What is Problem Drinking?

Health professionals group problem drinking into two categories: (1) Alcohol abuse and (2) Alcohol dependence.

Alcohol abuse is alcohol use that harms relationships with people in your life, can result in bad performance at work, and can cause problems at home. People who abuse alcohol may continue to do so, even though they realize it affects their life negatively. ²⁰

Alcohol dependence is alcohol use that harms relationships with people in your life, can result in bad performance at work, can cause problems at home, and results in tolerance or withdrawal. It usually includes several of the following symptoms: craving, which is a strong need, or desire, to drink; not being able to stop drinking on any given occasion; symptoms of withdrawal (e.g., nausea, sweating, shakiness, anxiety, among others) when one stops drinking; and tolerance, which is the need to drink greater amounts of alcohol to feel the same “high.”²¹

Two types of Dependence:

Dependence can be psychological (when a person believes he/she needs the effect of alcohol to function “normally,”) or physical (when a person needs alcohol to avoid getting sick). People could experience only one kind of dependence or the other, or both. ²² Either type of dependence is a sign of a problematic relationship to alcohol, and a person who fits into either category might want to change whether or how much he/she drinks. ²³

A WORD OF CAUTION

If you believe you are physically dependent on alcohol, you should not suddenly eliminate alcohol from your life. This could create dangerous health risks. It is advisable for all individuals who are physically dependent to at least reduce their level of drinking. If you think you are dependent on alcohol, your physician or other health care specialist would be able to help you devise a plan to change your drinking gradually.

How do people recover?

There are no magic cures for alcohol abuse or dependence. Almost all people who have drinking related problems will improve the quality of their life by not drinking or drinking less. Also, consistent and careful help can be useful to change drinking patterns. Some people decide to seek professional help, while others rely on support from family and friends, and still others change on their own. In 2001, 2.0 million people participated in treatment for alcohol abuse or dependence; 3.1 million people entered some kind of treatment for alcohol and/or drug abuse. Of these people 1.6 million people received treatment at a self-help group and 1.2 million people received treatment at a rehabilitation facility as an outpatient (some people reported more than one location). ²⁴

Either choice yields encouraging results. In a study of people untreated for alcohol abuse and/or dependence, by age 60, 59% were no longer drinking problematically (3 abstainers to every controlled drinker). ²⁵ Among treated individuals, rates for successfully coping with alcohol abuse and/or dependence over time vary from one to four in five (20% to 80%). It is important to note that these statistics apply to individual quit attempts—if you keep trying to quit, your chances of reaching your goal increase. ²⁶