Introduction to Alcoholism

The term "alcoholism" refers to a “disease” known as alcohol dependence syndrome, the most severe stage of a group of drinking problems which begins with binge drinking and alcohol abuse.
Note: The following definitions and verbage was quoted from about.com:Alcoholism. To read the orginal transcript and other interesting articles on a variety of subjects vist their website at http://alcoholism.about.com . As a Christ Centered Addiction Specialists, we do not recognize substance abuse as a disease but instead, an “illness” of the soul and spirit which in turn can lead to diseases of the liver, kidneys, and etc. Through out this presentation we will slightly alter the author’s original statement of disease to include illness.




Types of Alcohol Problems

Alcohol problems occur at different levels of severity, from mild and annoying to life-threatening. Although alcohol dependence (alcoholism) is the most severe stage, less severe drinking problems can also be dangerous.

Binge Drinking
Officially, binge drinking means having five or more drinks in one session for men and four or more for women. Another definition for binge drinking is simply drinking to get drunk. It is the most common drinking problem for young people, under age 21.

Alcohol Abuse
Binge drinking turns into alcohol abuse when:

• someone's drinking begins to cause problems and the drinking continues anyway.
• Alcohol abuse is when someone continues to drink in spite of continued social, interpersonal or legal difficulties.
• Alcohol abuse can result in missing time at school or work, neglecting child or household responsibilities or trouble with the law.

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.

Problem Drinkers

Many people who have a problem with alcohol are not alcoholics, and in order to quit drinking they do not necessarily need medical treatment, peer group support, or a spiritual awakening. In fact, most of the people who decided to stop drinking --for whatever reason -- do so without any outside help. They simply make up their minds to stop or modify their drinking patterns. Many one-time heavy drinkers merely "grow up" and change their behaviors. Others may have a particularly embarassing or frightening experience and swear off.

A survey by the University of Toronto revealed that more than 70 percent of recovered problem drinkers said they overcame their alcohol troubles without formal treatment. A similar study in the United States by Psychiatrist George Vaillant, at Cambridge Hospital in Massachusetts, reported that of those who either quit or cut back drinking, 75 percent did so without benefit of treatment or A.A. These findings are consistent with published studies on the About.com Smoking Cessation Site, which indicate that 80 to 90 percent of successful quitters give up cigarettes without professional help. In other words, if you have a drinking problem, there is a chance that you can do something about it without expensive medical help and without attending any meetings.
Even those drinkers who have become chemically dependent upon alcohol -- daily drinkers -- may not actually be suffering from the alcoholism, according to these studies. Such a drinker may need initial medical assistant to get through the detoxification period, but may be able to remain sober after detox without further assistance.

Alcohol Dependence

Alcohol abuse becomes alcohol dependence when drinkers begin to experience a craving for alcohol, a loss of control of their drinking, withdrawal symptoms when they are not drinking and an increased tolerance to alcohol so that they have to drink more to achieve the same effect. Alcohol dependence is a chronic and often progressive disease/illness that includes a strong need to drink despite repeated problems.

But It Doesn't Act Like a Disease/Illness!

One of the difficulties in recognizing alcoholism as a disease/illness is it just plain doesn't seem like one. It doesn't look, sound, smell and it certainly doesn't act like a disease. To make matters worse, generally it denies it exists and resists treatment.

Alcoholism has been recognized for many years by professional medical organizations as a primary, chronic, progressive and sometimes fatal disease. The National Council on Alcoholism and Drug Dependence offers a detailed and complete definition of alcoholism, but probably the most simple way to describe it is "a mental obsession that causes a physical compulsion to drink."

Mental obsession? Did you ever wake up in the morning with a song playing over and over in your head? It might have been a commercial jingle you heard on television, or a song from the radio, but it kept playing ... and playing and playing.

Mental Obsession

Remember what that was like? No matter what you did, that silly tune kept on playing. You could try to whistle or sing another song or turn on the radio and listen to another tune, but the one in your head just kept on playing. Think about it. There was something going on in your mind that you didn't put there and, no matter how hard you tried, couldn't get out!

That is an example of a simple mental obsession -- a thought process over which you have no control. Such is the nature of the "disease" of alcoholism. When the drinking "song" starts playing in the mind of an alcoholic, he is powerless. He didn't put the song there and the only way to get it to stop is to take another drink.

The problem is the alcoholic's mental obsession with alcohol is much more subtle than a song playing in his mind. In fact, he may not even know it's there. All he knows is he suddenly has an urge to take a drink -- a physical compulsion to drink.

Progressive Disease/Illness
Compounding the problem is the progressive nature of the disease/illness. In its early stages, taking one or two drinks may be all it takes to get the "song" to stop. But soon it takes six or seven and later maybe ten or twelve. Somewhere down the road the only time the song stops is when he passes out.

The progression of the disease/illness is so subtle and usually takes place over such an extended period of time, that even the alcoholic himself failed to notice the point at which he lost control -- and alcohol took over -- his life.

No wonder denial is an almost universal symptom. For those who have come to the realization that they do have a problem, help may be as close as the white pages of the telephone directory. But for those who need help and do not want it, intervention may be the only alternative.

Q&A About Alcoholism

Question: What Do We Mean By Alcoholism?
Answer: Alcoholism, also known as "alcohol dependence," is a disease/illness that includes alcohol craving and continued drinking despite repeated alcohol-related problems, such as losing a job or getting into trouble with the law. It includes four symptoms:

Craving -- A strong need, or compulsion, to drink.
Impaired control -- The inability to limit one's drinking on any given occasion.

Impaired control -- The inability to limit one's drinking on any given occasion.

Physical dependence -- Withdrawal symptoms, such as nausea, sweating, shakiness, and anxiety, when alcohol use is stopped after a period of heavy drinking.

Tolerance -- The need for increasing amounts of alcohol in order to feel its effects. Tolerance

Alcohol Abuse vs. Alcohol Dependence

Q: What is the difference between alcohol abuse and alcohol dependence?
A: Alcohol abuse is described as any "harmful use" of alcohol.

The Diagnostic and Statistical Manual of Mental Disorders IV describes alcohol abusers as those who drink despite recurrent social, interpersonal, and legal problems as a result of alcohol use. Harmful use implies alcohol use that causes either physical or mental damage.

Those who are alcohol dependent meet all of the criteria of alcohol abuse, but the will also exhibit some or all of the following:

• Narrowing of the drinking repertoire (drinking only one brand or type of alcoholic beverage).
• Drink-seeking behavior (only going to social events that will include drinking, or only hanging out with others who drink).
• Alcohol tolerance (having to drink increasing amounts to achieve previous effects).
• Withdrawal symptoms (getting physical symptoms after going a short period without drinking).
• Drinking to relieve or avoid withdrawal symptoms (such as drinking to stop the shakes or to "cure" a hangover).
• Subjective awareness of the compulsion to drink or craving for alcohol (whether they admit it to others or not).
• A return to drinking after a period of abstinence (deciding to quit drinking and not being able to follow through).

Typically, those drinkers who are diagnosed as only alcohol abusers can be helped with a brief intervention, including education concerning the dangers of binge drinking and alcohol poisoning. Those who have become alcohol dependent generally require outside help to stop drinking, which could include detoxification, medical treatment, counseling and/or self-help group support.

Is Alcoholism Inherited?

Alcoholism tends to run in families and a vast amount of scientific research indicates that genetics play a role in developing alcohol problems. But research also shows that a person's environment and peer influences also impact the risk of becoming alcohol dependent. Although a massive amount of scientific research indicates heredity plays some role in developing alcoholism, having a family history of alcoholism does not doom a person into becoming an alcoholic. The genetic tendencies can be overcome.

Points of Interest

1. Officially, binge drinking means having five or more drinks in one session for men and four or more for women.
2. Binge drinking is the most common drinking problem for young people under age 21.
3. Alcohol abuse differs from alcoholism in that it does not include an extremely strong craving for alcohol, loss of control of physical dependence.
4. Many people who have a problem with alcohol are not alcoholics.
5. Alcohol abuse becomes alcohol dependence when drinkers begin to experience a craving for alcohol and a loss of control of their drinking.
6. Alcoholism is a mental obsession that causes a physical compulsion to drink.
7. The progression of alcoholism is subtle.
8. The Four Symptoms of Alcoholism are
   (A.) Craving;
   (B.) Impaired Control;
   (C.) Physical dependence; Tolerance.

CONGRATULATIONS! You have finished the first lesson in Module 2. Continue to Mod2/Lesson 2 for more about Alcohol and Drug Abuse.

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