The concept of alcoholism does not have a univocal meaning, neither in the common language, nor in the scientific one; in fact, with it we mean both any alcohol abuse, even episodic or occasional (acute alcoholism), and a pathological state resulting from excessive consumption, prolonged over time and such as to generate dependence (chronic alcoholism).
Even medical classification systems distinguish between alcohol abuse and addiction: in the first case we refer to an abnormal drinking behavior, which involves somatic and psycho-social disturbances; in the second to the pathological need for recruitment. In a unitary vision, alcoholism can be considered a real disease, in whose etiology various components intervene: genetic, organic, psychological and environmental.
- Medical aspects
- by Giovanni Gasbarrini, Giovanni Addolorato, Giuseppe Francesco Stefanini
Alcoholism and drinking habits
It is not easy to establish what ‘normal’ alcohol consumption can be. The very attempt to define the daily dose of alcohol that can be considered harmless has proved to be a difficult, if not unrealistic, task, since there is a very wide range of responses of the human organism to alcohol.
- Each individual, in fact, has its own specificity, linked to genetic, physiological, psychological, as well as socio-cultural factors. The distinction between correct use and abuse of a socially accepted and widely used substance such as alcohol is therefore not immediate.
- ‘Normal drinker’ can be defined as someone who adheres to rules of moderation and common sense and uses alcoholic beverages as a pleasant opportunity or supplementary dietary component, without this becoming a necessity. , and therefore potentially dangerous, requires a definition, similarly not easy.
- An authoritative attempt was made, already at the end of the 1960s, by the World Health Organization, which distinguished two main conditions: the habit of drinking and drug addiction.
In the habit of drinking certain aspects prevail, such as the desire, and not the need, to drink alcohol to feel its pleasant effects and sense of well-being; the dependence on alcohol is of an exclusively psychic nature, while the physical one is absent; the propensity to increase doses is low, if at all; finally, the harmful effects are limited to the individual.
In drug addiction, on the other hand, the condition is defined as chronic and harmful, not only for the individual, but also for society, and is characterized by some peculiar characteristics, such as the compulsive craving for alcohol and the need to obtain it at any cost. tolerance – defined as the need to increase the doses taken – and physical and psychological dependence on alcohol, the lack of which can lead to the onset of withdrawal syndrome.
A more recent classification of alcoholism is that provided by the American psychiatric association in the fourth edition of the Diagnostic and statistical manual of mental disorders (DSM-IV, 1995).
Which distinguishes two forms: abuse and dependence.
Abuse refers to both occasional excesses and continued consumption of alcohol, and implies a psychological addiction, in which drinking is motivated by the need to feel fit, despite the social and occupational problems that arise. In addiction, in addition to the same problems, there is also an increase in both alcohol tolerance and physical withdrawal symptoms.
- Addiction therefore manifests itself as an inseparable or difficult to resolve bond with alcohol, in the absence of which more or less serious signs of physical and mental suffering usually appear.
- This condition causes the person’s lifestyle to undergo stable changes, even in the case of temporary or occasional abstinence, which causes both social, economic and family problems.
These concepts, which are valid in general for the use of any substance that involves the risk of addiction, are made specific by the interrelation of three elements, represented by the subject (the alcoholic), by the substance (alcohol) and from the environment (family, society).
It is therefore evident that, where favorable conditions coexist – such as the availability of alcoholic beverages, a fragile personality, a permissive environment (almost devoid of forms of control), little information on the possible harm – alcohol dependence will develop more or less intense, depending on the relationship between these elements.