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Alcohol abuse or alcohol dependence – what is the difference?

Published 22/05/2009

According to an alcohol fact sheet published by the Institute of Alcohol Studies (IAS), alcohol is the third leading cause of disease and injury in developed countries, causing nearly 10 percent of all ill health and premature deaths in Europe.  This is ahead of obesity, diabetes and asthma and second only to smoking and blood pressure conditions.

It is hard to define the moment when the ‘odd drink' becomes a need, not just a want, but more and more people are struggling with alcohol abuse and alcohol dependence across the UK.  So, what is the difference between the two, and how do you know if you, or a loved one, is suffering from either of these conditions?  Sue Allchurch, director of Linwood Group, a leading provider of alcohol treatment facilities, explains further: "Alcohol abuse becomes apparent when, over a period of time, a person's drinking has repeatedly caused or contributed to risk-taking behaviours, role impairment and relationship or legal problems.  It shows that the person is drinking alcoholic beverages to excess, either on individual occasions ('binge drinking') or as a regular practice, without the development of tolerance, withdrawal or a compulsive alcohol use pattern.  Alcohol dependence however is the next stage on from this and is characterised in a person by their increased tolerance to the effects of alcohol, the presence of characteristic withdrawal signs and symptoms, and impaired control over the quantity and frequency of their drinking.

"Typically, people who are diagnosed as alcohol abusers can be helped with a brief intervention, including education concerning the dangers of binge drinking and alcohol poisoning.  For those who have become dependent on alcohol however, more intensive help is required.   This could be in the form of detoxification, medical treatment, counselling and/or a self-help group support."

To help you see the degree of difference between the two conditions, Linwood Group operates a traffic light system:

The Traffic Light System for Drinking

Green: Safe drinking

Government guidelines for safe drinking suggest that 21 units for a man and 14 units per week for a woman are safe.  These should be spaced over a week and not consumed in one or two sessions.  The measurement of a unit of drink is suggested as being half a pint of beer, a glass of wine or a pub measure of spirits (however, be aware that a half pint of beer can contain 3.5 units of alcohol in special beers). 

Amber: Unsafe drinking - beginnings of alcohol abuse

This is when you are taking in more than the recommended amount on a regular basis and may be starting to show the early physical or emotional consequences of this.  If challenged about your drinking, you would strongly reject having a problem, after all ‘you deserve a drink' and ‘all my friends do this as well'.  At this level of drinking, you are more likely to show some blood chemical changes due to the high alcohol intake.  The enzyme in the liver, which deals with alcohol will be elevated as the liver is under some strain.

Red: Dangerous drinking - moving toward alcohol dependency

This is when you are at high risk of physical and emotional damage.  You drink even when you know it is not safe and at levels way above the safe limits.  Your friends and family have warned you and you may have already experienced difficulties at work, home or even with the police.  Your blood tests would show signs of dangerous drinking.  It is vital that you have the courage to admit and confront your drinking at this stage.  Being too proud or ashamed to admit you need help could cost you your life.

For those who are moving towards alcohol dependency, they will not only exhibit all of the characteristics depicted in the Red Traffic Light section, but also some of the following:  

  • Favouring one type of drink: drinking only one type or brand of alcohol
  • Seeking drinking opportunities: only going to social events where drinking is included, or choosing to spend time with those who drink
  • Increased tolerance: The need for increasing amounts of alcohol in order to feel its effects
  • Withdrawal: Withdrawal symptoms, such as nausea, sweating, shakiness, and anxiety when alcohol use is stopped after a period of heavy drinking;
  • Drinking to relieve withdrawal symptoms: such as drinking to stop the shakes or ‘cure' a hangover
  • Returning to drink after attempting to stop: being unable to resist drink, even if you have attempted to stop for a period of time

If you recognise yourself or a friend, or family member as suffering from alcohol abuse, then why not call Linwood Group on Freephone 0800 066 4173 (or if you are calling from a mobile phone or from overseas, call 01226 698 054) to find out how to get help sooner rather than later?

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