How Do You Know If It’s Alcohol Abuse Or Alcoholism?

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Updated 10/28/2022

How Do You Know If It’s Alcohol Abuse Or Alcoholism?

During my drinking years, I was in deep denial about having a problem with alcohol. I blamed negative consequences on everything but the drink—it was either bad luck, bad timing, or I just had a bad night. The stigma associated with “alcoholism” kept me sick. I was afraid to entertain this word because I thought it meant I was a failure.

But I was also unsure about the gray area between alcohol abuse and alcoholism. How do you know when you’ve crossed the line? I didn’t lose a job, my friends, or my home. And yet I was miserable. The truth is whether it’s alcoholism or alcohol abuse, you might need help.

What’s the difference between alcohol abuse and alcoholism?

Alcohol abuse is defined by the Centers for Disease Control and Prevention (CDC) as a pattern of drinking that results in harm to a person’s health, and other aspects of their life including work and personal relationships. If you abuse alcohol you might have participated in the following situations:

  • Drinking in dangerous places like while driving a car or operating machinery.
  • Legal trouble like being arrested or physical hurting yourself or others while drinking.
  • Continued drinking despite negative consequences while under the influence.
  • Failure to complete personal responsibilities like attend school, work, or other chores at home.

Alcohol abuse can lead to alcohol dependence. Alcohol dependence is when the body is physically dependent on the substance. This can also be called alcohol addiction. Physical dependence is a sign of the disease of alcoholism. Alcoholism is a chronic disease and can carry complications in addition to health issues associated with heavy alcohol use and withdrawal symptoms.

According to SAMHSA, there are 176.6 million alcohol drinkers in the U.S., and an estimated 17 million of them have an alcohol use disorder, also called alcoholism. Genetics have been shown to be a risk factor for alcoholism, as well as other qualifying criteria such as:

  • Continuing to drink despite negative health, social, or psychological consequences.
  • Attempting to stop drinking to no avail.
  • Alcohol cravings.
  • Giving up or reducing activities due to alcohol use.
  • Building up a tolerance to alcohol, meaning needing larger amounts of alcohol to get the desired effect.
  • Experiencing withdrawal symptoms after stopping use, such as anxiety, irritability, fatigue, nausea, hand tremors, or seizures.

The more of these symptoms you have, the more likely it is that you are experiencing an alcohol use disorder and not just alcohol abuse. Alcohol use disorder is a spectrum and can be experienced in a mild, moderate, or severe way, depending on the criteria met.

How to know when you’ve crossed the line from alcohol use to addiction

The million-dollar question is how do you know when your drinking has crossed the line? How do you know when you’re just using alcohol too much or if you have an alcohol use disorder? Regular alcohol use should not negatively affect your life at all. If you are able to moderate your consumption, you should enjoy drinking and not experience negative health or social consequences. SAMHSA defines three different levels of drinking:

  • Moderate – One drink per day for women and up to two drinks a day for men.
  • Binge drinking – Drinking five or more alcoholic drinks on the same occasion on at least one day in the last 30 days. This is also defined by the National Institute on Alcohol Abuse and Alcoholism as a pattern of drinking that produces blood alcohol concentrations of over 0.08 g/dL, or four drinks for women and five drinks for men over a two hour period.
  • Heavy drinking – Five or more drinks on the same occasion on each of five or more days in the past 30 days.

But it’s important to note that an alcohol use disorder isn’t solely dependent on how much you drink. It’s also about how your drinking affects your life and how it makes you feel inside.

If you’re trying to decide whether you have an alcohol use disorder, ask these questions. In the past year, have you:

  • Ended up drinking more or longer than you intended?
  • Had multiple experiences where you wanted to cut down or stop drinking, but couldn’t?
  • Spent a lot of time drinking or being sick from drinking?
  • Continued to drink even though it interfered with personal relationships with your family and friends?
  • Experienced a craving, or a strong urge, for a drink?
  • More than once gotten into situations while or after drinking that increased your chances of or resulted in you getting hurt?

The reality is most people who are on the alcoholism spectrum can benefit from addiction treatment, but many people do not receive. The NIAAA states that only a fraction of people who could benefit from treatment actually get it.

I spent too much time worrying about whether I was really an alcoholic or not when I could have been getting help. Don’t do what I did. If you are concerned about your drinking, chances are you could benefit from addiction treatment. Help is available, and we do recover. I am just one of 23 million Americans living in recovery today. You can too.

Written by: Kelly Fitzgerald

Kelly is a sober writer based in Cape Coral, Florida, best known for her personal blog The Adventures Of A Sober Señorita. Follow her on Twitter.

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