Definitions of Alcoholism:

Alcoholism has been understood to include the misuse, problem use, abuse, and/or heavy use of alcohol which may cause physical, social, or moral harm to the drinker. Moderate use is defined by The Dietary Guidelines for Americans as no more than two alcoholic beverages a day for men and no more than one alcoholic beverage a day for women.

Some drinkers may drink more than 600 ml of alcohol per day during a heavy drinking period. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) defines binge drinking as the amount of alcohol leading to a blood alcohol content (BAC) of 0.08, which, for most adults, would be reached by consuming five drinks for men or four for women over a 2-hour period.

Men may be at risk for alcohol-related problems if their alcohol consumption exceeds 14 standard drinks per week or 4 drinks per day, and women may be at risk if they have more than 7 standard drinks per week or 3 drinks per day. It defines a standard drink as one 12-ounce bottle of beer, one 5-ounce glass of wine, or 1.5 ounces of distilled spirits.

In professional and research contexts, the term “alcoholism” sometimes encompasses both alcohol abuse and alcohol dependence, and sometimes is considered equivalent to alcohol dependence. Talbot (1989) observes that alcoholism in the classical disease model follows a progressive course: if a person continues to drink, their condition will worsen. This will lead to harmful consequences in their life, physically, mentally, emotionally and socially.

Johnson (1980) explores the emotional progression of the addict’s response to alcohol. He looks at this in four phases. The first two are considered “normal” drinking and the last two are viewed as “typical” alcoholic drinking.  Johnson’s four phases consist of:

Learning the mood swing. A person is introduced to alcohol (in some cultures this can happen at a relatively young age), and the person enjoys the happy feeling it produces. At this stage there is no emotional cost.

Seeking the mood swing. A person will drink to regain that feeling of euphoria experienced in phase 1; the drinking will increase as more intoxication is required to achieve the same effect. Again at this stage, there are no significant consequences.

At the third stage there are physical and social consequences, i.e., hangovers, family problems, work problems, etc. A person will continue to drink excessively, disregarding the problems.

The fourth stage can be detrimental, as Johnson cites it as a risk for premature death. As a person now drinks to feel normal, they block out the feelings of overwhelming guilt, remorse, anxiety, and shame they experience when sober.

Preferred term(s) Definition of Alcoholism Related Conditions:

APA’s DSM-IV “alcohol abuse” and “alcohol dependence”
alcohol abuse = repeated use despite recurrent adverse consequences.
alcohol dependence = alcohol abuse combined with tolerance, withdrawal, and an uncontrollable drive to drink.[96] The term “alcoholism” was split into “alcohol abuse” and “alcohol dependence” in 1980’s DSM-III, and in 1987’s DSM-III-R behavioral symptoms were moved from “abuse” to “dependence”.[97] It has been suggested that DSM-V merge alcohol abuse and alcohol dependence into a single new entry,[98] named “alcohol-use disorder”.
WHO’s ICD-10 “alcohol harmful use” and “alcohol dependence syndrome” Definitions are similar to that of the DSM-IV. The World Health Organisation uses the term “alcohol dependence syndrome” rather than alcoholism.[24] The concept of “harmful use” (as opposed to “abuse”) was introduced in 1992’s ICD-10 to minimize underreporting of damage in the absence of dependence. The term “alcoholism” was removed from ICD between ICD-8/ICDA-8 and ICD-9.
The DSM-IV diagnosis of alcohol dependence represents one approach to the definition of alcoholism. In part this is to assist in the development of research protocols in which findings can be compared to one another. According to the DSM-IV, an alcohol dependence diagnosis is: “maladaptive alcohol use with clinically significant impairment as manifested by at least three of the following within any one-year period: tolerance; withdrawal; taken in greater amounts or over longer time course than intended; desire or unsuccessful attempts to cut down or control use; great deal of time spent obtaining, using, or recovering from use; social, occupational, or recreational activities given up or reduced; continued use despite knowledge of physical or psychological sequelae.”

Treatment of Alcoholism at Denali Healthcare:

At Denali Healthcare we treat Alcoholism using a multi pronged approach centered on support, referrals for counseling and medication.  We support Alcoholics Anonymous (to find a meeting click here).  Each office can help you find other local counseling resources.  We view alcoholism as a treatable condition, not a character flaw.  Our goal is your sobriety.

Medications helpful in the treatment of alcoholism to reduce cravings used by Denali Healthcare:

Acamprosate-  Typical Dosage is 2 tablets three times a day.  Studies suggest this medication, which is the most affordable option, reduces cravings by 40%.  There are several protocols for the use of acamprosate, but it relies on consistent and daily use.  Liver functions must be monitored.

Vivitrol-  A once a month injection provides consistent therapy that does not rely on remembering to take a daily medication.  The downside is the cost of the therapy.