Is
Alcoholism A Disease?
Definition of Alcoholism
"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.
"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 behavioral consequences of drinking.
"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, anemia, neurological disorders);
psychological functioning (e.g., impairments in cognition, changes in mood and
behavior); 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 defense mechanism disavowing the significance of events,
but more broadly to include a range of psychological maneuvers 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 recovery.
Approved
by the Boards of Directors of the National Council on Alcoholism and Drug
Dependence, Inc. (February 3, 1990) and the American
Society of Addiction Medicine (February 25, 1990).
This definition
was prepared by the Joint Committee to Study the Definition and Criteria for
the Diagnosis of Alcoholism of the National Council on Alcoholism and Drug
Dependence and the American Society of Addiction
Medicine:
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