Alcoholism is a
disease (a relatively recent definition) that is indicated by a progressive addiction toward the intake of
alcohol. There are many measures of alcoholism, from simple “When was the last time you had five or more drinks in a session?” to “Do you regularly drink alcohol? (Daily)”, to “Do you wake in the morning and have to have a drink to stop shaking and feel ‘normal’?”. The physical effects of alcohol on a person can also be measured to determine if the intake of alcohol constitutes a determined problem (e.g., a
liver enzyme test to evaluate damage caused by alcohol).
But the true indication of alcoholism is whether the consumption of alcohol by an individual is negatively, and progressively, affecting their life. This too is arbitrary because mitigating circumstances can lead to an increase of alcohol use that are not defined as “alcoholism,” rather they’re symptoms of an emotional cause that led to a temporary increase in alcohol use that is orthogonal to a diagnoses of alcoholism.
Some people don’t drink. Most others drink in moderation. And others make it a daily, progressive “habit” that envelops their life and takes over. “Addiction” is the simple definition, whether a person can drink alcohol without it impacting their function is the cut-line toward whether someone is actually an alcoholic, or a “drinker.”
The notion that someone who drinks daily is an alcoholic is well established, but waning in support. And the metrics used to define a “normal” drinking level tend to be arbitrary and rarely are they scaled to the individual under question. “More than two drinks per day” is a measure that disregards body type, gender, or effect. Yet it is a metric that is commonly applied and believed because it’s, simply, “measurable”. It is known that certain European descendants can metabolize alcohol at two or more times the rate of “standard” people, but this is rarely, if ever, accounted for in the typical models used to evaluate whether a person is an “alcoholic”.
Simply put, if you can’t stop drinking, and that drinking is causing real and tangible problems in your life, then you are almost certainly an alcoholic, and need to attend to it lest the progression continue and lead to your demise. The “problems” do NOT include concerns by family members or friends; third-party definitions of what a person “should” or “should not” do are not valid, and are in fact too subject to individual beliefs as to make them invalid measures of another’s actions. (This is a common and standard measure, but lacks in measurable and standardized accountability). The proper measure is whether the intake of alcohol is affecting your life, and whether it is progressive. If both criteria are not met, the diagnoses may be “Alcohol abuse,” a common condition based on individual patterns, or due to external influences such as impending divorce, work crisis, or any host of unusual stress that lead someone to drink abnormally, but not lead them to an addictive and progressive behavior that defines alcoholism.
The DSM-IV criteria for alcoholism is probably the most certain and accurate, but it too fails to account for individuals. The determination of these criteria is left to those who specialize in evaluating for alcoholism, but there is little rigor or training that is standard and accountable for such evaluators. Often, and unfortunately, it is left up to the personal impressions and biases of the evaluator.
The “bottom line” is whether the disease is existent, progressive, and affecting the individual. If it is, it is critically important that they first, and MOST importantly, decide that a problem exists. "Denial" is a hallmark of alcoholism. Once this is accepted, and hopefully so, they must enter into a treatment program that addresses the addiction, a treatment that is able to address, and ultimately stop it. Without such intervention, the progressive nature of alcoholism will eventually overwhelm the individual, and devastation will result.