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Alcohol Abuse Versus Dependence: The Journey From Desire To Need

A person might need an increasing amount of the substance to get the desired effect

Alcohol too can become a need of the body like food and water

Written by Kashish Sharma |Published : November 24, 2022 1:43 PM IST

In everyday life, the terms like abuse, addiction and dependence get all muddled up. One term is used for another. However, in clinical context, the exclusivity of these terms is very important and they can't be interchangeably used for another. The Diagnostic and Statistical Manual of Mental Disorders distinguishes the two levels of substance misuse, abuse and dependence. While abuse is a mal-adaptive use patter, dependence is a state of physical addiction.

Though both are a cause of concern, alcohol abuse is not same as alcohol addiction. Not everybody who abuses alcohol will become an addict. However, both can have a detrimental effect on the quality of one's life. A simple example of substance abuse could be you consuming a painkiller more often than prescribed but it doesn't mean that you might still be addicted to it. However, if the abuse continues for a long time, it might turn into addiction.

Changed physiology: From desire to need

Abuse is a milder level of substance misuse where a person might exhibit mal-adaptive use pattern for instance, remaining intoxicated all day. Dependence on the other hand is a state of physical addiction which involves a phenomenon called tolerance. A person might need an increasing amount of the substance to get the desired effect. In dependence, a person is also likely to experience withdrawal symptoms which are unpleasant physical symptoms that might arise when a person suddenly stops alcohol or reduces the quantity. These withdrawal symptoms and increased tolerance are signs that a real physical need has developed for alcohol and there are actual alterations in the person's physiology.

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Symptoms of alcohol dependence

In alcohol dependence, withdrawal symptoms may include tremor (the shakes), delirium, convulsions, and hallucinations; with or without convulsions, these symptoms are collectively called delirium tremens. The following might be few physical symptoms-

  1. Being unable to stop when you want to
  2. Constantly thinking about alcohol
  3. Inability to complete tasks
  4. Lack of personal hygiene
  5. Changes in appetite
  6. Stealing money to buy alcohol
  7. Constant irritability and irritation
  8. Relationship issues

You can't just stop

According to the National Institute on Drug Abuse, the hallmark feature of addiction is substance use that is compulsive and difficult to stop even in the presence of negative consequences. On the contrary, a person who abuses alcohol can still stop as alcohol is still not a need of his or her body.

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