Although many people use terms like ‘addiction,’ ‘abuse,’ ‘problem drinker’ as though they were interchangeable, they can mean different things. This can lead to a variety of difficulties– especially when considering an intervention– so it is imperative that everyone understand these nuances of meaning. Toward that end, this post will discuss alcohol misuse vs. abuse.
The Drinking Spectrum
While there are certainly large areas of overlap, any discussion of alcohol misuse vs. abuse should begin with specific definitions of the two terms. However, before we can do that, it will be helpful to summarize the symptoms of alcohol use disorder. Here are the criteria the DSM-5 has established for diagnosing someone with an alcohol use disorder:
- Consuming more alcohol for a longer period than intended
- Making failed attempts to stop drinking
- Excessive time and energy to facilitate drinking
- Alcohol cravings or preoccupation
- Repeated neglect of important responsibilities due to alcohol use
- Person continues to drink excessively despite negative social, legal, or interpersonal consequences
- The drinker becomes so preoccupied with alcohol consumption that formerly important recreational, social, and work-related activities are neglected
- Continued use of alcohol in dangerous environments or situations
- A person who has a physical or mental health condition that was brought on or worsened by alcohol continues to drink excessively
- A significant increase in alcohol tolerance
- The drinker begins to experience withdrawal symptoms when they go too long without drinking, typically symptoms that can only be alleviated by more alcohol
As you can see, these are not the reactions of a social or moderate drinker. Social or moderate drinkers typically do not experience more than an occasional negative consequence because of their alcohol consumption. If one or more of these are present in you or a loved one’s behavior, the only real question is whether you are dealing with alcohol misuse or abuse.
Alcohol Misuse Vs. Abuse: How to Tell the Difference
It might seem a bit overly clinical, but the best way to discern between problem drinking and alcohol abuse is to use the symptoms listed above as a barometer. These tendencies just don’t show up in the temperate drinker. So how do you use these symptoms to differentiate between the two higher levels of drinking?
Here is the short version. Alcohol abuse applies to anyone who has experienced two or more of the above symptoms over the course of a year. If these symptoms manifest with less frequency, you are probably dealing with a case of alcohol misuse.
Obviously, the discussion of alcohol misuse vs. abuse involves fluid categories that can make it difficult to make an accurate diagnosis. Fortunately, you can look at other factors as well. The amount of alcohol someone consumes is a great indicator of where they stand on the drinking spectrum:
- For men, drinking more than an average of two drinks a day is considered alcohol misuse. Treatment may be necessary at this point.
- If a man consumes an average of 4 or more drinks a day, he is engaging in alcohol abuse and needs immediate treatment.
- For women, drinking more than one drink a day is considered alcohol misuse. Depending on how their drinking affects their lives, these women may or may not be in need of treatment.
- A woman who consumes more than 3 drinks a day is abusing alcohol and should seek help immediately.
This is an incomplete guide to the alcohol misuse vs. abuse debate, but it is certainly a great place to start if you’re concerned about someone’s drinking. Please consider treatment options if you or a loved one falls into the misuse or abuse category.