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What is Alcoholism?

man holding alcohol bottle

Alcoholism is a commonly used term that describes an impaired ability to limit alcohol use, despite the harmful consequences of continued use.  In this respect, alcoholism meets the definition of addiction. In our topic center on addiction, we define addiction:

Addiction is the repeated involvement with a substance or activity, despite the substantial harm it now causes, because that involvement was (and may continue to be) pleasurable and/or valuable.

Alcoholism is not a diagnostic term recognized by American Psychiatric Association.  The correct diagnostic term would be alcohol use disorder (alcohol addiction).   The process of diagnosing alcohol addiction is discussed here.

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What is alcoholism?

  • Alcoholism is a commonly used term that describes an impaired ability to limit alcohol use, despite the harmful consequences of continued use.
  • In this respect, alcoholism meets the definition of addiction, which is "the repeated involvement with a substance or activity, despite the substantial harm it now causes, because that involvement was (and may continue to be) pleasurable and/or valuable."
  • Alcoholism is not a diagnostic term recognized by American Psychiatric Association. The correct diagnostic term would be alcohol use disorder (alcohol addiction).
  • Like all addictions, the severity of alcohol addiction may range from mild to severe.
  • Alcoholism generally refers to an extreme range of severity, but problems with alcohol use begin long before this degree of severity.
  • In 2011, 15 million people were classified with a substance use disorder for alcohol.
  • Estimates of the total overall costs of substance abuse in the United States, including productivity and health- and crime-related costs, were $235 billion for alcohol.

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What causes alcoholism?

  • There is no one single cause of alcohol addiction. Instead, there are multiple causes that can be grouped into four basic categories.
  • These four categories are: 1) biological causes, 2) psychological causes, 3) socio-cultural causes, and 4) spiritual causes. Psychologists call this the Bio-Psycho-Social-Spiritual Model of addiction.
  • The biological causes of alcohol addiction include each person's unique physiology and genetics.
  • Psychologically, people learn to anticipate some benefit from drinking alcohol even though it is harmful. These benefits can include: 1) stress reduction, 2) relief from boredom, 3) pleasurable sensations, 4) coping with negative feelings or situations, or 4) simply the benefit of avoiding withdrawal symptoms.
  • Socio-cultural influences also contribute to the development of alcohol addiction as it affords opportunities for pleasing social discourse and interaction.
  • Spirituality is another causal factor that can determine whether an addiction develops and flourishes.

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What are the signs and symptoms of alcoholism?

  • The diagnosis of an alcohol use disorder is based upon a pathological set of behaviors related to alcohol use. These behaviors fall into four main categories:
    • Impaired control - 1) Using alcohol for longer periods of time than intended, or using larger amounts than intended; 2) Wanting to reduce alcohol use, yet being unsuccessful doing so; 3) Spending excessive time getting/using/recovering from the alcohol use; 4) Cravings that are so intense it is difficult to think about anything else.
    • Social impairment - 1) People may continue to use alcohol despite problems with work, school or family/social obligations; 2) Someone continues to use alcohol despite having interpersonal problems because of that use; 3) Important and meaningful social and recreational activities may be given up or reduced because of alcohol use.
    • Risky use - 1) someone repeatedly uses substances in physically dangerous situations; 2) Some people continue to use alcohol even though they are aware it is causing or worsening physical and psychological problems.
    • Pharmacological indicators (tolerance and withdrawal) - 1) Tolerance occurs when people need to increase the amount of alcohol to achieve the same desired effect; 2) Withdrawal is the body's response to the abrupt cessation of a alcohol, once the body has developed a tolerance to it.

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How is alcoholism treated?

  • There are four basic approaches to alcoholism treatment: Biological, Psychological, Socio-Cultural, and Spiritual.
  • People can combine these various approaches to match their individual needs and circumstances as they work to develop their own individualized, custom-tailored approach to recovery.
  • Biological approaches to addictions treatment attempt to correct or modify the presumed underlying biological causes of addiction. According to biological models of addiction, a "broken" or damaged brain causes addiction.
  • Psychological approaches to alcoholism recovery aim to increase a person's motivation for change.
  • In addition to changing thoughts, feelings, and behaviors, individuals embracing recovery may also need to restructure their social world.
  • Strengthening the motivation for recovery is very helpful. One such approach is called Motivational Interviewing.
  • There are also several effective types of psychotherapy for addictions. These are: Relapse Prevention Therapy; Contingency Management; Cognitive-Behavioral Therapy; Dialectical Behavioral Therapy; Acceptance and Commitment Therapy.
  • Socio-cultural approaches to addictions recovery emphasize the important influence of social groups on individuals as they attempt to recover. These include: 1) harm reduction strategies such as needle exchange programs, or public campaigns such as designated drivers, 2) family approaches to addictions treatment, and 3) the social support approach to addictions treatment.
  • Spiritual approaches to alcoholism recovery are based on research that has repeatedly demonstrated that spirituality can have a positive effect on recovery from many diseases and disorders. The most well-known spiritual approaches to addictions recovery are the 12-step support groups such as Alcoholics Anonymous (AA).

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