Is Alcoholism a Disease? Understanding Alcohol Use Disorder

Alcohol Use Disorder (AUD), also known as alcoholism, is a health issue that affects millions of people across the world. This condition has been surrounded by stigma and has a large impact on a person’s career, social life, and emotional relationships. Alcoholism is defined as the inability to stop or regulate the consumption of alcohol despite its negative effects. The connection between genetics, individual behavior, and environmental factors helps determine whether or not alcoholism is a disease. 

According to the 2022 National Survey on Drug Use and Health (NSDUH), 29.5 million people ages 12 and older (10.5% in this age group) had AUD in the past year. The recognition of AUD as a medical condition requires examining multiple factors including the effects on the brain, genetic disposition, and comparing it to other chronic diseases.

What is Alcoholism?

Alcoholism is a chronic disorder characterized by an inability to control or stop alcohol use and can take years to recover from and for many it can be lifelong. The perception of alcoholism has changed throughout the years due to its addictive nature and outstanding reach. Though it was once thought to be a sign of weakness, knowledge has advanced to the point where AUD is now understood to be a complicated disease involving a number of social, psychological, psychological, and environmental variables. This change in thinking has made alcoholism less stigmatized and encouraged a more sympathetic approach toward individuals who are affected.

Alcoholism vs. Casual Drinking

What separates alcoholism from casual drinking is the pattern, frequency, and impact of alcohol consumption on an individual’s life. A moderate alcohol intake that has no detrimental impact is referred to as “casual drinking.” Casual drinkers may manage their alcohol intake since they often do not experience intense cravings or withdrawal symptoms associated with alcoholism.

However, excessive drinking behaviors that lead to a physical and psychological dependence on alcohol are a sign of alcoholism. Alcoholism can lead to problems with self-control, drinking despite negative effects on one’s health and well-being, and experiencing withdrawal symptoms when one tries to cut down or stop. 

Is Alcoholism Really a Disease?

Yes, alcoholism, more formally known as Alcohol Use Disorder (AUD), is recognized as a disease however the debate around why is complex. Recognized by the American Medical Association as a disease, alcoholism is understood to be a chronic condition that alters brain chemistry and function, leading to an addiction that is difficult to control. It is regarded as a chronic disease as well as a mental condition because it affects both physical and emotional aspects of an individual’s life. 

The Chronic Nature of AUD

Medically, alcoholism shares characteristics with other chronic diseases, such as long-term progression, the necessity for ongoing management, and a mix of genetic, lifestyle, and environmental risk factors. The persistence of alcohol dependence, along with the risk of relapse, emphasizes its chronic nature. This condition needs continuous care and strategies to manage its effects, much like other chronic diseases that require lifelong monitoring and treatment adjustments.

How AUD Compares to Other Chronic Diseases

Comparing AUD to other chronic diseases can help illustrate its classification as a disease. Like diabetes, heart disease, or asthma, AUD:

  • Have a genetic influence
  • Can be impacted by environmental factors and lifestyle choices.
  • Requires ongoing management, including lifestyle changes, medical treatment, and sometimes medication.

What is a Disease Model of Alcoholism?

The Disease Model of Alcoholism represents a major change in the way we view and treat alcohol addiction. Instead of thinking of alcoholism as just a sign of bad choices or a lack of moral strength, we now see it as a long-term health problem. This big shift started in the middle of the 20th century, thanks to new medical studies and changes in society's attitudes. 

The Evolution of the Disease Concept

Initially, society viewed alcoholism through a lens of judgment, but as research sheds light on the biological and genetic factors at play, perceptions changed. The American Medical Association labeling alcoholism as a disease in the 1960’s was a landmark moment, highlighting its complexity and the various factors contributing to its development, including genetics, environment, and psychology.

Impact on Treatment

This model has significantly influenced the treatment options, paving the way for strategies that include medical interventions, psychological support, and lifestyle adjustments. Viewing alcoholism as a disease means treatments are more holistic, focusing not just on stopping alcohol use but also on healing the individual physically and emotionally.

How Does Alcoholism Affect the Brain and Health?

Excessive drinking is a major health concern when we consider how it affects our bodies. Overindulgence in alcohol may seriously disrupt the chemistry of the brain, impairing our ability to process emotions and form judgments. It’s as if the brain is rewired to place alcohol above all other priorities, which is why quitting is so difficult. Alcohol interferes with neurotransmitters, which are the brain’s chemical messengers, altering mood, behavior, and cognitive functions. 

This results in impaired decision-making, memory lapses, and difficulty controlling impulses.

The impact of alcoholism on behavior is profound. As the brain becomes more accustomed to alcohol, it affects an individual’s ability to think clearly, make rational choices, and control their actions. This often leads to a cycle of drinking to alleviate discomfort or withdrawal symptoms, furthering the addiction and making it harder to quit.

How Alcohol Affects Health in General

Beyond the brain, alcoholism has negative effects on the body. Long-term alcohol effects include liver disease, heart disease, a weakened immune system, and an increased risk of certain cancers. Alcohol’s toll on the body is comprehensive, affecting nearly every organ system and significantly increasing the risk of premature death.

What Causes Alcohol Addiction?

Alcohol addiction is caused by a mix of genetic predispositions and environmental influences. According to the National Center for Drug Abuse (NCDAS) Children aged 17 years and younger are much more likely to live with an alcoholic parent than they are to be diagnosed with a learning disability, thus demonstrating the prevalence of alcohol exposure from a young age.  

Genetic and Environmental Risk Factors for Alcohol Addiction

Individuals may inherit a susceptibility to addiction, making them more vulnerable to alcohol's effects. Environmental factors also significantly contribute to the development of alcohol use disorders. Here is a list of risk factors for alcoholism:

  • Family History: Having relatives with addiction issues increases one's risk due to genetics.
  • Early Drinking: Starting to drink at a young age boosts the likelihood of later addiction.
  • Peer Pressure and Social Norms: The influence of friends and cultural attitudes towards drinking plays a significant role.
  • Stress and Trauma: High stress or PTSD can lead to using alcohol as a coping mechanism.
  • Mental Health Issues: Conditions like depression and anxiety are often linked with higher rates of alcohol use.
  • Socioeconomic Factors: Economic hardships and cultural contexts can affect drinking behaviors.
  • Isolation: Lack of social support may increase the tendency to turn to alcohol.
  • Home Environment: Exposure to alcohol use at home can influence one's own drinking patterns.
  • Education and Employment: Lower education levels and job-related stress can contribute to alcohol misuse.

The Role of Mental Health

Mental health conditions play a pivotal role. Many individuals struggling with mental health challenges, such as anxiety or depression, may turn to alcohol as a form of self-medication, inadvertently setting the stage for addiction. 

Recognizing the Symptoms of Alcohol Use Disorder

Understanding Alcohol Use Disorder (AUD) requires awareness of both physical and behavioral indicators that signal an unhealthy relationship with alcohol. Key symptoms to look out for include:

  • Physical Signs:
    • Increased tolerance to alcohol, needing more to feel its effects.
    • Withdrawal symptoms when not drinking, such as shaking, sweating, and nausea.
    • Neglecting personal grooming and nutritional needs.
  • Behavioral Signs:
    • Drinking more or for longer periods than initially intended.
    • Persistent desire or unsuccessful attempts to cut down on alcohol use.
    • Continuing to drink despite it causing problems in relationships or at work.
    • Reducing participation in social, occupational, or recreational activities.

Diagnostic Criteria for Alcoholism

The diagnostic criteria for Alcohol Use Disorder (AUD) as defined by the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), include a pattern of alcohol use leading to clinically significant impairment or distress, as manifested by at least two of the following criteria within a 12-month period:

  • Alcohol is often taken in larger amounts or over a longer period than was intended.
  • There are unsuccessful efforts to cut down or control alcohol use.
  • Time is spent in activities involving alcohol, use of alcohol, or recovery from its effects.
  • Craving, or a strong desire or urge to use alcohol.
  • Recurrent alcohol use resulting in a failure to fulfill obligations at work, school, or home.
  • Continued alcohol use despite having persistent social or interpersonal problems
  • Important social, occupational, or recreational activities are reduced 
  • Recurrent alcohol use in hazardous situations 
  • Alcohol use is continued despite recurrent physical or psychological problems
  • A change in tolerance for alcohol 
  • Withdrawal when alcohol consumption is stopped

The severity of AUD is gauged based on the number of criteria met: mild (2-3 criteria), moderate (4-5 criteria), and severe (6 or more criteria).

Exploring Treatment Options for Alcohol Use Disorder

Treating Alcohol Use Disorder (AUD) involves a comprehensive approach tailored to meet the individual needs of those affected. Effective treatment plans often include a combination of medications, behavioral treatments, and support groups, each playing a unique role in the recovery process.

Here are the Treatment Options for Alcohol Addiction:

  • Medications: Several medications are approved by the FDA to treat AUD, including Naltrexone, Acamprosate, and Disulfiram. These medications can help reduce drinking, prevent relapse, or create adverse reactions to alcohol to discourage drinking.
  • Behavioral Treatments: Behavioral therapies are aimed at changing drinking behavior through counseling. Cognitive-behavioral therapy (CBT), Motivational Enhancement Therapy, and Marital and Family Counseling are common approaches that help individuals develop skills to stop or reduce their drinking, build a strong support system, and cope with the triggers of relapse.
  • Support Groups: Groups like Alcoholics Anonymous (AA) and other community support groups offer a network of individuals facing similar challenges. These groups provide emotional support, shared experiences, and a sense of belonging that can be crucial for long-term recovery.

The Role of Treatment Centers

Treatment centers offer a personalized strategy with a supportive and structured recovery environment. They provide a blend of services tailored to each person's needs. These centers focus on teaching coping skills for sobriety, integrating treatments like behavioral therapy and support groups. They also assist in aftercare planning to maintain long-term recovery, addressing the comprehensive needs of individuals from physical detoxification to psychological support.

Recovery is possible

Can Recovery from Alcoholism Happen?

Curing alcoholism is achievable. Overcoming the challenges in treatment requires dedication, support, and addressing both the physical and psychological aspects of addiction. With effective treatment plans, individuals can navigate the path to recovery and rebuild their lives free from alcohol dependence. According to the National Institute on Alcohol Abuse and Alcoholism more than one-third (35.9 percent) of U.S. adults with alcohol dependence (alcoholism) that began more than one year ago are now in full recovery.

Is alcoholism officially considered a disease?

Yes, the medical community acknowledges alcoholism as a disease, specifically referred to as Alcohol Use Disorder (AUD), marked by the inability to regulate or stop drinking despite harmful consequences.  

Can alcoholism be described as just a state of mind?

No, alcoholism transcends being a mere state of mind, involving physical dependence, psychological challenges, and genetic factors.

Is alcoholism classified as a mental illness or a disease?

Alcoholism is recognized as both a mental illness and a chronic disease, impairing brain function and influencing behavior to make controlling alcohol consumption difficult.

What are the different types of alcoholics?

Research identifies four main types: young adult, young antisocial, functional, and chronic severe alcoholic, each with unique drinking habits and impacts.

Is consuming alcohol inherently wrong?

Drinking alcohol is a personal choice and not inherently wrong unless it leads to adverse effects on health, relationships, or legal status.

How is an alcoholic defined?

An alcoholic is someone who experiences a compelling urge to drink alcohol to the point where it overrides their ability to control it, detrimentally affecting their life and health.

What is the primary cause of alcoholism?

Alcoholism results from a mix of genetic, psychological, and environmental factors that collectively influence an individual’s drinking patterns and relationship with alcohol.

What is the role of denial in Alcohol Use Disorder (AUD)?

Denial is a common issue in AUD, often preventing individuals from recognizing their problem. An may underestimate the amount of alcohol they consume, its impact on their life, or their ability to control it, making it challenging to seek help.

Can lifestyle changes and therapy alone suffice for treating AUD?

For some individuals with Alcohol Use Disorder, lifestyle changes and therapy, including individual counseling, can play significant roles in the recovery process. According to health experts, incorporating healthy habits such as regular exercise, a balanced diet, and stress-reduction techniques can support overall well-being and reduce the likelihood of relapse. Therapy sessions can address psychological aspects of addiction, helping individuals understand their drinking patterns, identify triggers, and develop coping strategies.

How can I support a loved one who is struggling with Alcohol Use Disorder?

Supporting a loved one with Alcohol Use Disorder involves being understanding, patient, and encouraging them towards seeking help. It’s important to communicate your concerns without judgment and express your willingness to support them through their recovery journey. According to the CDC, providing emotional support and encouraging engagement with treatment and support groups can make a significant difference in their recovery process.

For families dealing with a loved one who is an alcoholic in denial about their condition, engaging in family therapy can be an effective way to address the situation. Family therapy can help improve communication, resolve conflicts, and create a supportive environment that encourages the individual to recognize the need for help and consider treatment options.

The Grove Editorial Team is a dynamic group of professionals at The Grove, a leading addiction treatment center in Indianapolis, Indiana. Comprising experienced therapists, medical experts, and dedicated support staff, this team brings a wealth of knowledge and compassionate insight into the complexities of addiction and recovery. Their collective expertise shines through in each article, offering readers valuable guidance, the latest in addiction science, and inspiring stories of healing and transformation. The Grove Editorial Team is committed to educating, supporting, and empowering individuals and families on their journey toward a healthier, substance-free life.

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