A Definition approved by the (U.S.)
National Council on Alcoholism and Drug Dependency,
and the American
Society of Addiction Medicine.
Alcoholism is a primary,
chronic disease with genetic, psychosocial, and environmental factors
influencing its development and manifestations. The disease is often
progressive and fatal.
It is characterized by continuous or periodic: impaired
control over drinking, preoccupation with the drug alcohol, use of alcohol
despite adverse consequences, and distortions in thinking, most notably denial.
"Primary" refers to the nature of alcoholism as
a disease entity in addition to and separate from other pathophysiologic states
which may be associated with it. "Primary" suggests that alcoholism,
as an addiction, is not a symptom of an underlying disease state or problem.
"Disease" means an involuntary disability. It
represents the sum of the abnormal phenomena displayed by a group of
individuals. These phenomena are associated with a specified common set of
characteristics by which these individuals differ from the norm, and which
places them at a disadvantage.
"Often progressive and fatal" means that the
disease persists over time and that physical, emotional, and social changes are
often cumulative and may progress as drinking continues. Alcoholism causes
premature death through overdose, organic complications involving the brain,
liver, heart and many other organs, and by contributing to suicide, homicide,
motor vehicle crashes, and other traumatic events.
"Impaired control" means the inability to limit
alcohol use or to consistently limit on any drinking occasion the duration of
the episode, the quantity consumed, and/or the behavioural consequences of
"Preoccupation" in association with alcohol use
indicates excessive, focused attention given to the drug alcohol, its effects,
and/or its use. The relative value thus assigned to alcohol by the individual
often leads to a diversion of energies away from important life concerns.
"Adverse consequences" are alcohol-related
problems or impairments in such areas as:
physical health (e.g., alcohol withdrawal syndromes, liver
disease, gastritis, anaemia, neurological disorders); psychological functioning
(e.g., impairments in cognition, changes in mood and behaviour); interpersonal
functioning (e.g., marital problems and child abuse, impaired social
relationships); occupational functioning (e.g., scholastic or job problems);
and legal, financial, or spiritual problems.
"Denial" is used here not only in the
psychoanalytic sense of a single psychological defence mechanism disavowing the
significance of events, but more broadly to include a range of psychological
manoeuvres designed to reduce awareness of the fact that alcohol use is the
cause of an individual's problems rather than a solution to those problems.
Denial becomes an integral part of the disease and a major obstacle to
James R. Milam & Katherine
Ketcham, Under the Influence. A Guide to the Myths and Realities of
Alcoholism. ISBN: 0553274872. http://www.lakesidemilam.com/uti.htm