Definitions of alcoholism
In Addiction, Change, & Choice: The New View of
Alcoholism (Sharp Press, Tucson, AZ, 1993), Vince Fox provided no fewer than 18
definitions of the term alcoholism, out of 40 he found!
He groups them as Traditional,
Nontraditional, and Exploratory. Parenthetical and bracketed notations are by
Fox, not me.
1-A) Traditional: By the National Council on Alcoholism
and Drug Dependence:
Part 1 (Initial statement, 1971). Alcoholism is a chronic,
progressive and potentially fatal disease characterized by tolerance and
physical dependency or pathological organ changes, or both—all the direct
or indirect consequences of the alcohol ingested.
Part 2 (1990): (Written jointly by the NCADD and ASAM—the
American Society of Addiction Medicine.) Alcoholism is a primary, chronic
disease with genetic, psychosocial, and environmental factors influencing its
development and manifestations. The disease is often progressive and fatal. It
is characterized by continuous or periodic impaired control over drinking,
preoccupation with the drug alcohol, use of alcohol despite adverse
consequences, and distortions in thinking, most notably denial.
(Note departure from the 1972 statement relative to
qualification of the progressive nature of alcoholism and the inclusion of
denial as a symptom of the define disease.)
1-B) Nontraditional: By Claude Steiner and Eric Berne:
Alcoholism is neither incurable nor a disease.
1-C) Exploratory: By the World Health Organization (WHO):
Alcoholics are those excessive drinkers whose dependence upon alcohol has
attained such a degree that it shows a noticeable mental disturbance or an
interference with their bodily and mental health, their interpersonal
relations, and their smooth social and economic functioning; or [those] who
show the prodromal (warning) signs of such developments.
2-A) Traditional: By the American Medical Association:
(1956, December 29): The medical treatment of alcoholism is rapidly becoming
more important in accomplishing recovery for this disease.
(1966, November 28 - 30): A reaffirmation of the 1956
(1987, June 21-25): RESOLVED, That the American Medical
Association endorses the proposition that drug dependencies, including
alcoholism, are diseases.
2-B) Nontraditional: By Black's Law Dictionary, 5th
Ed., 1979: The pathological effect (as distinguished from physiological effect)
of excessive indulgence in alcoholic liquors. [Pathological: that is, the
diseased condition or structural and functional effects produced as a result of
2-C): Exploratory: By Webster's New World Dictionary of
the American Language; Second College Edition:
The habitual drinking of alcoholic liquor to excess, or a
diseased condition caused by this.
3-A) Traditional: By Jim Christopher: Science has
established that alcoholism is a physiological disease predetermined by
heredity. Alcohol is a selectively physically addictive drug ... .
3-B) Nontraditional: By Jack Trimpey: [The words] "alcoholism"
and "alcoholic" are folk expressions ... . I will use the term "alcoholic"
to refer to people who believe they are powerless over their addictions and act
accordingly, and to those who call themselves "alcoholics." They are practicing
the philosophy of alcoholism, just as Catholics practice the philosophy of
Catholicism. I prefer the correct term "alcohol dependence" to describe the
problem of persistent, heavy drinking ... .
3-C) Exploratory: By Charles Bufe: [Of Alcoholic,
Alcoholism]: Since the terms were invented over 100 years ago, a great variety
of definitions have been offered, and there is still no uniformity of opinion
among the "experts" about what constitutes alcoholism nor about what
constitutes an alcoholic. The safest thing that can be said is that definitions
are largely arbitrary and can (and do) change over time.
4-A) Traditional: By Claudia Black: The alcoholic is a
person who, in his drinking, has developed a psychological dependency on the
drug alcohol coupled with a physiological addiction ... . They are people who
neither have the ability to consistently control their drinking, nor who can
predict their behavior once they start to drink.
4-B) Nontraditional: by the American Psychiatric
Association (ASA) (DSM-III-R): Note: The word alcoholism is no longer used as a
subject heading in the third edition of the familiar DSM-III-R (Diagnostic
Statistical Manual, Revised). It lists Alcohol Dependence (Section 303.90, p.
173) and Alcohol Abuse (Section 305.00, p. 173) in its stead. It observes that
abuse can lead to dependence.
Patterns of use. There are three main patterns of Alcohol
Abuse or Dependence. The first consists of regular daily intake of large
amounts; the second, of periods of sobriety interspersed with binges of daily
heavy drinking lasting for weeks or months. It is a mistake to associate one of
these particular patterns exclusively with "alcoholism."
Some investigators divide alcoholism into "species" [such
as the] so-called gamma alcoholism ... that is common in the United States and
conforms to the stereotype of the alcoholism seen in people who are active in
Alcoholics Anonymous ... [and that] involves problems with "control."
4-C) Exploratory: By The Encyclopedia Britannica: [The]
repetitive intake of alcoholic beverages to such an extent that repeated or
continued harm to the drinker occurs ... .Alcoholism may be viewed as a disease,
a drug addiction, a learned response to crisis, a symptom of an underlying
psychological or physical disorder, or a combination of these facts. The cause
of alcoholism is equally uncertain. It has been viewed as a hereditary defect,
a physical malfunction, a psychological disorder, a response to economic or
social stress, or sin.
5-A) Traditional: By Mark Keller: I think [alcoholism] is
a disease because the alcoholic can't consistently choose whether or not he
shall engage in self-injurious behavior—that is, any of the alcoholism
drinking patterns. I think of it as a psychological disablement.
5-B) Nontraditional: By Herbert Fingarette: Heavy drinkers
[alcoholics] are people who have over time made a long and complex series of
decisions, judgments, and choices of commission and omission that have
coalesced into a central activity ... . Instead of viewing heavy drinkers as the
helpless victims of a disease, we come to see their drinking as a meaningful,
however destructive, part of their struggle to live their lives.
5-C) Exploratory: By the United States Supreme Court
(1988): ... apparently nobody understands alcoholism ... it appears to be willful
6-A) Traditional: By Alcoholics Anonymous and Bill Wilson
(delivered at the National Clerical Conference on Alcoholism convention, April
21, 1960): We have never called alcoholism a disease because, technically
speaking, it is not a disease entity. (emphasis added) For example, there is no
such thing as heart disease. Instead there are many separate heart ailments, or
combinations of them. It is something like that with alcoholism. Therefore we
did not with to get in wrong with the medical profession by pronouncing
alcoholism a disease entity. Therefore we always called it an illness, or a malady—a
far safer term for us to use.
6-B) Nontraditional: by Morris Chavetz: Alcoholism is
drinking too much too often. It is permitting alcohol to play an inordinately
powerful role in a person's life.
6-C) Exploratory: By Arnold
Ludwig: There is no general agreement about the nature, cause, or treatment of
alcoholism. What is an alcoholic? Where does one draw the line between problem
drinking and alcoholism, between alcohol abuse and alcohol dependence? Is
alcoholism one disorder or a collection of different disorders? Is it a moral
failing, a bad habit, or a disease? Do alcoholics have distinctive personality
features? Is alcoholism hereditary or learned? Does excessive drinking
represent a symptomatic expressing of an underlying conflict or is it the
primary problem itself? Which treatment approach, if any, is most effective?
Who is best qualified to help? In the absence of facts, opinions and
beliefs tend to prevail.
From Fox's copious footnotes, here are two that might be
of interest. Portions that I have snipped are indicated with " ... "
people assume that what is termed a disease is scientifically determined within
set parameters and through laboratory testing. This is not always the case. The
determination is often made by voice vote within a committee designated by the
American Medical Association, as in the case of "alcoholism" as a disease ... ."
"16. Wilson's statement will come as a shock to many. It
stands, however, as written. I found it in a footnote on pp. 22-23 of Not-God
by Ernest Kurtz.
Is it possible that Wilson was a nontraditionalist? Yes,
but only in the narrow sense of not viewing alcoholism as a physiological
disease. In most other areas he was the quintessential traditionalist; he
promoted the loss-of-control notion, for example, and he postulated that
alcoholism was an incurable but arrestable 'malady' or 'illness.' ... .
His fundamental conviction ... was that alcoholism is a
spiritual disease in the metaphorical sense. On page 44 (1976 ed.) of the Big
Book he describes alcoholism as 'an illness which only a spiritual experience
Throughout the Big Book he refers to alcoholism as an
illness, malady, sickness, allergy, and craving. A.A. literature generally
refers to alcoholism as a 'physical, mental (or emotional), and spiritual
disease,' and shares with Wilson the conviction that the defining issue is