Yet because it’s impossible to determine which college bingers will moderate after graduation and who will go on to have lifetime problems, the distinction between abuse and dependence is difficult to pinpoint. The reality is that most college binge drinkers and drug users don’t develop lifelong problems. But most addiction treatment programs encourage them to see themselves as having a chronic, relapsing disease that requires a lifetime of attendance at 12-step meetings to keep in check. Currently, about 31% of college students meet criteria for “alcohol abuse,” while only 6% have the alcoholism-equivalent diagnosis of dependence.

Earlier editions of the DSM explicitly said there are alcohol and other drug problems that legitimately exist but do not reach the level of addiction; Alcoholics Anonymous itself differentiates between “problem drinkers” who can learn to moderate and alcoholics who can’t. DSM 5 obliterates the distinction. If the change is finalized, anyone whose drinking or drug use creates any problems will essentially be an addict or alcoholic with a “mild” case of the disease and presumably, therefore, not someone who can learn control over his habits.