A state of mental or physical dependence on a drug liable to have a damaging effect
In the 1960s, when the medical profession acknowledged alcohol as a medical condition, a moral view of excessive alcohol use was common. This sought to penalize rather than help the victim. While attitudes have changed considerably, holding responsible the victim is still part of society’s view of alcoholics and can affect legislation to control alcohol availability, for instance those who drink and drive, and cause harm, are frequently condemned in the media for their alcohol intake.
Among medical personnel, alcoholism, as opposed to merely excessive or irresponsible drinking, has been thought of as a symptom of mental or social stress. More recently, and probably more accurately, it has come to be viewed as a complex disease in its own right. Increased tolerence and dependence on alcohol and alcohol as a reward being the result. While the medical viewpoint of alcoholism undoubtedly offers a more humane and effective treatment policy than the moral view, it does mean that only certain people are perceived to constitute the “at risk” group. In fact, anyone who drinks excessively over a long period of time has the potential to cross the boundary between this stage of drinking and alcoholism, where removing access to alcohol would result in alcohol dependence syndrome (ADS).
A family history of alcoholism is one of the strongest predictors of risk. It is thought that the genetic basis for alcoholism may include congenital abnormalities in the brain’s neurotransmitter systems involving dopamine, opioid, and serotonin.
Alcoholism usually develops over a period of years. Early and subtle symptoms include placing undue importance on the availability of alcohol. Ensuring this availability strongly influences the person’s choice of friends, colleagues or activities. Alcohol comes to be used more as a mood-changing drug than as a drink served as a part of social customs.
Initially, the alcoholic may demonstrate a high tolerance to alcohol, consuming more and showing fewer adverse effects than others. Subsequently, however, the person begins to drink against his or her own best interests, as alcohol comes to assume more importance than personal relationships, work, reputation, or even physical health. The person commonly loses control over drinking and is increasingly unable to predict how much alcohol will be consumed on a given occasion or, if the person is currently abstaining, when the drinking will resume again. Physical addiction to the drug may occur, sometimes eventually leading to drinking around the clock to avoid withdrawal symptoms.
Alcohol has direct toxic as well as sedative effects on the body, and failure to take care of nutritional and other physical needs during prolonged periods of excessive drinking may further complicate matters. Alcoholics frequently suffer from protein deficiency and lack of B vitamins Advanced cases often require hospital treatment for alcohol-related disabilities, and specialist psychiatric units may be necessary to deal with the withdrawal symptoms associated with the most severe aspects of alcohol dependence syndrome (ADS).
Excessive alcohol consumption affects virtually all the major organ systems of the body and the effects are cumulative. Among the primary causes of death resulting from alcohol abuse are liver disease, severe respiratory infections, cancer(most commonly of the digestive system and upper respiratory system, cardiovascular disease, suicide and the effects of violence and accidents.
