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The American Medical Association (AMA) offers the following definition for alcoholism: “a primary, chronic disease with genetic, psychosocial, and environmental factors influencing its development and manifestations.” The definition as a disease is contentious but generally accepted. Alcoholics have changes to the ways their brains are wired. This has been demonstrated and there is a clear physical dependence that is very similar to other forms of addiction.
Any alcoholism definition, as they do vary, will include the following:
Generally, any alcoholism definition states that if a person were to stop drinking alcohol, they would suffer withdrawal symptoms. In practical terms, the definition of alcoholism includes problems caused by excessive and/or too frequent drinking.
Abusing alcohol is not the same as being an alcoholic. Some people abuse alcohol regularly but cannot be considered an alcoholic because they do not develop a physical or psychological dependence. The impact of alcohol abuse is considerable but it is a separate issue. Alcohol abuse can involve drinking too much, maybe even requiring hospitalization, or causing similar damage. However, alcoholism is alcohol abuse on a regular long-term scale–consistent alcohol abuse. Someone suffering from alcoholism has a different pattern of drinking, involving more drinks per week, than an occasionally abuser of alcohol.
According to one estimate, in the United States, of the people who died in 2012, about 5.9% were killed from drinking alcohol. In Europe, excessive alcohol drinking is the third biggest killer and cause of ill health; it is the leading preventable cause of death. In the UK, deaths from liver diseases related to alcohol consumption has increased fivefold since the 1950’s.
Millions of lives are ruined by alcoholism directly. Millions more are negatively impacted by the general effects of the disease. Alcohol addiction is associated with a higher risk of violence and mental health problems.
Alcoholism is often the result of trauma or abuse, and the disease burden of alcoholism is massive. Roughly 20% of people admitted to hospitals are alcohol dependent. The costs of alcoholism for society are reaching billions of dollars lost in GDP growth. These cases use medical resources that could be used to treat non-preventable conditions. Prisons and mental health facilities are packed with people who did regrettable things while under the influence of alcohol.
Whether someone can be defined as an alcoholic is relative. In past centuries, most people drank weak beer or wine in the West because it was safer than water. They would not have been considered alcoholics (though they certainly suffered the effects of long-term alcohol consumption) at the time.
Some cultures drink more than others. Many cultures drink differently to others. For example, the British drink episodically on weekends and at parties, whereas the French will drink more regularly with meals. It is believed that heavy, episodic drinking presents a much higher risk of morbidity than lower levels of regular consumption. Everyone has a different alcohol tolerance.
Are You an Alcoholic?
Alcoholism comes in many forms. Some alcoholics are much harder to spot than the stereotypical down-and-out alcoholic roaming the streets begging for change for their next drink. In fact, most alcoholics manage to live relatively normal lives. These alcoholics are defined as high-functioning alcoholics.
Just because many people can incorporate alcoholism into their daily lives in a relatively unobtrusive way does not mean that they are not doing themselves and others harm. The list of medical conditions that result from alcoholism is long, but here are a few of the most common short-term and long-term effects:
Becoming dependent on alcohol is relatively easy. The social effects of alcohol–like helping people relax–can become a crutch very quickly. Believing you need alcohol to be social or fun is a common delusion (alcohol enhances some behaviors, but it does not change your personality). Escapism is another reason people become alcoholics, alcohol has an ability for many people to numb emotional distress. Of course, this does not deal with the underlying reasons the person wants to escape from, so alcohol is needed continuously to alleviate the feelings or they return.
There are a few risk factors. Alcohol dependence runs in families, indicating it has a strong genetic component. Attitudes, culture, and environment are very important too. It is impossible to say alcoholism runs in families because of genes more than environment or vise versa.
Recognizing Alcohol Dependence
If you are always worried about when you can start drinking, this is a clear sign that you have become alcohol dependent. Planning your life around alcohol instead of family, work, and play is another sign. Drinking shortly after waking up or wanting to. Anxiety, depression and suicidal thoughts are common because of the disruption alcohol causes in the brain.
Physical alcohol withdrawal symptoms if you have not had a drink are the most obvious signs of alcoholism. Withdrawal symptoms include:
If these symptoms stop when you have some alcohol, they are strong indicators. If you cannot go for more than a day without alcohol, you are most likely an alcoholic.
Treating Alcohol Dependence
There are a wide variety of treatments available for alcoholism. The first step is to get a diagnosis. A doctor will help you examine your symptoms, results, and possible causes of your alcohol use. They will be able to direct you in the direction of appropriate treatment.
There are drugs that make the user ill if they drink alcohol, but they require the user to remember to take them. Talking therapies like cognitive behavioral therapies work in many cases.
One area of particular interest is the use of psychedelic medications. Evidence has shown that small doses of drugs like psilocybin can be more effective than other treatments by a substantial margin. There has also been recent interest on using medical cannabis to treat alcoholism.