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Alcohol Misuse vs. Dependence: What's the Difference?

July 31, 2023
9 min read
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Reframe Content Team
A team of researchers and psychologists who specialize in behavioral health and neuroscience. This group collaborates to produce insightful and evidence-based content.
July 31, 2023
9 min read
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Certified recovery coach specialized in helping everyone redefine their relationship with alcohol. His approach in coaching focuses on habit formation and addressing the stress in our lives.
July 31, 2023
9 min read
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Recognized by Fortune and Fast Company as a top innovator shaping the future of health and known for his pivotal role in helping individuals change their relationship with alcohol.
July 31, 2023
9 min read
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Reframe Content Team
July 31, 2023
9 min read

When it comes to having a problem with alcohol, there are all sorts of terms out there — from alcohol abuse and alcohol dependence to alcohol addiction and the more colloquial term, “alcoholism.” While similar, these terms don’t all mean the same thing. For instance, alcohol misuse and alcohol dependence are two different conditions. How so? Let’s dive in.

Understanding Alcohol Dependence

Alcohol dependence is a chronic medical condition that causes us to experience symptoms of withdrawal when we stop consuming alcohol. In other words, our body develops a physical dependence on alcohol, and we have to keep consuming alcohol to avoid experiencing withdrawal.

We might have alcohol dependence if we exhibit some or all of the following characteristics:

  • Increased tolerance. We need to drink increasing amounts over time to achieve the desired effects of alcohol. For instance, we used to drink two glasses of wine each night, but now it takes four to attain that “feel good” feeling.
  • Withdrawal symptoms. We experience physical symptoms (such as insomnia, tremors, shaking, or mood swings) after going for a short period without drinking.
  • Drinking to relieve or avoid withdrawal symptoms. We have to drink to stop the shakes or to “cure” hangovers.
  • Awareness of the need to drink. We’re aware of how strongly we’re craving alcohol, even if we don’t admit it to others.
  • Drinking larger amounts. We consume larger amounts of alcohol over a longer period than intended and are unsuccessful at any attempts to cut back.

Alcohol dependence is similar to drug addictions, such as cocaine or heroin, as they all can cause incredibly strong withdrawal symptoms. In fact, delirium tremens, otherwise known as DTs, is a severe, life-threatening form of alcohol withdrawal characterized by agitation, fear, shaking, hallucinations, seizures, and severe confusion. On rare occasions, it can even lead to death.

Understanding Alcohol Misuse

Alcohol misuse, on the other hand, refers to excessive alcohol consumption, and it’s characterized by continuing to drink even though it creates problems in our social, interpersonal, health, and work life.

While someone who misuses alcohol may be dependent on alcohol, they may also be able to stop drinking without experiencing withdrawal. Some experts describe alcohol dependence as the inability to quit, and alcohol misuse as drinking too much, too often.

One study noted that 90% of people who misuse alcohol are not alcohol dependent. This includes people who engage in excessive drinking and binge drinking. However, the study also noted that people who binge drink more often were more likely to be alcohol dependent.

We might misuse alcohol if we exhibit some or all of the following symptoms:

  • Drinking more alcohol over a longer period of time than intended
  • Wanting to cut back on drinking but being unable to do so
  • Spending a lot of time obtaining alcohol, consuming it, and then recovering
  • Inability to function normally in important areas of our life due to alcohol
  • Strong cravings for alcohol
  • Giving up important activities because of alcohol use
  • Using alcohol in situations that may be dangerous or risky
  • Continuing alcohol consumption despite negative consequences
  • Increased tolerance, (i.e., needing to drink more to experience the same effects)
  • Experiencing symptoms of withdrawal when alcohol use is reduced or stopped

It’s worth noting that alcohol misuse can eventually lead to alcohol dependency; and, as we’ve learned, once we become dependent, it’s much more difficult to quit drinking.

However, even though alcohol dependence is more severe, alcohol misuse can still be incredibly harmful and dangerous. For instance, many people who misuse alcohol binge drink regularly, which is defined as having five or more drinks in two hours for men, and four or more drinks in two hours for women. Binge drinking can be extremely dangerous, increasing our chance of alcohol poisoning, accidents, and injuries.

Treatment for Alcohol Misuse vs. Alcohol Dependence

People with alcohol dependence typically require comprehensive treatment by a medical professional. Doctors might prescribe medications to help manage withdrawal symptoms and support us in our effort to stop drinking. Benzodiazepines in particular can help alleviate withdrawal symptoms, and naltrexone can help us manage alcohol cravings. Healthcare providers might also recommend recovery centers to help prevent relapse.

In severe instances, alcohol use might also require professional medical help. In other cases, people can learn to alter their drinking patterns through a variety of tools and resources. In fact, meditation has proven to be particularly effective in helping people curb cravings and reduce their alcohol intake.

The Bottom Line

The main difference between alcohol misuse and alcohol dependence is that alcohol misuse doesn’t always include a physical dependence on alcohol. With alcohol dependence, we have a physical compulsion to drink and will experience withdrawal symptoms if we stop consuming alcohol. With alcohol misuse, we don’t necessarily have a physical dependence on alcohol, but engage in excessive drinking even if it’s causing us problems. If we don’t feel the need to drink, but turn to alcohol to escape difficult emotions, that is a sign of alcohol misuse.

If you suspect you’re misusing alcohol or have developed alcohol dependence, it’s important to contact your healthcare provider, who can help determine the best treatment option for you. You can also try Reframe, a research-backed app that has helped millions of people cut back on their alcohol consumption.

Cut Back on Alcohol With Reframe

Although it isn’t a treatment for alcohol use disorder (AUD), the Reframe app can help you cut back on drinking gradually, with the science-backed knowledge to empower you 100% of the way. Our proven program has helped millions of people around the world drink less and live more. And we want to help you get there, too!

The Reframe app equips you with the knowledge and skills you need to not only survive drinking less, but to thrive while you navigate the journey. Our daily research-backed readings teach you the neuroscience of alcohol, and our in-app Toolkit provides the resources and activities you need to navigate each challenge.

You’ll meet millions of fellow Reframers in our 24/7 Forum chat and daily Zoom check-in meetings. Receive encouragement from people worldwide who know exactly what you’re going through! You’ll also have the opportunity to connect with our licensed Reframe coaches for more personalized guidance.

Plus, we’re always introducing new features to optimize your in-app experience. We recently launched our in-app chatbot, Melody, powered by the world’s most powerful AI technology. Melody is here to help as you adjust to a life with less (or no) alcohol.

And that’s not all! Every month, we launch fun challenges, like Dry/Damp January, Mental Health May, and Outdoorsy June. You won’t want to miss out on the chance to participate alongside fellow Reframers (or solo if that’s more your thing!).

The Reframe app is free for 7 days, so you don’t have anything to lose by trying it. Are you ready to feel empowered and discover life beyond alcohol? Then download our app through the App Store or Google Play today!

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At Reframe, we do science, not stigma. We base our articles on the latest peer-reviewed research in psychology, neuroscience, and behavioral science. We follow the Reframe Content Creation Guidelines, to ensure that we share accurate and actionable information with our readers. This aids them in making informed decisions on their wellness journey.
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