Alcoholism is a broad term for problems with alcohol, and is generally used to mean compulsive and uncontrolled consumption of alcoholic beverages, usually to the detriment of the drinker’s health, personal relationships, and social standing. It is medically considered a disease, specifically an addictive illness. In psychiatry several other terms have been used, specifically “alcohol abuse”, “alcohol dependence,” and “alcohol use disorder” which have slightly different definitions.[1] Alcohol misuse has the potential to damage almost every organ in the body, including the brain. The cumulative toxic effects of chronic alcohol abuse can cause both medical and psychiatric problems.[2]
The American Medical Association considers alcoholism as a disease[3][4]:452 and supports a classification that includes both physical and mental components.[5]:33 The biological mechanisms that cause alcoholism are not well understood. Social environment, stress,[6] mental health, family history, age, ethnic group, and gender all influence the risk for the condition.[7][8] Significant alcohol intake produces changes in the brain’s structure and chemistry, though some alterations occur with minimal use of alcohol over a short term period, such as tolerance and physical dependence. These changes maintain the person with alcoholism’s compulsive inability to stop drinking and result in alcohol withdrawal syndrome if the person stops.[9] Identifying alcoholism may be difficult for those affected because of the social stigma associated with the disease that causes people with alcoholism to avoid diagnosis and treatment for fear of shame or social consequences. The evaluation responses to a group of standardized questioning is a common method of diagnosis. These can be used to identify harmful drinking patterns, including alcoholism.[10] In general, problem drinking is considered alcoholism when the person continues to drink despite experiencing social or health problems caused by drinking.[11]
Treatment of alcoholism takes several steps. Because of the medical problems that can be caused by withdrawal, alcohol detoxification should be carefully controlled and may involve medications such as benzodiazepines such as diazepam.[12] People with alcoholism also sometimes have other addictions, including addictions to benzodiazepines, which may complicate this step.[13] After detoxification, other support such as group therapy or self-help groups are used to help the person remain sober.[14][15] Thombs (1999) states according to behavioural sciences alcoholism is described as a “maladaptive behaviour”. He explains this must not be confused with “misbehaviour”. Behavioural scientists explain that addicts have a behaviour pattern that may lead to destructive consequences for themselves, their families and society. This does not label addicts as bad or irresponsible.[16] Compared with men, women are more sensitive to alcohol’s harmful physical, cerebral, and mental effects.[17]
In 1979, an expert World Health Organization committee discouraged the use of “alcoholism” in medicine, preferring the category of “alcohol dependence syndrome”.[18] In the 19th and early 20th centuries, alcohol dependence in general was called dipsomania, but that term now has a much more specific meaning.[19] People with alcoholism are often called “alcoholics”. Many other terms, some of them insulting or informal, have been used throughout history. The World Health Organization estimates that there are 140 million people with alcoholism worldwide.
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