What is alcoholism?

A disease – that has always been the belief of Alcoholics Anonymous from the beginning of the movement, you’ll find this described as they could in the “big book” – Alcoholics Anonymous the book that gave its name to the movement.

Today the World Health Organisation has a definition.  It is copied out below all this for you interest…

It is under Mental and Behavioural Disorders.  So there you have it, alcoholism is primarily a disease of the mind.  The writings in the big book in the 30s tell me that alcoholism is just that, it tells me that once I’m an alcoholic I cannot control my drinking, I will drink against all common sense and that it will cloud all my judgement.  Also it tells me I’m spritually sick to and that to cure that is to cure my alcoholism.

Excerpt from ICD – A cluster of behavioural, cognitive, and physiological phenomena that develop after repeated substance use and that typically include a strong desire to take the drug, difficulties in controlling its use, persisting in its use despite harmful consequences, a higher priority given to drug use than to other activities and obligations, increased tolerance, and sometimes a physical withdrawal state.

Now the clincher…

A pattern of psychoactive substance use that is causing damage to health. The damage may be physical (as in cases of hepatitis from the self-administration of injected psychoactive substances) or mental (e.g. episodes of depressive disorder secondary to heavy consumption of alcohol).

This is the recognised health definition.  “Depressive disorder” – it mentioned other issues with mental illness.

I came to look this up as I might use the definition in something I may be doing but it was like another one of those moments when all pretence I might have that I’m not an alcoholic is again washed away.  My wife has often in my life said to me “You’ll never be happy” – “depressive disorder”.  I have to say nearly 10 years without drink I am getting closer to happiness than ever before – I don’t really know what I’m doing with my life, I have an odd plan now that I’m working on but I’m not really there at all but I know what I’d rather not be doing.  That is progress.

The split personality thinking I’ve struggled with still dogs me I have this “I’m the best” thought followed by an equally or stronger “you’re a complete fraud” thought all the time.  If only I could have a bit of faith that I’m marginally ok or average about something that would be better but maybe it will come to me one day, we’ll see.  But that is my “depressive disorder” along with other things where my inclination is to be negative about myself.

WHO ICD definition

F10 Mental and behavioural disorders due to use of alcohol

The following fourth-character subdivisions are for use with categories F10-F19:

.0

Acute intoxication

A condition that follows the administration of a psychoactive substance resulting in disturbances in level of consciousness, cognition, perception, affect or behaviour, or other psycho-physiological functions and responses. The disturbances are directly related to the acute pharmacological effects of the substance and resolve with time, with complete recovery, except where tissue damage or other complications have arisen. Complications may include trauma, inhalation of vomitus, delirium, coma, convulsions, and other medical complications. The nature of these complications depends on the pharmacological class of substance and mode of administration.

Acute drunkenness (in alcoholism)
“Bad trips” (drugs)
Drunkenness NOS
Pathological intoxication
Trance and possession disorders in psychoactive substance intoxication
Excl.:
intoxication meaning poisoning (T36-T50)

.1

Harmful use

A pattern of psychoactive substance use that is causing damage to health. The damage may be physical (as in cases of hepatitis from the self-administration of injected psychoactive substances) or mental (e.g. episodes of depressive disorder secondary to heavy consumption of alcohol).

Psychoactive substance abuse

.2

Dependence syndrome

A cluster of behavioural, cognitive, and physiological phenomena that develop after repeated substance use and that typically include a strong desire to take the drug, difficulties in controlling its use, persisting in its use despite harmful consequences, a higher priority given to drug use than to other activities and obligations, increased tolerance, and sometimes a physical withdrawal state.

The dependence syndrome may be present for a specific psychoactive substance (e.g. tobacco, alcohol, or diazepam), for a class of substances (e.g. opioid drugs), or for a wider range of pharmacologically different psychoactive substances.

Chronic alcoholism
Dipsomania
Drug addiction

.3

Withdrawal state

A group of symptoms of variable clustering and severity occurring on absolute or relative withdrawal of a psychoactive substance after persistent use of that substance. The onset and course of the withdrawal state are time-limited and are related to the type of psychoactive substance and dose being used immediately before cessation or reduction of use. The withdrawal state may be complicated by convulsions.

.4

Withdrawal state with delirium

A condition where the withdrawal state as defined in the common fourth character .3 is complicated by delirium as defined in F05.-. Convulsions may also occur. When organic factors are also considered to play a role in the etiology, the condition should be classified to F05.8.

Delirium tremens (alcohol-induced)

.5

Psychotic disorder

A cluster of psychotic phenomena that occur during or following psychoactive substance use but that are not explained on the basis of acute intoxication alone and do not form part of a withdrawal state. The disorder is characterized by hallucinations (typically auditory, but often in more than one sensory modality), perceptual distortions, delusions (often of a paranoid or persecutory nature), psychomotor disturbances (excitement or stupor), and an abnormal affect, which may range from intense fear to ecstasy. The sensorium is usually clear but some degree of clouding of consciousness, though not severe confusion, may be present.

Alcoholic:

  • hallucinosis
  • jealousy
  • paranoia
  • psychosis NOS
Excl.:
alcohol- or other psychoactive substance-induced residual and late-onset psychotic disorder (F10-F19 with common fourth character .7)

.6

Amnesic syndrome

A syndrome associated with chronic prominent impairment of recent and remote memory. Immediate recall is usually preserved and recent memory is characteristically more disturbed than remote memory. Disturbances of time sense and ordering of events are usually evident, as are difficulties in learning new material. Confabulation may be marked but is not invariably present. Other cognitive functions are usually relatively well preserved and amnesic defects are out of proportion to other disturbances.

Amnestic disorder, alcohol- or drug-induced
Korsakov psychosis or syndrome, alcohol- or other psychoactive substance-induced or unspecified
Use additional code, (E51.2+, G32.8*) , if desired, when associated with Wernicke’s disease or syndrome.
Excl.:
nonalcoholic Korsakov psychosis or syndrome (F04)

.7

Residual and late-onset psychotic disorder

A disorder in which alcohol- or psychoactive substance-induced changes of cognition, affect, personality, or behaviour persist beyond the period during which a direct psychoactive substance-related effect might reasonably be assumed to be operating. Onset of the disorder should be directly related to the use of the psychoactive substance. Cases in which initial onset of the state occurs later than episode(s) of such substance use should be coded here only where clear and strong evidence is available to attribute the state to the residual effect of the psychoactive substance. Flashbacks may be distinguished from psychotic state partly by their episodic nature, frequently of very short duration, and by their duplication of previous alcohol- or other psychoactive substance-related experiences.

Alcoholic dementia NOS
Chronic alcoholic brain syndrome
Dementia and other milder forms of persisting impairment of cognitive functions
Flashbacks
Late-onset psychoactive substance-induced psychotic disorder
Posthallucinogen perception disorder
Residual:

  • affective disorder
  • disorder of personality and behaviour
Excl.:
alcohol- or psychoactive substance-induced:

.8

Other mental and behavioural disorders

.9

Unspecified mental and behavioural disorder
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About furtheron

Music and guitar obsessive who is a recovering alcoholic to boot
This entry was posted in Alcoholism. Bookmark the permalink.

2 Responses to What is alcoholism?

  1. sherryd32148 says:

    Wow! What a great post. So thought provoking. I’m sure you’ll get a lot of traffic on this one.

    I don’t really know what I think alcoholism is…all I know is that I have it and I can’t drink – ever. And I’m okay with that. Now.

    As for depression? Oh yeah…I’ve got that in spades. I’m not sure if I’ve always had a bit of it or if it kicked in after my dad died but either way – I’ve been medicated since. Happily. Pun intended.

    I love how you say you don’t know what you want to do, but you know what you don’t want to do. Brilliant! I think that’s okay…that as long as we’re not doing things that make us miserable, there’s a world of hope that we’ll find that thing that will.

    Bravo dude…great post.
    Sherry

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