The Disease of Alcoholism

The Disease of Alcoholism


Care Addiction has developed effective alcoholism treatment programs. The first step is to be informed. This article helps shed light on the disease, and may help determine if you or your loved one should seek treatment.

Alcoholism is a chronic disease marked by physical dependence, increasing tolerance, cravings, continued use despite physical, psychological, or interpersonal problems, and/or an inability to limit the amount consumed. Alcohol dependence is distinguished from alcohol abuse, which is manifested by similar symptoms of alcoholism but without increasing tolerance and physical dependence.

Health care professionals have viewed alcoholism as a disease for more than 50 years. In 1959, the American Medical Association officially declared alcoholism a disease.The World Health Organization followed suit in 1969 when it too classified alcoholism as a disease.

“Alcoholism is a primary, chronic disease with genetic, psychosocial, and environmental factors influencing its development and manifestations,” wrote a 23-member multidisciplinary committee on the National Council on Alcoholism and Drug Dependence and the American Society of Addiction Medicine in 1992. “The disease is often progressive and fatal. It is characterized by impaired control over drinking, preoccupation with the drug alcohol, use of alcohol despite adverse consequences, and distortions in thinking, most notably denial. Each of these symptoms may be continuous or periodic,” the group went on to say.

Characterizing alcoholism as “primary” simply means it is an illness in and of itself; it is not caused by something else nor is it the symptom of an underlying disease. “Chronic” means the disease of alcoholism cannot be cured, though it can be treated and held in check if the addicted person learns and employs specific recovery practices. “Progressive” means the illness runs a predictable course, will worsen over time and will not just disappear. Finally, alcoholism is often fatal because the damage done to internal organs, especially the heart, liver and brain are cumulative and frequently lead to premature death. In addition, alcohol addiction is a major contributing factor in many cases of suicide, homicide and accidents.

Why some people drink and become alcoholic while others drink and do not is not completely understood. However, certain factors do appear to influence a person’s chances of becoming addicted, including genetics, personality and environment. Alcoholism often runs in families. Increasingly, scientists are discovering specific genetic variations that appear to increase a person’s susceptibility to addiction. Scientists from the University of Michigan Health System located a genetic mutation that is associated with impulse control, craving, anxiety and alcoholism. The results, published online April 12, 2011, in Molecular Psychiatry, suggests variations to a particular gene increase a person’s risk of developing alcoholism by altering a portion of the brain known as the insula. Other studies involving identical twins and adoptive parents support the belief that genes play a crucial role in the development of alcoholism. Adopted children with one or more biological parents who are alcoholic are much more likely to become alcoholic themselves even if the parents who raised them do not drink. Likewise, adopted children who do not have a genetic predisposition to alcoholism are at low risk of becoming alcoholic even if they are raised by parents who are addicted.

A person’s psychological makeup and home environment also play key roles. There is a high correlation between certain mental illnesses and alcoholism but one does not cause the other. Environmental factors that put genetically predisposed people at greater risk include coming from a chaotic home; being the victim of physical, sexual or emotional abuse; academic failure; poor social skills; and early use.

According to the National Institute of Health, approximately 15 percent of the people living in the United States are problem drinkers. Among that 15 percent, 5-10 percent of the males and 3-5 percent of the females are considered alcoholic. Between 38-50 percent of all hospital admissions are chemically related and up to 60 percent of all fatal car accidents involve alcohol. More than half of all violence in the U.S. is alcohol or drug related.

Knowing when drinking alcohol has shifted from a social enjoyment to a medical problem is not always easy. Symptoms for the disease, as presented in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-R) describes alcoholism as a “maladaptive pattern of alcohol use, leading to clinically significant impairment or distress, as manifested by three (or more) of the following, occurring at any time in the same 12-month period:

  1. Tolerance, as defined by either of the following:
    1. Need for markedly increased amounts of alcohol to achieve Intoxication or desired effect
    2. Markedly diminished effect with continued use of the same amount of alcohol
  2. Withdrawal, as manifested by either of the following:
    1. The characteristic withdrawal syndrome for alcohol
    2. Alcohol (or a closely related drug such as valium) is used to relieve or avoid withdrawal symptoms
  3. Alcohol is often used in larger amounts or over a longer period than was intended
  4. There is a persistent desire or unsuccessful efforts to cut down or control alcohol use
  5. A great deal of time is spent in activities necessary to obtain alcohol, use alcohol, or recover from its effects
  6. Important social, occupational, or recreational activities are given up or reduced because of alcohol use
  7. Alcohol use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by alcohol (e.g. continued drinking despite recognition that an ulcer was made worse by alcohol consumption)

While many assessments are available to help determine whether a person has alcoholism, the CAGE Assessment for Alcohol Abuse is a four-item, quick and accurate preliminary screening:

  1. Have you ever felt the need to Cut down on your drinking?
  2. Do you feel Annoyed by people complaining about your drinking?
  3. Do you ever feel Guilty about your drinking?
  4. Do you ever drink an Eye-opener in the morning to relieve shakes?

Two or more affirmative responses suggests the person is a problem drinker.



One Response to “The Disease of Alcoholism”

Leave a Reply

Please log in using one of these methods to post your comment: Logo

You are commenting using your account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

This site uses Akismet to reduce spam. Learn how your comment data is processed.

%d bloggers like this: