What is Alcoholism
By Carla Moore, LCPC, LCAC
According to Joint Committee of the National Council on Alcoholism and Drug Dependence and the American
Society of Addiction Medicine, "Alcoholism is a primary chronic disease with genetic, psychosocial, and
environmental factors influencing its development and manifestations. The disease is often progressive
and fatal. It is characterized by impaired control over drinking, preoccupation with the drug alcohol,
use of alcohol despite adverse consequences, and distortions in thinking, mostly denial. Each of these
symptoms may be continuous or periodic."
“Alcoholism is a primary…” – what does this mean? According to www.Dictionary.com, a primary disease
is, “A disease arising spontaneously and not associated with or caused by a previous disease or injury.”
In other words, alcoholism and addiction are not CAUSED by other things. People are not alcoholic (or addicted)
because they had a difficult childhood, are in a bad marriage or have a stressful job. If someone is addicted,
they would be addicted regardless of external factors.
When we talk about addiction being a …"chronic disease"…, this means a disease that is long-lasting or recurrent.
Once an alcoholic or addict, always an alcoholic or addict. Once we lose the ability to control our drinking or
using, we will never regain the ability to control our intake or predict the outcome of our use. This is comparable
to diabetes and heart disease. The disease is manageable as long as we stay within the limitations presented by the
disease. There is hope for a productive, meaningful life for alcoholics and addicts!
When we talk about genetic factors of addiction, we are talking about the tendency for addiction to run in
families. This is the same with heart disease, cancer and diabetes. If a direct relative (parents, grandparents,
etc.) is addicted, your chance of addiction increases. For men, if your father was addicted, you have 4 times the
chance of becoming addicted if you use than the person off the street. For women, this number is smaller. This
is why we encourage people who are addicted, or have addiction in their family, to TALK about it with their families.
The more information your family has about addiction, the better chance they have of making an intelligent choice
as to whether to begin drinking/using or not.
Psychosocial factors reflect our personal growth as it relates to our social interactions. Alcoholics and addicts
have a tendency hang out with people who abuse alcohol or drugs. They begin to reflect the values of the people
they socialize with so their actions and beliefs do not stand out from their peers. As a family member or friend who
is watching someone enter the downward spiral of addiction, you begin to notice an increase in lying, sneaking
alcohol or drugs, a lower class of friends and/or an increase in excuses to drink/drug or not follow through with
Finally, environmental – where do you work, live, or play? One of the sayings in 12-step recovery meetings is,
“If you hang out in the barber shop long enough, you’ll get a hair cut.” This is a direct statement towards people
who are trying to get and stay sober hanging out in bars or at using friends’ homes. Are most of your clothes or
walls decorated with advertisements for beer, alcohol or drugs? Do you only go where beer or alcohol is served?
All of these are environmental factors to take into consideration. As humans, we have a tendency to surround
ourselves with what is important to us.
When we are talking about alcoholism (or addiction) we are talking about a disease which is progressive. In
other words, if left untreated, it will continue to get worse…not better. Most people begin drinking for the
social aspect or to relieve tension. As the disease grows in people who are susceptible, the need to drink more
often regardless of consequences becomes stronger. People begin to sneak drinks, drink before going out to drink,
lie about small things (including how much they have had to drink), experience blackouts (not the same as passing
out) and physical complaints. If left untreated, alcoholics can drink or drug themselves to death. It’s often a
long, drawn out process which affects the family and people who love the alcoholic, in painful ways.
Addiction can be continuous or happen in binges (periodic). Someone who is a continuous user or drinker will use on
a daily basis. This can grow to around the clock. This usually doesn’t happen at the beginning of the use but
escalates over time. Also the amount that is used increases over time as well and is called tolerance. This means
it takes more of the drug-of-choice to get the desired result.
Another pattern of use is called periodic, or binge, drinking/using. People with this drinking style can go for
extended periods of time between drinking events. This can be a matter of days to months but when they do begin
drinking, they cannot control the amounts they drink or the length of the binge. Some people drink for a weekend,
others for weeks. People with this type of drinking/using style are often the most difficult to treat because they
view their ability to NOT drink for lengths of time as control over their drinking. What they forget is that once
their use begins, they lose the illusion of control.
Addicted people have difficulty controlling the use of their substance of choice. Alcoholics and addicts can
control (or stop) their using at times, especially if a family member challenges them. But there will come a
time when they will not be able to predict how much or how long they will use once they have begun. The ability
to control one’s use decreases over time.
Alcoholics and addicts become preoccupied with their drug-of-choice. They spend most of their time getting and
finding their substance, using it or detoxing from it. You will discover over time they will stop attending
functions or going to places which do not sell alcohol or allow them to use freely. Many end up staying at home
and limiting their social involvement. Often extended family contact is the first to go as well as friends who
do not use.
One of the things which separate alcoholics and addicts from social users is their ability to justify their
continued use regardless of consequences. These can include loss of family, jobs, or money, jail time,
accidents, declining health. This is often a place where family and friends get confused. If it were a matter
of choice, the person would be able to stop. No one wants to experience the pain which comes with being completely
powerless over their chemical use! The goal is often to find a way to “drink without consequences”. It is
difficult for alcoholics and addicts to admit they have lost control.
Finally… the distortions in thinking. This can be one of the most frustrating parts of the disease from the family
standpoint. We have a tendency to try to apply logic to an illogical disease. What we don’t realize is that the
person’s thinking has been twisted by use of their drug-of-choice. The disease begins to warp the person’s focus
to protect the use. This can be seen in denial.
This is not the same as lying. In lying, the person consciously
does not tell the truth. Denial is subconscious – the addict/alcoholic actually believes what they are saying!
In recovery circles people say, “Denial – Don’t Even Notice I Am Lying.” Blame becomes one of the common defensive
stances of the addicted person. “It’s your [or the police’s, the boss’, the bank’s] fault.
Need Expert Advice?
Reference Our Clinician Library, Articles,
And Videos By Clicking Here