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Alcohol Misuse vs. Use Disorder: The Difference

Alcohol Misuse vs. Use Disorder: The Difference

Alcohol misuse, alcohol dependence, and alcohol use disorder all involve problematic drinking but with different behaviors and levels of severity.

There are several terms used to describe struggles with alcohol consumption, some of which have changed as we’ve learned more about how addictions work. Still, terms such as alcohol misuse, alcohol dependence, and alcohol use disorder (AUD) are often used interchangeably, although each is somewhat different. Understanding what each of these conditions is can help you recognize when your relationship with alcohol has become problematic and what you can do to modify or eliminate your alcohol consumption. 

If you are interested in cutting back on drinking but find it difficult, you may benefit from the help of Confidant Health's medication-assisted treatment for alcohol use. Whether you have alcohol dependence or alcohol use disorder, we can help you regain control of your drinking with medications, virtual therapy, and support. Download our app today to start receiving convenient online medication-assisted treatment.

What Is Alcohol Misuse?

Alcohol misuse is a pattern of drinking that increases one's risk of adverse effects. Although you can misuse alcohol without becoming dependent or addicted, it can quickly lead to alcohol dependence or AUD if left unchecked.

Signs of Alcohol Misuse

Alcohol misuse can lead to alcohol use disorder, so it is best to address it early on. Recognizing the signs of alcohol misuse can let you know when drinking has become a problem:

Using Alcohol to Self-Medicate

Reaching for a drink whenever you feel stressed, depressed, or have relationship problems is referred to as self-medication. Drinking alcohol to relax by numbing your feelings is a form of alcohol misuse. 

Drinking Alcohol in Risky Situations 

Consuming alcohol in situations that put you or others in danger qualifies as misusing alcohol. Operating a vehicle or machinery after drinking or mixing alcohol with illicit or prescription drugs can be life-threatening.

Drinking Heavily or Binge Drinking

According to the Centers for Disease Control (CDC) and Prevention Alcohol Team, heavy drinking is considered having more than four drinks per day or 14 per week for men. For women, heavy drinking consists of more than three drinks per day or more than seven per week. Binge drinking is defined as five or more drinks on a single occasion for men and four or more drinks for women. This method of alcohol misuse can be especially hazardous to your health if it becomes chronic. 

What Is Alcohol Dependence?

Alcohol dependence is described as needing alcohol to function and avoid withdrawal symptoms. However, it does not always involve heavy or binge drinking. A person can become alcohol dependent simply by drinking regularly over a long period. 

Signs of Alcohol Dependence

Although a person with alcohol dependence may not have an alcohol use disorder, they are at an increased risk for AUD if they do not address the problem. Some common signs of alcohol dependence include:

Developing a Tolerance to Alcohol 

Requiring larger amounts of alcohol to achieve the same effects is known as tolerance. If you find that you need more drinks to get the same buzz, your tolerance has increased, and you may be dependent on alcohol.

Having Cravings for Alcohol

Alcohol dependence can leave you thinking about drinking much of the time. You may crave alcohol and find it difficult to concentrate on things other than having your next drink. Because of this, your leisure activities may revolve mostly around alcohol, and you'll spend most of your free time drinking or recovering from drinking.

Experiencing Withdrawal Symptoms When Not Drinking

If you are dependent on alcohol, you may experience uncomfortable withdrawal symptoms when you're not drinking. Some symptoms of alcohol withdrawal are sweating, shaking, irritability, insomnia, nausea, vomiting, and a rapid heart rate. These symptoms can be mild to severe, depending on how advanced your alcohol dependence is. 

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What Is Alcohol Use Disorder (AUD)?

Alcohol use disorder (AUD) is characterized by an inability to moderate or stop one's alcohol consumption despite the negative consequences. 

Signs of Alcohol Use Disorder

Alcohol misuse and dependence can lead to AUD. Knowing the signs that you or a loved one has developed an alcohol use disorder can alert you that professional treatment may be needed:

Inability to Quit Drinking Despite the Consequences

Alcohol use disorder can negatively impact multiple areas of your life. You may see a decline in your performance at work or school, which can lead to losing a job or failing out of school. AUD can also lead to legal and financial issues if you drive under the influence and get into an accident or are arrested. Addiction can be so powerful that a person cannot discontinue drinking even when they experience serious consequences like these.

Trying to Stop Drinking Without Success

Once a person has developed an alcohol use disorder, they may find it challenging, if not impossible, to cut back their consumption or quit drinking altogether, no matter how much they want to. The cravings and withdrawal symptoms can be intense, so you may find yourself having another drink just to rid yourself of the discomfort.

Worsening Mental Health Problems

A person may start misusing alcohol to self-medicate mental health disorders, and AUD can exacerbate these issues. Alcohol use disorder can also instigate mental health conditions in people who did not have anxiety or depression before they started drinking. Without proper treatment for AUD and co-occurring mental health conditions, both will continue progressing, which can be life-threatening in severe cases.

Alcohol Misuse vs. Alcohol Dependence vs. Alcohol Use Disorder

A person can misuse alcohol without having alcohol dependence or alcohol use disorder. However, that doesn’t mean the behavior is harmless. The primary concern with alcohol misuse is that it can lead to consequences for your physical and psychological health and cause problems at work and in your relationships. It also increases your risk of developing alcohol dependence or AUD.

So how can you tell the difference between alcohol misuse, alcohol dependence, and alcohol use disorder?

Drinking Behaviors 

A person misusing alcohol may drink excessively or binge drink. Consuming more than moderate amounts of alcohol—up to one drink per day for women and two per day for men—is considered alcohol misuse. You can misuse alcohol without being dependent on or addicted to it. 

People with alcohol dependence may drink heavily or binge drink, but they can also become dependent through regular alcohol consumption. Their drinking behaviors may not necessarily be considered alcohol misuse, but the frequency of their consumption can lead to higher tolerance and withdrawal symptoms if they don't drink.

A person with alcohol use disorder has experienced changes in the brain after chronic alcohol misuse. The changes in brain neurotransmitters require a continuous supply of alcohol to function normally. If the person doesn't drink or cuts back significantly on the amount they drink, they may experience more severe psychological and physical withdrawal symptoms. To ease these symptoms, people with AUD may start drinking at unusual times, such as first thing in the morning or while at work. 

Severity of Withdrawal Symptoms 

If someone misuses alcohol but isn't dependent or addicted to it, they may not experience withdrawal symptoms. They might have a hangover afterward, which can present similar symptoms to withdrawal. The primary difference is that hangovers are caused by the effects of alcohol, while withdrawal is caused by the absence of alcohol once the body has become dependent.

If a person is dependent on alcohol and stops drinking, they may feel physical withdrawal symptoms, like nausea, shaking, and sweating.

A person with AUD experiences both psychological and physical symptoms if they quit drinking because their brain has come to depend on alcohol to activate certain neurotransmitters. 

Treatment Required

Alcohol misuse without dependence or AUD may simply require a desire to get one's drinking under control. If you take measures to drink in moderation, you may not need any formal treatment to prevent further alcohol misuse.

Since a person dependent on alcohol experiences physical withdrawal discomfort if they don't drink, they may need more support to cut back on drinking. You can try tapering your alcohol consumption, which involves slowly reducing the amount of alcohol consumed to minimize the discomfort of withdrawal symptoms. This method can be successful for those with mild alcohol dependence, but in more advanced cases, you may require the assistance of an addiction treatment program. 

Alcohol use disorders are the most severe alcohol-related condition and can be the most challenging to overcome. The combination of physical and psychological discomfort can make it feel impossible to abstain from drinking. People with AUD find the most success from medication-assisted treatment that addresses physical discomfort and neurotransmitter imbalances in the brain.  

Alcohol Withdrawal 

When a person with alcohol dependence or AUD attempts to decrease their consumption significantly or quit drinking altogether, they will experience physical and psychological symptoms referred to as alcohol withdrawal. Some common alcohol withdrawal symptoms are:

  • Anxiety
  • Elevated blood pressure
  • Irritability
  • Low mood
  • Muscle aches and pains
  • Rapid heartbeat
  • Sleep issues
  • Shaking or tremors
  • Sweating

These symptoms range from mildly uncomfortable to potentially dangerous based on the severity of one's dependence or addiction. In the most severe cases of alcohol withdrawal, a person can experience delirium tremens (DTs), characterized by hallucinations, confusion, restlessness, excessive sleep, and risk of seizures. 

Treatment and Medication

The best form of treatment for alcohol dependence or AUD approaches these conditions from multiple angles. Your physical and mental health can suffer from chronic alcohol misuse, so they need to be considered when developing an appropriate treatment plan. 

Medication-assisted treatment provides a comprehensive approach to treating alcohol use disorder. Medication helps manage withdrawal symptoms, mental health disorders, and chronic health conditions. Therapy is also a crucial part of recovery so that the underlying contributors to alcohol misuse can be addressed. Both of these components work together to ensure your best chance of success. 

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How many drinks would be considered an alcohol use disorder?

A person with alcohol use disorder cannot moderate their consumption or quit drinking despite the consequences for their health, relationships, or job. There is no specific number of drinks that signifies that a person has an alcohol use disorder. However, AUD often involves binge drinking, heavy drinking, or both. Binge drinking consists of five or more drinks within two hours for men and four or more drinks for women. Heavy drinking is considered consuming more than four drinks in a day or more than 14 in a week for men and more than three in a day or more than seven in a week for women. Engaging in these drinking behaviors frequently can cause changes in the brain that correlate with alcohol use disorder. 

How long does it take to become alcohol dependent?

How long it takes to become alcohol dependent is largely based on how much and how often you drink. A person can drink in moderation for years without developing a dependence, then abruptly increase their consumption due to a stressful event and become dependent. Others may start binge drinking or drinking heavily right off the bat and become dependent after a short time. 

Which behavior is most likely to indicate alcohol misuse?

Heavy and binge drinking is the most apparent behavior that indicates alcohol misuse. Although these behaviors may be overlooked as harmless partying and having a good time, they can lead to more serious consequences, such as alcohol use disorder, if misuse becomes more frequent.

Confidant Health: Discreet Virtual AUD Treatment 

Have you recognized the signs of alcohol misuse, alcohol dependence, or alcohol use disorder in yourself or a loved one? You can get confidential help online from Confidant Health's medication-assisted treatment for alcohol use. Our virtual treatment program offers the support of therapy and medication from the comfort of your home. If you're interested in seeing how our medication-assisted treatment program can help improve your relationship with alcohol, download our app today to schedule an assessment. 

This article has been medically reviewed by
Erin Hillers
Erin Hillers
Erin Hillers
Nurse Practitioner

Erin is a Nurse Practitioner with 8 years of experience in midwifery and women's health. She has spent the past 5 years specializing in the treatment of opioid and alcohol use disorders.

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