Alcohol is one of the most commonly abused substances in America today. It is legal for adults over age 21, easy to obtain and fairly inexpensive. Alcohol consumption is socially accepted and even promoted widely by the media. In 2012, as many as 87.6 percent of American adults over age 18 were reported in a SAHMSA study to have consumed alcohol at some point in their lives. Many of these people are considered light or moderate drinkers, but many also engage in binge drinking episodes.
According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), binge drinking raises your blood alcohol concentration levels to 0.08. Binge drinking is defined as consuming more than four drinks in a two-hour sitting for a woman and five in a sitting for a man. Even those engaging in binge drinking may not have a drinking problem necessarily.
It’s often considered customary to attend a party or social setting and drink, and sometimes even drink too much. So when does the problem occur?
Definition of Alcoholism
The NIAAA defines an alcohol use disorder, or AUD, as a diagnosable medical condition in which an individual’s alcohol consumption causes harm or distress. The AUD most are familiar with is alcoholism.
Symptoms of alcoholism include:
- Physical craving or urge to drink
- Dependence that includes withdrawal symptoms when drinking is stopped
- Increased tolerance levels in which more alcohol is required to obtain the same effects
- Inability to control or stop drinking once started
An addict’s life is often centered around their drug of choice, which in the case of an alcoholic is alcohol. They spend much of their time figuring out how to obtain it, drinking it, and recovering from its effects. They also do this at the expense of pretty much everything and everyone around them.
Jobs suffer as do relationships friends and family members, and often alcoholics are in trouble with the law. The National Institutes of Health estimated that 17 million adults in the United States in 2012 had an alcohol use disorder.
Alcoholism as a Disease
Toward the end of the 19th century and the beginning of the 20th century, addicts were often viewed as morally wrong and even shunned as being bad people or sinners. This type of thinking led many physicians of the time to fight to change common perceptions and try to help addicts instead of punish them.
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The formation of AA – Alcoholics Anonymous – in the 1930s and the publication of noted psychiatrist and Director of the Center of Alcohol Studies at Yale Medical School E. M. Jellinek’s famous book defining the concept of alcoholism as a medical disease facilitated moving alcoholism into a different light.
Jellinek is often called the father of the disease theory or model of alcoholism. His theory listed alcoholism as having stages that drinkers progressively passed through.
These stages are:
- Pre-alcoholic phase, which includes social drinking when drinkers often start to develop a tolerance for alcohol and drink to relieve stress or feel better
- Prodromal phase, also considered the early-alcoholic stage where blackouts begin to occur, the drinker begins to drink alone and in secret, and thinks about alcohol frequently while their alcohol tolerance continues to grow
- Crucial phase characterized by a spiral of out-of-control drinking at inappropriate times and problems with daily life and relationships as well as physical changes to the brain and body
- Chronic phase which includes daily drinking, drinking as the main focus of life, health problems cropping up, cravings and withdrawal symptoms, and physical and mental long-term alcohol abuse issues
Alcohol works largely as a depressant on the central nervous system and due to the relatively small size of alcohol molecules, it can affect many parts of the brain and body simultaneously. Alcohol changes brain chemistry, initially increasing neurotransmitters that drive the brain’s pleasure centers, but over time and with chronic abuse, depleting them. As the tolerance to alcohol increases, the abuser must take in more in order to feel the effects, which further damages both the body and brain.
The National Council on Alcoholism and Drug Dependence likens alcohol dependence – alcoholism – to a medical illness through the disease model. The disease model of alcoholism depends on it being a physical addiction that cannot be controlled, distinguishable by specific symptoms and requiring specialized medical treatment. Cycles of physical cravings and withdrawal symptoms, including shaking, sweating, nausea and dizziness, are part of the reason alcoholism has been classified as a physical disease.
As alcoholism is an addiction, it is considered a disease of the brain. The brain has been physically altered by extended exposure to alcohol, causing it to function differently and therefore creating addictive behavior.
This disease model may not take into account the reasons some people become addicted and others do not. Cultural and environmental factors need to be considered, as do traumatic events. Compounding on this disease model, the theory of addiction being genetic or hereditary was born. This theory states that addicts may have certain predispositions to addiction, or genes that may help determine whether or not a person becomes an alcoholic.
Many believe that it is a combination of genes and environmental stimuli that actually lead to addiction. Still others argue that addiction is a psychological symptom and not necessarily a physical disease.
Treatment for Alcoholism
Labeling alcoholism as a disease instead of merely deviant behavior can make medical treatment more accessible. Many medical facilities as well as insurance carriers recognize addiction as a physical malady that needs to be treated. Also the term “disease” carries implications of a chronic illness but also gives hope for treatment. It also implies that, like many other diseases, relapse is common and nothing to be ashamed of.
According to The New York Times, 80 to 90 percent of people treated for alcohol dependency relapse at some point. The initial disease model also indicates that alcoholism is incurable and irreversible with abstinence being the only answer. While still widely believed, this concept is debated by some in the addiction field as more research begins to surface.
A diagnosis of alcoholism can be scary but it does not mean that treatment and help are not readily available. Staying sober requires diligence and support. The trained professionals at our Foundations Recovery Network centers can help alcoholics to identify social, emotional and environmental triggers. Many alcoholics also suffer from mental health disorders as well, making getting well seem that much more daunting.
Dual diagnosis treatment works to treat the whole person, not just the addiction.
Both group and individual therapy can be important components of a customized treatment program for you or your loved one. According to the disease model of alcoholism, peer support is imperative as well. Please call now to talk with one of our admissions coordinators about how dual diagnosis treatment can help start a new life in recovery.
Further Reading About Disease Theory of Alcoholism
- Abuse and Pregnancy
- Alcohol in America
- Alcoholism and Anxiety Disorder
- Alcoholism Nature vs. Nurture
- Are Heavy Drinkers Alcoholics?
- Binge Drinking and Depression
- Dilated Cardiomyopathy
- Disease Theory of Alcoholism
- Guide to Living With an Alcoholic
- Historical Figures and Addiction
- Is There a Cure for It?
- Liver Damage Caused by Drinking
- Long-Term Health Risks Associated
- Risks of Alcohol Poisoning
- The Science of a Hangover
- Using a Breathalyzer at Home
- What Is a Functional Alcoholic?
- What Is Wet Brain?
- Women and Alcoholism
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David W. Newton is a board certified pharmacist and also has been a board member for boards of examiners for the National Association of Boards of Pharmacy since 1983. His areas of expertise are primarily pharmaceuticals as well as cannabinoids. You can read an article about his expertise in CBD on the National Library of Medicine.