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Why Alcohol Abuse is Not Alcoholism

We at Pat Moore Foundation continually reach out to others in the recovery community. Whether the person is in recovery, has a loved one in recovery or is a medical professional we work hard to bring all of us together. Our latest Guest Blog is from Lisa Frederiksen, of Breaking The Cycles. Please Enjoy and comment below! – Recovery Rob.

One of the misconceptions about drinking is the perception that drinking is either “normal” or “alcoholic.” In actuality, there are three stages of drinking – use, abuse and dependence. It is possible for a person who abuses alcohol to learn to “re-drink.” This is not true for a person with the disease of alcoholism.

“Can an Alcoholic Learn to Re-drink?” Answer: NO.

To be an alcoholic (dependent on alcohol) is to have the brain disease of alcoholism. Alcoholism is one of the diseases of addiction. Addiction is defined as a chronic, often relapsing BRAIN disease. A disease by its simplest definition is something that changes cells in a negative way. Alcoholism changes cells in the brain, which is what makes it a brain disease. Because the brain controls everything we think, feel, say and do and the nature of the disease of addiction, alcoholism changes the brain on a functional level, which is what makes it impossible for an alcoholic to drink if s/he wants to treat his/her brain disease. Stopping the drinking of alcohol is the first and most important step in their recovery process, which can include a number of treatment options, all of which work together to allow the brain to heal – to re-wire.

“What makes one person an alcohol abuser and another an alcoholic?” Answer: Alcohol abuse and RISK FACTORS.

It is important to understand that a person is not born an alcoholic. Alcoholism is a developmental disease, and it starts when a person’s drinking crosses the line from alcohol use (aka “low-risk” drinking – see below) to alcohol abuse. The drinking associated with alcohol abuse (described next) causes chemical and structural changes in the brain, which makes a person’s brain more vulnerable to his/her risk factors. The five key risk factors include: genetics, social environment, childhood trauma, mental illness and early use. Many of these five key risk factors are also brain cell changers in and of themselves — mental illness, childhood trauma, genetics and early use, in particular. Check out this explanation of Risk Factors, Understanding Addiction: Why Do Some People Become Addicted.

“Can an Alcohol Abuser Learn to Re-Drink?” Answer: POSSIBLY.

Alcohol abuse is not alcoholism. Alcohol abuse is defined as drinking more than low-risk limits but not being addicted to or dependent on alcohol (an alcoholic). Low-risk drinking limits are defined as no more than 7 standard drinks per week for women, with no more than 3 on any day; and as 14 per week for men, with no more than 4 on any day. A standard drink is defined as 5 ounces of table wine, 12 ounces of beer, 1.5 ounces of “hard liquor,” such as 80-proff vodka, bourbon, scotch or gin, or 8-9 ounces of malt liquor (ale or lager beers, for example). There are two “at-risk” drinking patterns (in other words – drinking more than low-risk limits) that lead to alcohol abuse. These are: 1) repeated binge drinking (defined as 4 or more standard drinks on an occasion for women and 5 or more for men), and 2) routine heavy social drinking (defined as routinely drinking more than the daily average of 1 for women [which totals 7 in a week] or 2 for men [which totals 14 in a week]). A person who is not an alcoholic but abuses alcohol can potentially learn to “re-drink,” meaning return to low-risk drinking limits. If they find those difficult to maintain, they may consider stopping drinking altogether.

“Does an alcoholic have to ‘hit bottom’?” Answer: NO!!!!!!!

Wresting control of a drinking problem during the abuse stage is important in order to avoid the chemical and structural brain changes that can make an individual especially vulnerable to his/her risk factors for developing alcoholism, aka the disease of addiction – an addiction to (dependence on) alcohol. That’s wresting control in the abuse stage. But even once a person’s crossed the line from alcohol abuse to alcohol dependence, the sooner treatment of their brain disease is sought and followed the better for their brain health and of course the beginning of a happier, healthier life!

For more information and help:

To help readers who may wonder about their drinking pattern and whether it might be a problem, visit NIAAA’s (National Institute on Alcohol Abuse and Alcoholism) website, “Rethinking Drinking,” where one can anonymously assess a drinking pattern and find tips for cutting down.

Related Posts:

Controlled Drinking Can’t Work for an Alcoholic 

Choosing Not to Drink 

The Brain Can Change When Substance Abuse is Stopped 

Lisa Frederiksen BIO

Lisa Frederiksen is the founder of and a consultant, speaker and author of nine books, including Crossing The Line From Alcohol Use to Abuse to Dependence and If You Loved Me, You’d Stop! She writes the blog,, and works with families, businesses, treatment center providers, schools, community coalitions and others. Please visit her website, 
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