Alcoholism and Alcohol Abuse

For most adults, moderate alcohol use is probably not harmful. However, about 18 million adult Americans have an alcohol use disorder (AUD). This means that their drinking causes distress and harm. It includes alcoholism and alcohol abuse.

Alcoholism, or alcohol dependence, is a disease that causes

• Craving - a strong need to drink
• Loss of control - not being able to stop drinking once you've started
• Physical dependence - withdrawal symptoms
• Tolerance - the need to drink more alcohol to feel the same effect

With alcohol abuse, you are not physically dependent, but you still have a serious problem. The drinking may cause problems at home, work, or school. It may cause you to put yourself in dangerous situations, or lead to legal or social problems.

Another common problem is binge drinking. It is drinking about five or more drinks in two hours for men. For women, it is about four or more drinks in two hours.

Too much alcohol is dangerous. Heavy drinking can increase the risk of certain cancers. It can cause damage to the liver, brain, and other organs. Drinking during pregnancy can harm your baby. Alcohol also increases the risk of death from car crashes, injuries, homicide, and suicide.

You may have an AUD if you can answer yes to two or more of these questions:

In the past year, have you

• Ended up drinking more or for a longer time than you had planned to?
• Wanted to cut down or stop drinking, or tried to, but couldn't?
• Spent a lot of your time drinking, or recovering from drinking?
• Felt a strong need to drink?
• Found that drinking - or being sick from drinking - often interfered with your family life, job, or school?
• Kept drinking even though it was causing trouble with your family or friends?
• Given up or cut back on activities that you enjoyed just so you could drink?
• Gotten into dangerous situations while drinking or after drinking? Some examples are driving drunk and having unsafe sex.
• Kept drinking even though it was making you feel depressed or anxious? Or when it was adding to another health problem?
• Had to drink more and more to feel the effects of the alcohol?
• Had withdrawal symptoms when the alcohol was wearing off? They include trouble sleeping, shakiness, irritability, anxiety, depression, restlessness, nausea, and sweating. In severe cases, you could have a fever, seizures, or hallucinations.

If you have any of these symptoms, your drinking may already be a cause for concern. The more symptoms you have, the more serious the problem is. If you think you might have an AUD, see your health care provider for an evaluation. Your provider can help make a treatment plan, prescribe medicines, and if needed, give you treatment referrals.

NIH: National Institute on Alcohol Abuse and Alcoholism