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Alcoholism vs. Alcohol Use Disorder
For the first time, the 2019 National Survey of Drug Use and Health (NSDUH) found that women were drinking and getting drunk at higher rates than men.1 While more women drinking by itself is not an issue, the glamorization of parental binge drinking increases the risk of side effects, dependence, and alcohol addiction, and this drinking ripples out to impact children and loved ones.
Often, we hear the two terms – alcoholism and alcohol use disorder (AUD) used interchangeably. A quick Google search to find statistics on alcoholism quickly turns up scores of pages on alcohol use disorder. According to the 2019 NSDUH, 14.5 million people ages twelve and up struggle with alcohol use disorder.2 However, is there a difference between alcoholism and alcohol use disorder? Where do binge drinking and “problem drinking” fall into the frame?
Is There a Difference Between the Two?
The core difference between AUD and alcoholism lies in clinical use.
Alcoholism is a catch-all phrase for everything considered “problem drinking.” It is a phrase commonly used in Alcoholics Anonymous and casual conversation, though you’re unlikely to hear it in medical settings. Alcoholism could look like binge drinking, daily drinking, drinking that impacts our ability to function, and it could indeed look like an alcohol use disorder.
Alcohol use disorder – also called alcohol addiction – is a clinical term classified under the Diagnostics and Statistical Manual of Mental Disorders (DSM-V) with criteria to help care providers accurately assess whether someone suffers from an alcohol problem and to what degree. To receive a diagnosis of AUD, you must have experienced at least two of the eleven symptoms associated with AUD.3
Criteria of AUD
You may meet the criteria for AUD if in the past twelve months you:
- Had occasions where you drank more or longer than intended.
- Dedicate a lot of your time to drinking or dealing with side effects.
- Attempted to lessen or stop drinking on multiple occasions but could not.
- Wanted to drink so badly you were unable to think about anything else.
- Found your drinking habits interfered with life (work, relationships, family).
- Continued drinking even while experiencing consequences in relationships.
- Reduced time spent on previously enjoyed activities in favor of drinking.
- Found yourself in situations during or after drinking that increase the potential for injury more than once.
- Continued drinking even with diminished enjoyment, increased anxiety, depression, memory blackouts, or other health problems as a result.
- Experienced withdrawal symptoms when you go without alcohol for too long.
- Found you need to drink more to achieve the same effects you previously felt.
The severity of alcohol addiction depends on the number of symptoms:
- Mild AUD: 2-3 symptoms
- Moderate AUD: 4-5 symptoms
- Severe AUD: 6+ symptoms
The 2019 NSDUH report found binge drinking to be on the rise, with 25.8% of people over eighteen years old reporting they engaged in heavy binge drinking in the past twelve months. Additional research suggests that compared to those who do not binge drink, people who drank at twice the gender-specific binge drinking thresholds were 70% more likely to experience an emergency room visit relating to alcohol.2
Causes of Alcohol Use Disorder and Alcoholism
The most significant factors contributing to habitual alcohol misuse include how much, how often, and how quickly an individual drinks. Consistent and repeated exposure can swiftly build a psychological dependence that leads someone to reach for the bottle over and over again.
Binge drinking, heavy alcohol use, and other types of problem drinking also increase the risk of developing alcohol addiction or alcoholism.
Other factors that point towards AUD include:
- Pre-existing mental health conditions (disorders like PTSD, depression, ADHD, and more are directly associated with higher rates of AUD)
- A history of trauma and ACEs (adverse childhood experiences)
- Genetics and family history. The hereditary potential is about 60%, but just as impactful is the experience of growing up around alcohol misuse.
- Drinking before the age of fifteen, which people who do have five times the risk of developing AUD compared to people who began drinking at twenty-one. This risk increases for women.4
Signs and Symptoms of Alcohol Abuse
Early Alcohol Abuse Signs
- Experiencing irritability or extreme mood swings
- Feeling hungover or experiencing withdrawal when not drinking
- Becoming secretive about drinking habits
- Growing distant from friends and loved ones
- Experiencing memory blackouts
- Prioritizing drinking over other responsibilities
- Making excuses to continue drinking even when there are adverse effects
Severe Alcohol Abuse Signs
- Digestive issues
- Increased blood pressure
- Heightened risk of heart failure or stroke
- Heightened risk of liver disease
- Development of nystagmus (involuntary eye movement)
- Osteoporosis and increased risk of bone fractures
- Weakened immune system
- Impaired cognitive functioning
- Increased risk of cancer
- Heightened risk of adverse effects from drug or substance interactions
What is Wine Mom Culture?
Wine mom culture refers to the growing movement that supports, celebrates, and often glamorizes alcohol use to cope with daily life. Many moms find themselves stressed and overwhelmed by responsibilities and the need to keep up appearances. Wine mom culture embraces alcohol as a well-deserved method of rewarding yourself and unwinding after a long day.
How Can You Tell if You’re a “Wine Mom?”
It can be difficult to spot when a fun, stress-relieving activity develops into a dependence. Wine moms may engage in heavy drinking (more than four drinks over two hours), disguise alcohol in other drinks, and drink during nap time or when kids are on playdates.
If you find yourself drinking more than you intend, experiencing withdrawal symptoms when you stop drinking, find you need more alcohol to achieve intoxication, and are falling through on responsibilities due to alcohol use, you may have shifted from wine culture to dependence.
Dangers of Wine Mom Culture
While a few glasses of wine now and again will not hurt, repeated bouts of drinking can preempt substance abuse and mental health issues.
Wine moms who engage in binge drinking, defined as four or more drinks in one sitting at least once over two weeks, put themselves at higher risk for developing a substance use disorder.
Moms who embrace wine culture often find it is a quick road to connecting and bonding with peers who are similarly looking for ways to relax. Unfortunately, this mindset can quickly lead to a dependence on alcohol to feel more connected to fellow wine moms.
Effects of Parental Binge Drinking on Children
Psychological and Emotional Effects
Mom wine culture typically frames drinking for moms as a well-deserved stress-reliever for coping with daily stressors and kids. However, the impact it has on kids could be a parent who is less engaged and frames childcare as something stressful that requires alcohol. While all parents know the stress of raising children, framing things this way can tell kids they are a burden and that it’s their fault their parents are not as engaged in their lives.
Parents often try to hide drinking habits from their kids, leading to secrecy, lying, and denial that can contribute to lifelong trust issues. Trust issues can also contribute to low self-esteem, where children feel they are not good enough to warrant their parent’s trust or attention.
Children who grow up with parents that engage in binge drinking are more likely to experience substance use disorders and struggles with mental health in the future. Growing up with an alcoholic parent can create instability at home, where rules are always changing and children do not know how to satisfy their parents. Over time, it can contribute to numerous personality disorders.
Drinking to Cope with the COVID-19 Pandemic and Problem Drinking
Treatment for Alcohol Abuse
If you find yourself struggling with problematic drinking habits you would like to get a handle on, there are many pathways available to you.
Behavioral therapy for alcohol treatment typically includes cognitive-behavioral therapy (CBT). CBT is a talk therapy that seeks to empower people to recognize the patterns of their thoughts to influence what people feel and change their behavior and habits.
Certain counseling techniques, like motivational interviewing, can prove beneficial for helping people boost their internal motivation through recovery. Motivational interviewing works by exploring and clearing away beliefs and ambivalence that are holding you back.
Treating Underlying Problems
Support groups are staples of alcohol addiction treatment. Groups like Alcoholics Anonymous, SMART Recovery, and Secular Organizations for Sobriety offer dependable support systems to help people explore their goals with a community of people who understand your experience.
Alcohol treatment typically begins with detox, which centers on removing all traces of alcohol from the body. For alcohol treatment, individuals must seek medical support as they attempt withdrawal, as alcohol withdrawal can prompt life-threatening side effects such as hallucinations, seizures, and delirium tremens.
The FDA has approved three medications to assist with alcohol addiction: naltrexone, acamprosate, and disulfiram. Acamprosate helps decrease cravings and alleviate withdrawal symptoms. Disulfiram also reduces cravings but does so by causing unpleasant symptoms like nausea and headaches when alcohol is consumed while using disulfiram. Naltrexone reduces the euphoric effects that accompany drinking, making the prospect of drinking less attractive.