“94 percent of people who screen positive for drug or alcohol abuse [not to be confused with drug or alcohol dependence, aka drug addiction or alcoholism] are completely unaware they have a problem,” says Bertha Madras, MD, professor of psychobiology at Harvard University School of Medicine, as quoted in Donna Vaillancourt’s article, “ Effective Screening: It’s How You Ask ,” appearing as Join Together’s November 19, 2010, blog post.
One of the misconceptions about drinking — and therefore the part about “how you ask” or talk to a person about their drinking and its effect on you — is the misconception that drinking is either “normal” or “alcoholic.” In actuality, there are three stages of drinking – use, abuse and dependence. And, within these stages, there are levels. In other words, someone who abuses alcohol (drinks more than moderate levels described below), may not be an alcoholic, but their level of drinking still causes problems for themselves or others. Similarly, some people who are alcoholics are still able to hold jobs, have meaningful relationships, but they pass out every evening at 7:30 and are uncomfortable doing anything that does not include large amounts of alcohol or sufficient drinking opportunities.
So to the point of this post — “Is Alcohol Abuse Alcoholism?” Answer: NO.
To be an alcoholic (dependent on alcohol) is to have the disease of alcoholism. Alcoholism is one of the diseases of addiction. Addiction is a chronic, often relapsing BRAIN disease. Because it is a brain disease — it changes cells in the brain. Because the brain controls everything we think, feel, say and do, alcoholism changes the way a person’s thinks and feels; what a person says and does, because it changes the way the brain works. BUT, alcohol abuse also changes the brain — alcohol abuse causes chemical and structural changes in the brain, which is why someone who is drunk (regardless of whether they’re an alcoholic or an alcohol abuser) behaves the way they do.
So what makes one an alcohol abuser and another an alcoholic? Answer: RISK FACTORS.
A person who abuses alcohol and then crosses the line to alcoholism generally has one more of the five key risk factors: genetics, social environment, childhood trauma, mental illness and early use. The brain changes caused by alcohol abuse make a person more susceptible to their risk factors — many of which are also brain cell changers — mental illness, childhood trauma, genetics and early use in particular. Check out this explanation of Risk Factors, “ Understanding Addiction: Why Do Some People Become Addicted .”
The following slide tells the story of how alcohol hijacks the brain:
Returning to the title / topic of this post: “Is Alcohol Abuse Alcoholism?” Answer: NO.
Alcohol abuse is not alcoholism. Alcohol abuse is defined as drinking more than moderate limits but not being addicted to alcohol (an alcoholic). Moderate limits are defined as 7 per week for women; with no more than 3 of the 7 on any given day; and as 14 per week for men, with no more than 4 of the 14 on any given day. There are two key reasons to stay within moderate drinking limits and thereby avoid alcohol abuse:
to avoid the destructive drinking behaviors that occur with consuming too much alcohol — including binge drinking, blackouts, DUIs, unplanned or unprotected sex, verbal abuse, physical violence, poor work performance, financial problems, arrests and fighting with loved ones about the drinking. (Basically doing things you wouldn’t do if it weren’t for the drinking.) These drinking behaviors are related to the amount of alcohol consumed and are common to both alcoholics and alcohol abusers; and
to avoid the chemical and structural changes in the brain that occur with alcohol abuse. To see brain change images of alcohol abuse, visit www.amenclinics.com . The World Health Organization reports that all alcoholics go through a period of alcohol abuse but not all alcohol abusers become alcoholics.
To help readers who may wonder about their drinking pattern and whether it might be a problem, Join Together has launched a complete new online screening tool, “ How Much is Too Much? ” There is also NIAAA’s (National Institute on Alcohol Abuse and Alcoholism) website, “ Rethinking Drinking ,” where one can find a similar assessment and tips for cutting down.
In summary, wresting control of a drinking problem during the abuse stage is important in order to avoid harmful drinking behaviors and the chemical and structural brain changes that can make an individual especially vulnerable to their risk factors for developing alcoholism, aka the disease of addiction – an addiction to (dependence on) alcohol.