World Health Organisation

[changraider]

I was browsing some old threads and found some serious misinformation about the WHO's position, so here`s their real position:

"alcoholism (F10.2) A term of long-standing use and variable meaning, generally taken to refer to chronic continual drinking or periodic consumption of alcohol which is characterized by impaired control over drinking, frequent episodes of intoxication, and preoccupation with alcohol and the use of alcohol despite adverse consequences. The term alcoholism was originally coined in 1849 by Magnus Huss. Untill the 1940s it referred primarily to the physical consequences of long-term heavy drinking (beta alcoholism in Jellinek's typology). A narrower concept is of alcoholism as a disease (see alcoholism, disease concept of) marked by loss of control over drinking, caused by a pre-existing biological abnormality, and having a predictable progressive course. Later, the term was used by Jellinek and others to denote the consumption of alcohol leading to any type of harm (physical, psychological, or social; individual or societal). Jellinek subdivided alcoholism thus defined into a series of "species" designated by Greek letters (see Jellinek's typology). The inexactness of the term led a 1979 WHO Expert Committee* to disfavour it, preferring the narrower formulation of alcohol dependence syndrome as one among a wide range of alcohol-related problems. Alcoholism is not included as a diagnostic entity in ICD-IO (see dependence syndrome). Despite its ambiguous meaning, alcoholism is still widely employed as a diagnostic and descriptive term. For instance, in 1990 the American Society of Addiction Medicine defined alcoholism as "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." Other formulations have split alcoholism into various types, some regarded as diseases and some not (see Jellinek's typology). Distinctions are made between essential alcoholism and reactive alcoholism, where "essential" indicates that alcoholism is not secondary to or precipitated by some other condition; between primary and secondary alcoholism, to indicate the order of onset in cases of dual diagnosis; and between Type I and Type II alcoholism, the latter having a male-linked, strongly genetic component. In older usage, dipsomania (episodic drinking) and alcohol addiction referred to loss-of-control drinking: inebriety also had a broader reference to habitual intoxication and its harmful effects.

* Problems related to alcohol consumption. Report of a WHO Expert Committee. Geneva. World Health Organization, 1980 (WHO Technical Report Series, No.650).

alcoholism, disease concept of, The belief that alcoholism is a condition of primary biological causation and predictable natural history, conforming to accepted definitions of a disease. They lay perspective of Alcoholics Anonymous (1939)-that alcoholism, characterized by the individual’s loss of control over drinking and thus over his or her life, was a "sickness"-was carried into the scholarly literature in the 1950s in the form of the disease concept of alcoholism. The concept was rooted in 19th-century medical and lay conceptions of inebriety as a disease. In 1977, a WHO Group of Investigators* responding to the loose and varying usage of alcoholism, proposed substituting the term alcohol dependence syndrome in psychiatric nosology. "

The WHO's whole section on alcohol is interesting in that it highlights many many risks associated with alcohol other than alcoholism:

http://www.who.int/substance_abuse/terminology/who_lexicon/en/

[RickThai]

"A rose by anyother name . . .".

The important thing (to me anyway), is that if you are drinking enough to destroy your liver, you need to stop now or otherwise, you will come to a horribly painful end, that you will regret in your final days.

RickThai (been there, done that)

[StreetCowboy]

"A rose by anyother name . . .".

The important thing (to me anyway), is that if you are drinking enough to destroy your liver, you need to stop now or otherwise, you will come to a horribly painful end, that you will regret in your final days.

RickThai (been there, done that)

I would say the important word is not "need".but "can"... If you can stop when you want to, there's no problem. Just an opportunity to stop. The problem is that free will becomes - blurred. Blur, at least.

Do I want to drink, or am I at the mercy of unconscious cravings? If you want to drink while destroying your liver, why do you need to stop? Whose need? Its a choice between abstinence and agonising and debilitating illness... The alcoholic asks for help when he says "I am willing to sacrifice poverty, squalor and pitiful loss of control in order to avoid agonising physical illness - but I find that I cannot"

If you can stop drinking, why not try it? If you cannot - then surely now is the time to overcome the challenge and fight that battle.

It will not be easier tomorrow

SC

[changraider]

"A rose by anyother name . . .".

The important thing (to me anyway), is that if you are drinking enough to destroy your liver, you need to stop now or otherwise, you will come to a horribly painful end, that you will regret in your final days.

RickThai (been there, done that)

I tend to agree Rick, waiting til you can't stop is a recipe for disaster, and not only for the liver. I've been through several times in my life when I was drinking too much, and I knew it, even though I didn't satisfy the criteria to label myself an 'alcoholic'. These days I prefer to be sober.

[RickThai]

I agree with both comments. Maybe "must" is a better word than "need" or "can".

It is amazing how much happiness you can find in life, once you stop drinking alcohol entirely.

It's almost like being a child again (remember how simple and happy life was before drink?).

Best wishes to all,

Rick

[rmacdon61]

For me it was a "life skills" problem and addiction to booze. Quiting was not enough, I needed to deal with life. When I was sober, I hated my life, when drinking I hated me.

AA gave me the skills to take back my life and stay sober. AA allowed me to be the man I always wanted to be and not the a--hole I turned out to be. Happy 24 all.

[Ijustwannateach]

I rather liked the old kinds of lists about evaluating oneself as an addict; questions like,

1. Have you ever worried about your drinking?

2. Have friends or family ever expressed concern about your drinking?

3. Has drinking caused you to lose social or work opportunities on a regular basis, or has drinking ever caused you to lose a job or relationship?

4. Do friends who drink less tend to stop seeing you?

5. Have you ever had a medical problem related to drinking treated by a doctor?

6. Do you drink alone or when you are feeling sad or tired?

I just did a sample search on self-evaluations and now it seems that most of them are very event-oriented; how many times a week or month do you do this, that, etc. Which would be fine if the addict isn't completely in denial or delusional- that's why questions about what other people have said to you or done about you matter.

Since it has so many social links, I would expect that the diagnosis for alcoholism would be quite hard to pin down by numbers, as with many of the mental/emotional illnesses which are situated in a social context and also possibly culturally dependent.

[Johnniey]

For instance, in 1990 the American Society of Addiction Medicine defined alcoholism as "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."

I think this is the best definition of alcoholism.