Alcoholism, also known as alcohol dependence, is a disease that
includes four determining symptoms:
- Craving: A strong need and desire to drinking spite of
consequences ;
- Loss of Control: The inability to limit the amount of one's
drinking on any given occasion;
- Physical Dependence: An indication of the body's physical
adjustment to the presence of alcohol and with resulting physical withdrawal symptoms,
including, but not limited to, nausea, vomiting, sweating, sweating, shakiness,
hallucinations and anxiety, which occur when use is stopped after a period of heavy
drinking;
- Tolerance: The need to drink greater amounts of alcohol in
order to "get high" or feel the desired effect.
Alcoholism is the consumption of, or preoccupation with, alcoholic
beverages to the extent that this behavior interferes with the drinker's normal personal,
family, social, moral or work life and frequently leads to both physical and emotional
harm. The resulting chronic use can result in many psychological and physiological
disorders.
Although some people are able to recover from Alcoholism without
help, the majority of alcoholics need assistance. Through treatment and support many
individuals are able to stop drinking and rebuild their lives.
Addiction and Dependence Defined
People who are not alcoholic often do not understand why an alcoholic
can't just "use a little willpower" about their drinking. It is difficult to understand
that alcoholism has little to do with "willpower". Alcoholics are in the grip of a
powerful "craving", an uncontrollable need, for alcohol that overrides their ability to
stop drinking, a need as strong as that for food or water.
Many terms are applied to a drinker's relationship with alcohol. Use,
misuse, heavy use, abuse, addiction and dependence are all common labels, but are not
always used with an understanding of the associated medical conditions and therefore have
acquired highly variable and sometimes non-standard meanings. In order to further the
understanding of alcoholism, the focus in this section is on the terms addiction and
dependence.
In 2004, the American Society of Addiction Medicine, along with other
members of the American Medical Association, issued a statement defining Addiction, as
follows:
"Addiction is a primary, chronic, neurobiologic disease, with
genetic, psychosocial and environmental factors influencing its development and
manifestations. It is characterized by behaviors that include one or more of the
following: impaired control over use, compulsive use, continued use despite harm and
craving."
They further defined Dependence in the following language:
"Physical Dependence is a state of adaptation that is manifested
by a drug-class-specific withdrawal syndrome that can be produced by abrupt cessation,
rapid dose reduction, decreasing blood level of the drug, and/or administration of an
antagonist".
In 1992, a joint committee of the National Council on Alcoholism and
Drug Dependence and the American Society of Addiction Medicine was formed to establish a
definition of Alcoholism that was appropriate for clinical settings. The committee
defined the condition as follows:
" Alcoholism is a primary, chronic disease with genetic,
psychosocial and environmental factors influencing its development and manifestations.
The disease is often progressive and fatal…characterized by impaired control over
drinking, preoccupation with the drug alcohol, use of alcohol despite adverse
consequences, and distortions in thinking, most notably denial. Each of these symptoms
may be continuous or episodic".
The biological mechanism of alcoholism is unknown. While alcohol use
is required to trigger alcoholism, the majority of the population can drink alcoholic
beverages with no danger of suffering from it. One of the several other factors must
exist for alcohol use to develop into alcoholism. These factors include a person's social
environment, emotional health and genetic predisposition. An alcoholic can develop
several forms of addiction to alcohol simultaneously, psychological, biological and
neurochemical, and they must all be treated in order to effectively treat the
condition.
Statistics:
Substance use disorders are the major public health problem facing
many countries. In the United States today, 15 million Americans are estimated to suffer
from alcoholism. Those with the condition are classified by the American Psychiatric
Association as either actively using alcohol or being in early or sustained
remission.
Almost half of Americans, (48 percent) aged 12 or older, reported
being current drinkers of alcohol in the 2001 survey (SAMHSA). This translates into an
estimated 109 million people. Both the rate of alcohol use and the number of drinkers
increased from 2000, when 104 million (46.6 percent) of people aged 12 years or older
reported drinking in the past 30 days.
Approximately one fifth (20.5 percent) of persons aged 12 years or
older participated in binge drinking at least one or more days prior to the survey.
Although the number of current drinkers increased between 2000 and 2001, the number of
binge drinkers did not change significantly.
Heavy drinking was reported by 5.7 percent of the population aged 12
or older, or 12.9 million people. These estimates are similar to the 2000
estimates.
The highest prevalence for both binge and heavy drinking in 2001 was
for young adults aged 18 to 25, with most occurring at age 21.
Among youth aged 12 to 17, an estimated 17.2 percent used alcohol in
the month prior to the survey, which reflected and increase from the 200 rate of 16.4
percent. Of all youths, 10.6 percent were binge drinkers and 2.5 were heavy
drinkers.
Approximately 14 million Americans meet the diagnostic criteria for
alcoholism.
Approximately one-half of Americans have a close family member who
has or has had active alcoholism.
Approximately one in four children younger than 18 years old in the
United States is exposed to alcoholism and alcohol dependence in the family.
Alcohol consumption has consequences for the health and well-being of
those who drink and, by extension, those around them.
References:
US Department of Health and Human Services: Substance Abuse and
Mental Health Services Administration (2002, September 4). Results from the 2001
National Household Survey of Drug Abuse: Volume I. Summary
Findings (Office of Applied Studies, NHSDA Series H-17 ed.) (BKD461, SMA 02-3758)
Washington, DC: U.S.A.
http://www.oas.samhsa.gov/nhsda/2k1nhsda/vol1/chapter3.htm
U.S. Department of Health and Human Services. National Institute on
Alcohol abuse and Alcoholism. Alcohol Research & Health: Highlights From The Tenth
Special Report To Congress, Health Risk and Benefits of Consumption (Volume 24,
Number 1, 200 ed.)
http://en.wikipedia.org/wiki/Alcoholism
