Binge Drinking and Alcohol Abuse: What’s the Difference?

According to the dietary guidelines outlined by the U.S. Department of Health and Human Services and the U.S. Department of Agriculture, moderate alcohol use is defined as two drinks per day or less for men and one drink per day or less for women. That said, it’s sometimes unclear when alcohol use is safe and recreational versus when it becomes a problem. While binge drinking and alcohol misuse may result in harm to one’s health, the two are not the same.

The Centers for Disease Control and Prevention (CDC) define alcohol misuse as more than one alcoholic drink a day on average for women or two drinks a day on average for men. Similarly, the National Institute on Alcohol Abuse and Alcoholism (NIAAA) defines heavy alcohol use as more than four drinks per day or 14 drinks per week for men and more than three drinks per day or seven drinks per week for women.

Moderate alcohol use is defined as two drinks per day or less for men and one drink per day or less for women.

Binge drinking refers to a pattern of drinking that occurs all on one occasion. The CDC considers more than four drinks for women or five drinks for men on a single occasion to be binge drinking. The NIAAA defines binge drinking as drinking an amount that causes your blood alcohol concentration (BAC) to reach 0.08 percent or higher.

Risks of Binge Drinking and Alcohol Misuse

The CDC reports that binge drinking is the most common, expensive, and fatal form of excessive alcohol use in the United States. Binge drinking costs the United States millions each year. In 2010 alone, binge drinking-related issues, like healthcare expenditures, criminal justice charges, and work productivity losses, totaled $191 billion.

Even occasional binge drinking and alcohol misuse can be dangerous. Some risks include:

  • Alcohol poisoning
  • Accidents such as car crashes, falls, burns, drownings, and other injuries
  • Memory and learning problems
  • Unprotected sex
  • Unintentional pregnancies
  • Sexually transmitted infections
  • Stillbirth, miscarriage, and congenital disabilities, including fetal alcohol syndrome
  • Sudden infant death syndrome (SIDS)
  • Violence such as murder, physical assault, sexual assault, domestic violence, child abuse, and suicide
  • Chronic diseases including liver cirrhosis, pancreatitis, and high blood pressure
  • Central nervous system diseases, including dementia and stroke
  • Psychological disorders such as depression and anxiety
  • Heart disease, including abnormal heart rhythm, high blood pressure, congestive heart failure, and coronary heart disease
  • Cancers of the liver, breast, colon, mouth, throat, esophagus, and larynx
  • Alcohol use disorder (AUD)

Defining Alcohol Use Disorder


A 2019 national survey revealed that 14.1 million American adults had some form of AUD in 2019. AUD is a medical diagnosis that encompasses all forms of alcohol misuse: alcohol misuse, alcohol addiction, alcohol dependence, and alcoholism. It is a brain disorder characterized by being unable to control or stop alcohol use despite adverse physical, mental, professional, and social effects.

Medical professionals use the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) to diagnose AUD. Meeting two to three diagnostic criteria can indicate mild AUD. Moderate AUD may be diagnosed when four to five diagnostic criteria are met, while meeting six or more criteria tends to indicate severe AUD.

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Signs and Symptoms of Alcohol Use Disorder

Alcohol misuse manifests in a variety of ways. For some people, it may look like binge drinking on the weekends while drinking moderately on the weekdays. For others, it may mean needing to drink every day just to feel normal.

Some common signs and symptoms of AUD include:

  • Spending a significant amount of time drinking
  • Becoming ill or having adverse effects after a night of drinking (often called a hangover)
  • Wanting an alcoholic drink so badly that you can’t think about anything else
  • No longer participating in hobbies or other activities you enjoy because of your drinking
  • Drinking habits that interfere with your ability to care for your family, home, and keep up with commitments at school or work
  • Continuing drink even though it is causing problems with family or friends
  • Increased tolerance to alcohol and need to consume larger amounts to achieve the same effect
  • Desiring to cut back on drinking or stop completely but being able to do so
  • Consuming more alcohol and/or drinking for longer periods than intended
  • Continuing to drink even when it causes depression, anxiety, memory loss (blackouts), and/or other adverse effects
  • Experiencing withdrawal symptoms when the alcohol wears off, such as sweating, nausea, racing heart, shakiness, restlessness, insomnia, or seizures

Finding Treatment and Support

You have various treatment options available if you are suffering from mild, moderate, or severe AUD. Depending on the severity, duration, and extent of misuse, you may seek inpatient or outpatient treatment. Some binge drinkers stop drinking on their own with very little support, whereas people with AUD typically do need more intensive support.

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Because each person is unique, there is no one-size-fits-all approach to treatment. As a result, treatment may take place over 30, 60, or 90 days. Some programs even last six months, one year, or three to five years, depending on addiction severity and individual needs.

Some evidence-based treatments available include medications such as naltrexone, disulfiram, and Acamprosate, which help to control drinking and prevent relapse. A variety of behavioral treatments are available, including counseling and psychotherapy, which may consist of cognitive-behavioral therapies, mindfulness-based interventions, motivational interviewing, relapse prevention, and coping skills development. Support groups such as Alcoholics Anonymous are common and conveniently available at treatment centers and churches around the country.

If you or a loved one are struggling with AUD, you are not alone. For information on treatment options, contact a treatment support specialist by calling 800-839-1686Who Answers?.

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