Drunk Vs Alcoholic: What's The Real Difference?

Being drunk and being an alcoholic are two distinct states with different implications. Being drunk is a temporary state of intoxication after consuming alcohol, which affects cognitive and physical functions. Alcoholism, on the other hand, is a chronic disease characterised by a continuous struggle with drinking, impacting an individual's health, relationships, and career. While occasional drunkenness may not indicate a deeper issue, alcoholism involves a long-term physical and psychological dependence on alcohol, leading to significant life disruptions and adverse consequences. Understanding this distinction is crucial for addressing alcohol-related concerns and providing effective support to those affected by alcohol addiction.

Social drinkers vs. alcohol abusers

Drinking alcohol is not inherently bad, but it can lead to addiction. Social drinking is a common way to socialise, relax, and celebrate. Social drinkers typically drink for enjoyment, know when to stop, and do not regularly get intoxicated. There is no set amount of alcohol that defines a social drinker, but the CDC characterises alcohol use as moderate drinking if a female consumes one drink per day or a male consumes two drinks per day. This becomes binge drinking if a male consumes five or more drinks or a female consumes four or more drinks during a general two-hour time frame on at least one occasion within a month.

Problem drinking goes beyond social drinking. Problem drinkers spend a lot of time drinking alone and may turn to alcohol when they are bored or lonely. They may also make time in their schedule for drinking. Many social drinkers do not decline into alcoholism, but those who transition from social drinking to problem drinking may find it challenging to stop without assistance.

Alcoholism, or alcohol use disorder, is a long-term issue with significant life disruptions due to an inability to control drinking, a focus on alcohol, and drinking despite harmful consequences. It often starts with frequent excessive drinking, leading to tolerance and withdrawal. Alcoholics may appear highly functional and may not fit into any stereotype. However, signs of alcoholism include the inability to stop or control alcohol intake, obsessive thoughts about alcohol, a high tolerance for alcohol, and displaying behaviour that is uncharacteristic of their sober personality.

While occasional drunkenness may not have lasting effects for some, alcoholism can deeply harm an individual's life, damaging their physical and mental health, straining personal relationships, and causing professional issues. Understanding the difference between social drinkers, problem drinkers, and alcoholics is crucial for addressing alcohol-related issues.

Alcoholism as a disease

Alcoholism, or alcohol use disorder, is a long-term issue that significantly disrupts an individual's life due to their inability to control drinking despite facing harmful consequences. It is often marked by frequent excessive drinking, leading to tolerance and withdrawal. On the other hand, drunkenness is a short-term effect of alcohol consumption, causing temporary intoxication and impaired judgment and coordination. While occasional drunkenness may not indicate alcoholism, frequent episodes of heavy drinking may signal a deeper problem.

Alcoholism has been recognised as a disease by professional medical organisations for many years. The American Medical Association (AMA) classified alcoholism as a disease in 1956 and included addiction as a disease in 1987. The AMA described alcoholics as "those excessive drinkers whose dependence on alcohol has attained such a degree that it shows a noticeable disturbance or interference with their bodily or mental health, their interpersonal relations, and their satisfactory social and economic functioning". This classification was significant in changing how the court system viewed and treated those struggling with alcoholism, shifting from punishment to recognition as a "major medical problem".

The progression of alcoholism is often subtle, occurring over an extended period, and even the alcoholic may fail to notice the point at which they lost control. Denial is a common symptom of the disease. Alcoholism is characterised as a mental obsession causing a physical compulsion to drink. The reward system in the brain is disrupted, leading to a pathological release of dopamine, which fuels cravings and creates a habit loop. As a result, alcoholics experience a reduced ability to control their impulse to drink, even when aware of the negative consequences.

Like other chronic diseases, alcoholism develops and progresses over time, and experts are still learning about its complex nature. It can impact various aspects of an individual's life, including health, relationships, and career. Treatment for alcoholism aims to address the root causes and promote lasting recovery through comprehensive care and support, including individual therapy, group sessions, and holistic approaches. Understanding the distinction between being drunk and being an alcoholic is crucial for grasping the full impact of alcohol consumption and providing effective support and treatment.

Binge drinking and heavy alcohol use

Binge Drinking

Binge drinking is a pattern of alcohol consumption that leads to a blood alcohol concentration of 0.08% or higher. This typically corresponds to consuming five or more drinks for men or four or more drinks for women in about two hours. Binge drinking is a form of alcohol misuse and can have harmful effects on the body, including impaired judgment and coordination. It is important to note that any amount of alcohol consumption can be associated with potential harm, and the level of harm increases with the amount consumed.

Heavy Alcohol Use

Heavy alcohol use is characterised by excessive drinking that exceeds recommended guidelines. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) defines heavy drinkers as men who consume more than four drinks in a day or fourteen in a week and women who consume more than three drinks in a day or seven in a week. Substance Abuse and Mental Health Services (SAMHSA) provides slightly different guidelines, suggesting that heavy drinking corresponds to fifteen drinks for men and eight drinks for women per week. Heavy alcohol use can increase the risk of developing alcohol use disorder and can have severe negative consequences.

Alcohol Use Disorder

Alcohol use disorder (AUD), also known as alcohol dependence, addiction, or alcoholism, is a chronic condition characterised by an inability to control alcohol consumption despite adverse consequences. It often arises from frequent excessive drinking, leading to tolerance and withdrawal. AUD differs from occasional drunkenness as it involves a continuous struggle with drinking, impacting various aspects of an individual's life. While only a small proportion of heavy drinkers may be alcoholics, many still struggle with severe drinking problems.

Social Drinkers, Alcohol Abusers, and Alcoholics

It is important to distinguish between social drinkers, alcohol abusers, and alcoholics. Social drinkers can take or leave alcohol and do not depend on it. Alcohol abusers drink to get drunk and may engage in risky behaviour, but they still have the ability to quit drinking if they choose to. In contrast, alcoholics are unable to function without alcohol and cannot get through each day without it. Alcohol abusers and alcoholics often require professional support to address their drinking habits effectively.

Alcohol's effects on the brain

The difference between an alcoholic and a drunk lies in the underlying patterns, effects, and implications of alcohol use. Alcoholism is a long-term issue with significant life disruptions due to an inability to control drinking, a focus on alcohol, and drinking despite harmful consequences. On the other hand, being drunk is a temporary state of intoxication that occurs after consuming alcohol, affecting cognitive and physical functions. While occasional drinking can lead to drunkenness without indicating alcoholism, frequent episodes of heavy drinking may signal a deeper issue.

Alcohol has a profound impact on the brain, affecting its appearance and function. It interferes with the brain's communication pathways, particularly those areas controlling balance, memory, speech, and judgment. This interference results in a higher likelihood of injuries and other adverse outcomes. For instance, driving under the influence can have lasting consequences. As the brain is responsible for controlling behaviour and social interactions, the changes caused by alcohol can lead to negative social outcomes.

The effects of alcohol on the brain are swift and far-reaching. Within 10 minutes of consumption, alcohol starts to affect the brain. It increases the effect of GABA, a neurotransmitter that 'calms' the brain and body, resulting in a feeling of relaxation and reduced anxiety. Simultaneously, alcohol decreases the effect of glutamate, the neurotransmitter that 'stimulates' the brain and body, leading to decreased alertness. This disruption in the balance of neurotransmitters can have a detrimental impact on mental health, increasing the risk of depression, panic disorder, and impulsive behaviour.

Prolonged and excessive alcohol consumption can lead to progressive changes in the brain's structure and function, compromising brain health. Heavy drinking causes alterations in neurons, including reductions in their size. Adolescent brains are particularly vulnerable to the negative effects of alcohol, with misuse during this stage potentially resulting in long-lasting changes in brain structure and function. Furthermore, prenatal alcohol exposure can cause brain damage, leading to a range of developmental, cognitive, and behavioural problems that can manifest at any time during childhood.

Chronic alcohol misuse can lead to alcohol addiction and alcohol use disorder (AUD). The brain changes induced by AUD can be significant, and while some improvements may occur with prolonged abstinence, the extent of the brain's recovery to normal function is not yet fully understood. Wernicke's Encephalopathy is a life-threatening condition that can occur due to alcohol abuse, resulting in confusion, disorientation, and requiring urgent medical attention. Ultimately, excessive drinking can cause severe and potentially permanent brain damage, highlighting the destructive potential of alcohol.

Recognising and addressing alcohol-related issues

Understanding the Differences

The distinction between a drunk and an alcoholic lies in the level of control over alcohol consumption and the impact on their lives. A "drunk" person describes an individual who experiences temporary intoxication and impaired judgment after consuming alcohol. This state is short-lived as the body processes the alcohol. On the other hand, an "alcoholic" refers to someone with alcoholism or alcohol use disorder (AUD), characterised by a chronic inability to control or cease alcohol consumption despite adverse consequences. Alcoholism is a progressive disease, with continuous struggles that impact health, relationships, and careers.

Recognising Alcohol-Related Issues

To recognise alcohol-related issues, it's important to look for signs of alcohol abuse or dependence. These can include drinking more than intended, continued drinking despite negative consequences, and a preoccupation with alcohol. Alcohol abuse can lead to risky behaviours, relationship issues, and health problems. Alcoholics, on the other hand, are physically dependent on alcohol and experience withdrawal symptoms if they go without a drink. They may struggle with daily functioning and experience severe health, social, and professional consequences.

Addressing Alcohol-Related Issues

If you or someone you know is struggling with alcohol-related issues, it's crucial to seek professional support. Resources are available for individuals of all ages and circumstances. Rehabilitation centres, therapy, and support groups can provide comprehensive care and address the root causes of alcohol misuse. It is important to communicate concerns without judgment and motivate affected individuals to seek professional assistance. Support from loved ones can positively impact their recovery journey.

Frequently asked questions