What Is Alcoholism?Alcoholism is a chronic disease, progressive and often fatal; it is a primary disorder and not a symptom of other diseases or emotional problems. The chemistry of alcohol allows it to affect nearly every type of cell in the body, including those in the central nervous system. In the brain, alcohol interacts with centers responsible for pleasure and other desirable sensations. After prolonged exposure to alcohol, the brain adapts to the changes alcohol makes and becomes dependent on it. For people with alcoholism, drinking becomes the primary medium through which they can deal with people, work, and life. Alcohol dominates their thinking, emotions, and actions. The severity of this disease is influenced by factors such as genetics, psychology, culture, and response to physical pain. Alcoholism can develop insidiously; often there is no clear line between problem drinking and alcoholism [see Box, below]. The only early indications of alcoholism may be the unpleasant physical responses to withdrawal that occur during even brief periods of abstinence. Sometimes people experience long-term depression or anxiety, insomnia, chronic pain, or personal or work stress that lead to the use of alcohol for relief, but often no extraordinary events have occurred that account for the drinking problem.
Alcoholics have little or no control over the quantity they drink or the duration or frequency of their drinking. They are preoccupied with drinking, deny their own addiction, and continue to drink even though they are aware of the dangers. Over time, some people become tolerant to the effects of drinking and require more alcohol to become intoxicated, creating the illusion that they can "hold their liquor." They have blackouts after drinking and frequent hangovers that cause them to miss work and other normal activities. Alcoholics might drink alone and start early in the day. They periodically quit drinking or switch from hard liquor to beer or wine, but these periods rarely last. Severe alcoholics often have a history of accidents, marital and work instability, and alcohol-related health problems. Episodic violent and abusive incidents involving spouses and children and a history of unexplained or frequent accidents are often signs of drug or alcohol abuse