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 simplest way to describe it is “a mental obsession that causes a physical compulsion to drink.”
Early signs of alcoholism include frequent intoxication, an established pattern of heavy drinking and drinking in dangerous situations, such as when driving. Other early signs of alcoholism include black-out drinking or a drastic change in demeanor while drinking, such as consistently becoming angry or violent. The main symptom of alcohol abuse occurs when someone continues to drink after their drinking reaches a level that causes recurrent problems. Continuing to drink after it causes someone to miss work, drive drunk, shirk responsibilities or get in trouble with the law is considered alcohol abuse.
The Diagnostic and Statistical Manual of Mental Disorders, IV, defines alcohol abuse as drinking despite alcohol-related physical, social, psychological, or occupational problems, or drinking in dangerous situations, such as while driving. The World Health Organization’s International Classification of Diseases refers to “harmful use” of alcohol, or drinking that causes either physical or mental damage in the absence of alcohol dependence. In other words, alcohol abuse is any harmful use of alcohol.
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.
The scenario has been played over and over many times. After a particularly damaging or embarrassing binge, the hungover person will make an oath to himself and others to drink “never again” and quite often is sincere about quitting. But with the onset of withdrawal symptoms, also comes the “craving” for more alcohol. The body is telling the drinker that it “needs” alcohol. As the physical symptoms of withdrawal begin to increase, taking another drink simply becomes less painful than not taking one — or so it seems at the time.
Sometimes admitting to yourself and others that you need help can be one of the most difficult steps to take on your road to recovery. In our society, the myth prevails that an alcohol problem is somehow a sign of moral weakness. “As a result, you may feel that to seek help is to admit some type of shameful defect in yourself. In fact, however, alcoholism is a disease that is no more a sign of weakness than is asthma or diabetes.”
Based on your doctor’s assessment of the severity of your problem, your treatment could involve several phases. If you have become “chemically dependent” upon alcohol, treatment may include detoxification; taking doctor-prescribed medications, to help prevent a return to drinking once drinking has stopped; and individual and/or group counseling. Counseling can help you identify situations and feelings that “trigger” the urge to drink and to find new ways to respond that do not include alcohol. These treatments are usually available in a hospital or residential treatment facility or on an outpatient basis. Because the involvement of family members can be important, many programs also offer marital counseling and family therapy as part of the treatment process.