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Alcohol addiction, or alcoholism, is characterized by a persistent, habitual use of alcohol, even when the alcoholic is aware of the harm being done. This is different than alcohol abuse.
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- Drinks to get drunk
- Drinks in social situations, often to excess
- Externally driven by peer pressure or circumstance
- Usually has periods of sobriety between binges or parties.
- Drinks to prevent withdrawal, to become ‘normal,’ and then gets drunk
- Drinks whether or not the situation calls for it and may seek out permissible circumstances, but will drink in any case
- May have some sobriety but at great difficulty.
It is not always possible to distinguish someone who abuses alcohol from an alcoholic. There are so-called, "high functioning" alcoholics who hold jobs and are able to maintain relationships. Some will point to these facts and deny they have a problem. This is why the first step in the Alcoholics Anonymous (AA) program is: "We have admitted we are powerless over alcohol and our lives had become unmanageable."
Alcoholism as a disease
The number one predictor of who will have an alcohol addiction is a family history of alcoholism1 Those at most risk have an alcoholic parent or sibling. This implies a genetic component, or predisposition to addiction.
However, the story isn’t always so clear. Though there is ongoing research into an "alcoholic" gene, discovered2, this still does not explain all cases of alcohol addiction. Currently the disease of alcoholism is thought to be some combination of factors that include genetics, family influences, and societal values and standards.
In the disease model, alcohol addiction is treated as a chronic, progressive, and ultimately fatal disease. Treatment for alcoholism extends over a lifetime, much as it would be for diabetes or high blood pressure.
Alcoholism as a character flaw
While the disease model is prevalent, there is another viewpoint that stresses alcohol addiction as a disease of the will. The argument revolves around choice and whether addiction amounts to a loss of control or is the result of a lack of self control3.
Alcoholics Anonymous mentions alcoholism as "a disease of the spirit" and looks to reliance on a higher power as one of their 12 steps. Scientology runs treatment programs for addiction under the name Narconon, employing high dose vitamins and other techniques.
The chief characteristic of alcohol addiction in either model is excessive craving and an inability to abstain from alcohol. The form doesn’t matter. Alcoholics may prefer beer, wine, or any other intoxicating beverage – the common ingredient is alcohol. The craving to drink has been compared to that for food when starving or water when dehydrated.
As the disease progresses, more and more of a person’s life becomes dedicated to drinking. Relationships fail, health deteriorates, and loss of employment occurs. Alcoholics put others at risk when they drive or operate machinery under the influence. Gradually, the health problems mount and death from liver failure is the predicted outcome. Fatty tissue builds up in the liver, constricting blood flow and eventually, the alcoholic drowns because of backed-up fluid in the lungs.
- "Family history as a predictor of alcohol dependence," Dawson DA et al, National Institute on Alcohol Abuse and Alcoholism
- "A Gene for Alcoholism is Discovered," MedicineNet
- "Alcoholism, a disease of speculationBaldwin Research