Alcoholism: A Definition
by Terry Heick
While articles about alcoholism aren’t exactly on-brand for TeachThought, our mission is social improvement through innovation in education (through the growth of innovative teachers). In pursuit, over the years we have explored sociocultural issues from gender, race, and poverty to sexuality, child abuse, and disaster preparation among others.
What is the definition of alcoholism? Simply put, alcoholism is having a problem with your drinking.
Of course, there are many caveats. Who gets to decide what a ‘problem’ is? What are the different kinds of ‘problems’? What about being a ‘functional alcoholic’? It all has to do with the effect the drinking has on you.
If the general effect on you–physically, psychologically, medically, socially, professionally, and otherwise–is negative and you either don’t stop or try to stop and can’t, you may have a problem with alcoholism.
But do even a little reading on this and you’ll see the limits of that as any kind of statement of the definition for alcoholism. It misses so much and sometimes the best way to understand what it means to be an alcoholic is to listen to an alcoholic discuss it (even saying ‘former alcoholic,’ as you’ll discover, is inaccurate). Recently I was doing research for another article about race in the United States and saw this in the recommended videos.
What I found was Dick Van Dyke explaining alcoholism better–and more authentically–than I’ve heard it explained before.
Why Do People Drink Alcohol?
Why do people drink alcohol? Well, it depends. This is a hopelessly complex topic. Why do people create art? Why do people love? Why do they hope? Why do people suffer? Why do they avoid suffering? Why do they sometimes avoid suffering in healthy ways and sometimes avoid suffering in unhealthy ways? And once the suffering is unavoidable, why are there differences in how they process that suffering?
Generally speaking, however, it might be simple: alcohol provides people a means to change how they feel–either to avoid feeling something or to feel something they otherwise perceive themselves to be lacking.
While Van Dyke never offers up a clear definition for alcoholism, he does etch out a very lucid shape for what and how and why people use alcohol: feelings. In ‘The Art of the Commonplace,’ Wendell Berry cited the loss of human community and the need to feel ‘whole.’
“People use drugs, legal and illegal, because their lives are intolerably painful or dull. They hate their work and find no rest in their leisure. They are estranged from their families and their neighbors. It should tell us something that in healthy societies drug use is celebrative, convivial, and occasional, whereas among us it is lonely, shameful, and addictive. We need drugs, apparently, because we have lost each other.”Wendell Berry In ‘The Art Of The Commonplace’
People drink because life is difficult and cognitive behavior can cause tremendous suffering that only deepens the challenge. Alcohol is a legal way to, at least for a short period of time, avoid confronting some of those challenges. Obviously there are drawbacks and for many, no real benefits at all. Becoming an alcoholic can be such an invisible process with such an urgent and intense gravity that it feels unavoidable–and worse, yields a potentially lifelong struggle.
What Is Alcohol Use Disorder?
According to the Mayo Clinic, it’s not just about amount of alcohol but rather how that alcohol functions in your life.
“Alcohol use disorder (which includes a level that’s sometimes called alcoholism) is a pattern of alcohol use that involves problems controlling your drinking, being preoccupied with alcohol, continuing to use alcohol even when it causes problems, having to drink more to get the same effect, or having withdrawal symptoms when you rapidly decrease or stop drinking…If your pattern of drinking results in repeated significant distress and problems functioning in your daily life, you likely have alcohol use disorder. It can range from mild to severe. However, even a mild disorder can escalate and lead to serious problems, so early treatment is important.”
Alcoholism is a chronic disease in part characterized by a preoccupation with alcohol. It is, on a functional level, the inability to control your drinking due to a dependence on alcohol (physically and psychologically).
What Are The Warning Signs Of Alcoholism?
Some of the common warning signings for alcoholism include:
Drinking consistently over a long-period of time
Gradual increase in quantity of alcohol consumed (or ‘harder’ drinks with higher alcohol content levels)
Feelings of isolation (and often behavioral changes that deepen those feelings)
Change in social habits (friendships, relationships, recreation, etc.)
What Are The Symptoms Of Alcoholism?
Symptoms of alcoholism include:
Continued loss of appetite and other healthy habits
Deepened feelings of isolation and depression
Reduced ability to prioritize the most important things in your life (i.e., executive brain function)
Drinking instead of pursuing activities that used to bring you happiness
Dependence on alcohol to ‘do’ certain things
Gradual increase in quantities of alcohol (or drinks with higher alcohol content levels)
Habitual thinking about drinking or planning the next time you’ll drink
The continued use of alcohol even in the face of detrimental effects
Mental health changes when drinking or when abstaining from drinking
Physical withdrawal symptoms when drinking is quickly reduced or discontinued
Reduced internal organ function (liver and pancreas function, for example)
The Difference Between Alcohol Abuse And Alcohol Dependence
How we view alcoholism–in terms of medical treatment and as a culture, changes over time. Terms like, ‘boozer,’ ‘wino’ and ‘drunk,’ ‘lush,’ and others are not only hurtful but also misleading. A verywellmind.com explains, “Until recently with the publication of the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM), substance issues were generally divided into abuse and dependence. The DSM-5 combines these categories into a single substance use disorder, measured on a continuum from mild to severe. This change was made to update the idea that abuse was a mild and early phase of the illness and dependence was a more severe manifestation. In reality, abuse can often be quite severe.”
In fact, the World Health Organization doesn’t even like the term ‘alcoholic’ or ‘alcoholism,’ preferring ‘alcohol dependence syndrome, instead. Wikipedia continues by clarifying some of the difference between alcohol abuse and alcohol dependence:
“Alcoholism, also known as alcohol use disorder (AUD), is, broadly, any drinking of alcohol that results in mental or physical health problems. The disorder was previously divided into two types: alcohol abuse and alcohol dependence. In a medical context, alcoholism is said to exist when two or more of the following conditions are present: a person drinks large amounts of alcohol over a long time period, has difficulty cutting down, acquiring and drinking alcohol takes up a great deal of time, alcohol is strongly desired, usage results in not fulfilling responsibilities, usage results in social problems, usage results in health problems, usage results in risky situations, withdrawal occurs when stopping, and alcohol tolerance has occurred with use.”
In summary, alcohol dependence is what it sounds like it would be: an unhealthy dependence on alcohol–usually to cope with emotional problems or situational circumstances. And because of the long-term physiological effects of alcohol, alcohol dependence is for many just a predecessor to alcohol abuse.