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Alcohol Dependence vs. Alcoholism: Is There a Difference?

By  Meagan Drillinger
Alcohol dependence and alcoholism may sound similar, but they are two very different problems. Here's how to know the difference.

While the terms are often used interchangeably when you speak to friends and loved ones, alcoholism and alcohol dependency aren't necessarily the same things. One is uncontrollable, while the other involves making a conscious decision to drink. Both can have terrible consequences, but here's how you can tell the difference between the two. 

What is alcohol dependence?

Dependence, with respect to any substance—but in this case alcohol—can be abused, but there is still the element of choice involved.

"Inappropriate use can occur, but the person can choose to stop," Lawrence Weinstein, MD, Chief Medical Officer at American Addiction Centers tells WebMD Connect to Care. "Additionally, this inappropriate use may not impact various aspects of the person's life."

That said, dependence can quickly lead to an addiction.

What is alcoholism?

When someone struggles with alcoholism ("alcohol use disorder"), it means the person no long has a choice when it comes to use. There is a physical dependence on alcohol, and quitting without the proper treatment and medical oversight can result in death.

"Alcohol use disorder has altered areas of the individual's brain and the brain's reward center has been negatively affected due to the frequent spiking and cashing of dopamine levels," Weinstein says. "With alcohol use disorder, even though alcohol use disrupts many areas of the person's life and can cause a host of medical issues, legal trouble, physical problems and other detrimental situations, alcohol use will persist."

Here are five signs that you may be struggling with an addiction:

  • Alcohol is all that's on your mind.
  • You drink regardless of the consequences.
  • You are either constantly drinking, drunk, or hungover.
  • You have attempted to stop/cut back on drinking but failed.
  • You have withdrawal symptoms, including restlessness, sweating, trouble sleeping, nausea, or a racing heart.

What's the difference?

The difference between dependence and addiction is the element of choice. A person who is dependent on alcohol may be using alcohol inappropriately, but is still physically capable of stopping. Someone who is addicted to alcohol can no longer make the choice to stop.

Getting help

Fortunately there are many options available for those struggling with alcohol dependence or addiction to get help, according to the National Institute on Alcohol Abuse and Alcoholism.

There are different types of behavioral treatments that work at changing drinking behavior through counseling.

Support Groups
Groups like Alcoholics Anonymous (AA) and other 12-step programs bring people together to help support each other quitting or cutting back on their drinking. These groups are combined with behavioral treatments.

Rehabilitation Centers
"If someone is clinically diagnosed with alcohol use disorder, medical detox is necessary because alcohol withdrawal can lead to seizure and possibly death," said Dr. Weinstein.

For this level of help, an addiction treatment facility is highly recommended.