Alcohol abuse

Summary

Alcohol has been consumed by people in all parts of the world for thousands of years. Most people who routinely consume alcohol generally do not develop drinking problems. Nevertheless, the millions of people who do develop problems associated with alcohol create enormous social, economic and medical costs to society. Complications resulting from chronic alcohol problems include liver damage, strokes and memory loss, as well as a host of negative life events. Although the term ‘alcoholism’ is used widely in both the lay and professional communities, its lack of specificity and moralistic overtones have led to use of alternative terms such as ‘alcohol abuse’ and ‘alcohol dependence’ in recent diagnostic formulations.

In the most recent edition of the Diagnostic and Statistical Manual of the Mental Disorders (DSM-IV-text revision: American Psychiatric Association, 2000), ‘alcohol dependence’ includes biological, psychological and social components. Most importantly, alcohol dependence involves difficulty controlling alcohol consumption and continued drinking despite aversive consequences. Edwards (1986) notes an increase in the salience of drinking, with alcohol taking on an increasingly dominant role in a drinker's life, as an important element in the alcohol dependence syndrome. Although none of the following is required for diagnosis, alcohol dependence symptoms include: tolerance (a diminished effect of alcohol, usually accompanied by increased consumption); withdrawal symptoms following reduced consumption; consumption of larger amounts or for a longer time period than was intended; persistent desire or unsuccessful efforts to cut down or control drinking; excessive time spent obtaining, consuming, or recovering from the effects of alcohol; reduction of important activities due to drinking; and continued drinking despite knowledge that it is causing or exacerbating a physical or psychological problem.