By David Joel Miller.
How is Alcohol Use Disorder different from Alcoholism?
Used to be a time when doctors treated medical issues, Therapists treated mental illness, Social services treated poverty-related issues and – well – no one exactly wanted to do anything with drug addicts and alcoholics. Times are changing.
Turns out that no matter where you are and who you work with there is a good chance that people around you are being affected by chemicals, alcohol in particular, long before they reach the “alcoholic” or “Chemically Dependent” stage.
In Drug and Alcohol counseling we used to spend a lot of time debating what made you an alcoholic or addict. Turns out the lines are fuzzy. One estimate is that 90% of alcoholics have full-time jobs. Some people do not drink that often. Half the adult U. S. population did not drink in the last thirty days.
Even if you only drink once a year, say for New Years, if you have gotten into fights while drinking, gotten DUI’s several times, then your only drink once a year is not of much import. If when you drink, bad things happen, then you have an Alcohol Use Disorder. The DSM uses the expression “Problematic Pattern of Alcohol Use.”
What we discovered was that it was not so much what you drink or when you drink that matters when it comes to Alcohol Use Disorders, it is what happens when you drink that is significant.
The Symptoms of Alcohol Use Disorder.
The new DSM-5 has switched to the use of the term “Alcohol Use Disorder” to indicate someone whose use of alcohol is causing them problems whether they are “Alcoholic” or not and lists 11 criteria for Alcohol Use being a problem. Here is my plain language version of those Criteria.
- Once you start drinking you drink more than you planned on and/ or keep drinking longer than planned.
- You keep trying to cut down on your drinking. In other Alcoholism texts, this is also described as efforts to control your drinking or to quit drinking. See, people do not try to cut down, control or quit drinking unless it is a problem.
- Drinking eats up a lot of your time.
- You have cravings for alcohol when you are not drinking.
- Drinking gets in the way of work, school, home life or recreation. A real Alcoholic cuts out this other stuff so they can concentrate on their drinking.
- You know that when you drink bad stuff happens but you keep drinking anyway.
- You start cutting out other parts of your life to spend more time drinking.
- You try to get away with drinking even when you know it makes the situation dangerous.
- You keep drinking even though you now realize it is causing you problems.
- Your body starts building up tolerance. (See post “What is Tolerance” in the “What is” section.)
- You experience “withdrawal” when you stop drinking and the blood alcohol level starts dropping. (See post “What is Withdrawal” in the “What is” section.)
These problems with Alcohol can come in mild, moderate or severe. Mild Alcohol Use Disorder would have 2-3 of these symptoms, Moderate has 4-5 symptoms and severe has 6 or more.
If you or someone you know is exhibiting these symptoms think about treatment and or self-help groups. The sooner Alcohol Use Disorder gets treated the better the life prognosis. While sooner is better it is never too late to get treatment for an alcohol use disorder as long as you are alive.
Terms and their meaning can differ with the profession using them. The literature from the Rehab or AOD (Alcohol and Other Drug) field may be very different from that in the mental health field. There is still a large gap between recovery programs, AOD professionals and the terms and descriptions used in the DSM.
FYI These “What is” sometimes “What are” posts are my efforts to explain terms commonly used in Mental Health, Clinical Counseling, Substance Use Disorder Counseling, Psychology, Life Coaching and related disciplines in a plain language way. Many are based on the new DSM-5; some of the older posts were based on the DSM-IV-TR, both published by the APA. For the more technical versions please consult the DSM or other appropriate references.
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For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page or my Facebook author’s page, David Joel Miller. A list of books I have read and can recommend is over at Recommended Books. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.