Alcoholism Terminology

There are many terms, such as use, misuse, heavy use, addiction, abuse and dependence, all of which have different and sometimes non-standard meanings. 'Use' refers to simple use of a substance.

An individual who drinks a beer once a day uses alcohol. Misuse and 'heavy use' do not have standard definitions in the field. It has been determined that the human system can tolerate up to 14 two-ounce "doses" of alcohol per week before they begin to show signs of long-term cellular damage.

Addiction refers to any single or group of conditions which cause a user of a substance to continue using a substance in spite of any negative effects that that use may cause. Negative effects are highly varied, but include those that are psychological, physical, social or monetary.

Alcohol addiction has been identified as having many components.

Psychological addiction involves those things which convince a person that they gain benefit from the use of the substance. For instance, if they feel that they are more socially adept while drunk or that it allows them to better handle stress, then they might feel that any problems caused were worth the benefits.

Physical addiction (a.k.a., dependence) involves the physical adaptation of a person's biological systems to the continued presence of alcohol in their system. The person's systems become more comfortable when they have the "normal" level of alcohol, and higher doses are required to maintain an equivalent effect. A decrease in the level of alcohol causes reverse imbalances resulting in withdrawal symptoms, which for alcohol can be deadly.

Neurochemical addiction involves the hijacking of existing learning mechanisms in order to convince the system that an addictive behavior is good for it, despite all evidence to the contrary. Endorphin is the body's way of telling the mind that a behavior is good for it. We release endorphin into the blood stream during sex, exercise and consumption of some foods for instance, and this is responsible for "runner's high" and "afterglow". This is more than just a good feeling, it is teaching our brain that these are the behaviors that it should repeat. It has been demonstrated in various clinical tests that mammals with more active endorphin systems are more prone to alcohol addiction. This is because alcohol triggers the release of endorphins into our system, and we learn that alcohol drinking is a behavior that we should repeat. This effect is also visible in the use of opiates, and in various risk-taking behaviors such as skydiving and gambling.

Psychological versus Physical Addiction

One of the primary components of alcohol addiction is the person's belief that alcohol provides value to them. This value can come from any of a large selection of sources, including:

• belief that it improves their ability to socialize
• belief that it helps them handle pressure
• desire for a state of calm and well-being brought on by alcohol consumption
• peer pressure, or fear of alienation if the person does not drink
  desire to conform
• sense of superiority from ability to handle extreme intoxication
• sense of superiority from knowledge of alcoholic drinks

These effects all contribute to a person's impression of the beneficial effects of alcohol in his/her life, and may result in a denial of the negative effects. It is important to recognize that many of these benefits can be real, not imagined. For instance, some people really are more enjoyable to be around when they're intoxicated, and alcohol really does help some people handle stress better. Alcoholism becomes a problem when the negative effects exceed the positive ones, although for a typical alcoholic this point is reached very quickly.

Psychological addiction factors are often responsible for encouraging potential alcoholics to drink in quantities which result in other forms of addiction to alcohol, and they are also responsible for maintaining alcoholism in the absence of other forms of addiction. The person must be convinced of the net negative value of alcohol in their lives before any treatment can have meaningful lasting effects. An inability to stop drinking despite a clear understanding of alcohol's negative balance of effects on his or her life is a primary indicator that a person suffers from alcoholism.

A person's "social dependence" is defined by the Prevention Research Institute from Kentucky as a condition that a person experiences and re-experiences in a social setting. It reflects the habitual experiences one has as they enjoy "partying" with the same people.