Alcohol Dependence - Other Alcohol-related Disorders

Other Alcohol-related Disorders

Because only 3 of the 7 DSM-IV criteria for alcohol dependence are required, not all patients meet the same criteria and therefore not all have the same symptoms and problems related to drinking. Not everyone with alcohol dependence, therefore, experiences physiological dependence. Alcohol dependence is differentiated from alcohol abuse by the presence of symptoms such as tolerance and withdrawal. Both alcohol dependence and alcohol abuse are sometimes referred to by the less specific term alcoholism. However, many definitions of alcoholism exist, and only some are compatible with alcohol abuse. There are two major differences between alcohol dependence and alcoholism as generally accepted by the medical community.

1. Alcohol dependence refers to an entity in which only alcohol is the involved addictive agent. Alcoholism refers to an entity in which alcohol or any cross-tolerant addictive agent is involved.
2. In alcohol dependence, reduction of alcohol, as defined within DSM-IV, can be attained by learning to control the use of alcohol. That is, a client can be offered a social learning approach that helps them to 'cope' with external pressures by re-learning their pattern of drinking alcohol. In alcoholism, patients are generally not presumed to be 'in remission' unless they are abstinent from alcohol.

The following elements are the template for which the degree of dependence is judged:

1. Narrowing of the drinking repertoire.
2. Increased salience of the need for alcohol over competing needs and responsibilities.
3. An acquired tolerance to alcohol.
4. Withdrawal symptoms.
5. Relief or avoidance of withdrawal symptoms by further drinking.
6. Subjective awareness of compulsion to drink.
7. Reinstatement after abstinence.