You often hear alcoholism characterized as a chronic disease, but why? There is nothing organic that inspires a person to pick up that first drink; that is a decision. It's what happens to the body after that drink that is the basis for the disease theory.
To understand why alcoholism is a disease and more than just a choice for someone you love, you must understand the fundamentals of alcoholism.
The Disease Theory
Alcoholism is sometimes called a disease of the brain, because chronic drinking alters brain structure and function. Alcohol addiction is a progressive and lifelong illness just like diabetes or high blood pressure. The progression of it includes difficulty controlling drinking habits, preoccupation with alcohol and continuing to use even when drinking causes problems.
Over time, habitual drinkers develop both a dependence and a tolerance to alcohol. Addiction to any drug, including alcohol, stimulates the reward center in the brain, leading to what the World Health Organization refers to as dependence syndrome1.
How Alcoholism Works
As part of dependence syndrome, the user develops a tolerance to alcohol that requires them to drink more in order to get the same effect. This need turns the occasional drinker into an alcoholic.
The complications that come with alcoholism that really pinpoint the disease process. Heavy long-term drinking can lead to inflammation of the liver and eventually alcoholic hepatitis and cirrhosis. Excess drinking may inflame the lining of the digestive tract, which leads to ulcers. It weakens the immune system and increases a person’s risk of chronic illness like cardiovascular disease and diabetes.
It's possible for a person to be a potential alcoholic even if they don’t drink every day. Binge drinking is defined as a pattern of drinking where a man consumes five or more drinks, four for a woman, in a short time frame.
In other words, if a man goes out for a few drinks with a friend and can’t stop at just one or two this indicates he may be a binge drinker. Binge drinking is a precursor to alcoholism and often seen in young people2.
Symptoms of Alcoholism
There is no blood test that helps determine if someone suffers from the disease of alcoholism. Physicians and counselors will ask a series of questions instead. The goal is to understand the person’s drinking habits and their need for alcohol.
In some cases, it is the family members that first see the signs. They may be in a better position to answer the questions honestly than the alcoholic unwilling to accept a problem exists.
The Diagnostic and Statistical Manual of Mental Disorders has established criteria for diagnosing alcoholism.
- Tolerance, meaning it takes an increased amount of alcohol needed to feel intoxicated
- Withdrawal, the symptoms that occur when a person stops drinking
- Drinking more than intended, larger quantities and more frequently than planned
- An ongoing desire to drink, despite attempts to cut down or stop
- Spending more time drinking as well as recovering from heavy drinking
- Continuing to use alcohol, even though it is damaging to your body and life
The withdrawal symptoms of the severe alcoholic are potentially life-threatening without medical intervention. They include:
- Nausea and vomiting
- Rapid heart rate
- Severe confusion
How Alcohol Damages Every System in the Body
The disease changes the structure of the brain, making it difficult to find pleasure in anything but alcohol. Over time, it can damage every system in the body. Alcoholics don’t always see the harm their addiction does to their family and to their lives.
It's up to those on the outside looking in to recognize the need for treatment and to get help for their loved one suffering from the disease of alcoholism.
- "Neuroscience of Psychoactive Substance Use and Dependence," World Health Organization, 2004,http://www.who.int/substance_abuse/publications/en/Neuroscience.pdf
- "Alcoholism," Mayo Clinic,http://www.mayoclinic.org/diseases-conditions/alcoholism/basics/definition/CON-20020866