Alcohol abuse and alcohol dependence are maladaptive patterns of drinking that cause repeated, serious problems for the drinker. Alcohol dependence is currently defined in the Diagnostic and Statistical Manual of Mental Disorders4 (DSM-IV-TR, henceforth DSM-IV) as meeting at least 3 of 7 criteria (Table 1). Alcohol abuse is defined by meeting two of four criteria but not meeting criteria for dependence; abuse criteria are often met on the path to dependence. Based on data from the 2001-2002 National Epidemiological Survey on Alcohol and Related Conditions (NESARC), a large general population sample from the US, in any one year 3.8% of Americans meet DSM-IV criteria for alcohol dependence and an additional 4.7% meet DSM-IV criteria for abuse5. A follow-up study in 2004-2005 showed 4.4% of Americans met these criteria for alcohol dependence and an additional 5.3% met criteria for alcohol abuse6, 7. When considering lifetime risk for alcohol use disorders, the rates are higher: 12.5% of individuals meet criteria for alcohol dependence at some stage during their life, and another 17.8% meet criteria for alcohol abuse5.
