What Is Alcoholism?

The term "alcoholism" refers to a disease known as alcohol dependence, the most severe stage of a group of drinking problems which begins with binge drinking and alcohol abuse.

Types of Alcohol Problems

Alcohol problems occur at different levels of severity, from mild and annoying to life-threatening. Although alcohol dependence (alcoholism) is the most severe stage, less severe drinking problems can also be dangerous.

Binge Drinking

Officially, binge drinking means having five or more drinks in one session for men and four or more for women. Another definition for binge drinking is simply drinking to get drunk. It is the most common drinking problem for young people, under age 21.
 
"It's not only the amount of alcohol consumed that shapes the risk for injury, but also the usual consumption pattern," said lead researcher Gerhard Gmel, of the Alcohol Treatment Center at the Lausanne University Hospital and the Swiss Institute for the Prevention of Alcohol and Drug Problems. "At highest risk are those who usually consume moderately but sometimes binge drink. This is true for both sexes."
Gmel and colleagues screened 8,736 emergency department patients who had been admitted to the hospital's surgical ward during an 18-month period. Their study examined how the interaction among three aspects of drinking behavior -- average weekly consumption, binge-drinking episodes and the amount of alcohol consumed before hospital admission -- affects risk of injury.
The risk of injury increased for all types of drinkers with higher alcohol consumption in the 24 hours before hospital admission, but the greatest risk was among moderate drinkers who occasionally drank heavily and who had drank heavily in the previous 24 hours.
According to Gmel, during bouts of heavy drinking, moderate-drinking women were more than seven times as likely to be injured than women who never drank. Among moderate-drinking men who sometimes binged, the risk of injury were more than six times greater compared to male non-drinkers.

Binge Drinkers At Risk

About 20 percent of adults in the United States are considered hazardous and harmful drinkers. "These are people who are not physically dependent on alcohol, but they binge drink or have health or social consequences because of their drinking," Degutis said.
Interventions that target chronic high-volume drinkers will not be effective in reducing injuries, according to Gmel, because the majority of injuries occur in the much larger population of moderate drinkers.

Rapid Consumption Is the Problem

"There are many effective preventive measures, including strict enforcement of drinking driving policies and responsible beverage serving," he said. "The most effective strategy would be a combined effort at the individual and societal levels. This would include targeting happy hours and other environments that encourage rapid consumption of large quantities of alcohol and changing social norms of what is acceptable drinking behavior."

Source: Gmel's study, "Alcohol-attributable injuries in admissions to a Swiss emergency room--an analysis of the link between volume of drinking, drinking patterns and pre-attendance drinking" was published in the January 2005 issue of Alcoholism: Clinical and Experimental Research.

Alcohol Abuse

Binge drinking turns into alcohol abuse when someone's drinking begins to cause problems and the drinking continues anyway. Alcohol abuse is when someone continues to drink in spite of continued social, interpersonal or legal difficulties. Alcohol abuse can result in missing time at school or work, neglecting child or household responsibilities or trouble with the law.
 
Alcohol abuse differs from alcoholism in that it does not include an extremely strong craving for alcohol, loss of control, or physical dependence. In addition, alcohol abuse is less likely than alcoholism to include tolerance (the need for increasing amounts of alcohol to get "high").

Alcohol abuse is defined as a pattern of drinking that is accompanied by one or more of the following situations within a 12-month period:
·        Failure to fulfill major work, school, or home responsibilities;
·        Drinking in situations that are physically dangerous, such as while driving a car or operating machinery;
·        Recurring alcohol-related legal problems, such as being arrested for driving under the influence of alcohol or for physically hurting someone while drunk;
·        Continued drinking despite having ongoing relationship problems that are caused or worsened by the effects of alcohol.
While alcohol abuse is basically different from alcoholism, it is important to note that many effects of alcohol abuse are also experienced by alcoholics.

Alcohol Dependence

Alcohol abuse becomes alcohol dependence when drinkers begin to experience a craving for alcohol, a loss of control of their drinking, withdrawal symptoms when they are not drinking and an increased tolerance to alcohol so that they have to drink more to achieve the same effect. Alcohol dependence is a chronic and often progressive disease that includes a strong need to drink despite repeated problems.
 
Alcoholism, also known as "alcohol dependence," is a disease that includes alcohol craving and continued drinking despite repeated alcohol-related problems, such as losing a job or getting into trouble with the law. It includes four symptoms:

Craving -- A strong need, or compulsion, to drink.

Impaired control -- The inability to limit one's drinking on any given occasion.

Physical dependence -- Withdrawal symptoms, such as nausea, sweating, shakiness, and anxiety, when alcohol use is stopped after a period of heavy drinking.

Tolerance -- The need for increasing amounts of alcohol in order to feel its effects.

For clinical and research purposes, formal diagnostic criteria for alcoholism also have been developed. Such criteria are included in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, published by the American Psychiatric Association, as well as in the International Classification Diseases, published by the World Health Organization.

Is Alcoholism Inherited?

Alcoholism tends to run in families and a vast amount of scientific research indicates that genetics play a role in developing alcohol problems. But research also shows that a person's environment and peer influences also impact the risk of becoming alcohol dependent.
Although a massive amount of scientific research indicates heredity plays some role in developing alcoholism, having a family history of alcoholism does not doom a person into becoming an alcoholic. The genetic tendencies can be overcome.