Alcoholism is a chronic disease characterized by several symptoms:
- an inability to control one’s drinking,
- preoccupation with alcohol,
- persisting in alcohol use even after it has caused problems,
- increasing cravings for drink, or
- withdrawal symptoms when one stops drinking.
Those struggling with alcoholism have trouble predicting how much they will drink or the consequences of their drinking.
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Alcoholism can be influenced by genetic, psychological, social, and environmental factors. It usually comes on gradually, although there are people who have an immediate abnormal response to alcohol that can lead to alcoholism. Drinking too much may be caused by an imbalance of chemicals in the brain associated with pleasure and judgment. Alcoholics often are unable to control their behavior and may crave alcohol in order to feel better.
Debate about whether alcoholism is a disease has been ongoing since the 1940s when a study suggested that alcoholism is progressive disease, characterized by uncontrollable drinking, that eventually leads to blackouts and, in some cases, death. Though the study was accepted by many as fact, researchers considered it a starting point for research.
The American Medical Association (AMA) first declared alcoholism an illness in 1956, and in 1991, endorsed the classification of alcoholism as a disease. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) also describes the condition as a chronic disease. However, the NIAAA points out that the majority of alcoholics have only a single episode of alcohol dependence, typically lasting 3 to 4 years, and notes that many alcoholics can recover.
Evidence shows that genetic factors influence alcoholism. Children of alcoholics are about four times more likely than the general population to develop alcohol problems. Certain genetic differences in the brain are associated with increased risk for alcoholism. These include emotional differences that can lead to cravings and a high tolerance for alcohol.
In addition, certain personality traits have been identified as common among alcoholics, including emotional immaturity, difficulty coping with frustration, a competitive nature, and perfectionism. Alcoholics often have difficulty with communication in relationships, a feeling of inferiority, and a sense of guilt.
Those who begin drinking at a young age, under 21, are at increased risk for developing alcoholism. People who have their first drink before the age of 15 are 4 times more likely to develop an alcohol use disorder than those who put off drinking until they are 21 or older. Prolonged exposure to alcohol can cause dependency. In addition, a person can build a tolerance to alcohol after repeated exposure.