Alcoholism Essays (4186 words) - Alcohol Abuse, Alcoholism

Alcoholism alcoholism Definitions and causal factors of alcoholism Alcoholism consists of a repetitive intake of alcoholic beverages to an extent that the drinker is harmed. The harm may be physical or mental; it may also be social or economic. Implicit in the conception of alcoholism as a disease is the idea that the person experiencing repeated or long-lasting injury from his drinking would alter his behaviour if he could. His failure to do so shows that he cannot help himself, that he has lost control over drinking. This conception incorporates the idea of addiction or dependence. Formal definitions of alcoholism vary according to the point of view of the definer. A simplistic, old-fashioned medical definition calls alcoholism a disease caused by chronic, excessive drinking. A purely pharmacological-physiological definition of alcoholism classifies it as a drug addiction recognizable by the need for increasing doses to produce desired effects and by the occurrence of a withdrawal syndrome when drinking is stopped. This definition is inadequate, since alcoholism does not resemble other addictions in the need for increased doses. Opium addicts become adapted to and require as much as hundreds of times the normal lethal dose, but the increased amounts to which alcoholics become adapted are well below the normal single lethal dose. Moreover, the withdrawal syndromes in alcoholism occur inconsistently, sometimes failing to appear in the same persons who experienced them previously and apparently never occurring in some persons who cannot be distinguished from confi rmed alcoholics. Behavioral rather than pharmacological-physiological signs are much more consistent and reliable in defining and diagnosing alcoholism. A sophisticated definition representing modern conceptions of comprehensive medicine classifies alcoholism as a disease of unknown cause, without recognizable anatomical signs, manifested by addiction to or dependence on alcohol. A more comprehensive definition incorporating the perspectives of both psychological and physical medicine recognizes that alcoholism may be either a symptom of another underlying, possibly psychological, disorder or a disease itself: alcoholism, in this view, is a chronic and usually progressive disease or a symptom of an underlying psychological or physical disorder, characterized by dependence on alcohol (manifested by loss of control over drinking) for relief from psychological or physical distress or for gratification from alcohol intoxication itself, and characterized also by a consumption of alcoholic beverages suffic iently great and consistent to cause physical or mental or social or economic disability. Here, the conception of disease undoubtedly rests on the evidence of disablement. The various definitions that rely on the symptom of loss of control over drinking often consider the loss of control to consist of an inability to stop drinking once it is started, implying that the alcoholic can choose not to take the first drink. But the more comprehensive definition sees the alcoholic as starting a drinking episode because he cannot refrain. Nor does the loss of control over drinking hold true all the time. As with symptoms in many diseases, the loss of control is active in most alcoholics only inconsistently. This means that an alcoholic is not always under internal pressure to drink and can sometimes resist drinking, or, if he drinks, he can sometimes drink in a controlled way. The inconsistency of the loss of control is, however, consistent with a definition of alcoholism based on learning psychology: alcoholism, in this definition, is a learned (or conditioned) dependence on (or addiction to) alcohol that irresistibly activates resort to drinking whenever a cr itical internal or environmental stimulus (or cue) presents itself. This definition leaves room for the conception that alcoholism may start as a symptom of an underlying disorder, which induces the learning of the alcoholismic pattern, and that once the pattern is fixed or conditioned it may become a disease in its own right (that is, an addiction), capable of surviving even the disappearance of the original underlying cause. Some theorists who regard alcoholism as primarily a symptom do not necessarily subscribe to the idea that it is learned, although they recognize that it may progress to the state of a primary disease. Alcoholism is a multifarious phenomenon requiring more than one definition. Epidemiologists need a definition that will enable them to identify alcoholics within a population not available for individual examination. Such a definition may rely on a quantity-and-frequency measurement of drinking