alcoholism

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Alcohol dependence is characterised by craving, tolerance, a preoccupation with alcohol and continued drinking in spite of harmful consequences (e.g, liver disease or depression caused by drinking).

continued hazardous and harmful drinking can result in alcohol dependence.
alcohol dependence is also associated with increased criminal activity and domestic violence, and an increased rate of significant mental and physical disorders

ICD-10 defines dependency as:

“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.”.

In earlier disease-classification systems this has been referred to as ‘alcoholism’.

Alcohol use disorder (AUD) was estimated to affect approximately 18% of the general population lifetime and 5% annually (3)

DSM-5 definition of alcohol use disorder (AUD) combined DSM-IV alcohol abuse and dependence symptoms (4)
estimated that almost 20% of adult patients in the emergency rooms suffer from AUD and that the incidence of alcohol withdrawal syndrome (AWS) in patients admitted to surgical Intensive Care Unit (ICU) varies from 8 to 40%, and seems to be associated with infectious complications and a higher mortality rate
up to 50% of AUD patients experience withdrawal symptoms, a minority of whom requires medical treatment

Griffith Edwards and Gross(1976) defined some simple markers of alcoholism. These are:

dependent drinkers have a narrow repertoire of alcohol consumption: alcohol is used to avoid withdrawal symptoms
drinking overtakes the individual's activities to the exclusion of everything else, leading to theft, begging and borrowing
withdrawal symptoms include trembling, fear, insomnia, nightmares, sweating and hallucinations.
tolerance develops so that the dependent drinker consumes quantities which might make non-drinkers unconscious
dependent drinkers know that they cannot control their alcohol use
there is a high tendency to relapse after abstinence

Alcohol withdrawal symptoms occur within 12 hours of the last drink.

Reference:

(1) NICE (February 2011). Alcohol-use disorders - Diagnosis, assessment and management of harmful drinking and alcohol dependence
(2) NICE (June 2010). Alcohol use disorders
(3)Mirijello A et al. Identification and Management of Alcohol Withdrawal Syndrome Drugs. 2015 Mar; 75(4): 353–365.
(4)American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th. Arlington: American Psychiatric Association; 2013

Last edited 10/2020 and last reviewed 10/2020

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