The term “alcohol use disorders” refers to a spectrum of disorders, and it’s rare that two people’s drinking behaviors and the harms caused by their drinking will be defined in exactly the same way. “Heavy drinking” is an especially ambiguous term because it can refer to binge drinking, or it can reference a chronic drinking problem – or some may use it interchangeably with “alcoholic.” But are all heavy drinkers alcoholics? And are all alcoholics heavy drinkers?
Almost all alcoholics do drink heavily, but not all heavy drinkers are alcoholics. Binge drinkers, for example, are defined by the practice of drinking more than four (for women) or five (for men) drinks in about a two-hour period. On average, about one in six American report binge drinking, and those who say that they binge drink ingest an average of eight drinks per binge about four times per month, according to the Centers for Disease Control (CDC). Despite the fact that so many Americans indulge in the behavior regularly, it is far from healthy. Binge drinking is associated with such issues as unintentional and intentional injuries, a range of cardiovascular disorders, liver disease and neurological damage.
Chronic drinking is defined by drinkers who drink more than the recommended one (for women) or two (for men) drinks a day, or more than seven (for women) or 14 (for men) drinks in a week, according to the National Institute of Alcohol Abuse and Alcoholism (NIAAA). How this shakes out in terms of daily drinking – whether it’s drinking three drinks at lunch every day during the week or drinking cocktails plus a bottle of wine at dinner – adds up to drinking that is harmful to the drinker’s health, and potentially puts their safety and the safety of others at risk.
According to the National Institutes of Health (NIH), alcoholism is defined by:
- Tolerance: The need to drink more and more in order to feel a buzz or get drunk is one of the hallmarks of alcoholism.
- Physical dependence: After tolerance develops, many drinkers find that when they are without a certain amount of alcohol in their systems, they go into detox characterized by withdrawal symptoms.
- Cravings: Additionally, when without alcohol, many drinkers crave alcohol and cannot stop thinking about getting a drink until they have one in their hands.
- Compulsive drinking: Alcoholics are unable to stop drinking once they start. It’s almost impossible to have just one.
Treatment for Alcohol Use Disorders
One of the major differences between alcoholism and heavy drinking is the need for treatment. Most alcoholics will benefit most from an inpatient alcohol rehabilitation program that offers medical detox and long-term follow-up care in therapeutic treatment. Heavy drinkers, on the other hand, may need different types of alcohol treatment services depending upon:
- Their ability to moderate their alcohol intake or stop drinking on their own
- The nature of the consequences they experience due to the choices they make while drinking
- Whether or not they are also living with co-occurring mental health issues
- If they ever get behind the wheel after drinking or hurt others when under the influence
Sometimes, environmental or underlying factors can make even a few drinks a huge problem for the drinker. If it triggers unsafe behavior of any kind or if moderation is impossible alone, then it’s time to seek help. A range of alcohol abuse treatment options are available. Contact us at the phone number listed above today, and our admissions coordinators can discuss which services will be best in your loved one’s situation.
David W. Newton is a board certified pharmacist and also has been a board member for boards of examiners for the National Association of Boards of Pharmacy since 1983. His areas of expertise are primarily pharmaceuticals as well as cannabinoids. You can read an article about his expertise in CBD on the National Library of Medicine.
Reviewed by: Kim Chin and Marian Newton