Alcoholism and Alcohol Use Disorder

What is Alcoholism?

Alcoholism is a non-medical term for someone with an alcohol problem. Alcohol Use Disorder (AUD) is a diagnosis made by medical professionals for people suffering from an alcohol addiction or dependency. AUD is a “chronic relapsing brain disease characterized by compulsive alcohol use, loss of control over alcohol intake, and a negative emotional state when not using” NIAAA.NIH.gov.

Given the genetic factors that contribute to developing AUD and the evolution of the terminology, the following is a succinct timeline of alcoholism.

When was Alcoholism Identified as a Problem

In 1819, C.W. Hufeland coined the term “dipsomania” (preceding the term “alcoholism”). Dipso came from the Greek word which meant “thirst”. Hufeland specifically used it in context with alcohol to describe the chronic craving for the drink.

In 1849, Magnus Huss first used the term “alcoholism” to describe the adverse and systematic side effects of alcohol consumption.

Alcoholism Disease v Alcohol Dependence Syndrome

In 1956, the American Medical Association (AMA) declared alcoholism a disease, however in 1979 the World Health Organization (WHO) disagreed with AMA stating alcoholism was an imperfect term as it did not specify the illness. Even the co-founder of Alcoholics Anonymous stated it was an imperfect term, saying, “We have never called alcoholism a disease because it is not a disease entity… We called it an illness or a malady”. (McGovern, Thomas. Alcohol Problems in the United States: Twenty Years of Treatment Perspective. 2002.)

As a result, WHO chose the term, “alcohol dependence syndrome” in 1979.

Alcoholism v Alcohol Use Disorder

In the 1980’s however, the Diagnostic and Statistical Manual of Mental Disorders (DSM) – the most-used global standard in psychology and psychiatry – split “alcoholism” into “alcohol abuse” and “alcohol dependence”. Alcohol abuse was defined as the repeated use of alcohol despite negative and recurring consequences. Alcohol dependence meanwhile was considered alcohol abuse, but with the uncontrollable cravings and withdrawals.

In 2012, DSM-5 was released and a notable change was alcohol abuse and alcohol dependence were merged into on condition called “Alcohol Use Disorder” (AUD) with varying levels of severity.

Diagnosing Alcohol Use Disorder

DSM-5 listed 11 symptoms associated with Alcohol Use Disorder. People are usually diagnosed with AUD if they have experienced a combination of these symptoms in the last 12 months.

1. Feeling unable to restrict the amount of alcohol consumed.

2. Drinking more than intended or drinking for a longer period of time than intended.

3. Sickness or illness brought on by drinking in excess.

4. Inability to focus due to thoughts of drinking or wanting to drink.

5. Drinking despite being cognizant of recurring, negative effects: health, depression, blacking out, etc.

6. Loss of job, productivity, and/or performance in school.

7. Finding oneself in risky, dangerous, or harmful situations due to inebriation.

8. Decreased motivation to participate in hobbies or activities that were once held as important.

9. Consuming more alcohol regularly due to a heightened tolerance.

10. Continuing to drink despite problems its caused with friends, family, and relationships.

11. Experiencing withdrawal symptoms.

The DSM also labels a level of severity to the person suffering AUD, from mild to moderate and severe. If you suffer from 2-3 symptoms above in a 12-month period, then it’s considered mild AUD; 4-5 is moderate; 6 or more is considered severe AUD.