to get rid of these symptoms.

Alcohol dependence can also include drinking more and more over more extended periods of time than you intend.

If someone is dependent on alcohol and wants to stop, they may need medical detox. During medical detox, a person is monitored and kept safe and comfortable with medications and treatments as required. Alcohol withdrawal can be deadly, especially in its most severe form—delirium tremens.

It’s hard to predict who will have severe alcohol withdrawal symptoms and who won’t, but if you think you’re dependent, you should speak to your healthcare provider before you try to stop drinking.

Alcohol dependence occurs because it affects brain chemicals and function. Your brain will adjust how it works and produces neurotransmitters in response to the presence of alcohol. Over time, your brain starts to see the effects of alcohol as normal.

If you stop drinking, your body tries to regain a sense of balance and homeostasis and readjust to no alcohol. That period of readjustment is when withdrawal symptoms occur.


Alcohol abuse vs dependence

Alcohol Use Disorder

If someone drinks excessively and has certain symptoms, they might be diagnosed with an alcohol use disorder. The most severe type of alcohol use disorder is alcoholism.

You can depend on alcohol without being addicted, and vice versa, but typically the two conditions occur together.

Symptoms of a substance use disorder involving alcohol include:

  • Drinking more over a longer time than you intend
  • Having the desire to cut back on your alcohol intake but being unable to
  • Spending a lot of your time-consuming alcohol, getting it, and then recovering from its effects
  • Drinking is interfering with your ability to function normally in areas of your life
  • You experience strong cravings
  • You’re giving up other once-important activities because of alcohol use
  • The use of alcohol in dangerous situations
  • Developing a tolerance
  • Continuing to drink even though you know it’s creating health risks or worsening mental health conditions. 
  • Withdrawal symptoms when cutting back or stopping alcohol consumption 

If someone has a moderate to severe alcohol use disorder, they often need help to stop drinking. Treatment for a moderate to severe alcohol use disorder can include medical detox, professional rehab, counseling, or participation in a self-help group like Alcoholics Anonymous

Health professionals can diagnose an alcohol use disorder in many cases. 

There is a move away from using the word abuse in the addiction science space. It’s more common to see excessive alcohol intake referred to as alcohol misuse and addiction as an alcohol use disorder. 

We still sometimes use the term abuse, but it’s important to be careful that we don’t stigmatize people experiencing a drinking problem. Dependence and addiction are chronic diseases that require appropriate treatment and aren’t the result of a lack of character or willpower.


Finding Addiction Treatment in Orange County, CA

The difference between alcohol abuse and alcohol dependence is that abuse can be any situation where a person drinks too much. Alcohol dependence is a chronic condition with physical symptoms, particularly withdrawal symptoms, and dependence often comes along with alcohol addiction, a chronic disease affecting the brain and behavior.

If you’d like to learn more about effective treatments for alcohol dependence and addiction, alcohol detox, or you’re ready to take the next step toward a healthier life, please reach out to the experienced Opus Health team by calling 855-953-1345.                                                                                                                                                 

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