Differences Between Alcoholism and Compulsive Drinking

Young adults in college tend to drink often because it can feel like “the thing to do.” Everyone is doing it, and many see it as part of the college experience. Some may look at the average college student and think they are compulsive drinkers. To a certain extent, they could be right. However, understanding the differences between alcoholism and compulsive drinking shows that this does not automatically make someone an alcoholic.

A study at Vanderbilt University found that “Occasional binge drinking isn’t uncommon, but about 30 percent of all adults exposed to alcohol engage in compulsive drinking despite negative effects and consequences – a major feature of alcohol use disorder.”

Negative side effects and consequences can mean completely different things from person to person. What is negative to one may not be negative to the next. This is why it is tough to diagnose someone as an alcoholic. We don’t know what one person considers a negative side effect.

Compulsive Drinking vs. Alcoholism: Key Differences at a Glance

The two terms overlap, but they are not interchangeable. Here is how compulsive drinking vs alcoholism compares side by side.

	Compulsive Drinking	Alcoholism (Severe AUD)
What it is	A pattern of drinking that is hard to control or stop	A medical condition diagnosed against set criteria
Scope	One behavior, which can show up at any stage of AUD	Many symptoms across health, work, relationships and daily life
Physical dependence	Not always present	Often present, with tolerance and withdrawal
Can it change on its own?	Sometimes, especially if caught early	Rarely without structured treatment and support
Typical next step	An honest look at drinking habits and a professional screening	A professional assessment and a treatment plan

Here is an example

An average working man is compulsively drinking. Let’s say he comes home from work and drinks six beers a night and maybe a glass of wine. At the end of the night, his wife, at this point, cleaned up the house, put all the dishes away, got the kids to bed, and finally had a chance to sit down. She is super resentful towards her husband because her husband sits on the back patio watching football and drinking beer the whole time she’s doing these chores. This goes on for months and months or potentially years. It gets to the point where it causes a lot of turmoil within the family. The wife has gone on the entire time, not saying a word and just bottling everything up inside. She hasn’t said anything to anyone. She keeps it to herself and builds a lot of resentment toward her “alcoholic” husband. One night, she has had enough. She can’t take it anymore. She knows that she needs to say something to her husband. Instead of consulting a therapist, she says what is on her mind and tells her husband that she wants to separate for a while because she does not know if the marriage will last. She even goes as far as calling her husband an alcoholic. She could say, “You know, while I am doing all the work around the house, you sit on the back patio and drink all night! I am starting to think you are an alcoholic!”

Meanwhile, he had NO IDEA that she even felt this way. She has never said anything or alluded to anything like this before. It catches him off guard.

Now, is he an alcoholic? Well, it would depend on what he does next. Does he recommend that they have a deeper conversation about her feelings? Is he willing to explore her feelings and make a change? Does he have feelings of remorse? Or does he not care at all and does nothing? Does he view this as an opportunity to start fights with her and justify his drinking more?

To an outsider looking in, it is apparent he has had negative consequences for his drinking. Does he believe that they are negative consequences? He may view this as an opportunity to leave a marriage he doesn’t want! If that’s the case, his drinking gave him positive reinforcement!

What is Alcoholism, aka AUD (Alcohol Use Disorder)

First and foremost, there is a lot of debate around the term “Alcoholism.” Some say that if you drink anywhere from 4-14 drinks a day, you have alcoholism. Others will say it needs to be self-diagnosed, and there cannot be a clear-cut guideline for diagnosing. Reality is, it is a blend of both.

According to Medline, “Moderate alcohol use is probably not harmful to most adults. However, about 18 million adult Americans have an alcohol use disorder (AUD). This means that their drinking causes distress and harm. AUD can range from mild to severe, depending on the symptoms. Severe AUD is sometimes called alcoholism or alcohol dependence.”

This seems to be an “ok” description of alcoholism, but it can be interpreted very differently from person to person. As stated before, negative consequences are relative to the specific person, which is why there has to be a level of self-diagnosis involved. Alcoholism isn’t generally diagnosed after a couple of severe consequences. Some people who have undergone complete liver transplants due to drinking still believe they are not alcoholics. They could sometimes say, “I am just a social drinker,” and social drinking to them means 24 beers and half a bottle of whiskey. But because they are with their friends and having a good time, they are not alcoholics.

True Signs of Alcoholism

Here are some signs and symptoms to look out for that may lead to a diagnosis of alcoholism:

• Health consequences (organ failure, heart problems, blood pressure issues)
• Relationship issues (marriage separation, divorce, changing friend groups)
• No longer partaking in activities that you once enjoyed, unless alcohol is involved
• Making decisions based on alcohol
• Job loss due to alcoholic drinking
• Drinking to mask a certain feeling or emotion
• Drinking in the morning

These are just a few things to watch out for. These are very broad topics and can be analyzed however you choose. The bottom line is if you notice that you or a loved one has any of these signs or symptoms, a conversation may be necessary.

Signs of Compulsive Drinking

Compulsive drinking is less about how much someone drinks on a given night and more about the pull behind it. These are the patterns we see most often in the men who call us:

• Planning to have one or two and regularly ending up with far more
• Trying to cut back or take a break and not being able to stick with it
• Feeling a strong urge or craving to drink at certain times, like right after work
• Spending a lot of time thinking about the next drink or recovering from the last one
• Hiding how much you drink, or getting defensive when someone brings it up
• Drinking alone, or before a social event so you “start off right”
• Continuing to drink after it has caused an argument, a missed shift or a health scare

One or two of these on a rough week does not make a diagnosis. When several of them show up month after month, the pattern deserves an honest look.

What Causes Compulsive Drinking?

There is rarely one single cause. Most of the time, a few risk factors stack on top of each other.

Genetics and Family History

Alcohol problems tend to run in families. The National Institute on Alcohol Abuse and Alcoholism estimates that genes account for roughly half of a person’s risk for AUD. Growing up around heavy drinking also shapes what feels normal. A family history is not a sentence, but it is a reason to pay closer attention to your own habits.

Stress, Trauma, and Mental Health

Many men start drinking to take the edge off. Work pressure, money problems, grief, military service or childhood trauma can all make a drink feel like relief. Depression, anxiety and PTSD often travel with compulsive drinking, and each one can make the other worse. Over time, the brain learns to reach for alcohol whenever those feelings come up.

Social and Environmental Factors

Friend groups, job culture and easy access all play a part. If every gathering, game day or work event centers on alcohol, heavy drinking can look ordinary even when it isn’t. Starting to drink at a young age also raises the risk of problems later in life.

Can Compulsive Drinking Turn Into Alcoholism?

Yes, and that is the main reason not to brush it off. Repeated heavy drinking changes how the brain handles reward and stress. What starts as a choice slowly becomes a habit, and then something closer to a need. Not everyone who drinks compulsively goes on to severe AUD, but the longer the pattern continues, the harder it is to break.

How Alcohol Use Disorder Is Diagnosed

Clinicians use the 11 criteria in the DSM-5, the manual mental health professionals rely on. They include drinking more or longer than intended, failed attempts to cut down, cravings, giving up activities, tolerance and withdrawal. Meeting two or three criteria within a year points to mild AUD, four or five to moderate, and six or more to severe AUD, which is what most people mean by alcoholism.

Warning Signs the Pattern Is Getting Worse

• You need more alcohol to feel the same effect
• You feel shaky, sweaty, anxious or sick when you stop
• You drink to stop those withdrawal symptoms
• Blackouts or memory gaps happen more often
• Drinking starts earlier in the day or shows up at work

Withdrawal from heavy, long-term drinking can be dangerous. If these signs sound familiar, do not quit cold turkey on your own. Speak with a medical professional first.

How the Differences Between Alcoholism and Compulsive Drinking Affect Treatment

Generally, alcoholism is progressive. It takes time to develop. For some, it can take years and years to be considered a full-blown alcoholic. If you are in a situation where you have someone in your life that you believe is an alcoholic, you cannot label them an alcoholic. It is ok to have your beliefs, but if you find it necessary to label them, it could backfire. Alcoholics do not want to be called alcoholics. It is demeaning and condescending. It will not, under any circumstances, help the situation if you attack them out of frustration and call them an alcoholic. Chances are, they will get defensive and angry, and at that point, it makes it harder to get them the help that they need. It is best to approach someone out of love and concern. It is best to seek wise counsel around this. Try to find someone who has dealt with this before and get direction from them.

There are many resources for someone who has alcoholism. Once they recognize that they are alcoholics and are willing to make a change, help may be presented.

• Alcoholics Anonymous is an excellent resource for someone looking to recover from alcoholism. There are meetings conducted around the world to address this very issue. It is generally a group of individuals who are all dealing with alcoholism. AA has been around since 1935 and has, at this point, gotten millions of people sober.
• Substance Abuse Treatment is an excellent resource for someone looking to get sober. Generally, SAT has a heavy emphasis on therapy. This usually is within a group setting and also an individual setting. There is often a living component associated with it as well. This is a good resource for someone who wants to get away from their hometown for some time.
• Church or some spiritual practice is often a key component to getting sober. There are many great resources within the church for one trying to get sober. They usually offer some recovery support programs for those struggling with alcoholism.
• Private therapists are also utilized rather often for people getting sober. It allows someone to identify why they drink the way they do. Having a private therapist in conjunction with another support program is helpful for long-term sobriety.

It is important to recognize that no matter what the situation is, anyone has the opportunity to get sober. We do not have to be an “alcoholic” to get sober. Becoming an alcoholic generally means that you have gone through a lot of un-needed harmful situations. Many people decide to get sober well before they destroy their lives. Alcoholism isn’t something to be ashamed of. We can and will recover if we are willing to do the work.

When to Seek Help for Your Drinking

There is no rule that says you have to lose everything first. Maybe you swore off weeknight drinking in January and were back at it by February. Maybe your wife has stopped bringing it up because the conversation always goes sideways. Maybe mornings start with shaky hands. Any one of those is reason enough to talk to someone. Men who reach out early tend to have a shorter, less painful road back.

Recovery Bay Center is a men’s-only treatment center in Panama City, Florida. Our admissions coordinators pick up 24/7, day or night. They can walk you through what treatment looks like, answer your questions about admissions, and help you figure out a sensible next step. Recovery is a fresh start, and it is closer than it feels.

References:

• https://medlineplus.gov/alcoholusedisorderaud.html
• https://news.vanderbilt.edu/2019/11/22/what-leads-to-compulsive-alcohol-use-with-new-experiments-into-binge-drinking-researchers-are-finally-getting-answers/

FAQs

What is the difference between compulsive drinking and alcoholism?

Think of it this way. Compulsive drinking describes how a man drinks; alcoholism describes the condition he is in. A man can lose control on Friday nights for a season of his life without tolerance, withdrawal or wreckage at home. Severe AUD usually brings all three.

Is compulsive drinking the same as alcohol use disorder (AUD)?

Not quite. It is one piece of the AUD picture, and a clinician looks at the whole thing. A diagnosis needs at least two of the 11 DSM-5 criteria within the same 12 months, so a stretch of out-of-control drinking alone may not qualify.

What are the signs of compulsive drinking?

Watch for the gap between plan and reality. Two beers turn into eight. A dry month ends on day nine. Bottles get tucked away in the garage. If drinking keeps going after a DUI scare, a fight or a doctor’s warning, that is compulsion talking.

Can compulsive drinking turn into alcoholism?

It can, and it often does if nothing changes. Each round of heavy drinking teaches the brain to want the next one a little more. Mild AUD can slide into moderate or severe over a few years. Here is the hopeful part: the earlier a man steps in, the less ground he has to win back.

When should someone get help for compulsive drinking?

Get help as soon as drinking feels hard to control or starts causing problems. You do not need to wait for a crisis. If you notice withdrawal symptoms, talk to a medical professional before stopping on your own.