ALCOHOLISM - THE DISEASE CONCEPT

al·co·hol·ism   [al-kuh-haw-liz-hum] 
noun - Pathology 

A chronic disorder characterized by dependence on alcohol,  repeated excessive use of alcoholic  beverages, the development of withdrawal symptoms on reducing or ceasing intake, morbidity that may include cirrhosis of the liver, and decreased ability to function socially and vocationally.


dis·ease   [dih-zeez] noun, verb, -eased, -eas·ing.
noun

a disordered or incorrectly functioning organ, part, structure, or system of the body resulting from the effect of genetic or developmental errors, infection, poisons, nutritional deficiency or imbalance, toxicity, or unfavorable environmental factors; illness; sickness; ailment.

The following article from about.com sums up the disease concept of alcoholism and provides an illustrative example.

One of the difficulties in recognizing alcoholism as a disease is it just plain doesn't seem like one. It doesn't look, sound, smell and it certainly doesn't act like a disease. To make matters worse, generally it denies it exists and resists treatment. Alcoholism has been recognized for many years by professional medical organizations as a primary, chronic, progressive and sometimes fatal disease. The National Council on Alcoholism and Drug Dependence offers a detailed and complete definition of alcoholism, but probably the most simple way to describe it is "a mental obsession that causes a physical compulsion to drink."

Mental obsession? Did you ever wake up in the morning with a song playing over and over in your head? It might have been a commercial jingle you heard on television, or a song from the radio, but it kept playing ... and playing and playing. Remember what that was like? No matter what you did, that silly tune kept on playing. You could try to whistle or sing another song or turn on the radio and listen to another tune, but the one in your head just kept on playing. Think about it. There was something going on in your mind that you didn't put there and, no matter how hard you tried, couldn't get out!

That is an example of a simple mental obsession -- a thought process over which you have no control. Such is the nature of the disease of alcoholism. When the drinking "song" starts playing in the mind of an alcoholic, he is powerless. He didn't put the song there and the only way to get it to stop is to take another drink.

The problem is the alcoholic's mental obsession with alcohol is much more subtle than a song playing in his mind. In fact, he may not even know it's there. All he knows is he suddenly has an urge to take a drink -- a physical compulsion to drink.

Progressive Disease

Compounding the problem is the progressive nature of the disease. In its early stages, taking one or two drinks may be all it takes to get the "song" to stop. But soon it takes six or seven and later maybe ten or twelve. Somewhere down the road the only time the song stops is when he passes out.

The progression of the disease is so subtle and usually takes place over such an extended period of time, that even the alcoholic himself failed to notice the point at which he lost control -- and alcohol took over -- his life.

No wonder denial is an almost universal symptom of the disease. For those who have come to the realization that they do have a problem, help may be as close as the white pages of the telephone directory. But for those who need help and do not want it, intervention may be the only alternative.

In a 1992 JAMA article, the Joint Committee of the National Council on Alcoholism and Drug Dependence, Inc. (NCADD) and the American Society of Addiction Medicine (ASAM) published this definition for alcoholism:
“Alcoholism is a primary chronic disease with genetic, psychosocial and environmental factors influencing its development and manifestations. The disease is often progressive and fatal. It is characterized by impaired control over drinking, preoccupation with the drug alcohol, use of alcohol despite adverse consequences, and distortions in thinking, mostly denial. Each of these symptoms may be continuous or periodic.”