In our current drinking culture, it can be difficult to find the line between going out and having "crazy nights" and having a potential alcohol addiction, while still managing to stay responsible with work and life duties. But there are number of differences that can distinguish what is considered binge drinking from what is considered high-functioning alcoholism, as each has their own set of root issues, symptoms, and treatment plans. They can look similar from the outside, but knowing the difference can help you or someone else get the best type of health they need.
"On the surface, the behavior of alcoholics and binge drinkers appears very similar: excessive drinking and the inability to control their drinking," Kristin Wilson, MA, LPC, Vice President of clinical outreach at Newport Academy, tells Bustle. "Both types may appear to be the life of the party, even though the mechanisms underlying the drinking are different. Furthermore, binge drinking and alcoholism (even high-functioning alcoholism) have very similar short-term consequences, including greater risk of accidents, death, violence, and injury; and long-term consequences, including damage to relationships, serious health conditions, and a greater risk of legal problems."
Although they can look the same, these two conditions do have their own distinguishing features. Here are five differences between binge drinking and high-functioning alcoholism, according to experts.
1. Physical Dependence
Binge drinkers and high-functioning alcoholics differ in whether or not they are physically dependent on alcohol. "Alcoholics are addicted to alcohol, meaning that they are physically dependent and feel ongoing, intense cravings to drink," says Wilson. "Binge drinkers are not usually physically dependent. In addition, binge drinking does not necessarily indicate future alcoholism, though it may increase the risk, according to some researchers."
2. How Much They Drink
Binge drinking is defined by the number of drinks consumed, enough to raise the drinker’s blood alcohol content to .08 or higher over a couple of hours, according to the National Institute on Alcohol Abuse and Alcoholism (NIAAA). "This is usually quantified as five or more drinks for men, and four or more drinks for women, in two hours or less time," says Wilson. "The criteria for alcoholism are not defined by quantity, but rather by physical dependence, tolerance, preoccupation with drinking, and distress associated with drinking."
3. How Often They Drink
Frequency of drinking can also help distinguish between someone who is a binge drinker or someone who is an alcoholic. "Binge drinkers are not readily identified as alcoholics because the frequency of drinking may be very low, so they may be able to keep their binges to themselves or within a small group of people," Jeremy Pitzer, LCSW, CEO of The Oaks at La Paloma, tells Bustle. "Functional alcoholics usually have ritualized drinking habits (picking up a beer after work, a cocktail before dinner, beginning to drink at a certain time, etc.) and will work to maintain the ritual at any cost.
3. The Situations Where Drinks Are Consumed
Where and when someone chooses to drink alcohol can also distinguish between a binge drinker or a high-functioning alcoholic. "While alcoholics may drink alone, drink in the morning, and/or drink secretively, binge drinkers almost always consume alcohol in social situations," says Wilson.
4. Control/Ability To Stop
Unlike someone who is an alcoholic, a binge drinker may have an easier time cutting down on drinking. "People who abuse alcohol drink too much on a regular basis," Mae Casanova, PsyD and Director of Admissions at Casa Palmera Treatment Center, tells Bustle "Their abuse can be self-destructive or dangerous to others, but they are still able to demonstrate some control over their drinking and set limits."
On the flip side, alcoholism occurs when drinking alcohol becomes essential in order to function. "Unlike alcohol abusers, alcoholics will experience uncontrollable drinking, craving, physical dependence, and tolerance," Dr. Bruce Figuered, PhD and Clinical Director at Casa Palmera Treatment Center, tells Bustle. "An alcoholic will be unable to stop drinking despite severe physical and psychological consequences."
5. Treatment Methods
Both conditions also differ in how they are treated. "Binge drinking typically involves a brief intervention that might include sessions with an addiction recovery counselor, support groups, and complementary therapies," says Wilson. "Alcoholism requires a structured, long-term approach to sustainable healing."
Both binge drinking and high-functioning alcoholism can be dangerous, so it's important to seek out treatment for either when necessary.
Editor's Note: If you or someone you know are experiencing difficulties with alcohol addiction, call the Substance Abuse and Mental Health Services Administration's National helpline at 1-800-662-HELP (4357) or visit www.samhsa.gov.