Table 1.
Glossary of Terms on the Spectrum of Alcohol Misuse*
| Term | Definition† |
|---|---|
| Risky or hazardous use | Excess daily consumption (>4 drinks/d in men or >3 drinks/d in women and men aged ≥65 y) or excess total consumption (>14 drinks/wk in men or >7 drinks/wk in women and men aged ≥65 y) associated with increased risk for health problems. |
| Harmful use | A pattern of drinking that is already causing damage to health. The damage may be physical (e.g., liver damage) or mental (e.g., depressive episodes). |
| Alcohol abuse‡ | A maladaptive pattern of alcohol use leading to clinically significant impairment or distress (e.g., failure to fulfill major obligations). Continued use despite persistent or recurrent social or interpersonal problems caused or exacerbated by alcohol. |
| Alcohol dependence‡ | A maladaptive pattern of alcohol use leading to clinically significant impairment or distress, which may include the following symptoms associated with alcoholism or addiction: tolerance, withdrawal, excessive amounts consumed or time spent drinking, unsuccessful attempts to decrease use, or a pattern that continues despite persistent problems caused by or associated with alcohol. |
| AUD§ | A person continues a pattern of alcohol use despite >2 clinically significant alcohol-related problems in the following areas: impaired control over use (e.g., inability to decrease consumption), social impairment (e.g., failing to fulfill an obligation or foregoing a favorite activity), health consequences (physical or mental), and physiologic dependence (e.g., cravings). The disorder is classified as mild, moderate, or severe, depending on the number of symptoms. |
AUD = alcohol use disorder; DSM-IV = Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition; DSM-5 = Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition.
Alcohol misuse (sometimes called unhealthy alcohol use) is an umbrella term for a spectrum of potentially problematic patterns of alcohol use. This table was adapted with permission from reference 4 and uses terminology from DSM-IV for alcohol abuse and alcohol dependence and from DSM-5 for AUD. In collaboration with Dr. Jonas, we abbreviated and updated the table in the original source to reflect DSM-5 terminology.
Reference time period of 1 y.
DSM-IV criteria. Not all exact criteria are listed.
DSM-5 criteria. Not all exact criteria are listed. This new category integrates the 2 DSM-IV disorders “alcohol abuse” and “alcohol dependence” into a single disorder for DSM-5.