Is Alcoholism A Mental Disease?
We are used to hearing about Alcoholism quite often, we even lightly use the term most of the time to refer to someone who just likes to drink, but it is a really serious disease and should not be taken lightly. In the scientific article ‘The Definition of Alcoholism’ Morse RM, Flavin DK, published on Jama Network Journal, a 23-member multidisciplinary committee of the National Council on Alcoholism and Drug Dependence and the American Society of Addiction Medicine conducted a 2-year study of the definition of Alcoholism.
Referring to the question ‘Is Alcoholism A Mental Disease?‘ the committee agreed to define Alcoholism “as a primary, chronic disease with genetic, psychosocial, and environmental factors influencing its development and manifestations. The disease is often progressive and fatal. It is characterized by impaired control over drinking, preoccupation with alcohol, use of alcohol despite adverse consequences, and distortions in thinking, most notably denial. Each of these symptoms may be continuous or periodic.”
Alcohol Use Disorder (AUD) in the United States
According to the 2019 NSDUH, 14.5 million people ages 12 and older had AUD. This number includes 9.0 million men and 5.5 million women. This problem threatens a big number of young people too, as stated by the same source, an estimated 414,000 adolescents between the ages of 12 to 177 had AUD. This number includes 163,000 males and 251,000 females.
An estimated 95,000 people, approximately 68,000 men, and 27,000 women die from alcohol-related causes annually, making alcohol the third-leading preventable cause of death in the United States. The first is tobacco, and the second is poor diet and physical inactivity.
Causes of Alcoholism
It is common to think this condition arises from a person who simply does not know how to control their alcohol consumption and is trapped in a vicious circle, but according to the scientific piece ‘The many causes of Alcoholism’ Cohen, S. Published on the Drug Abuse & Alcoholism Newsletter, there are three main causes of this disease: biological, physiological, and sociocultural.
- Biological causes may be:
- Genetic: “inherited susceptibility to alcohol’s acute effects, impaired ability to catabolize ingested alcohol, or difficulty in dealing with anxiety, frustration, and depression”.
- Biochemical: insulin sensitivity, episodes of spontaneous hypoglycemia, or adrenal insufficiency.
- Or endocrine: persistently low levels of androgenic hormones.
- Among the psychological causes of Alcoholism are:
- Need for tension relief and anxiety control
- Personality disorders
- Psychodynamic factors
- Learning: tension reduction from drinking provides a positive reinforcement to continue drinking
- Role modeling: peer example or occupational pressures
- Culture-specific drinking traditions and those stresses and conflicts experienced by certain subcultures also contribute to overindulgence in alcohol
Alcoholism and Other Psychiatric Disorders
Clinicians working with alcohol-abusing or alcohol-dependent patients sometimes face the difficult task of assessing their patient’s psychiatric complaints because heavy drinking associated with alcoholism can coexist with, contribute to, or result from several different psychiatric syndromes.
To improve diagnostic accuracy, clinicians can follow an algorithm that distinguishes between alcohol-related psychiatric symptoms and signs, alcohol-induced psychiatric syndromes, and independent psychiatric disorders that are commonly associated with alcoholism. The patient’s gender, family history, and course of illness over time also should be considered to attain an accurate diagnosis. Moreover, clinicians need to remain flexible with their working diagnoses and revise them as needed while monitoring abstinence from alcohol.
The evaluation of psychiatric complaints in patients with alcohol use disorders (i.e., alcohol abuse or dependence, which hereafter are collectively called alcoholism) can sometimes be challenging. Heavy drinking associated with alcoholism can coexist with, contribute to, or result from several different psychiatric syndromes.
As a result, alcoholism can complicate or mimic practically any psychiatric syndrome seen in the mental health setting, at times making it difficult to accurately diagnose the nature of the psychiatric complaints. When alcoholism and psychiatric disorders co-occur, patients are more likely to have difficulty maintaining abstinence, attempt or commit suicide, and utilize mental health services. Thus, a thorough evaluation of psychiatric complaints in alcoholic patients is important to reduce illness severity in these individuals.
Why do some people become addicted to alcohol or other drugs while other people don’t?
Let’s suppose that two people consume alcohol at the same rate over time. One person may become addicted while the other does not, but why? The simple answer to this question is: there is no straightforward answer. Some may find this response frustrating, as it may not satiate their need for certainty. One thing we have learned from advancements in technology and subsequent findings in neurobiology is that addiction is a much more intricate and convoluted condition than we once thought, but some clues can help us anticipate who may become addicted.
While there are many unknowns when looking at why some people become addicted while others are not adversely impacted by their drinking or drug use, what we do know is this: some people have a greater likelihood of developing substance use disorders than others. The most cutting-edge theory (based on a bio-psycho-socio-spiritual approach and knowledge from neuroscience and attachment theory) finds that individuals with unhealthy dysregulated brains, minds, and social capacities are most vulnerable to this condition.
Genetics is still the number one predictor of addiction, followed by the early onset of first use. Data findings have demonstrated the validity of these factors, but there are others that treatment professionals must also consider when diagnosing substance use disorders. They have to look at the complex interaction between a combination of biological, psychological, social, and spiritual determinants. Aside from the family history of addiction and the age a person began using drugs or alcohol, these include:
- How a substance is consumed: Injecting a drug produces a greater dopamine rush, making a user that much more likely to become dependent on it.
- Mental health: Those already struggling with mood disorders, such as anxiety and depression, may be more likely to seek out unhealthy coping mechanisms for dealing with stress, including drinking or using drugs.
- Environment: Those who grow up around peers who use drugs and alcohol are more likely to begin using themselves.
- The potency of substance used: Certain drugs, such as fentanyl and heroin, are stronger and more addictive than others.
It is important to note that nobody is fully immune to addiction, though a person’s addictive tendencies may vary in terms of intensity and pervasiveness based on the risk factors mentioned above. Like many other chronic diseases, such as diabetes, some will be more at-risk than others, but there is no definitive way of knowing who will be impacted. Therefore, everyone must examine their risk factors and take precautions to prevent the onset or development of substance use disorders.
Symptoms of Alcoholism
Is Alcoholism A Mental Disease? As stated by the National Institute on alcohol abuse and alcoholism, these are the signs to be aware of in terms of this condition:
- Giving up or cutting back on activities that are important or interesting to you, to drink
- More than once gotten into situations while or after drinking that increased your chances of getting hurt (such as driving, swimming, using machinery, walking in a dangerous area, or having unsafe sex)
- Continuing to drink even though it was making you feel depressed, anxious, or adding to another health problem, or after having had a memory blackout
- Having to drink much more than you once did to get the effect you want. Or finding that your usual number of drinks has much less effect than before
- Finding that when the effects of alcohol are wearing off, you have withdrawal symptoms, such as trouble sleeping, shakiness, irritability, anxiety, depression, restlessness, nausea, or sweating.
- Appearing intoxicated more regularly
- Appearing tired, unwell, or irritable
- An inability to say no to alcohol
- Becoming secretive or dishonest
- Drinking more, or longer than one intended
- Want to cut down or stop drinking, or tried to, but haven’t been able to do so
- Spending a lot of time drinking, being sick, or getting over the aftereffects
- Experiencing craving, a strong need, or an urge to drink
- Founding that drinking, or being sick from drinking, often interferes with taking care of your home or family, job troubles, or school problems
- Continuing drinking even though it was causing trouble with family or friends
Treatment for alcoholism
When it comes to Alcoholism treatment, it is normal to think of 12-step programs or 28-day inpatient rehab, but it becomes difficult to think of more options of treatment for this condition. There are a variety of treatment methods currently available. According to the National Institute on Alcohol Abuse and Alcoholism, there are three types of treatment:
- Behavioral Treatments for alcoholism: are aimed at changing drinking behavior through counseling. They are led by health professionals and supported by studies showing they can be beneficial.
- Medications for alcohol treatment: Three medications are currently approved in the United States to help people stop or reduce their drinking and prevent relapse. They are prescribed by a primary care physician or other health professional and may be used alone or in combination with counseling.
- Mutual-Support Groups for alcoholism: Alcoholics Anonymous (AA) and other 12-step programs provide peer support for people quitting or cutting back on their drinking. Combined with treatment led by health professionals, mutual-support groups can offer a valuable added layer of support. Due to the anonymous nature of mutual-support groups, it is difficult for researchers to determine their success rates compared with those led by health professionals.
Reclaim your life from Alcoholism – Dual Diagnosis Rehab Washington
Is alcoholism a mental disease? Yes, alcoholism is a serious disease that should not be taken lightly. We Level Up dual diagnosis rehab Washington can provide you, or someone you love, the tools to recover from alcoholism with professional and safe treatment. Feel free to call us to speak with one of our counselors. We can inform you about this condition and give you clarity about questions such as ‘Is Alcoholism A Mental Disease?’ by giving you relevant information. Our specialists know what you are going through. Please know that each call is private and confidential.
 National Institute on Drug Abuse. (2018). Drugs, Brains, and Behavior: The Science of Addiction.
 National Institute on Drug Abuse. (2018). Principles of Drug Addiction Treatment: A Research-Based Guide.
 Morse RM, Flavin DK. The Definition of Alcoholism. JAMA. 1992;268(8):1012–1014.