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Bottled Up
 
Support for people living with a problem drinker

Alcoholism Definition
The term alcoholism is one that tends to be used less often in professional circles these days. One of the main reasons being the huge controversy that tends to surround the actual term "alcoholism". More commonly used terms these days are the terms Alcohol Abuse and Alcohol Dependence. Definitions of both as laid out in DSM IV will be given here. DSM is the acronym for Diagnostic Statistical Manual (the official manual for diagnosis), IV means that it is in its 4th edition. The 5th edition, or DSM V, is due in 2011. So the criteria given below is the currently used diagnostic criteria.
DSM-IV Diagnostic Criteria for Alcohol Abuse


1. A maladaptive pattern of alcohol abuse leading to clinically significant impairment or distress, as manifested by one or more of the following, occurring within a 12-month period:

a) Recurrent alcohol use resulting in failure to fulfil major role obligations at work, school, or home (e.g., repeated absences or poor work performance related to substance use; substance-related absences, suspensions or expulsions from school; or neglect of children or household).

b) Recurrent alcohol use in situations in which it is physically hazardous (e.g., driving an automobile or operating a machine).

c) Recurrent alcohol-related legal problems (e.g., arrests for alcohol-related disorderly conduct).

d) Continued alcohol use despite persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the alcohol (e.g., arguments with spouse about consequences of intoxication or physical fights).

2. These symptoms must never have met the criteria for alcohol dependence.


The main features of Alcohol Abuse are using alcohol often and in a reckless or dangerous manner.
DSM-IV Diagnostic Criteria for Alcohol Dependence

A maladaptive pattern of alcohol use, leading to clinically significant impairment or distress, as manifested by three or more of the following seven criteria, occurring at any time in the same 12-month period:

1. Tolerance, as defined by either of the following:

a) A need for markedly increased amounts of alcohol to achieve intoxication or desired effect.

b) Markedly diminished effect with continued use of the same amount of alcohol.

2. Withdrawal, as defined by either of the following:

a) The characteristic withdrawal syndrome for alcohol (refer to DSM-IV for further details).

b) Alcohol is taken to relieve or avoid withdrawal symptoms.

3. Alcohol is often taken in larger amounts or over a longer period than was intended.

4. There is a persistent desire or there are unsuccessful efforts to cut down or control alcohol use.

5. A great deal of time is spent in activities necessary to obtain alcohol, use alcohol or recover from its effects.

6. Important social, occupational, or recreational activities are given up or reduced because of alcohol use.

7. Alcohol use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the alcohol (e.g., continued drinking despite recognition that an ulcer was made worse by alcohol consumption).


As you can see the criteria for dependence are much more about the 'need' to drink and the physiological changes that appear to be occuring. This term dependence tends to replace the previous term alcoholism.

 
 
All material copyright Lou Lewis and John McMahon © 2010

All photographs by Cassia Lewis