ALCOHOLISM

repetitive intake of alcoholic beverages to such an extent that repeated or continued harm to the drinker occurs. Conceptions of what constitutes alcoholism vary with the traditional dietary use of alcohol and the social-drinking patterns of a community. Alcoholism may be viewed as a disease, a drug addiction, a learned response to crisis, a symptom of an underlying psychological or physical disorder, or a combination of these factors. The cause of alcoholism is equally uncertain. It has been viewed as a hereditary defect, a physical malfunction, a psychological disorder, a response to economic or social stress, or sin. Manifestations of alcoholism vary with the individual. Intoxication may be followed by the relatively mild syndrome known as a hangover; extreme symptoms of withdrawal may include delirium tremens, hallucinations, and other acute brain disorders. Polyneuropathy, a degenerative disease of the nervous system, and acute hepatitis are common. Alcoholics also suffer the consequences of a deficient diet. Cirrhosis of the liver is associated with chronic alcoholism, as are numerous forms of brain damage. Alcoholics also suffer high accident rates, lowered resistance to infection, loss of employment and family life, and a reduction in life span of 10 to 12 years. Most approaches to the treatment of alcoholism require the alcoholic to recognize his illness and to abstain from alcohol. Treatment programs then vary according to the accepted definition and theory of cause of alcoholism. They include combinations of inpatient programs; general psychological rehabilitative treatments; organized self-help groups such as Alcoholics Anonymous (AA); the use of abstinence-maintaining drugs, such as Antabuse (disulfiram) and Temposil (citrated calcium cyanamide); injections of vitamins or hormones; and aversion therapy based on principals of behaviour modification. excessive and repeated use of alcoholic beverages, usually considered to be compulsive and thus an addiction and a disease. The conception of inveterate drunkenness as a disease appears to be rooted in antiquity. The Roman philosopher Seneca classified it as a form of insanity. The term alcoholism, however, appeared first in the classical essay Alcoholismus Chronicus (1849) by the Swedish physician Magnus Huss. The phrase chronic alcoholism rapidly became a medical term for the condition of habitual inebriety conceived as a disease; and the bearer of the disease was called an alcoholic or alcoholist (e.g., Italian alcoolisto, French alcoolique, German Alkoholiker, Spanish alcohlico, Swedish alkoholist). Mark Keller excessive and repeated use of alcoholic beverages, usually considered to be compulsive and thus an addiction and a disease. The conception of inveterate drunkenness as a disease appears to be rooted in antiquity. The Roman philosopher Seneca classified it as a form of insanity. The term alcoholism, however, appeared first in the classical essay Alcoholismus Chronicus (1849) by the Swedish physician Magnus Huss. The phrase chronic alcoholism rapidly became a medical term for the condition of habitual inebriety conceived as a disease; and the bearer of the disease was called an alcoholic or alcoholist (e.g., Italian alcoolisto, French alcoolique, German Alkoholiker, Spanish alcohlico, Swedish alkoholist). Mark Keller Reference works include Marc A. Schuckit, Drug and Alcohol Abuse: Clinical Guide to Diagnosis and Treatment, 4th ed. (1995), clearly and economically written; and Jerome H. Jaffe (ed.), Encyclopedia of Drugs and Alcohol, 4 vol. (1995), containing more than 500 articles, bibliographic references, and an extensive index. Griffith Edwards, Awni Arif, and Jerome H. Jaffe (eds.), Drug Use & Misuse: Cultural Perspectives (1983), contains chapters on alcohol abuse. Charles P. O'Brien and Jerome H. Jaffe (eds.), Addictive States (1992), reviews addictive disorders. Malcolm Lader, Griffith Edwards, and D. Colin Drummond (eds.), The Nature of Alcohol and Drug Related Problems (1992), focuses on scientific views. Harold I. Kaplan and Benjamin J. Sadock (eds.), Comprehensive Textbook of Psychiatry/VI, 6th ed. (1995), includes a chapter on substance-related disorders.The nature and causes of alcoholism and descriptions of its symptomatology are dealt with in Mark Keller, Some Views on the Nature of Addiction (1969); David Lester, Self-Selection of Alcohol by Animals, Human Variation, and the Etiology of Alcoholism, Quarterly Journal of Studies on Alcohol, 27:395438 (1966); E.M. Jellinek, The Disease Concept of Alcoholism (1960), and Phases of Alcohol Addiction, Quarterly Journal of Studies on Alcohol, 13:673684 (1952); C. Douglas Chaudron and D. Adrian Wilkinson (eds.), Theories on Alcoholism (1988); and Robert M. Rose and James E. Barrett (eds.), Alcoholism: Origins and Outcome (1988). James E. Royce, Alcohol Problems and Alcoholism, rev. ed. (1989), is a useful introduction to alcohol use and abuse and alcoholism prevention and treatment. National Institute on Alcohol Abuse and Alcoholism (U.S.), Alcohol Consumption and Related Problems (1982), contains essays dealing with attitudes toward alcohol among adults and young people, epidemiological problems of alcohol use and abuse, international trends in alcohol consumption and related pathologies, alcohol and family violence, and genetic influences on alcohol-related behaviour.Treatments of alcoholism are described in M.J. Hill and H.T. Blane, Evaluation of Psychotherapy with Alcoholics: A Critical Review, Quarterly Journal of Studies on Alcohol, 28:76104 (1967); Morris E. Chafetz, Howard T. Blane, and Marjorie J. Hill (eds.), Frontiers of Alcoholism (1970); National Institute on Alcohol Abuse and Alcoholism (U.S.), Prevention, Intervention, and Treatment: Concerns and Models (1982), a discussion of research on alcoholism, the problems of drinking and driving, the diagnosis of alcoholism, and methods of intervention, treatment, and evaluation; Donald M. Gallant, Alcoholism: A Guide to Diagnosis and Treatment (1987); and Jack H. Mendelson and Nancy K. Mello (eds.), Medical Diagnosis and Treatment of Alcoholism (1992), somewhat technical in scope, covering all aspects of alcoholism. Institute of Medicine (U.S.), Broadening the Base of Treatment for Alcohol Problems (1990), extensively reviews and documents the effectiveness of alcoholism treatments. The ideology and role of the leading self-help fellowship are detailed in Bill W., Alcoholics Anonymous: The Story of How Many Thousands of Men and Women Have Recovered from Alcoholism, 3rd ed. (1976); Barry Leach et al., Dimensions of Alcoholics Anonymous, The International Journal of the Addictions, 4:507541 (1969); and Nan Robertson, Getting Better: Inside Alcoholics Anonymous (1988).Broad data and perspectives on alcohol-related health and social problems are presented in Thomas F.A. Plaut, Alcohol Problems: A Report to the Nation (1967); National Institute on Alcohol Abuse and Alcoholism (U.S.), Alcohol and Health: First Special Report . . . from the Secretary of Health, Education, and Welfare (1971), and Alcohol Health and Research World (1993), articles dealing with the problems of alcohol as seen from various national perspectives; Clifford F. Gastineau, William J. Darby, and Thomas B. Turner (eds.), Fermented Food Beverages in Nutrition (1979), discussing the hazardous aspects of alcohol consumption and the often disregarded nutritional aspects; and United States, Dept. of Health and Human Services, Office of the Secretary and National Institute on Alcohol Abuse and Alcoholism (U.S.), Eighth Special Report to the U.S. Congress on Alcohol and Health from the Secretary of Health and Human Services (1993), summarizing research findings related to alcoholism. The effects of alcoholic parents on children is covered in Roy W. Pickens, Children of Alcoholics (1984); and Marc Galanter (ed.), Children of Alcoholics (1991).Chemical and biological aspects relating to alcohol include National Institute on Alcohol Abuse and Alcoholism (U.S.), Biomedical Processes and Consequences of Alcohol Use (1982), papers on the effect of alcohol on membranes, protein synthesis, the liver, the cardiovascular system, and other topics; Emanuel Rubin (ed.), Alcohol and the Cell (1987); Oscar A. Parsons, Nelson Butters, and Peter E. Nathan, Neuropsychology of Alcoholism (1987); Peter L. Petrakis, Alcohol and Birth Defects: The Fetal Alcohol Syndrome and Related Disorders (1987); Kathleen Whalen Fitzgerald, Alcoholism: The Genetic Inheritance (1988); Toshikazu Saito, Boris Tabakoff, and Kalervo Kiianmaa (eds.), Genetic Effects of Alcoholism (1989); H. Werner Goedde and Dharam P. Agarwal (eds.), Alcoholism: Biomedical and Genetic Aspects (1989); and Kenneth Blum and James E. Payne, Alcohol and the Addictive Brain (1991). Mark Keller The Editors of the Encyclopdia Britannica