I would like to offer a perspective on the complex issue of alcoholism. The definition of alcoholism is a highly debated topic and there is often difficulty in reaching a consensus, even within organisations such as AA, the world's largest addiction organisation, where I have been a member for over 15 years. Despite years of meetings, readings, and prayers, the disease 'model' is not accepted as a definitive diagnosis.
American Society of Addiction Medicine
The American Society of Addiction Medicine defines addiction as a chronic disease of the brain that affects reward, motivation, memory, and related circuits, leading to characteristic biological, psychological, social, and spiritual manifestations that exhibit as substance abuse and other behaviours.
The Diagnostic & Statistical Manual of Mental Disorders DSM-5 lists 11 criteria for Alcohol Use Disorder (AUD), which range from drinking more alcohol than intended, to experiencing withdrawal symptoms when alcohol's effects wear off. A mild AUD involves two or three symptoms, a moderate AUD involves four or five symptoms, and a severe AUD involves six or more symptoms.
The 11 criteria for defining an AUD (Alcohol Use Disorder)are:
- Drinking more alcohol, or for longer, than intended
- Trying to cut down or stop drinking, but being unsuccessful
- Spending a lot of time drinking or feeling sick from a hangover or other aftereffects
- Experiencing interference in daily life and relationships because of drinking or being sick from drinking too much
- Having cravings for alcohol
- Continuing to drink even though it hurt relationships with friends and family
- Cutting back on, or giving up, hobbies to consume more alcohol
- Repeatedly being in situations where alcohol put one at risk of harm
- Having to consume more alcohol to experience the desired effects
- Continuing to consume alcohol even though it worsens a health condition, including anxiety or depression
- Experiencing withdrawal symptoms when alcohol’s effects began to wear off
Dr Gabor Mate
However, other experts, such as Dr. Gabor Mate, question whether addiction can be classified as a disease or an allergy. He looks for the pain that addicts suffer prior to the addictive behaviour. Do not ask, “why the addiction” but “why the pain?”. In order to heal addiction, we must look at the underlying trauma.
In his definition of addiction, Dr. Maté identifies three key components: an intense desire or craving for the addictive substance or behaviour, engaging in the substance or behaviour to attain pleasure or alleviate some form of discomfort, and a persistent inability to abstain from it. He often says that if we continue to do something despite it’s negative consequences, we are addicted.
I have come to the position that addiction often stems from trauma, which can be difficult for some people to understand as it encompasses a wide range of experiences. Genius Recovery has a great resource page which you may want to refer to for further research of your own. Furthermore, I can’t stress enough if one is experiencing pain as a direct consequence of their addiction, to seek help immediately.
I do not have a clear definition of alcoholism but believe that it is a life-threatening issue that kills millions each year and can be treated daily but not cured. I have, so far, found a suitable remedy to my alcoholism that involves the 12-Step Program and Buddhism. I must emphasise that everyone's experience is unique and cannot be defined by one standard definition.
There are several methods for recovery from alcoholism, including:
- Abstinence-based recovery: Abstinence-based recovery involves completely stopping the use of alcohol and relying on support from family, friends, and support groups.
- Medication-assisted treatment (MAT): MAT combines medication, such as naltrexone, acamprosate, and disulfiram, with behavioural therapy and counselling.
- Cognitive behavioural therapy (CBT): CBT is a type of talk therapy that helps individuals identify and change negative thought patterns and behaviours related to alcohol use.
- Motivational interviewing (MI): MI is a client-centered approach that helps individuals explore and resolve their ambivalence about changing their alcohol use.
- Twelve-step programs: Twelve-step programs, such as Alcoholics Anonymous (AA), provide a supportive community, structure, and guidance for individuals in recovery.
- Holistic approaches: Holistic approaches to recovery often focus on addressing the physical, emotional, and spiritual aspects of addiction. This can include practices such as yoga, meditation, acupuncture, and massage.
It is important to note that recovery is an individual process, and what works for one person may not work for another. It is recommended that individuals work with a mental health professional to determine the best course of action for their specific needs.