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The American Medical Association (AMA) defines alcoholism as an illness or disease. Cancer Web's medical dictionary defines alcoholism as a disorder characterized by a pathological pattern of alcohol use that causes a serious impairment in social or occupational functioning. A disease is medically defined as an alteration of the state of the body or some of its organs, interrupting or disturbing the performance of vital functions, and causing or threatening pain or weakness. The important thing to note is that alcoholism is not a lifestyle choice. It is a disease, an actual impairment of the body's health that prevents the person from functioning normally and causes not only pain to the alcoholic but also to family and friends.

A few things must be understood to fight and beat the disease:

  • Alcoholism is chronic. It can last a lifetime without help and treatment.
  • Alcoholism is progressive. It will not get better with time and it will not go away. It gets progressively worse and an alcoholic can relapse with only a single drink even after an extended period of sobriety.
  • Alcoholism is incurable. A patient recovered from alcoholism can never go back to "normal" drinking. A "normal" life may resume but only with the permanent and complete abstinence from alcoholic consumption.

Alcoholism results in loss of control. Once a drink is taken after sobriety, the alcoholic cannot control nor predict whether the drinking will be "normal" or "abnormal." The alcohol controls the alcoholic -- not vice versa.

Alcoholism is a disease that is characterized by the following:

  • Craving: A strong need, or compulsion, to drink.
  • Loss of control: The frequent inability to stop drinking once a person has begun.
  • Physical dependence: The occurrence of withdrawal symptoms, such as nausea, sweating, shakiness, and anxiety, when alcohol use is stopped after a period of heavy drinking. These symptoms are usually relieved by drinking alcohol or by taking another sedative drug.
  • Tolerance: The need for increasing amounts of alcohol in order to get "high."

Alcoholism has little to do with what kind of alcohol one drinks, how long one has been drinking, or even exactly how much alcohol one consumes. But it has a great deal to do with a person's uncontrollable need for alcohol.

This description of alcoholism helps us understand why most alcoholics can't just "use a little willpower" to stop drinking. He or she is frequently in the grip of a powerful craving for alcohol, a need that can feel as strong as the need for food or water. While some people are able to recover without help, the majority of alcoholic individuals need outside assistance to recover from their disease. With support and treatment, many individuals are able to stop drinking and rebuild their lives. Many people wonder: why can some individuals use alcohol without problems, while others are utterly unable to control their drinking? Recent research has demonstrated that for many people a vulnerability to alcoholism is inherited. Yet it is important to recognize that aspects of a person's environment, such as peer pressure and the availability of alcohol, also are significant influences. Both inherited and environmental influences are called "risk factors." But risk is not destiny. Just because alcoholism tends to run in families doesn't mean that a child of an alcoholic parent will automatically develop alcoholism.

Alcoholism is a primary, chronic disease with genetic, psychological, and environmental factors influencing its development and manifestations. This disease is often progressive and fatal. It is characterized by continuous or periodic: impaired control over drinking, preoccupation with the drug alcohol, use of alcohol despite adverse consequences, and distortions in thinking, most notably denial.

Primary refers to the nature of alcoholism as a disease entity, in addition to and separate from other patho-physiologic states that may be associated with it. Primary suggests that alcoholism, as an addiction, is not a symptom of an underlying disease state. Primary also implies that when this disease coexists with other conditions, therapies applied to them are ineffective until the alcoholism is dealt with.

Disease means an involuntary disability. It represents the sum of abnormal phenomena displayed by a group of individuals. These phenomena are associated with a specific common set of characteristics by which these individuals differ from the norm and which places them at a disadvantage.

Often progressive and fatal means that the disease persists over time and that physical, psychological, and emotional changes area often cumulative and may progress as drinking continues. Alcohol causes premature death through overdose; organic complications involving the brain, liver, heart, and other organs; and by contributing to suicide, homicide, motor vehicle crashes, and other traumatic events.

Impaired control means inability to limit alcohol use or consistently limit, on any drinking occasions, the duration of the episode, the quantity consumed, and/or the behavioral consequences of drinking.

Preoccupation, in association with alcohol use, means excessive focused attention given to the drug alcohol, its effects, and/or its use. The relative value assigned to alcohol by the individual often leads to diversion of energies away from important life functions.

Adverse consequences are alcohol-related problems or impairments in such areas as: physical health (e.g., alcohol withdrawal symptoms, liver disease, gastritis, anemia, pancreatic and neuralgic disorders); interpersonal functioning (e.g., marital problems, child abuse, impaired social relationships); occupational functioning (e.g., scholastic or job problems); and legal, financial, or spiritual problems.

Denial is used here not only in the psychoanalytic sense of a single psychological defense mechanism disavowing the significance of events, but more broadly to include a range of psychological maneuvers designed to reduce awareness of the fact that alcohol use is the cause of an individual's problems rather than a solution to those problems. Denial becomes an integral part of the disease and a major obstacle to recovery.

What Is Alcohol Abuse?

Alcohol abuse differs from alcoholism in that it does not include an extremely strong craving for alcohol, loss of control, or physical dependence. In addition, alcohol abuse is less likely than alcoholism to include tolerance (the need for increasing amounts of alcohol to get "high"). Alcohol abuse is defined as a pattern of drinking that is accompanied by one or more of the following situations within a 12-month period:

  • Failure to fulfill major work, school, or home responsibilities;
  • Drinking in situations that are physically dangerous, such as while driving a car or operating machinery;
  • Recurring alcohol-related legal problems, such as being arrested for driving under the influence of alcohol or for physically hurting someone while drunk;
  • Continued drinking despite having ongoing relationship problems that are caused or worsened by the effects of alcohol.

While alcohol abuse is basically different from alcoholism, it is important to note that many effects of alcohol abuse are also experienced by alcoholics.

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Date of Last Update: 07/27/12