There are a lot of terms that surround alcohol use problems, including alcohol dependence and addiction. In some situations, these terms are used interchangeably, but they actually have different meanings. If you or someone you know is struggling with a substance use issue that’s related to alcohol, you may want to learn more about the issue as you seek help in dealing with it. Which one do you have? Do you have both? Is there a real difference?
What is the difference between alcohol dependence and alcohol addiction? Learn more about these two problems that are related to alcohol use disorders and what causes them.
What is Alcohol Dependence?
Alcohol dependence has to do with physical and chemical changes that your body goes through in response to alcohol. To understand it, it’s important to understand some basics about the brain. Your brain sends messages all over your body through your nervous system, which is made up of nerve cells called neurons. These neurons send and receive chemical messengers called neurotransmitters. Psychoactive substances like alcohol disrupt this natural process of brian communication to achieve its effects. Prescription drugs do the same thing to help ease uncomfortable symptoms and to treat things like pain, insomnia, and many other issues.
Alcohol is a central nervous system depressant, which means that it works to slow down activity in the nervous system. It does that by increasing the effectiveness of a natural chemical called gamma-aminobutyric acid, which helps you rest, relax, and sleep.
Dependence also involves another important aspect of the brain and body called homeostasis. Homeostasis is a state of natural balance that your brain and body work to maintain. When it comes to brain chemistry, your brain has many facets and features that work to make sure you’re not so relaxed that you feel depressed and fatigued and not so excited that you feel anxious and agitated. As a depressant, alcohol disrupts your brain chemistry to make you feel more relaxed, which causes a euphoric relaxing feeling. But drinking too much can also make you feel depressed, sleepy, and sedated.
However, your brain has a remarkable ability to adapt to new chemicals you introduce, like alcohol. If you consistently drink a lot or binge drink, your brain will try to balance your brain chemistry around alcohol to achieve and maintain homeostasis. It will stop producing some of its own inhibitory, calming chemicals and start increasing excitatory chemicals to compensate for the effects of alcohol. This can cause you to build up a tolerance, and you’ll feel like you need to drink more to maintain the same effects.
As your body comes to rely on alcohol to maintain homeostasis, you become chemically dependent on alcohol.
Signs and Symptoms of Alcohol Dependence
People that become dependent on alcohol often feel like they are no longer drinking to socialize or to experience the euphoria of being drunk. Instead, they drink just to feel normal and to stave off uncomfortable symptoms of withdrawal. Withdrawal may be one of the most unpleasant parts of chemical dependence. Since your brain relies on alcohol to maintain balanced brain chemistry, drinking less will cause you to experience a chemical imbalance, which causes withdrawal.
The signs of alcohol dependence may include:
- Using to feel normal
- Using to avoid uncomfortable symptoms
- Drinking more than you used to
- Needing to drink more to feel the same effects
- Needing to drink more often
- Drinking alone and at odd times like the morning
- Feeling uncomfortable withdrawal symptoms
Alcohol, like other depressants, can cause potentially dangerous withdrawal symptoms. Since alcohol dependence causes your brain to adapt to a depressing chemical, its removal will lead to your nervous system becoming overstimulated. This can cause withdrawal symptoms like anxiety, shaky hands, tremors, insomnia, nausea, vomiting, sweating, and headaches. Quitting cold turkey after developing a severe alcohol dependence can cause seizures, and a condition called delirium tremens, which can be fatal.
What is Alcohol Addiction?
Addiction is a disease that affects the reward center of the brain and can affect your biological, psychological, and social health. While dependence has to do with your brain’s chemical communication, addiction deals with other parts of the brain tied to reward and motivation. Alcohol addiction is identified by the compulsive use of alcohol despite consequences to your health, relationships, finances, or other parts of your life.
Alcohol addiction is caused when the use of a substance causes your brain’s reward system to treat alcohol as an important, vital activity like eating or drinking. Your reward system motivates you to maintain life-sustaining and enriching activities like getting nutrition, finding comfortable shelter, and forging interpersonal relationships. In basic terms, it motivates you to find food, protection, and sex.
The reward center works with chemicals in your brain like dopamine, serotonin, endorphins, and oxytocin, which are often called feel-good chemicals. Alcohol and other drugs can manipulate these chemicals, causing a powerful, rewarding effect. As you continue to drink excessively, your brain associates drinking with that potent rewarding feeling. Addiction is often associated with negative emotions that your brain learns to mask by causing compulsions and cravings to drink. Many people with addictions also have other mental health issues that may be related.
It’s unknown why some people can binge drink without developing an alcohol addiction while others do. But it’s clear that heavy drinking increases your risk of developing an addiction.
Signs and Symptoms of Alcohol Addiction
Addiction is usually identified when it starts to interfere with your life. In many cases, friends and family members recognize the problem before you do, which can be painful. Addiction can be difficult to control, and it often comes with signs related to a loss of control, like drinking when you intended not to. Other signs and symptoms of alcohol addiction include:
- Drinking more than you intended to drink
- Drinking to mask uncomfortable emotions
- Hiding alcohol or lying about drinking
- Trying and failing to cut back on drinking
- Strained relationships caused by alcohol
- Problems at school or work-related to drinking
- Unconscious compulsions to drink
Drinking is not unrelated to dependence. In many cases, the uncomfortable symptoms of dependence and withdrawal can reinforce your compulsions to drink. Needing to drink more and more to maintain your dependence can worsen your addiction too.
What is an Alcohol Use Disorder?
An alcohol use disorder (AUD) is the official diagnosis for someone that struggles with alcohol-related problems like misuse, dependence, and addiction. An alcohol use disorder is a diagnosis in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). It’s diagnosed at three levels: mild, moderate, and severe. The DSM-5 lists 11 criteria that are used to identify a substance use disorder. The severity of an alcohol use disorder depends on the number of criteria that apply to you.
Alcohol use disorders often involve both addiction and dependence. If an AUD is ignored, it can be progressive, taking over multiple areas of your life. However, though alcoholism is a chronic disease, it can be effectively treated.