Problem Drinking vs. Alcoholism

Misuse of alcohol is the 3rd most preventable cause of death in the United States, with almost 90,000 people dying annually from alcohol-related causes. Irresponsible use of alcohol is one of the most significant public health issues in the world.

Alcohol use doesn’t need to take place over a long period of time to be dangerous. If the very first experience with alcohol involves binge drinking or results in risky behavior, the outcome can prove fatal.

Alcohol abuse, alcohol dependence, and alcoholism are now known clinically as Alcohol Use Disorder (AUD), which is recognized as a treatable, chronic disease. Although many consider problem drinking and Alcohol Use Disorder to be the same thing, there are important differences between them.

What is Problem Drinking?

Anytime the consumption of alcohol causes a person to use poor judgment or exhibit risky behavior or adversely impacts relationships, work or school performance, or mental or physical health, it has become a problem.

Problem drinkers have not yet developed a physical or mental dependence on alcohol. They can go for long periods of time without drinking alcohol, and won’t experience withdrawal symptoms when they’re not drinking. However, when they do drink, the behavior has negative consequences, to themselves, and often to others in their lives.

No one takes their first drink planning to have an alcohol use problem. Often what starts out as social drinking leads to problem drinking, which can then progress to dependence on the addictive substance. The way alcohol affects the brain circuitry is what leads to dependence, and why withdrawal symptoms occur if alcohol use stops.

When problem drinking becomes severe it is given the medical diagnosis of AUD.

What is Alcohol Use Disorder?

According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), “AUD is a chronic relapsing brain disease characterized by compulsive alcohol use, loss of control over alcohol intake, and a negative emotional state when not using.”

The 2018 National Survey on Drug Use and Health (NSDUH) found over 14 million adults age 18 and over, and approximately 401,000 adolescents ages 12–17 had AUD. Of those, only about 8 percent of adults and 5 percent of adolescents received treatment in the previous year.

Physicians use the criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to diagnose Alcohol Use Disorder. The Manual lists 11 questions to be asked of those who may have an AUD. The number of questions answered affirmatively indicates whether an alcohol use problem is likely and the potential severity of the disorder.

The following questions pertain to behavior over the past year. Have you:

1. Had times when you drank more, or longer than intended?
2. Wanted to cut down or stop drinking, but couldn’t?
3. Spent a lot of time drinking? Or being sick or getting over the aftereffects?
4. Experienced a strong craving to drink alcohol?
5. Found that drinking — or being sick from drinking — often interfered with taking care of your home or family? Or caused job or school problems?
6. Continued to drink even though it was causing trouble with family or friends?
7. Given up or cut back on activities that were important to you, in order to drink?
8. Gotten into situations while or after drinking that increased your chances of getting hurt (such as driving, swimming, using machinery, walking in a dangerous area, or having unsafe sex)?
9. Continued to drink even though it was making you feel depressed or anxious or added to another health problem? Or after having had a memory blackout?
10. Had to drink increasingly more to get the desired effect?
11. Found that when the effects of alcohol were wearing off, you had withdrawal symptoms, such as trouble sleeping, shakiness, irritability, anxiety, depression, restlessness, nausea, or sweating? Or sensed things that were not there?

Answering yes to even one of these questions may indicate a problem. The more that apply, the greater chance there is an AUD. If problem drinking or AUD is suspected, it’s vitally important to seek treatment before permanent damage or an unsafe situation occurs.

How Alcohol Affects the Brain

Alcohol affects the central nervous system (CNS), which is made up of the brain and spinal column. Acting as a depressant, alcohol signals the CNS to slow down motor and cognitive functioning, which can dangerously suppress life-sustaining functions, including the regulation of breathing and body temperature.

Alcohol also affects the pleasure and reward center of the brain, triggering the release of dopamine, which increases a sense of euphoria. Although the body naturally releases dopamine in response to a pleasurable experience, alcohol triggers the release of abnormally high levels, leading to a more intense desire to repeat the behavior. If alcohol use continues, the brain becomes dependent on its presence, and withdrawal may occur if alcohol use stops.

Even short term use of alcohol can impair memory, learning, reasoning, judgment, coordination, and disturb sleep patterns. Just one experience with binge drinking, which is drinking an excessive amount of alcohol over a short period of time, can be fatal. When more alcohol is consumed than the body can metabolize, alcohol poisoning may occur.

Signs of alcohol poisoning may include confusion, slurred speech, vomiting, aggression, extremely slow breathing (less than 8 breaths per minute), irregular breathing (more than 10 seconds between breaths), bluish or pale skin, dangerously low body temperature, and unconsciousness.

Excessive alcohol intake can also impair the gag reflex, increasing the risk of vomiting and choking to death. Alcohol poisoning may result in coma, brain damage, or death. It is a medical emergency.

Long term use of alcohol can permanently destroy brain cells, damage organs, cause dementia, result in permanent learning deficits, and lead to other mental and physical disorders. With treatment, it may be possible to repair some damage. The sooner treatment begins, the more likely damage can be reversed.

Help is Available

The NIAAA has an extensive online tool – NIAAA Alcohol Treatment Navigator – designed to help you find the best treatment for yourself or a loved one. It provides educational information as well as a step-by-step guide to finding a qualified treatment provider.

As an extended care treatment facility, Midwest Recovery Centers serves to provide intensive recovery treatment for alcohol addiction as well as other life problems. Contact us today to see how we can help you or your loved one begin recovery.

Reviewed and Assessed by
Taylor Brown, B.A.Com., MAADC II
Tim Coleman, M. of Ed.