Up until the twentieth century the word alcoholism did not exist. Those who appeared to have no control over their alcohol intake were classified as being dipsomaniacs. This was not viewed as a type of medical condition but instead as a moral failing. Up until a hundred years ago the common belief was that alcoholics were just bad people. The views on alcoholism have changed a great deal in the last century. It is no longer widely believed that the alcoholic is fully responsible for their drinking. In the US the common perception is that alcoholism is a treatable disease.
Alcoholism is used to describe a situation where an individual has developed a physical and psychological dependence on alcohol. This person is no longer drinking simply because they like to engage in this behavior. If they don’t drink they will begin to feel unwell, and they will also have a compulsion that drives them to keep engaging in this type of substance abuse. Once a person has become an alcoholic they will never be able to regain control over their drinking. Their only option is complete abstinence.
Alcohol abuse and alcoholism are not considered to be the same thing. This is because it is possible for people to abuse alcohol without developing an addiction. The individual who is abusing alcohol may change their behavior easily if they have good reason to do so. Those who are addicted to alcohol will usually have a much harder time of it if they decide to quit. Alcohol abuse is a path to alcoholism, but it is not a certain destination. Many individuals have gone through a stage of abusing alcohol, especially during their college years, but never progressed to alcoholism.
The symptoms of alcoholism include:
* The individual experiences increased tolerance for alcohol. This means that they have to drink more in order to get the same effects.
* The alcoholic has a strong compulsion to drink.
* They will often drink more than they intended to.
* They are likely to experience blackouts. This refers to a type of amnesia that people can experience when they drink too much.
* They may try to hide the extent of their drinking.
* Drinking alone.
* They will experience withdrawal symptoms if they attempt to significantly reduce or quit alcohol.
* The individual deliberately sets out to become intoxicated.
* Feelings of guilt about their drinking.
* They will become irritable if there is no alcohol available at a time when they would normally drink.
* Lack of interest in activities that do not involve alcohol.
* Drinking alcohol before going to a party.
* Hiding alcohol around the home.
* The individual continues to drink even when alcohol is causing problems in their life.
* They alcoholic will repeatedly neglect their responsibilities because of alcohol.
* This individual struggles to reduce their alcohol intake.
* They feel uncomfortable if they do not have access to alcohol.
* Legal problems as a result of drinking.
* Legal problems as a result of drinking.
* Financial problems as a result of drinking.
* Relationship problems as a result of drinking.
It is not necessary for people to have all these symptoms in order for them to be considered an alcoholic.
Alcoholics Anonymous in the UK have produced a self test that the individual can use to determine if they are alcoholic. If the individual answers yes to four or more of the following questions they are likely to be an alcoholic:
* Have you had problems connected with drinking during the past year?
* Have you ever decided to stop drinking for a week or so, but only lasted for a couple of days?
* Has your drinking caused trouble at home?
* Have you ever felt that your life would be better if you did not drink?
* Do you wish people would mind their own business about your drinking- stop telling you what to do?
* Do you have blackouts?
* Have you ever switched from one kind of drink to another in the hope that this would keep you from getting drunk?
* Have you missed days off work because of drinking?
* Have you had to have a drink in the morning during the past year?
* Do you envy people who can drink without getting into trouble?
* Do you ever try to get ‘extra’ drinks at a party because you do not get enough?
* Do you tell yourself you can stop drinking any time you want to, even though you keep getting drunk when you don’t mean to?
Research has not been able to find a clear cause for alcoholism. It is likely to involve a number of factors including:
* The addictive personality. Some individuals are believed to have personal characteristics that make them more prone to falling into substance abuse and becoming addicted.
* It is suggested that people who abuse alcohol can develop altered brain chemistry, and it is this that leads to alcoholism.
* There appears to be a hereditary predisposition towards alcoholism – it can run in families.
* Those individuals who grew up in an environment where there was a great deal of heavy drinking are more likely to become addicted later on.
* The younger the age people are when they begin using alcohol the more likely they are to develop alcoholism.
* Men seem to be more likely to develop alcoholism than women.
* It is suggested that some individuals with mental health problems turn to alcohol abuse as a means to self-medicate. This is usually referred to as a dual diagnosis.
* Those individuals who regularly drink above the recommended levels for alcohol intake are more at risk of developing alcoholism.
The American Medical Association considers alcoholism to be a disease because it shares five characteristics common to diseases including:
* The symptoms of progressive
* It involves a pattern of symptoms
* It is a chronic condition
* It is a condition that often involves relapse
* It is treatable
There is a great deal of debate as to the description of alcoholism as a disease. Some suggest that this way of looking at the problem is disempowering because it eliminates the responsibility for making choices. The alcoholic can always say that they are not responsible for their behavior because they have a disease.
Not everyone who develops alcohol dependence will wish to be referred to as an alcoholic. This is because there is still a great deal of stigma attached to this name. There are also those who object to the disease model of alcoholism and have no wish to be identified with it. Other names that have been used to describe the condition include:
* Alcohol Dependence
* Alcohol Dependence syndrome – this is the name preferred by the World Health Organization.
* Dipsomania was once a common way to describe the symptoms of alcoholism, but this word is now considered a bit archaic.
* Problem drinking can be used to describe a variety of different patterns of drinking. It is most often used to describe those who have not yet developed a physical dependence.
* Alcohol abuse
Alcohol withdrawal symptoms can range from mild to severe. Those individuals who have been drinking heavily for many years are at risk of developing delirium tremens (DTs). This can be a life threatening condition. The symptoms of alcohol withdrawal include:
* Restlessness and irritability
* Feelings of depression
* Nausea and vomiting
* Stomach upset
* Shakes and tremors
* Changes to blood pressure and pulse
* Fever and sweating
* Mild confusion
* Feelings of fatigue
The symptoms of the DTs are more intense and can include:
* Convulsions and seizures of the tonic-clonic variety.
* Intense hallucinations usually involving small animals and insects.
* Confusion that can be severe.
* Elevated blood pressure, pulse, and temperature.
* The individual going through DTs is likely to experience a great deal of anxiety.
There are now many options open to people who are looking to be treated for alcoholism including:
* Attendance at rehab. Here the individual can become sober and learn the tools they will need to build a successful recovery.
* Addiction therapists can assist the individual to move from alcoholism to sober living. This can involve using techniques such as cognitive-behavioral therapy.
* Some people find that Alcoholics Anonymous offers a useful program for building a life in recovery.
* There have been other groups such as Rational Recovery that have arisen as an alternative to Alcoholics Anonymous.