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Alcoholism is a term with multiple and sometimes conflicting definitions to describe the detrimental effects of alcohol intake.
In common and historic usage, alcoholism refers to any condition that results in the continued consumption of alcoholic beverages despite health problems and negative social consequences. Modern medical definitions[1] describe alcoholism as a disease and addiction which results in a persistent use of alcohol despite negative consequences. In the 19th and early 20th centuries, alcoholism, also referred to as dipsomania[2] described a preoccupation with, or compulsion toward the consumption of, alcohol and/or an impaired ability to recognize the negative effects of excessive alcohol consumption.
Although not all of these definitions specify current and on-going use of alcohol as a qualifier for alcoholism, some do, as well as remarking on the long-term effects of consistent, heavy alcohol use, including dependence and symptoms of withdrawal.
While the ingestion of alcohol is, by definition, necessary to develop alcoholism, the use of alcohol does not predict the development of alcoholism. The quantity, frequency and regularity of alcohol consumption required to develop alcoholism varies greatly from person to person. In addition, although the biological mechanisms underpinning alcoholism are uncertain, some risk factors, including social environment, stress,[3] emotional health and genetic predisposition, have been identified.
The definitions of alcoholism and related terminology vary significantly between the medical community, treatment programs, and the general public.
The Journal of the American Medical Association defines alcoholism as “a primary, chronic disease characterized by impaired control over drinking, preoccupation with the drug alcohol, use of alcohol despite adverse consequences, and distortions in thinking.”[4]
The DSM-IV (the standard for diagnosis in psychiatry and psychology) defines alcohol abuse as repeated use despite recurrent adverse consequences.[5] It further defines alcohol dependence as alcohol abuse combined with tolerance, withdrawal, and an uncontrollable drive to drink.[5] (See DSM diagnosis below.)
According to the APA Dictionary of Psychology, alcoholism is the popular term for alcohol dependence.[5] Note that there is debate whether dependence in this use is physical (characterised by withdrawal), psychological (based on reinforcement), or both.
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