Alcohol Dependence vs Alcohol Abuse: Understanding the Differences

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If you have been consuming alcohol heavily for an extended period, quitting on your own has the potential to be dangerous. Those with mild to moderate symptoms may receive treatment in an outpatient setting. You should ask a loved one to stay with you during this process, and you may need to visit a clinician for daily monitoring.

  • Often, people drink to try and reduce symptoms (sometimes known as ‘self-medicating’), but in the long-term alcohol makes these disorders worse because it interferes with the chemical balance in our brains.
  • The inclusion of assessment, intensive case management, motivational interventions, behavior interventions, family treatment, as well as services for housing, rehabilitation, and medication management improve such interventions.
  • The clinical efficacy of naltrexone is believed to be mediated through interactions between dopamine and the endogenous opioid neuropeptide systems.8 The endogenous opioids are involved in the expression of alcohol’s reinforcing effects and may promote drug-seeking behaviors.


If you or a loved one thinks they are experiencing physical alcohol dependence, do not hesitate to contact a treatment provider to explore your treatment options. In contrast, if you are physically dependent on alcohol, you may feel like it is a central part of your life and that you are unable to function or survive physiological dependence on alcohol without it, but those feelings do not mean your condition classifies as an AUD. The National Institute on Drug Abuse further explains that physical dependence on alcohol is a factor of addiction, but not addiction itself. However, the heavy drinking caused by physical dependence can lead to an alcohol addiction.

physiological dependence on alcohol

Health problems caused by alcohol dependence

Sometimes, severe withdrawal symptoms require monitoring from doctors in a hospital setting. It occurs when a person has difficulty stopping substance use or engaging in a behavior that provides some type of benefit. Explore how many people ages 18 to 25 engage in alcohol misuse in the United States and the impact it has. Learn how many people ages 12 to 20 engage in underage alcohol misuse in the United States and the impact it has. “If you’re using alcohol to cope with stress or anxiety, if you’re going out and intending to drink one drink and you’re not able to stop yourself from drinking, it’s important to talk to your doctor and meet with a specialist,” encourages Dr. Anand.

What is the prognosis of drug abuse and addiction disorders?

Glutamate is a major neurotransmitter responsible for brain stimulation, and alcohol affects glutamate through its inhibitory action on N-methyl D-aspartate (NMDA)-type glutamate receptors, producing amnesia (for example, blackouts) and sedation (Krystal et al., 1999). There is a wide range of other environmental factors that predispose to the development of alcohol-use disorders (Cook, 1994). These include the affordability and availability of alcohol, high consumption rates in the general population, occupational risk factors (such as working in the alcohol or hospitality industries), social pressure to drink, and religious- and culturally-related attitudes towards alcohol. Data on alcohol-related attendances at accident and emergency departments are not routinely collected nationally in England. However, a 24-hour weekend survey of 36 accident and emergency departments found that 40% of attendances were alcohol related and at peak times (midnight to 5 a.m. at weekends) this rises to 70% (Drummond et al., 2005).

It has a neural and behavioral profile that in almost every aspect is opposite to that of CRF. Moreover, alcohol-dependent rats exhibit decreased NPY content in the central nucleus of the amygdala during withdrawal (Roy and Pandey 2002), whereas, as stated above, CRF levels in this brain region are increased in alcohol-dependent animals. Furthermore, stimulation of NPY activity in this brain structure suppresses anxiety-like behavior (Thorsell et al. 2007) and dependence-induced increases in alcohol drinking (Gilpin et al. 2008a). The anatomical distributions of CRF and NPY are highly overlapping, suggesting that one might serve as a “buffer” for the effects of the other.

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When you miss your morning cup, you might develop physical withdrawal symptoms, like a headache, fatigue, difficulty concentrating, and more. The brain is a delicate and intricate organ that must maintain a careful balance of chemicals, called neurotransmitters, for a person to function properly. Alcohol intoxication can disrupt this fine balance, disturbing the brain’s natural equilibrium, and long-term, chronic use forces a person’s brain to adapt in an effort to compensate for the effects of alcohol. If you think you may be dependent on alcohol, you should consult your doctor or another medical professional before stopping drinking. You could speak to a health professional at your GP surgery, or there are also a number of national alcohol support services that you can confidentially self-refer to for advice and support.

  • Services that are involved with those who misuse alcohol fit into a wider context of safeguarding young people from harm and need to work to ensure that the rights of children, young people and their parents are respected.
  • Therefore, treatment staff need to be trained to identify, monitor and if necessary treat or refer to an appropriate mental health specialist those patients with comorbidity which persists beyond the withdrawal period, and/or are at risk of self-harm or suicide.
  • Even if you don’t recognise the symptoms above, there are varying degrees of alcohol dependence.
  • Listen to relatives, friends or co-workers when they ask you to examine your drinking habits or to seek help.
  • For example, investigators can use progressive-ratio schedules of reinforcement, in which the number of responses (e.g., lever presses) required for subsequent delivery of the reinforcer (e.g., alcohol) gradually increases throughout a session.
  • Specifically, such groups provide an emotionally safe place for people with substance use disorders and their loved ones to share their feelings and experiences, as well as benefit from the experiences of others in their efforts to abstain from using drugs.
  • According to a 2021 research article, healthcare professionals often misunderstand them, which can lead to misdiagnosis.

Early Stage – Though deemed the “early” stage, this stage is where a regular drinking pattern develops. Tolerance becomes noticeable, as you must drink more to reach the desired effect and feeling. In this transitional stage, as the disease becomes more severe, you may experience frequent blackouts and find that drinking and alcohol consume much of your thoughts. Due to increased tolerance, when not drinking, you may experience mild withdrawal symptoms common to physical alcohol dependence, including anxiety, shakiness, headache, insomnia, heart palpitations, and stomach problems such as nausea or vomiting. Another molecule involved in regulating the body’s stress response is called neuropeptide-Y (NPY).

  • The society that you live in plays an important role in how likely you are to develop problems with alcohol.
  • For other diseases such as cancer and heart disease the AAF is less than 1 (that is, partly attributable to alcohol) or 0 (that is, not attributable to alcohol).
  • Further, the age at which deaths from alcoholic liver disease occur has been falling in the UK, which is partly attributable to increasing alcohol consumption in young people (Office for National Statistics, 2003).

12.2. Current service provision for children and young people

physiological dependence on alcohol

Compounds targeting the glutamate systems also are being used in the treatment of alcohol dependence. For example, the agent acamprosate modulates glutamate transmission by acting on NMDA and/or metabotropic glutamate receptors (for a review, see Littleton 2007). Thus, by dampening excessive glutamate activity, acamprosate blocks excessive alcohol consumption. This process appears to depend on the involvement of genes such as Per2, which typically is involved in maintaining the normal daily rhythm (i.e., the circadian clock) of an organism (Spanagel et al. 2005).

Within the brain, a mix of chemical and electrical processes controls the body’s most basic functions, like breathing and digestion. These processes also control how people react to the multitudes of sounds, smells, and other sensory stimuli around them, and they organize and direct individuals’ highest thinking and emotive powers so that they can interact with other people, carry out daily activities, and make complex decisions. Pharmacological compounds that target the serotonin system by inhibiting neuronal reuptake of serotonin,5 thereby prolonging its actions, or by blocking specific serotonin receptor subtypes have been shown to suppress alcohol-reinforced behavior in rats (for a review, see Johnson 2008). However, some researchers are debating whether these compounds can affect alcohol-reinforced behavior without affecting consummatory behavior in general. During alcohol withdrawal, serotonin release in the nucleus accumbens of rats is suppressed, and this reduction is partially reversed by self-administration of alcohol during withdrawal (Weiss et al. 1996).