5 ms·

How do you distinguish alcoholism from alcohol abuse? As an alcoholic myself, the terms have always meant the same thing to me.

notacoward 6y ago
It's the difference between long-term dependency and short-term overuse. There's plenty of overlap, of course. Many people's need for alcohol leads to both behaviors. But they're still conceptually different things. It's possible, though perhaps rare, for an alcoholic to drink every day but never enough to be a danger to themselves or others. It's all too common for people in their teens or twenties to binge drink and get themselves or others killed, without ever being alcoholics.
- nate_meurer 6y ago
  This doesn't seem like a useful distinction. There are plenty of people who will drink every day of their life in a way that evidences dependence, but with little or no evidence of abuse. I've had some of these in my family. They drank at the same time in the evening and in the same quantity every day for decades, and they were likely in some state of mild chemical dependence, but the addiction, as it were, never caused any trouble whatsoever. It's not useful to call these people alcoholics. Likewise, it would be absurd to label people who drink coffee or tea daily with "caffeinism", even if physical dependence is present. And we don't label people who are chemically dependent on anti-depressants with "SSRI-ism". In my mind, attaching an "ism" to a substance is only useful to identify pathology, which doesn't necessarily have anything to do with dependence.
  - notacoward 6y ago
    > were likely in some state of mild chemical dependence > It's not useful to call these people alcoholics. Whether it's useful is not the point, especially whether it's useful to you personally. Alcoholism has a definition, which revolves around dependence. If they're dependent they're alcoholics, and it's still different than non-dependent binge drinking. You're basically trying to make the same distinction I just did (contrary to your own "they're the same" from two posts earlier), except that that you're using the term "alcoholism" for the wrong side of the distinction. > In my mind, attaching an "ism" to a substance is only useful to identify pathology You're using "pathology" in a very idiosyncratic way, almost opposite to its real meaning. To a clinician, social effects are not pathology. The pathology is the causes and effects on the individual, so dependence qualifies but wrecking your car doesn't.
    - nate_meurer 6y ago
      > Alcoholism has a definition, which revolves around dependence. Not... really. The problem here is that the term "alcoholism" is a colloquialism, not a technical term. Neither the DSM nor ICD uses it. So I suppose it can mean whatever you want, but it would be good for the common usage of the term to be useful in some way, and indeed it is in this case. In everyday language, the term alcoholism overwhelmingly connotes problem drinking. I'm quite steeped in the culture for personal reasons, and I've never in my entire life heard anyone use the word "alcoholism" to refer to completely harmless and controlled consumption. > contrary to your own "they're the same" from two posts earlier No, I asserted that alcoholism, in its everyday colloquial sense, connotes abuse. I definitely do not assert the same regarding the notion of "dependence", which does have a widely used technical definition. If it's dependence that we're debating, I'll argue that mere dependence on alcohol should not qualify it for the "alcoholism" label in the common pejorative sense. If you disagree, then I really am curious why you would not likewise label daily coffee drinkers with "caffeinism"? In the other direction, I assert that any regular, pathological pattern of consumption indicates a degree of dependence, but I recognize that there's some semantic debate there. > You're using "pathology" in a very idiosyncratic way, almost opposite to its real meaning. To a clinician, social effects are not pathology. We're not talking about oncology here. Alcoholism is not diagnosed, treated, studied, or managed quite like a medical condition such as cancer or diabetes. Outside the world of medical doctors, the term "pathology" is usually truer to its greek root "pathos". "Pathologic behaviour", "pathological gambling", etc. For what it's worth, the DSM and ICD largely classify mental disorders based on behavioural evidence. This is certainly true for alcohol dependence and abuse (DSM-IV) and alcohol use disorder (DSM-V).
      - notacoward 6y ago
        > No, I asserted that In https://news.ycombinator.com/item?id=26763944 https://news.ycombinator.com/item?id=26763944 you used the exact words "meant the same". Don't retcon. > Alcoholism is not diagnosed, treated, studied, or managed quite like a medical condition Don't throw around terms like "pathology" then. If you have moral opinions about other people's drinking, just say so. > DSM and ICD largely classify mental disorders based on behavioural evidence "Behavioral" does not mean only effect on others. The distinction you're trying to make keeps shifting around, but AFAICT it hasn't at any point matched any common one.
  - prionassembly 6y ago
    https://en.m.wikipedia.org/wiki/Caffeinism https://en.m.wikipedia.org/wiki/Caffeinism
    - nate_meurer 6y ago
      Thanks, I had no idea! So this would seem to support my assertion that an "ism" generally denotes excessive consumption leading to "problems" by whatever definition one chooses. I've used a month's worth of scare quotes today.
DanBC 6y ago
In the UK people tend not to use the term alcoholic in a formal setting. They'll talk about dependant drinking or problem drinking or binge drinking. A person can regularly binge drink, but not be dependant on alcohol.
- nate_meurer 6y ago
  If by "not be dependant" you mean "I can quit any time", I think only an unreformed alcoholic would strongly agree. Even if you could arrange a definition of dependence such that it doesn't apply to a regular problem drinker, then I think the term loses it's utility. The physiology and psychology of dependence is an interesting topic, but the disease of substance abuse IS the problematic behavior. EDIT: I had to clean this up a bunch, apologies for the butchered first attempt.
dragonwriter 6y ago
> How do you distinguish alcoholism from alcohol abuse? Alcoholism a behavioral health condition which inclines one toward unhealthy alcohol use. Alcohol abuse is a behavior which can exist with or without that underlying condition.

notacoward 6y ago

It's the difference between long-term dependency and short-term overuse. There's plenty of overlap, of course. Many people's need for alcohol leads to both behaviors. But they're still conceptually different things. It's possible, though perhaps rare, for an alcoholic to drink every day but never enough to be a danger to themselves or others. It's all too common for people in their teens or twenties to binge drink and get themselves or others killed, without ever being alcoholics.

nate_meurer 6y ago
This doesn't seem like a useful distinction. There are plenty of people who will drink every day of their life in a way that evidences dependence, but with little or no evidence of abuse. I've had some of these in my family. They drank at the same time in the evening and in the same quantity every day for decades, and they were likely in some state of mild chemical dependence, but the addiction, as it were, never caused any trouble whatsoever. It's not useful to call these people alcoholics. Likewise, it would be absurd to label people who drink coffee or tea daily with "caffeinism", even if physical dependence is present. And we don't label people who are chemically dependent on anti-depressants with "SSRI-ism". In my mind, attaching an "ism" to a substance is only useful to identify pathology, which doesn't necessarily have anything to do with dependence.
- notacoward 6y ago
  > were likely in some state of mild chemical dependence > It's not useful to call these people alcoholics. Whether it's useful is not the point, especially whether it's useful to you personally. Alcoholism has a definition, which revolves around dependence. If they're dependent they're alcoholics, and it's still different than non-dependent binge drinking. You're basically trying to make the same distinction I just did (contrary to your own "they're the same" from two posts earlier), except that that you're using the term "alcoholism" for the wrong side of the distinction. > In my mind, attaching an "ism" to a substance is only useful to identify pathology You're using "pathology" in a very idiosyncratic way, almost opposite to its real meaning. To a clinician, social effects are not pathology. The pathology is the causes and effects on the individual, so dependence qualifies but wrecking your car doesn't.
  - nate_meurer 6y ago
    > Alcoholism has a definition, which revolves around dependence. Not... really. The problem here is that the term "alcoholism" is a colloquialism, not a technical term. Neither the DSM nor ICD uses it. So I suppose it can mean whatever you want, but it would be good for the common usage of the term to be useful in some way, and indeed it is in this case. In everyday language, the term alcoholism overwhelmingly connotes problem drinking. I'm quite steeped in the culture for personal reasons, and I've never in my entire life heard anyone use the word "alcoholism" to refer to completely harmless and controlled consumption. > contrary to your own "they're the same" from two posts earlier No, I asserted that alcoholism, in its everyday colloquial sense, connotes abuse. I definitely do not assert the same regarding the notion of "dependence", which does have a widely used technical definition. If it's dependence that we're debating, I'll argue that mere dependence on alcohol should not qualify it for the "alcoholism" label in the common pejorative sense. If you disagree, then I really am curious why you would not likewise label daily coffee drinkers with "caffeinism"? In the other direction, I assert that any regular, pathological pattern of consumption indicates a degree of dependence, but I recognize that there's some semantic debate there. > You're using "pathology" in a very idiosyncratic way, almost opposite to its real meaning. To a clinician, social effects are not pathology. We're not talking about oncology here. Alcoholism is not diagnosed, treated, studied, or managed quite like a medical condition such as cancer or diabetes. Outside the world of medical doctors, the term "pathology" is usually truer to its greek root "pathos". "Pathologic behaviour", "pathological gambling", etc. For what it's worth, the DSM and ICD largely classify mental disorders based on behavioural evidence. This is certainly true for alcohol dependence and abuse (DSM-IV) and alcohol use disorder (DSM-V).
    - notacoward 6y ago
      > No, I asserted that In https://news.ycombinator.com/item?id=26763944 https://news.ycombinator.com/item?id=26763944 you used the exact words "meant the same". Don't retcon. > Alcoholism is not diagnosed, treated, studied, or managed quite like a medical condition Don't throw around terms like "pathology" then. If you have moral opinions about other people's drinking, just say so. > DSM and ICD largely classify mental disorders based on behavioural evidence "Behavioral" does not mean only effect on others. The distinction you're trying to make keeps shifting around, but AFAICT it hasn't at any point matched any common one.
- prionassembly 6y ago
  https://en.m.wikipedia.org/wiki/Caffeinism https://en.m.wikipedia.org/wiki/Caffeinism
  - nate_meurer 6y ago
    Thanks, I had no idea! So this would seem to support my assertion that an "ism" generally denotes excessive consumption leading to "problems" by whatever definition one chooses. I've used a month's worth of scare quotes today.

DanBC 6y ago

In the UK people tend not to use the term alcoholic in a formal setting. They'll talk about dependant drinking or problem drinking or binge drinking. A person can regularly binge drink, but not be dependant on alcohol.

nate_meurer 6y ago
If by "not be dependant" you mean "I can quit any time", I think only an unreformed alcoholic would strongly agree. Even if you could arrange a definition of dependence such that it doesn't apply to a regular problem drinker, then I think the term loses it's utility. The physiology and psychology of dependence is an interesting topic, but the disease of substance abuse IS the problematic behavior. EDIT: I had to clean this up a bunch, apologies for the butchered first attempt.

dragonwriter 6y ago

> How do you distinguish alcoholism from alcohol abuse? Alcoholism a behavioral health condition which inclines one toward unhealthy alcohol use. Alcohol abuse is a behavior which can exist with or without that underlying condition.