Alcoholism is a specific type of addiction. Like all addictions, there are varying degrees of severity. Note that the American Psychiatric Association's Diagnostic Manual, DSM-5 (APA, 2013) does not use the word alcoholic. As such, it has no diagnostic meaning. Nonetheless, most people are familiar with the term "alcoholic." It is often used to describe severe alcohol use disorders. Risky or problematic drinking occurs long before this level of severity and most certainly does require attention.
Alcohol is the most widely used (and overused) substance (drug) in the United States. The majority of people who drink are able to drink in moderation. We might call these people occasional, light, or moderate drinkers. They have never met diagnostic criteria for an alcohol use disorder. However, about 7% of the people in the United States DO meet these diagnostic criteria (NIAAA, 2004; Miller, Forcehimes and Zweben, 2011). In addition, about 20% of men and 10% of women drink more than the recommended moderation guidelines. The interested reader may find it helpful to review these guidelines published by National Institute on Alcohol Abuse and Alcoholism:
The identification of problematic or "risky" drinking is a complex one. This is because individual drinking patterns change over time. Moreover, many of the people in the "high risk" category do not consider themselves "alcoholic." Therefore, they falsely conclude they do not need to pay attention to their drinking (Doyle & Nowinski, 2012).
Moderation guidelines are based on the number of drinks per day, and the total number of drinks per week. A drink equal a 12 oz. beer, or a 5 oz. glass of wine, or a 1.5 oz. shot of liquor. For men, the maximum limits are: a) no more than 4 drinks in a day, and b) no more than 14 drinks per week. For women, the maximum limits are: a) no more than 3 drinks in a day, and b) no more than 7 drinks per week. For some people moderation is extremely difficult to maintain. They end up over-drinking. These people may go on to develop an alcohol use disorder. Withdrawal from alcohol use can begin 4-12 hours after stopping or reducing heavy use. Symptoms of alcohol withdrawal are often extremely unpleasant. It may include sensations such as sweating; tremor; insomnia; nausea/vomiting; hallucinations; agitation; anxiety; and even seizures. In severe and untreated cases, alcohol withdrawal may result in death. Consult with a physician prior to discontinuing heavy alcohol use.