When Was Alcoholism Recognized as a Disease?

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The American Medical Association (AMA) classified alcoholism as a disease in 1956. (1) Over the following decades, alcoholism has been increasingly considered and treated as a chronic disease by most health and addiction experts. Like other conditions, such as high blood pressure and diabetes, alcoholism is characterized by alternating periods of remission and relapse. According to the Centers for Disease Control and Prevention (CDC), chronic diseases last at least one year and “require ongoing medical attention or limit activities of daily living or both.” (2) These conditions can often be managed but not cured. Moreover, chronic diseases tend to worsen over time and can often be fatal if they go untreated.

Alcoholism can be challenging to overcome, but professional treatment is available to help those struggling with addiction. Guardian Recovery offers comprehensive programs that provide multiple levels of care and evidence-based therapies and services to address the causes and effects of alcohol. If you are ready to end active addiction and reclaim your life, reach out to us today to learn more about our many treatment options.

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What Is Alcoholism?

Alcoholism is a chronic disease in which an individual has lost control of their drinking. A person with this condition must drink increasing amounts of alcohol to experience the same effects (tolerance). Also, due to the development of physical dependence, withdrawal symptoms occur upon alcohol cessation. Alcoholism can severely impact physical and mental health and cause problems with family, friends, work, finances, and social life. Health complications associated with heavy alcohol use include liver damage, high blood pressure, heart disease, pancreatitis, and increased risk for several types of cancer.

Alcohol Use Disorder

Alcohol use disorder (AUD) is a clinical term with established criteria required for a diagnosis. It is an umbrella term comprising conditions commonly referred to as alcohol abuse or misuse, alcohol dependence, alcohol addiction, and alcoholism. AUD is considered an incurable brain disorder that can be mild, moderate, or severe. Long-lasting chemical and structural changes in the brain caused by long-term excessive drinking perpetuate AUD and make those who suffer susceptible to relapse.

Healthcare and addiction professionals use criteria specified by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), to determine if a person has AUD and, if so, its severity. (3) According to the National Institutes of Alcohol Abuse and Alcoholism (NIAAA), the following characteristics can be found among individuals who struggle with AUD: (4)

  • Drinking more or for longer than intended.
  • Attempting to reduce or stop drinking multiple times without success.
  • Spending significant time drinking or recovering from adverse effects.
  • Having powerful cravings and obsessing over alcohol.
  • Experiencing negative consequences of drinking involving family, work, school, etc., and continuing to drink despite these effects.
  • Neglecting activities once important or enjoyable to drink.
  • Engaging in potentially dangerous activities while drinking, such as driving, swimming, having unprotected sex, etc.
  • Continuing to drink despite incurring physical or mental health problems.
  • Having to drink increasing amounts of alcohol to achieve the effect.
  • Experiencing withdrawal symptoms, such as sleep disturbances, shakiness, nausea, elevated heart rate, seizure, or hallucinations.

Are Alcoholism & Addiction Diseases?

The American Medical Association first classified alcoholism as a disease in 1956 and, in 1987, classified addiction as a disease as well. In 2011, the American Society of Addiction Medicine (ASAM) also began defining addiction as a chronic brain disorder versus a behavioral problem, moral deficiency, or a product of personal choice. (5) Since then, most experts, such as addiction medicine specialists and neuroscientists from the National Institute on Drug Abuse (NIDA) and other health organizations, have come to a consensus that addiction should, in fact, be considered a disease. (6) Like other chronic diseases, researchers and experts continue to learn how and why addiction and alcoholism develop.

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How Addiction Changes the Brain

Alcoholism and drug addiction occur when a person becomes unable to control their substance use. This subsequently causes adverse consequences in their daily lives, such as family conflict, poor work performance, financial and legal issues, and more. Over time, exposure to substances with a potential for addiction alters the brain’s function and structure.

Habit-forming psychoactive substances interfere with how information in the brain is sent, received, and processed. The brain’s reward system activates in response to pleasurable feelings driven by neurotransmitters like dopamine. Drugs and alcohol release a flood of these chemical messengers, compelling the person to repeat the behavior. In addition, the brain begins associating the use of the substance with specific physical, psychological, emotional, and environmental triggers, which then induce cravings when experienced.

Continued substance use causes the brain to produce less of its own dopamine. Consequently, other previously rewarding activities, such as eating and exercising, become less stimulating and are often neglected. This is one reason individuals with AUD begin to avoid social events or situations that don’t involve drinking. In addition, they may start to drink in isolation because nothing else feels worth the effort it would take to be sober for a significant amount of time.

How Addiction Impacts Behavior

Addiction alters function in brain regions responsible for judgment, decision-making, learning, memory, and behavioral control. When these alterations occur, they affect a person’s willpower and can increase impulsivity and reduce restraint. Furthermore, when a person attempts to stop using a substance, their brain increases urges to recommence use to protect them from the discomfort of withdrawal.

Addiction Has Complex Risk Factors

Addiction has many risk factors, but anyone can become addicted to alcohol, other substances, or behaviors for a multitude of reasons. Addiction does not have one single cause and is often fueled by a combination of factors, such as genetics, family history, environment, co-occurring physical and health conditions, and many more.

For example, NIDA reports that having a family history of substance use issues increases your risk of developing similar habits by 40%-60%. NIDA also states that drug exposure in those vulnerable due to risk factors “trigger neuroadaptations in the brain,” resulting in compulsive substance misuse and loss of control of addictive behaviors. (7)

Is There Disagreement?

Although alcoholism and addiction have been recognized as diseases, there is still some debate. Some still hold onto the notion that using drugs and alcohol is a choice. However, scientific research has shown beyond doubt that addiction is, at the very least, far more complex than previously assumed.

Criticism surrounding treating addiction as a disease claims that this characterization undermines a person’s ability to choose and provides them with a convenient justification. This is controversial, however, as it directly conflicts with the long-term use of evidence-based treatments adopted by hospitals, clinics, and treatment facilities. Likewise, major health organizations recommend the disease model, and many individuals who’ve recovered using this approach attest to its success.

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Professional Help Is Available for Alcoholism

Alcoholism is a complex condition associated with numerous risk factors and adverse effects. Viewing alcoholism as a chronic disease indicates that integrated treatment for co-occurring physical and mental health disorders is more likely to succeed than a single-minded approach. Indeed, ample research supports dual diagnosis treatment, and it is usually the preferred method used by high-quality treatment facilities.

At Guardian Recovery, we understand that alcoholism should be treated as a disease and may, therefore, require long-term treatment and periodic adjustments of treatment plans customized to each individual’s unique needs. Contact us today to speak with an experienced Treatment Advisor and receive a complimentary, no-obligation assessment, and health benefits check. We strive to provide individuals with the comprehensive, effective treatment they deserve and the tools they need to conquer alcoholism for life.

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Disclaimer: Does not guarantee specific treatment outcomes, as individual results may vary. Our services are not a substitute for professional medical advice or diagnosis; please consult a qualified healthcare provider for such matters.

(1)https://www.ama-assn.org/delivering-care/public-health/court-listened-ama-defining-alcoholism-disease-not-crime (2)https://www.cdc.gov/chronicdisease/about/index.htm (3)https://www.hakjisa.co.kr/common_file/bbs_DSM-5_Update_October2018_NewMaster.pdf (4)https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/understanding-alcohol-use-disorder (5)https://www.asam.org/docs/default-source/publications/asam-news-archives/2010s/vol26-3.pdf?sfvrsn=12cd5bc2_8 (6)https://nida.nih.gov/publications/drugs-brains-behavior-science-addiction/drug-misuse-addiction (7)https://pubmed.ncbi.nlm.nih.gov/15464133/

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Reviewed professionally for accuracy by:

Ryan Soave

L.M.H.C.

Ryan Soave brings deep experience as a Licensed Mental Health Counselor, certified trauma therapist, program developer, and research consultant for Huberman Lab at Stanford University Department of Neurobiology. Post-graduation from Wake Forest University, Ryan quickly discovered his acumen for the business world. After almost a decade of successful entrepreneurship and world traveling, he encountered a wave of personal and spiritual challenges; he felt a calling for something more. Ryan returned to school and completed his Master’s Degree in Mental Health Counseling. When he started working with those suffering from addiction and PTSD, he found his passion. He has never looked back.

Written by:

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Cayla Clark

Cayla Clark grew up in Santa Barbara, CA and graduated from UCLA with a degree in playwriting. Since then she has been writing on addiction recovery and psychology full-time, and has found a home as part of the Guardian Recovery team.

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