The concept of alcoholism is complex and difficult to understand, even if it’s something you’re living with or a family member suffers from. There are a lot of misconceptions and questions people have about alcoholism.
The American Medical Association recognized alcoholism as an illness in 1956, based on the theory that excessive drinking and alcohol addiction is caused by a disease that affects the structure and function of the brain. Understanding why alcoholism is a problem can help you understand how the medical community reached this conclusion.
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What Is Alcoholism?
Alcoholism goes by many other names, including “alcohol use disorder,” “alcohol abuse,” “having a drinking problem” and others. Ultimately, alcoholism refers to a pattern of alcohol misuse in a person’s life that has led to problems and negative consequences. This can include health, mental, financial, familial or relationship issues.
Alcoholism is something that tends to develop or progress over years. A person may start as a social drinker and become a heavy drinker. Ultimately, they may become dependent on alcohol, meaning if they don’t have it, they experience physical symptoms of alcohol withdrawal.
Many factors contribute to alcoholism, including genetics and the environment a person grew up in. It’s believed that people with certain mental health disorders such as depression or bipolar disorder may be more likely to be an alcoholic. Situational factors including easy alcohol access or being in a culture where alcohol use is common can also contribute to problems.
Alcohol Use Disorder
Alcohol use disorder (AUD) is a medical condition that can be diagnosed. In the general sense, it refers to a condition where a person consumes alcohol to the point where it causes harm. Alcoholism is just one manifestation of AUD. Symptoms include a physical craving for alcohol, a dependence that leads to withdrawal when you don’t drink, higher tolerance levels and the feeling that you’re unable to stop drinking once you begin. The person may also have compulsive thoughts and distorted beliefs about alcohol.
According to the National Institutes of Health, around 14.5 million people in the U.S. aged 12 and older had an alcohol use disorder in 2019.
Is Alcoholism a Disease?
The American Medical Association deemed alcoholism a disease in its Reports of Officers in 1956, which was then referenced in cases before the U.S. Supreme Court in 1966 and 1968. These cases reaffirmed what the medical community had generally concluded: suffering from an alcohol use disorder is having an illness, not committing a willful crime or misconduct.
The American Psychiatric Association defines alcoholism in the same terms as alcohol dependence. The American Hospital Association, American Public Health Association, National Association of Social Workers, and the American College of Physicians all classify alcoholism as a disease.
The National Institute on Alcohol Abuse and Alcoholism (NIAAA), which is part of the National Institutes of Health, has also taken the position that alcoholism is a disease. They highlight the fact that the craving an alcoholic feels can be as strong as their craving for life-sustaining food or water. As part of the disease of alcoholism, a person will continue to drink despite serious consequences. Like many other illnesses, alcoholism:
- Follows progressive steps
- Has definable symptoms
- Is chronic
- Can last a lifetime with definable symptoms
Medical professionals also point to how alcohol impacts the brain and its reward system, which is a chemical process, not a choice. These chemical processes can ultimately trigger an addicted response in certain individuals.
While it’s been many decades since alcoholism was recognized as a disease, there is still debate and controversy around the subject. Many still believe that addictive behavior is a choice, even as science has shown that it’s much more complicated than that.
Criticism of the idea of alcoholism as a disease asserts the designation takes away from the personal choice component of abusing alcohol and gives an excuse to the person. Opponents of the disease model also say that this theory and approach don’t offer a real solution for people to stop abusing alcohol. This is highly controversial, as it conflicts with the evidence-based medical approach used at hospitals, clinics and treatment facilities, the recommendations of the expert organizations already mentioned, and the success stories of many recovering alcoholics.
If you’re struggling to control your alcohol use or worry you have an alcohol use disorder, you can get better with help. Treatment centers like The Recovery Village treat thousands of people every year with compassionate, evidence-based care that addresses alcohol dependence, withdrawal, and the reasons you started drinking in the first place. Take the first step: contact us today to discuss treatment options that can help you start an alcohol-free life.
National Institute on Alcohol Abuse and Alcoholism. “Alcohol Facts and Statistics.” June 2021, Accessed August 20, 2021.
Journal of the American Medical Association (JAMA). “Reports of Officers.” October 20, 1956. Accessed August 20, 2021.
Albert Henry, Tanya. “Court listened to AMA on defining alcoholism as a disease, not a crime.” American Medical Association, August 16, 2019. Accessed August 20, 2021.
Clapp, Peter; Bhave, Sanjiv V.; and Hoffman, Paula L. “How Adaptation of the Brain to Alcohol Leads to Dependence.” National Institute on Alcohol Abuse and Alcoholism. Accessed August 20, 2021.
Sha, Carrie. “The Science of Alcohol Addiction.” Harvard Science Review. 2021. Accessed August 20, 2021.
American Psychological Association. “Understanding alcohol use disorders and their treatment.” September 2018. Accessed August 20, 2021.
National Institute on Alcohol Abuse and Alcoholism. “Understanding Alcohol Use Disorder.” April 2021. Accessed August 20, 2021.
Heather, N. “Why alcoholism is not a disease.” Medical Journal of Australia. February 1992. Accessed August 20, 2021.
Medical Disclaimer: The Recovery Village aims to improve the quality of life for people struggling with a 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 provider.