Alcoholism is a chronic disease that gets worse over time. Like many chronic diseases, it can be diagnosed and treated but not cured, and carries a risk of relapse.
One of the primary questions a lot of people have about addiction is, “Why is it considered a chronic disease?” Alcoholism and other drug addictions have many things in common with other chronic diseases. This article reviews the components and parallels between alcoholism and other chronic diseases.
What Is a Chronic Disease?
To compare alcoholism to chronic diseases, it can be helpful to understand the medical definition of chronic disease. Chronic disease is classified as one that lasts three months or more and has other common features including vaccines that can’t prevent them, they can’t be cured by medicine and they don’t just go away.
According to the CDC, six out of ten Americans have at least one chronic disease. Some behaviors contribute to chronic diseases, including using tobacco, not being physically active and having poor eating habits. Some of the most common chronic diseases include arthritis, cardiovascular disease, breast and colon cancer, obesity and oral issues.
Chronic diseases are the top cause of disability and death in the U.S. and the leading contributor to the nation’s $3.5 trillion in annual health care costs. While no cure may exist, many chronic conditions can be managed or treated with lifestyle changes or certain medicines. While medications can treat the symptoms of many chronic conditions, these drugs often have their own side effects and may also interact with one another.
What Is Alcoholism?
Alcoholism, also called alcohol use disorder, is using alcohol in excessive amounts and being unable to control one’s use of alcohol. Someone who is an alcoholic isn’t able to manage their drinking. Alcohol use disorder may be characterized as mild, moderate or severe, and every category has its own symptoms and side effects.
Alcohol use disorder was previously broken into two categories by the medical community: abuse and dependence. It’s now measured on a spectrum. Depending on the number of criteria a person meets, they can be diagnosed as having mild to severe alcoholism. Some of the alcoholic diagnosis criteria include having a craving to use alcohol, drinking more than was intended or continuing to use alcohol despite problems in relationships. Research shows that alcohol use disorder often co-occurs with other mental health disorders, including bipolar disorder and major depression.
Alcoholism and alcohol abuse are serious problems in the U.S. In 2018, 14.4 million adults had alcohol use disorder, with only 7.9% of them receiving treatment. Another 401,000 teens aged 12 to 17 had an alcohol use disorder.
Alcoholism is a problem on a personal, familial and societal level. Alcoholism diminishes the health of the addicted person, damaging the liver, brain and heart and leading to disease and, ultimately, death. Addicted individuals are also at a higher risk of sustaining injuries, hurting someone else or having relationship issues or financial problems that impact their loved ones, especially children. Alcoholism’s impact on society includes drunk driving deaths and injuries, high healthcare costs and losses in productivity.
When Alcoholism Becomes A Disease
It can be difficult to determine when alcohol use becomes alcoholism, but in the simplest terms, it’s often when a person loses control over their use of alcohol. You may start drinking casually, and then more heavily. This could constitute an abuse problem, but not necessarily the disease of alcoholism. Alcoholism typically becomes a disease when:
- You try to stop and can’t
- You continue despite sometimes extremely adverse outcomes
- You have a physical dependence on alcohol and experience withdrawal if you try to stop
Medical providers can diagnose when alcoholism becomes a disease using sets of criteria established by experts to describe the signs and symptoms of alcoholism.
So, Why Is Alcoholism Considered a Chronic Disease?
Alcoholism is considered a chronic disease for several reasons. It has some elements of heritability, meaning there are genetic components that can run in families. Environmental factors are also part of the equation. Consider diabetes, another chronic disease. Whether or not you develop diabetes is based on a combination of your family’s genes and your personal lifestyle choices, like diet and exercise. Alcoholism is similar. You may be genetically more predisposed to developing alcoholism if you have an alcoholic family member or ancestor. Growing up in an environment where alcohol is prevalent contributes to this risk. The environmental risk factors and genetics work together and determine the course of the disease.
Like other chronic diseases, alcoholism can be identified and diagnosed based on certain symptoms and can be managed with professional treatment. Treatment options often include a combination of medications, therapy and cognitive-behavioral treatment in inpatient and outpatient settings.
When alcoholism and other chronic diseases aren’t being properly treated and managed, relapse is possible. While you can’t necessarily cure diabetes, you can keep it under control with medications and lifestyle choices like exercise and a healthy diet. If you stop doing these things, your diabetes would be out of control, and there would be adverse consequences.
Alcoholism similarly has no cure and carries a risk of relapse. However, if you participate in an alcohol rehab program or a group like AA, make lifestyle changes and potentially take certain medicines, you can keep it under control. Otherwise, you’re putting yourself at risk of relapse. Alcoholism’s progressive nature is another reason it’s considered a chronic disease. Alcoholism moves through stages, and certain symptoms and behaviors mark each stage. For example, during early-stage alcoholism, the person is usually drinking larger amounts and becoming more secretive or elusive about what they’re doing. As alcoholism progresses, behaviors become more out of control and more health symptoms begin to appear.
Alcoholism is considered a chronic disease with a long-term course, so treatment must mirror this concept. The best treatment plans are typically long-term and evolve over time to continue addressing the changing needs of the individual as they move through the steps of recovery.
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National Center for Health Statistics. “Summary Health Statistics for the U.S. P[…]erview Survey, 2012.” Centers for Disease Control and Prevention, December 2013. Accessed April 30, 2020.
National Center for Chronic Disease Prevention and Health Promotion. “Chronic Diseases in America.” Centers for Disease Control and Prevention, October 23, 2019. Accessed April 30, 2020.
National Center for Chronic Disease Prevention and Health Promotion. “About Chronic Diseases.” Centers for Disease Control and Prevention, October 23, 2019. Accessed April 30, 2020.
National Institute on Alcohol Abuse and Alcoholism. “Alcohol Facts and Statistics.” February 2020. Accessed April 30, 2020.
The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.