Is Alcohol Use Disorder (AUD) the Same Thing as Alcoholism?

Alcohol addiction is incredibly common. For years, terms like “alcohol abuse,” “alcohol dependence,” “alcoholism,” and “alcohol use disorder” have often been used interchangeably to describe this condition. 

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However, these terms do not actually mean the same thing. Alcohol use disorder (AUD) is now the clinically accepted term used by doctors and mental health professionals. 

AUD describes a diagnosable condition that involves drinking alcohol excessively or uncontrollably to the point that it negatively affects your life or health. AUD exists on a spectrum, meaning you can have a mild, moderate or severe case. 

“Alcoholism,” on the other hand, is a term used colloquially to describe alcohol dependence, or a physical reliance on alcohol that can cause withdrawal symptoms when you try to quit (1). But as of 2013, alcoholism is no longer considered a diagnostic term used by medical professionals (2). Instead, doctors use the term AUD, relying on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) to diagnose it. 

If you or a loved one are struggling with alcohol use, it’s helpful to understand the differences between terminology like alcoholism and AUD. Knowing the difference between AUD and alcoholism can help you find the right treatment for a successful recovery.

What is alcohol use disorder (AUD)?

AUD is a mental health condition characterized by symptoms such as drinking too much alcohol in one sitting, drinking alcohol too frequently, or not being able to control your alcohol consumption. 

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), about 28 million adults in the United States live with AUD (3).

Though AUD has often been used interchangeably with other terms related to alcoholism, previous editions of the DSM listed alcohol abuse and alcohol dependence as two distinct disorders with similar but separate criteria. In 2013, the DSM-5 officially combined alcohol abuse and alcohol dependence into one diagnostic definition — AUD. Notably, this update added craving alcohol and eliminated experiencing legal problems as symptoms, and also described a spectrum of mild, moderate, and severe AUD (4). 

AUD’s symptoms can range in severity from mild to debilitating. According to the DSM-5, you may have AUD if you have experienced at least two of the following symptoms in the last year:

- drinking more alcohol or drinking for a longer period of time than intended 

- experiencing an inability to lessen alcohol consumption despite your desire to 

- spending a lot of time ill or recovering from hangovers as a result of drinking 

- feeling consumed by an obsessive desire to drink 

- noticing that drinking or hangovers are interfering with your responsibilities at home, school, or work but continuing to drink anyway 

- choosing to drink instead of pursuing enjoyable activities or hobbies 

- engaging in risky or dangerous behaviors while drinking, such as driving, swimming, using machinery, or having unsafe sex

- experiencing memory blackouts, anxiety, or depression as a result of drinking but continuing to drink anyway 

- noticing an increase in alcohol tolerance or that you need much more alcohol to feel its intoxicating effects 

- experiencing symptoms of alcohol withdrawal, like trouble sleeping, shakiness, restlessness, nausea, sweating, a racing heart, seizures, or sensing things that are not there

What is alcoholism?

Alcoholism is now considered an outdated term for describing a condition that causes people to crave and consume alcohol inappropriately or excessively despite negative impacts on their lives or health. AUD has been used as the official diagnostic term since 2013, when the DSM-5 updated its criteria (5).

Though some people may view terms like “alcoholic” as unhelpful or negative, many still use this term to describe their experience with AUD. Alcoholics Anonymous (AA), for example, uses terms related to alcoholism to describe those in recovery (6).

What’s the difference between AUD and alcoholism? 

Alcohol use disorder is a diagnosable condition characterized by excessive drinking that becomes uncontrollable and/or negatively impacts a person’s life or health. Alcoholism is no longer diagnosed but is instead an everyday term used to describe symptoms of AUD (7).

The terms “alcoholic” and “alcoholism” are popular among adherents of 12-step programs like AA. “AUD” is not a term you are likely to hear at an average AA meeting, though plenty of other recovery programs and groups do use this clinically accurate term. 

Only a doctor can diagnose you with AUD. Alcoholism is a layman’s term and not a clinical term used in medical diagnosis. Physicians screen for AUD using the DSM-5 criteria to measure your symptoms and whether you have a mild, moderate, or severe case of AUD (8).

How is alcoholism or AUD diagnosed in individuals?

If you’re concerned that you or someone you love may have AUD, it’s important to speak with a physician. Though AUD can only be diagnosed by a medical doctor, mental health professionals can also be integral in connecting you to AUD treatment

Your doctor may screen you for this condition by asking you questions about your drinking habits, including how much and how often you drink and whether or not you feel drinking alcohol has interfered with your life negatively. They may also perform a physical exam to assess whether your alcohol consumption is detrimentally affecting your health. 

Blood tests are often used to evaluate your overall health, with particular attention to parts of the body most affected by excessive alcohol use, such as the heart, liver, brain, and nervous system. 

Once your doctor has made a diagnosis, they will be able to help you find the best treatment plan possible. 

FAQs: alcoholism vs alcohol use disorder

Is alcoholism a substance use disorder?

Yes and no. Alcoholism is an outdated term used to describe what’s now called AUD. Though “alcoholism” and “alcoholic” are terms used casually by recovery programs like AA, alcoholism is no longer a diagnosable condition. AUD, on the other hand, is a formal condition your physician can diagnose you with. 

What factors make the difference between AUD and alcoholism?  

The main difference between AUD and alcoholism is clinical terminology and diagnosis. A doctor won’t diagnose you with alcoholism, but you may hear this term used in non-clinical settings to describe the symptoms and effects of alcohol use disorder. These two terms were once used interchangeably, but this changed in 2013, when the DSM-5 recognized AUD as the official diagnosable condition. 

Is AUD worse than alcoholism?

Not necessarily. AUD exists on a spectrum that ranges from mild to severe, while alcoholism has often been used to describe alcohol dependence in more black-and-white terms. Mild AUD may include “problem drinking” behaviors, but alcohol dependence involves an uncontrollable urge to drink that can result in a person hitting “rock bottom,” experiencing withdrawal symptoms when they quit drinking, and potentially never being able to consume alcohol again safely (9).

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