New definition of alcoholism includes victim's denial of problem

August 27, 1992|By San Francisco Chronicle

A national medical panel is issuing a new clinical definition of alcoholism, and for the first time, the alcoholic's denial of a drinking problem is included as one of the defining charasteristics of the disease.

For centuries, physicians have recognized habitual drunkeness and alcoholism as serious threats to health. But formal attempts to define alcoholism go back only about 20 years.

The new, 59-word definition expands earlier attempts, adding a phrase stressing that alcoholics often suffer from "distortions in thinking" that include denial of their drinking problems.

"The term alcoholism has many meanings to different people, and what we attempted to do is to come up with a consensus definition that ...is not a bunch of scientific jargon so that it would be understandable to the lay public," said Dr. Daniel K. Flavin, a phychiatrist and scientific director at the New York-based National Council on Alcoholism and Drug Dependence.

Here is the definition:

"Alcoholism is a primary, chronic disease with genetic, psychosocial and environmental factors influencing its development and manifestation. The disease is often progressive and fatal. It is characterized by impaired control over drinking, preoccupation with the drug alcohol, use of alcohol despite adverse consequences, and distortions in thinking, most notably denial. Each of these symptoms may be continuous or periodic."

The council joined the American Society of Addiction Medicine in sponsoring the committee, which published the definition in yesterday's issue of the Journal of the American Medical Association.

Psychological denial, the report says, typically "becomes an integral part of the disease and is nearly always a major obstacle to recovery." It includes "a range of psychological maneuvers that decrease awareness of the fact that alcohol use is the cause of the person's problems rather than a solution to those problems."

Adding the denial aspect of alcoholism, Dr. Flavin said, is significant because it highlights "the psychological component of the disease. It is not enough to describe it as just too much drinking and a set of organic problems that result. We have to address why people become and remain alcoholic."

More than 10 million Americans are alcoholics.

One-fourth of U.S. families are directly affected by alcohol-related problems.

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