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Alcohol dependence

Alcohol dependence (also called alcoholism) occurs when you have a physical or emotional dependence on the use of alcohol. Alcohol dependence is diagnosed when a pattern of alcohol use leads to significant impairment or distress with at least 3 of the following occurring any time in the same 12-month period:1

  • You experience tolerance to alcohol as defined by either:
    • A need for increasingly large amounts of alcohol to become intoxicated (drunk) or feel the effects of the alcohol.
    • A lack of intoxication with continued use of the same amount of alcohol.
  • You experience withdrawal from alcohol as demonstrated by either:
    • Withdrawal symptoms that occur when not drinking alcohol.
    • Alcohol being taken to relieve or avoid withdrawal symptoms.
  • You drink alcohol in larger amounts or over a longer period of time than you intended.
  • You experience a persistent desire or unsuccessful efforts to cut down or control your drinking.
  • You spend a great deal of time in activities necessary to obtain alcohol, use it, or recover from its effects.
  • You give up or are not as involved in important social, occupational, or recreational activities because of alcohol use.
  • You continue drinking alcohol even though you know it is causing or making worse physical or psychological problems (such as continued drinking even though you know it is aggravating an ulcer).

If you have a history of experiencing withdrawal symptoms, this may indicate that you have severe alcohol dependence.1 Because withdrawal symptoms can be very uncomfortable and sometimes intense, some people with alcohol dependence choose to continue drinking to avoid or relieve withdrawal symptoms. Occasionally these symptoms can continue at lower intensities for months (such as difficulty sleeping).


  1. American Psychiatric Association (2000). Alcohol-related disorders. In Diagnostic and Statistical Manual of Mental Disorders, 4th ed., text rev., pp. 212-223. Washington, DC: American Psychiatric Association.

Author Jan Nissl, RN, BS
Editor Susan Van Houten, RN, BSN, MBA
Associate Editor Tracy Landauer
Primary Medical Reviewer Adam Husney, MD
- Family Medicine
Specialist Medical Reviewer William M. Green, MD
- Emergency Medicine
Last Updated January 18, 2008

WebMD Medical Reference from Healthwise

Last Updated: January 18, 2008
This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.

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