The
definitions of alcoholism and related terminology vary significantly between the medical community, treatment programs,
and the general public.
Medical
Definitions The Journal of the American Medical Association defines alcoholism as "a primary, chronic disease characterized by impaired control over drinking, preoccupation with the drug alcohol, use of alcohol despite adverse consequences, and distortions in thinking." <1>
The DSM-IV (the standard for diagnosis in psychiatry and psychology) defines
alcohol abuse as repeated use despite recurrent adverse consequences.<2> ; further defining
alcohol dependence as
alcohol abuse combined with tolerance, withdrawal, and an uncontrollable drive to drink.<2> (See
DSM diagnosis below.)
According to the
APA Dictionary of Psychology, alcoholism is the popular term for
alcohol dependence.<2> Note that there is debate whether
dependence in this use is physical (characterised by withdrawal), psychological (based on reinforcement), or both.
Terminology
Many terms are applied to a drinker''s relationship with alcohol.
Use,
misuse,
heavy use,
abuse,
addiction, and
dependence are all common labels used to describe drinking habits, but the actual meaning of these words can vary greatly depending upon the context in which they are used. Even within the medical field, the definition can vary between areas of specialization. The introduction of politics and religion further muddles the issue.
Use refers to simple use of a substance. An individual who drinks any alcoholic beverage is
using alcohol.
Misuse,
problem use, and
heavy use do not have standard definitions, but suggest consumption of alcohol beyond the point where it causes physical, social, or moral harm to the drinker. The definitions of social and moral harm are highly subjective and therefore differ from individual to individual.
Within politics,
abuse is often used to refer to the illegal use of any substance. Within the broad field of medicine,
abuse sometimes refers to use of prescription medications in excess of the prescribed dosage, sometimes refers to use of a prescription drug without a prescription, and sometimes refers to use that results in long-term health problems. Within religion,
abuse can refer to any use of a poorly regarded substance. The term is often avoided because it can cause confusion with audiences that do not necessarily share a single definition.
Remission is often used to refer to a state where an alcoholic is no longer showing symptoms of alcoholism. The American Psychiatric Association considers remission to be a condition where the physical and mental symptoms of alcoholism are no longer evident, regardless of whether or not the person is still drinking. They further subdivide those in remission into
early or
sustained, and
partial or
full. Others (most notably Alcoholics Anonymous) use the term
recovery to describe those who have completely stopped consumption of alcohol