Alcohol use disorder, commonly known as alcoholism, is a chronic condition in which one’s ability to control their drinking is compromised. There has been a long-standing debate about whether alcoholism should be classified as a disease. Given the chronic nature of alcoholism and how it progresses, the vast majority of medical professionals classify it as a disease. Doing so creates a framework for treating and managing the condition.
DSM-5 Criteria for Alcohol Use Disorder
It can be challenging to diagnose a drinking problem. Fortunately, the Diagnostic and Statistical Manual 5th Edition (DSM-5) offers guidance for mental health professionals. The criteria1 outlined in the DSM-5 can help a professional diagnose an alcohol use disorder and determine the degree of severity, whether mild, moderate or severe.
Diagnosis of an alcohol use disorder depends on cravings, persistent use, and alcohol’s impact on the person’s psychological and physical state. According to the DSM-52, one must meet at least two of these criteria to be diagnosed with alcohol use disorder:
- Engaging in hazardous use: Alcohol consumption that puts one in harm’s way (blacking out, use that harms bodily systems or functions)
- Social or relationship problems related to alcohol use: Family or friends are impacted by one’s drinking.
- Neglecting roles as a result of alcohol consumption: Drinking affects one’s role as an employee, a parent or another important responsibility.
- Experiencing withdrawal symptoms when not using: During periods of abstinence, symptoms such as shaking, sweating, nausea etc.
- Increased tolerance level: Needing to drink more alcohol to achieve the same effects
- Using larger amounts over longer periods of time: Drinking patterns change in intensity over time, getting more significant as time goes on.
- Repeated attempts to stop drinking or control use: Efforts to quit or cut back have been unsuccessful.
- Excessive amount of time spent using alcohol: Consumption of alcohol takes up more time during each day, and becomes a priority.
- Physical/psychological problems related to use: Challenges with heart, liver, digestive and other ailments commonly related to alcoholism. Struggles with depression, anxiety and self-worth.
- Reduction or elimination of other activities in order to drink alcohol: Avoiding friends, family or formerly-enjoyed hobbies so that one can use alcohol.
- Cravings for alcohol: Strong desire to drink alcohol that makes it difficult to focus on other aspects of life.
Why Is Alcoholism Considered a Chronic Disease?
A disease is considered chronic3 when it lasts at least one year, requires ongoing treatment and impacts daily life. Alcoholism meets these criteria; it is an all-encompassing disease that has lasting effects on emotional and physical health. Often, chronic diseases, including alcoholism, require treatment or medical intervention to be managed effectively.
Depending on severity level, an alcohol use disorder can be managed with a combination of treatments. Some people may require detoxification assistance to begin treatment, while others may start with mentorship, therapy services or a combination of treatment strategies. Like other diseases, alcoholism worsens over time without intervention and puts individuals at greater risk for harm if left untreated.
Criticism of the Disease Theory of Alcoholism
Some researchers and providers in the field of addiction have long criticized the categorization of alcoholism as a disease. These critics argue4 that it is a risky lifestyle choice rather than a disease process, but the pervasive nature of alcoholism makes it a high-risk condition that is often life-threatening as it progresses over time. Whether it is classified as a disease or acknowledged as a disorder, the treatment and management of the condition is the most important issue.
Alcohol Abuse vs. Alcoholism
The terms “alcoholism” and “alcohol abuse” are not the same. Alcohol abuse can be a one-time event in which one misuses or over-indulges in alcohol consumption, or engages in problem use without meeting criteria for alcohol addiction. Alcoholism, however, is categorized by the pervasive pattern of alcohol abuse in spite of biological, psychological and social problems that are caused by it.
Though alcohol abuse is a component of alcoholism, one can abuse alcohol without being an alcoholic. Recognizing if their alcohol use patterns are problematic or unhealthy can help people make decisions about the kind of treatment they need.
Related: Is Alcohol a Drug?
Drug and Alcohol Rehab Centers in New Jersey
Recovery centers like The Recovery Village Cherry Hill at Cooper offer a safe healing atmosphere for people to address substance use disorders, including alcoholism. Our professionally licensed staff create evidence-based, individualized treatment plans using a full continuum of care. Treatment can involve medical detox, individual and group therapy, medication management and recreational therapy options.
The Recovery Village is an accredited facility and is partnered with Cooper University Health Care to provide the highest quality of patient care to anyone struggling with an alcohol use disorder. If you or a loved one is experiencing challenges related to alcohol use, reach out today to get started on the path to recovery.
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- National Institute of Alcohol Abuse and Alcoholism. “Alcohol Use Disorder: A Comparison Between DSM-IV and DSM-5.” April 2021. Accessed December 24, 2021.
- Hasin, Deborah S., et al. “DSM-5 Criteria for Substance Use Disorde[…]ations and Rationale.” The American Journal of Psychiatry, August 2013. Accessed December 24, 2021.
- Centers for Disease Control and Prevention (CDC). “About Chronic Diseases.” April 28, 2021. Accessed December 24, 2021.
- Heather, N. “Why alcoholism is not a disease.” The Medical Journal of Australia, February 3, 1992. Accessed January 3, 2022.
The Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.