Alcohol Use Disorders – Beyond Alcoholism
To some degree, any alcohol consumption that exceeds moderate use can be considered an alcohol use disorder. Moderate use is considered to be two drinks daily equaling one ounce of alcohol for men, or one drink daily equaling 0.5 ounces of alcohol for women and the elderly. By these measurements, one drink is roughly 12 ounces of beer, five ounces of wine, or 1.5 ounces of spirit alcohol.
The nature of alcohol means that even isolated or rare consumption has the potential to be harmful or problematic. Extremely high levels of consumption over a relatively short period of time can be poisonous to the system and has the potential to be fatal or cause long-term medical complications.
On a lesser scale, alcohol intoxication can be dangerous because it impairs both judgment and physical coordination. Individuals can endanger themselves or others when they engage in high-risk activities that require coordination and concentration. Alcohol intoxication is a factor in many accidents and injuries, both minor and serious.
Alcohol intoxication may be unintentional or deliberate. Many drinkers actively strive to become intoxicated because of the decreased inhibitions that act as a social lubricant. Inexperienced drinkers may unintentionally consume alcohol well past the point of intoxication because alcohol needs a little time to take effect, and they do not know their limits.
Most people who drink alcohol have experienced alcohol intoxication, and many will regularly achieve mild intoxication whenever they drink. Consequently, it may seem unrealistic or unfair to categorize alcohol intoxication as an alcohol use disorder. However, the loss of judgment and control while under the influence as well as the health risks of binge drinking make it worth discussing.
Individuals who regularly drink to the point of intoxication may fall into the category of problem drinkers. Problem drinkers consume alcohol in sufficient quantities to put themselves at repeated risk from alcohol-related accident and injury or to have a detrimental effect on their overall health. Regular moderate or heavy drinkers as well as periodic binge drinkers may fall into this category.
Drinkers in this category of alcohol use disorders do not find alcohol-related problems interfering to a great extent in other areas of their lives. However, the risk for accident or long-term health problems can have anything from a sudden and catastrophic effect to a gradual deteriorating effect on their ability to function.
Problem drinking crosses into alcohol abuse when alcohol use begins to have a significant and detrimental effect on a person's ability to perform at work or school or to meet social obligations. Alcohol abusers often persist in high-risk alcohol-related behaviors such as drinking and driving in spite of the dangers. They may also develop legal problems related to their behavior while under the influence and see social relationships deteriorate due to their alcohol use.
While alcohol abuse has many symptoms and features in common with alcohol dependence, several important factors distinguish the two disorders. The first is that alcohol abusers do not exhibit an increased tolerance for alcohol, forcing them to drink larger and larger amounts in order to achieve the same effects. Another is that abusers do not experience the symptoms of withdrawal that affect those with alcohol dependence when they attempt to cut back on their alcohol use. The defining characteristic of alcohol dependence is a loss of control - control over the decision to drink, and how much to drink.