Alcoholism? Alcohol Abuse? Alcohol Use Disorder? What Do These Mean?

Alcohol is dated as far back as China in 7000 BCE. Since then, our relationship with the drink has evolved as it can have adverse health, social, and mental impacts. There are a lot of different terms to describe how alcohol is used, with alcohol use disorder (AUD) the latest phrase on the scene.

Sometimes it may be difficult to distinguish which one is most appropriate. The terms used interchangeably with AUD are alcoholism, alcohol abuse, alcohol dependence, alcohol addiction, and excess drinking. While they may have different meanings, they all refer to the same problem – an unhealthy pattern of alcohol consumption.

This article will help you distinguish between these terms and describe what they mean. You’ll discover if they apply to you and what you can do to turn a problematic diagnosis into triumph using The Sinclair Method.

Let’s Start with Alcoholism

The term “alcoholism” was first used in the 1800s in the essay Alcoholismus Chronicus by the Swedish physician Magnus Huss. According to the definition initially put forward by Huss, an alcoholic is a person who “exhibits signs of physical and psychological dependence on alcohol and is unable to control their consumption.”

Nowadays, alcoholism is generally referred to as a severe, chronic addiction to alcohol that affects a person’s ability to function in everyday life. It refers to the physical and psychological need to drink even when it causes problems or disrupts essential activities of their life. Such a condition was not recognized as an illness until 1956 by the American Medical Association based on the theory that drinking excessive amounts of alcohol affects the structure and function of the brain.

What About Alcohol Abuse?

Alcohol abuse is a less severe form of alcohol use disorder. It’s characterized by frequent episodes of heavy drinking (binge drinking) in one sitting or too often during the week. Sometimes, alcohol abuse can interfere with daily activities and possibly your health.  A person who abuses alcohol can move on to AUD. Someone abuses alcohol if they meet any of the following criteria:

• Has a pattern of drinking that results in social or interpersonal problems such as arguments with family or co-workers, or trouble with the law

• Appears intoxicated regularly, and binge drinks weekly or at social gatherings

• Feels the need to cut down on or control their alcohol intake but finds it difficult to do so

• Regularly consumes large amounts of alcohol at one time

• Needs more alcohol to feel the same effects or feel fewer side effects than they did in the past 

• Has experienced withdrawal symptoms after stopping or cutting back on their alcohol intake.

Alcohol abuse differs from alcoholism in that the former is a less severe form of addiction that affects a person’s ability to function in everyday life rather than causing long-term harm to their health. However, alcohol abuse is still a serious condition that requires treatment to avoid its progression to severe forms of the disorder.

Alcohol Dependence

Alcohol dependence is a more severe form of alcohol use disorder in which a person becomes physically and psychologically dependent on alcohol to function normally. People who are dependent on alcohol tend to experience withdrawal symptoms such as nausea, vomiting, shaking, headaches, and sweating if they suddenly stop drinking or if they severely restrict their alcohol intake.

Studies have shown that alcohol-dependent people tend to drink more than what is considered healthy, which can cause various health problems. This dependency on alcohol can occur within a short period, with some individuals developing an addiction within weeks of starting to drink heavily. In contrast, others may take years to reach this point. Regardless of the individual’s timeline, all cases of alcohol dependence require some form of treatment or medical support. Getting professional help is also crucial to help manage their symptoms as they reduce their alcohol consumption.

Are You Addicted?

Alcohol addiction is defined as a "chronic relapsing disorder" that causes a person to continue using alcohol despite the adverse effects it can have on their health and relationships. It involves excessive consumption of alcohol and impaired control over your drinking behavior. People who suffer from alcohol addiction usually try to quit drinking, often without success. The urge to continue drinking continues despite harmful consequences and interferes with other essential life responsibilities.

Alcohol addiction can cause many physical and psychological problems, such as the increased risk of liver cirrhosis, heart disease, high blood pressure, mental illness, and even death. Since alcohol addiction can be moderate to severe, seeking professional help is crucial since quitting on your own can be difficult and even life-threatening.

What Is Excess Drinking?

We’ve all been out on the town with friends or brought in the New Year and had too many drinks. Excess drinking is defined as a pattern of alcohol consumption exceeding what is considered healthy. While occasional overindulgence is fine for most people, excessive drinking is typically defined as consuming 5 or more drinks on any occasion for men and 4 or more drinks for women. 

Another term you may hear is binge drinking, which is when a person consumes four or more drinks on one occasion at least once a month. Excess drinking happens occasionally, but it’s a slippery slope.

If left unchecked excess drinking can harm personal and professional relationships. People with excessive drinking problems may engage in risky behaviors such as drunk driving, verbal or physical altercations, or making poor decisions while under the influence. This type of drinking can cause serious short-term and long-term health problems, including alcohol poisoning, alcohol abuse, and, eventually, alcohol use disorder.

Alcohol Use Disorder

Alcohol use disorder (AUD) is the most accurate and scientifically accepted term covering all the above mentioned illnesses about an unhealthy pattern of alcohol consumption and is widely accepted in the medical and scientific literature. In line with this, alcohol use disorder is officially defined as impaired control over drinking despite its adverse consequences. An individual can be diagnosed with AUD if they meet any of the 11 following criteria in The Diagnostic and Statistical Manual of Mental Disorders (DSM–5).  Some examples on this list include:

• More than once having tried to cut down or stop drinking without success

• Spending a lot of time drinking and being hungover

• Wanting a drink so badly you can’t think of anything else?

• Drinking no longer has the same effect, so you need to drink more

• Experiencing withdrawal symptoms when the effects of alcohol are wearing off 

On the Spectrum?

AUD is considered a spectrum disorder because not all individuals experience the same symptoms, severity, or course of this disorder. While some people may develop severe problems with AUD quickly, others may develop symptoms gradually. 

There are 3 general categories of AUD that are defined by the amount and frequency of alcohol consumed by the individual: mild, moderate, and severe. The severity of AUD affects how a person’s mind and body are affected by their consumption of alcohol. 

Mild AUD is typically characterized by any 2-3 criteria on DSM-5. Some people may experience some short-term problems related to drinking, such as weight gain or stomach issues. Generally, they still function well, and their overall health is fine. Some may not even be aware of AUD.

Moderate AUD is characterized by excessive drinking that occurs at least weekly and results in several physical, mental, and social harms to the drinker and those around them. Moderate AUD covers 4 or 5 criteria on the list. This level of consumption is considered unhealthy and may be a precursor to more severe forms of the disorder.

Lastly, severe AUD is marked by frequent episodes of alcohol misuse that lead to dangerous consequences such as loss of control over one’s drinking and impaired social, work, and family life. At this point, the person covers 6 or more of the 11 criteria on DSM-5. The person has become so dependent on alcohol that they cannot stop. They may experience severe withdrawal symptoms if they attempt to reduce their drinking or quit altogether. This type of AUD is considered a life-threatening condition and needs professional help.

Can the Sinclair Method Help?

The Sinclair Method is a treatment program for people suffering from alcohol use disorder. The treatment uses naltrexone, a safe, FDA approved medication that blocks endorphin activity at the brain-neuronal level, which otherwise triggers dopamine release and reinforces the desire for more alcohol. Most recovery protocols involving naltrexone for alcohol use disorder call for the patient to take naltrexone on a daily basis so that the medication is in the patient’s system 24/7.

However, the Sinclair Method calls for patients to take naltrexone “as-needed” and to pair its endorphin blocking effects with being under the influence of alcohol. That targets the endorphin blocking mechanism of the drug to just the act of drinking, and by repeatedly complying with this specialized dosing protocol the patient undergoes a process called extinction. Alcohol use disorder is slowly eroded and the patient will restore controlled drinking as cravings and the strong desire for alcohol dissipate over time. Not only is this method more effective than constant dosing of naltrexone, but it results in less use of the medication.

The Sinclair Method is growing in popularity as it can be done at home and without checking into an expensive rehabilitation facility, it’s incredibly effective and very cost-effective. Using specialized telehealth access, like Alcure, you can meet with a medical provider online, have naltrexone prescribed to your local pharmacy for immediate pickup, and be guided with video courses, tutorials, and ongoing coaching and communication with your medical provider on exactly how to follow Sinclair Method protocol unique to you so that you can reach your goals as efficiently and quickly as possible. And, with the Sinclair Method you can choose to either cut back drinking to safe levels or quit entirely. 

They All Mean One Thing

The terms alcoholism, alcohol abuse, alcohol dependence, and excess drinking are often used interchangeably. However, they all are under the umbrella of the phrase alcohol use disorder. If any of these terms come to mind when you drink, the goal is not to be concerned about semantics. If excessive alcohol use impacts your health, relationships, or work, you should take immediate action. Use the DSM-5 criteria to see which stage of AUD applies to you. Next, consider using a forward approach like the Sinclair Method. At Alcure, we’ve helped hundreds of people struggling with alcohol finally regain control, and you can too.

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