“Is alcoholism a disease?” is one of the most widely discussed issues concerning addiction and recovery.
Opinions and viewpoints on addiction have changed radically over the years. Where once addiction was perceived as a moral failing or a lack of willpower, most researchers and addiction experts now view alcoholism through the lens of the disease model of addiction.
Before we highlight why alcoholism is now almost universally considered a brain disease, we need to define alcoholism.
What Is Alcoholism?
Alcoholism is an informal term for alcohol use disorder (AUD).
AUD is characterized by the compulsive consumption of alcohol regardless of negative outcomes. As alcohol use disorder sets in, so tolerance for alcohol builds. This means you will need more alcohol to achieve the same effects.
According to NSDUH 2020, 28 million people in the United States meet the criteria of alcohol use disorder with fewer than 10% receiving any form of treatment.
Alcohol use disorder is diagnosed based on the diagnostic criteria in APA’s DSM-5, the most current edition of the Diagnostic and Statistical Manual of Mental Disorders. A mental health professional or addiction specialist will ask you variations of the following eleven questions:
1. Do you often drink more than intended or drink for longer than planned?
2. Have you tried more than once to cut down or eliminate alcohol use?
3. Do you spend lots of time obtaining alcohol, drinking alcohol, and recovering from its effects?
4. Have you experienced cravings for alcohol?
5. Is your alcohol consumption impacting your ability to meet personal and professional obligations?
6. Do you consume alcohol in potentially hazardous situations – when driving, for instance?
7. Is drinking causing problems in your interpersonal relationships?
8. Are you spending less time doing things you once enjoyed in favor of drinking alcohol?
9. Is tolerance to alcohol building so you need more to achieve the same effects?
10. Do you get withdrawal symptoms in the absence of alcohol?
11. Do you continue to drink alcohol despite a psychological or physical problem caused or worsened by alcohol?
Alcohol use disorder is diagnosed as follows depending on the number of symptoms present:
- Mild AUD: 2 or 3 symptoms
- Moderate AUD: 4 or 5 symptoms
- Severe AUD: 6 or more symptoms
The most effective treatment for alcohol use disorder should be personalized. The optimum route to recovery involves medical detox followed by residential rehab or outpatient rehab, depending on your needs, the extent of your alcoholism, and the presence of any co-occurring mental health disorders.
Most rehabs offer access to the following evidence-based therapies:
- Medication-assisted treatment (MAT)
- Psychotherapy (talk therapies like CBT and DBT)
- Family therapy
The right treatment plan will allow you to create a solid foundation for ongoing recovery, while minimizing your chances of relapse.
What Is a Disease?
The American Medical Association (AMA) reports that a condition must satisfy the following before it is classified as a disease:
- The condition represents a bodily dysfunction
- Consistent signs and symptoms are present
- The condition causes bodily harm
Viewing alcoholism through this lens, satisfies all three criteria. Your body will not function normally when you abuse alcohol long-term. Alcoholism is characterized by observable, consistent signs and symptoms, and abusing alcohol will trigger a variety of adverse physical and mental outcomes.
Why Alcoholism Is a Disease
The three areas where the disease of alcoholism manifests negative effects are as follows:
- Alcoholism is damaging to the body
- Alcoholism is damaging to the brain
- Alcoholism is characterized by a loss of control
1) Alcoholism is damaging to the body
The chronic abuse of alcohol leads to many adverse physical effects.
NIAAA reports that 95,000 people die in the United States each year from alcohol-related causes. This makes alcohol abuse the third-leading cause of preventable death in the U.S.
Alcohol can detrimentally affect the heart, liver, and brain. Other potentially negative outcomes of alcohol abuse include:
- High blood pressure
- Increased risk of certain cancers
- Increased risk of dangerous behaviors
- Injury or death from accidents, violence, domestic violence, or suicide
Every case of alcohol use disorder is different, but like all diseases, alcoholism takes a sharp physical toll.
2) Alcoholism is damaging to the brain
Over time, sustained alcohol abuse brings about functional and structural changes to the brain. The nature and scope of the impact on brain health will vary according to the age of the person abusing alcohol and the amount of alcohol they are consuming.
The brain changes caused by abusive alcohol consumption impact these areas:
- Decision making
- Reaction times
- Learning new things
3) Alcoholism is characterized by a loss of control
When someone develops alcohol use disorder, the brain has already been impacted to the extent that willpower alone is unlikely to be enough to stop drinking and maintain a healthy lifestyle.
The loss of control over alcohol consumption is perhaps the most defining symptoms of alcoholism. Those in the grip of alcohol use disorder typically find it challenging to control use, moderate use, or discontinue use.
If you have a loved one struggling with alcohol addiction, it may seem frustrating when they continue to drink in spite of demonstrably negative consequences. If you are experiencing this issue in your life, take a step back and consider that your loved one’s brain is physiologically altered by alcohol abuse.
The definition of addiction will vary from person to person. Viewpoints among medical professionals and organizations also evolve as science continues to shine more light on what drives addiction.
That said, NIH (National Institutes of Health), SAMHSA (Substance Abuse and Mental Health Services Administration), CDC (Centers for Disease Control and Prevention), and NIDA (National Institute on Drug Abuse) all view addiction similarly. All of these organizations describe alcoholism as a chronic and relapsing condition defined by the compulsive use of alcohol despite demonstrably negative consequences.
Those organizations classify alcoholism as a disease or a disorder because addiction changes the way the brain responds to scenarios involving self-control, stress, and reward. Additionally, the changes triggered by alcoholism are long-term, often lingering after the person stops consuming alcohol.
With the medical and scientific communities in almost complete accord concerning the disease model of alcoholism, why is alcoholism considered a chronic disease?
Why Alcoholism is a Chronic Disease
While early-stage alcohol use tends to be voluntary, most experts agree that loss of control follows the brain changes triggered by chronic alcoholism.
Chronic diseases are broadly defined by the CDC as conditions lasting for more than one year and requiring ongoing medical care, while potentially disrupting daily living. Alcohol use disorder is a lifelong and relapsing condition that interferes with daily living, fitting neatly into this definition of addiction as a chronic disease.
Ultimately, however, alcohol use disorder develops, and whatever its root cause, the treatment of alcoholism as a disease will typically generate the most favorable outcomes.
Medical detox will streamline the alcohol withdrawal process, reducing cravings and withdrawal symptoms while ensuring you have continuous emotional and clinical care on hand. This helps you to address the physical component of alcoholism.
After detox, ongoing medication-assisted treatment is often a central component of treatment, always delivered in combination with psychotherapy and counseling.
Cognitive behavioral therapy (CBT) is the most common form of psychotherapy or talk therapy used to treat the symptoms of alcohol use disorder. Working closely with a therapist, you’ll explore and identify what triggers you to use alcohol. Your therapist will help you to formulate healthier coping stressors, enabling you to deal with life’s ups and downs more confidently and without reaching for the bottle.
Like other chronic diseases, alcoholism has a relapse rate of between 40% and 60%. With the appropriate treatment and aftercare plan, though, there is no reason you cannot leave alcohol use disorder behind and embrace lifelong sober living.
Reach Out to Renaissance Recovery for Alcohol Rehab
If you or a loved one is struggling with an alcohol use disorder, or some sort of other addiction problem, reach out to our team at Renaissance Recovery today to better understand how treatment will look for you.
Call our addiction hotline today to get set back on the right path and begin your journey toward long-term recovery.