How Do You Define Alcoholism?

Different terms lead to more confusion 

There are no universally accepted definitions in the alcoholism field. Each of us has his private view and personal meaning attached to the words used in the alcohol field. 

The professionals believe they are entitled to their own opinions about alcoholism because there has been, until recently, no clear picture of what alcoholism is, what caused it, how it progresses, and why certain people become addicted while others do not. 

AA gives us the best insight  

The founders of Alcoholics Anonymous did define and describe the causes, effects and recovery of alcoholism, but it was more aimed at the alcoholics than the professionals. However, the truths captured in their literature, especially their main book titled Alcoholics Anonymous (often called the Big Book), still have the best and most relevant insight into the disease of alcoholism. 

And yet there is a firm basis of research evidence for understanding the disease. The disease is understandable and definable, and the recovery process is understandable and definable. 

The Rand Report  

Opinions must no longer be allowed to overshadow facts. An example of the dangers inherent in allowing researchers to interpret the data according to their meanings is contained in the 1976 Rand Report. In this government-funded study, which assessed the effectiveness of forty-four federal government treatment programs, the term “recovery” was replaced with the broader term “remission.” “Remission” included the category “normal drinking,” defined by the authors as drinking less than 3 ounces of pure alcohol daily. An alcoholic was considered to be in remission if he was drinking the equivalent of 6 ounces or less of 100 proof whiskey every day. Thus, treatment centres which embraced this definition of “remission” could claim up to 80 per cent success rates – even though most of the alcoholics so labelled were still drinking! 

Four years later, the Rand researchers backed away from their original conclusions. A follow-up study found that the so-called normal alcoholic drinkers had nearly three times the relapse rate of long-term abstainers when they tried to stop drinking. “Normal drinking” is not possible for the alcoholic. At the same time, he can control his intake for months or even years. His disease will steadily progress until, eventually, the addiction overpowers his best efforts to control it. 

Some useful definitions 

The need for precise definitions should be obvious. Based on the facts already established in the scientific literature, the following definitions are central to any attempt to communicate clearly about alcoholism. 

Alcoholism: A chronic, primary, hereditary disease which progresses from an early physiological susceptibility into an addiction characterized by tolerance changes, physiological dependence, and loss of control over drinking. Psychological symptoms are secondary to the physiological disease and unrelated to the onset. 

Recovery: A return to normal functioning based on total, continuous abstinence from alcohol and substitute drugs, corrective nutrition, and an accurate understanding of the disease. The word “cure” should not be used because it implies that the alcoholic can normally drink after his “problem” has been corrected. 

Problem Drinker: A person who is not an alcoholic but whose alcohol use creates psychological and social problems for himself or others. 

Heavy Drinker: Anyone who drinks frequently or in large amounts. A heavy drinker may be a problem drinker, an alcoholic, or a normal drinker with a high tolerance for alcohol. 

Alcoholic: An alcoholic is a person with the disease of alcoholism regardless of whether he is initially a heavy drinker, a problem drinker, or light or moderate drinker. The alcoholic’s increasing problems and heavier drinking stem from his addiction and should not be confused with problem drinking or heavy drinking in the nonalcoholic. 

Recovered Alcoholic: The alcoholic who maintains continuous, total abstinence from alcohol and substitute drugs and has returned to a normal lifestyle. The term “reformed alcoholic” implies that the alcoholic has been “bad” and is now being “good” – a reflection of the moralistic approach to alcoholism which has no basis. The term “ex-alcoholic” should not be used either, for it implies a cure rather than a recovery. 

Relapse: Any intake of alcohol or substitute drug by a recovering alcoholic. Although not usually considered a relapse, taking a substitute drug seriously interferes with recovery and almost always leads to a return to drinking. 

However, our favourite definition of alcoholism and one that effectively describes the all-pervasive nature of the disease is as defined in the Big Book of AA: “A soul sickness.” 

Seek help before it’s too late 

It is easy to get confused and slip into denial about our addiction. Denial is a symptom of the disease. If you are concerned about your or a loved one’s drinking, it is best to get professional support.   

If you or a loved one is struggling with alcoholism, call Freephone 0800 140 4044 

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