The Difference Between Problem Drinking and Alcoholism

Is there a line between being a problem drinker and actually being an alcoholic?  If so, does the difference really matter?

According to the most recent diagnostic manual used by psychiatrists (DSM), there is no difference.

The DSM recently made a change to their classification and diagnosis criteria to determine where someone falls on the line between sobriety and alcoholism.

Previous Criteria

In previous versions of the DSM, there were more levels of alcohol use along this continuum.  Someone who abused alcohol was given a different diagnosis as someone who was considered an alcoholic.

  • An alcoholic was considered to be someone who developed a dependency on alcohol and their prolonged alcohol abuse has become very entrenched in their life.
  • A person was diagnosed as an alcohol abuser if their abuse appeared to be short term, or due to a specific life event.  College students who binge drink make up a large portion of the “alcohol abuser” group.

However, in the updated version of the DSM, the two different levels of diagnosis were combined into the category of “alcoholic”.  There is no longer a difference from a diagnostic perspective between a life-long alcoholic and a college student who binge drinks.

This may not seem like a significant change, but there are many experts in the field that are concerned, particularly as it relates to college students and younger people.

Under the new guidelines, those young people will be labeled as alcoholics.  However, multiple studies have shown that people who binge drink at that age are much more likely to simply grow up and leave their problems with alcohol behind than they are to escalate into becoming a true alcoholic.

Studies have shown that more than 40% of college students binge drink and could be labeled as alcoholics under the new guidelines.  However, that number drops to only 5% when you look at those people when they are 26 years old.

By putting people who binge drink in college in the same group as life-long alcoholics, you are labeling 15% of college kids with something that isn’t true and could stay with them for the rest of their lives.

If they are officially diagnosed by a doctor, that type of diagnosis would go on that young person’s permanent medical record and remain there forever.

Having that diagnoses can also have a severe impact on that person’s self-perception.  If they have a negative connotation of “alcoholics”, it could hurt their self-esteem.  There is also a danger that the diagnosis could function as a self-fulfilling prophecy.

Previous post:

Next post: