Definition of Alcoholism
The definition of alcoholism has changed over the years, as experts’ understanding of the disease has grown. According to the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM), an alcohol use disorder occurs when the recurrent use of alcohol causes clinically and functionally significant impairment, such as health problems, disability, and failure to meet major responsibilities at work, school, or home. Alcohol use disorder (AUD) is now classified by using 11 criteria that describe drinking habits. By assessing a person according to the new DSM criteria, individuals are now classified as having none, mild, moderate, or severe use disorder. Moderate and Severe would be equivalent to addiction. The benefit of using the DSM-5 definition of alcohol dependence is it reflects the very dangerous downward spiral many people have from alcohol use, to abuse into alcohol dependence, and then addiction. Read more and take a quiz reviewed by Dr. Karl Benzio using the DSM’s 11 criteria here: Alcohol Use Disorder Quiz
What it Means to be an Alcoholic
Quite simply, an alcoholic is the person who experiences consequences from drinking but can’t control their drinking, even if they try.
Some drinkers completely lose everything: their spouse, their family, their job, their house, their direction, their spiritual hope and connection to God, and their health, often dying a difficult death. Everything is consumed by their desire to drink, no matter the damage it is doing to their life.
Sadly, the usual slide into alcohol destruction is a gradual one, when the person holds it together for some time (and often with the help of enabling loved ones), and then slowly loses control. Since it is gradual, neither the addict nor the loved ones realize what’s happening until the hole is pretty deep and the damage is significant.
Other alcoholics are called functioning alcoholics, because these individuals are addicted to alcohol and cannot stop drinking, but have learned to live a juggling act where they can hold down a job and keep their family intact. Their relationships suffer, their finances are not what they should be, their emotional maturity is poor, and they are in danger of losing it all because of their drinking. Even though a functioning alcoholic may feel like they’re still able to carry out everyday responsibilities and life is OK on the surface, the foundation of their life is cracking and the fall is inevitable.
According to the Substance Abuse and Mental Health Services Administration (SAMHSA), 16.3 million adults ages 18 and older (6.8 percent of this age group) had an alcohol use disorder in 2014. This includes 10.6 million men (9.2 percent of men in this age group) and 5.7 million women (4.6 percent of women in this age group). Clearly, this is an issue that is causing devastation in many lives, and needs to be dealt with. Dr. Karl Benzio
Alcoholism begins with alcohol use, then abuse, but not everyone who abuses alcohol will become addicted to it. Risk factors for alcoholism include: environment, age, ethnicity, and family history. According to the National Council on Alcoholism and Drug Dependence, genetic temperament can make up 50% of the risk for alcohol and drug dependence.
The two biggest risk factors are:
- Trouble handling stress and needing to escape, self-medicate, or soothe your discomfort immediately,
- Not being connected or feeling you belong to something significant. A person develops a dysfunctional relationship with a bottle, looking to alcohol to meet many of their relational needs.
In addition, people who are depressed, were a victim of past trauma, have other mental health or medical problems, prone to peer pressure, have low self-esteem, or are faced with a high level of stress are more likely to struggle with alcohol use disorder. Those who binge drink on a regular basis are also at greater risk for developing an alcohol addiction.
Symptoms of Alcohol Abuse Disorder
Symptoms of alcohol abuse disorder are based on the consequences that occur as a result of excessive drinking.
Individuals with alcohol use disorder will:
- Have a high tolerance for alcohol (can drink more than normal people or have less acute impairment than others)
- Crave alcohol and develop withdrawal symptoms when they don’t drink
- Neglect personal hygiene
- Miss work or school because of drinking
- Develop poor eating habits
- Be unable to control drinking, despite legal, social, and financial problems
- Make frequent excuses, lies, tells partial truths or are secretive
- Become irritable or have an edgy attitude
- Suffer with depression or anxiety
- Experience difficulties with responsibilities, reliability, or trustworthiness
- Drink alone
- Give up things that were once important to them because of their drinking
- Become defensive when approached about their drinking
- Experience blackouts due to drinking
- Experience cirrhosis of the liver and other health issues because of alcohol consumption or impairment (falls and accidents)
Assessment and Professional Diagnosis
The best place to start when you suspect alcoholism among a loved one is your family doctor or a psychiatrist. These doctors can perform an assessment to help determine your loved one’s level of alcohol abuse and dependence. Typically, the doctor’s assessment will consist of some pointed questions about the person’s life situation and stressors, functioning, drinking habits, and lifestyle. Blood work can be done to assess the impact of the person’s drinking on the liver, blood chemistry, blood count, and other organs. Your doctor can then diagnose your loved one and recommend a treatment plan.
Your loved one’s rehab center will also conduct an assessment to help them determine the intensity of treatment and level of care appropriate for the needs. Even though your loved one is embarrassed or ashamed about their drinking, it’s important during these assessments and diagnostic tests that they don’t downplay their drinking habits. The more honest the person is, the more likely it is for your insurance to approve the intensity of treatment necessary for a long enough period of time for the best chance of success.
Prognosis and Recovery
Alcoholism is a devastating disease, and the longer it continues, the poorer the prognosis if the person doesn’t get professional treatment. With a good Christian rehab program, however, an individual can learn how to overcome this disease and enjoy a sober life. Treatment for alcoholism includes first of all detox, and then intense psychotherapy and behavioral management. As your loved one learns how to heal some past wounds, renew their attitude, transform their thinking, strengthen their decision-making skills, and gain a deeper understanding of their goals and beliefs, they can defeat this disease and enjoy fulfilled life achieve their God-given potential. The key is finding the rehab program that will customize the treatment to your loved one’s specific struggles and personality, use proven therapy methods, and help devise a long-term treatment strategy. To learn more about how to choose the right alcohol rehab, visit: http://lighthousenetwork.org/alcohol-rehab-guide/selecting-best-alcohol-rehab-needs/
Prevention of Alcohol Use Disorder
Of course, the best way to handle alcoholism is to not let it start in the first place. But for some, though, drinking responsibly and for momentary enjoyment is controllable, fine, and will not lead to physical dependence or addiction. These individuals need only drink responsibly and in moderation to keep them from developing alcoholism. If you choose to drink, set up some limits and monitor potential red flags to make sure alcohol use stays biologically, psychologically, and spiritually healthy.
But others need to guard their actions closely so they do not fall into the trap of alcoholism. For those at high risk of alcohol addiction (those who have a family history of alcoholism, who suffer from psychological issues, high level of stress, who have addictive tendencies, etc), not drinking at all and getting some counseling to help with stressors and psychological struggles will not only help avoid the trap of alcoholism, but also free you from other psychological baggage weighing you down on your journey through life.
The problem arises in determining what kind of person is at highest risk for alcoholism and helping them see what they risk by drinking. This takes education starting in the family, schools, and at a community-wide level. Couple this with regular screening by physicians and health professionals so everyone’s antennae are up and our society will become better at preventing this disease.
Many professionals advise not drinking at all, as no significant or sustained benefits are gained from drinking alcohol. Why play with fire? God will provide you peace, joy, and comfort through safer and healthier options.