Americans like their alcohol, and the amount of revenue the legal substance generates annually is astounding.  Alcohol sales totaled an estimated $252.82 billion, according to Statista. The sale of beer has remained the same in previous years, but the sale of spirits, such as whiskey and vodka, has risen dramatically, with more than 13 percent of sales growth per year.

Accordingly, the National Institute on Alcohol Abuse and Alcoholism (NIAAA) reports that Americans are indeed indulging in alcohol use and abuse. Who’s doing the drinking?

Close to 70% of people over the age of 18 reported they drank in the past year, and almost 55% said they drank in the past month. Additionally, 25.8% of those over age 18 admitted they engaged in binge drinking in the past month, and 6.3% said they engaged in heavy alcohol use.

A more sobering statistic about alcohol use to consider is that 95,000 people die from alcohol-related causes every year. Plus, there were 9,967 alcohol-impaired driving deaths in 2014.

Alcohol abuse and alcoholism affect everyone involved with the person who is drinking. Individuals under the age of 20 are trying alcohol for the first time and are experimenting with heavy and binge drinking. The national drinking age is 21. The prevalence of alcohol-related vehicle crashes, risk of assault, verbal, physical, and sexual, increase when college-aged children abuse alcohol.

It rather seems, from all these statistics, that alcoholism is a choice and not a disease. After all, human beings make the decision to drink, binge drink or drink heavily.

But is it really a choice, or is it a disease? Let’s find out what research on the question has to say.

Is Alcohol Use Disorder a Disease?

Addiction is characterized as a chronic brain disease affecting the motivation and reward centers of the brain. The National Institute on Drug Abuse (NIDA) states, “an addiction is a brain disorder.” Alcohol use disorder (AUD) is a medical term for alcohol abuse, alcoholism, or alcohol addiction.

In addition, the Mayo Clinic writes that “alcohol use disorder (which includes a level that’s sometimes called alcoholism) is a pattern of alcohol use that involves problems controlling your drinking, being preoccupied with alcohol, continuing to use alcohol even when it causes problems, having to drink more to get the same effect, or having withdrawal symptoms when you rapidly decrease or stop drinking.”

Alcohol use disorder, or alcoholism, is a chronic, relapsing, and treatable disease of the brain.

Why Is Alcoholism Considered a Disease?

If alcoholism is also called alcohol use disorder, then why is it considered a disease? Good question. Let’s examine the research behind why alcoholism is considered a disease.

A 2016 Surgeon General’s report titled “Facing Addiction in America” documented the changes in the brain that occur when a person abuses alcohol. It states, “These changes take place in brain circuits that are involved in pleasure, learning, stress, decision making, and self-control.” 

In addition, when a person drinks alcohol, it produces a pleasurable dopamine surge in the brain’s basal ganglia, the area of the brain that controls reward and the ability to learn based on rewards.

The brain’s dopamine transmitters cause us to seek pleasure. The stress neurotransmitters in the extended amygdala part of the brain cause us to avoid pain and unpleasantness. When these two types of transmitters work together, they cause us to act.

Substance use can upend the normal balance of the aforementioned actions. Substance use includes nicotine, opioids, and alcohol, to name a few.

If a person is healthy and a moderate drinker, they can control their impulse to drink because two essential circuits of the brain, judgment and decision-making, located in the prefrontal cortex balance the impulse to drink. Heavy drinkers and those with alcoholism have had those circuits disrupted.

Research noted in the Surgeon General’s report indicates that alcoholics and addicts have reduced capability to control the strong impulse to drink or use drugs, even when they know it will cause problems in their life. When this occurs, their reward system is diseased.

Is Alcoholism a Disease or a Lifestyle Choice?

How does someone become an alcoholic? Are they born that way, or is it a lifestyle choice? While there has been some research on whether or not people inherit alcoholism, taking that first drink is a choice one makes.

Alcoholism is also alcohol addiction. Is alcohol dependence the same as addiction?

When someone drinks regularly or heavily, their body and brain become tolerant of the effects alcohol once gave them. When they aren’t feeling the same pleasurable effects as before, they will drink more to feel them. 

If they continue to drink, their system becomes dependent on alcohol. If they feel physical symptoms when they stop drinking (withdrawal), they have become addicted. Alcohol dependence is not the same as addiction, but it accompanies it, as NIDA states.

Alcoholism produces uncontrollable compulsive seeking behavior and use that interferes with every aspect of a person’s life. It is defined as a chronic, relapsing disease of the brain but one that is treatable.

Is Alcoholism a Progressive Irreversible Illness?

is alcoholism a disease or choice

Alcoholism, as a progressive illness, is a theory that Alcoholics Anonymous and other well-known 12-step programs are based on. If we look at this disease as progressive, we learn that an individual may progress from one stage of drinking to the next. The compulsive behavior and drinking intensify over time until they reach the stage of alcoholism.

Is alcoholism an irreversible illness? First, irreversible means cannot be changed. Alcoholism is a disease impacting the reward and judgment circuits of the brain. So, can the brain be rewired, thus, changed so that a person is not an alcoholic? Addiction and alcoholism are relapsing substance use disorders. This means that if an individual goes into and completes addiction treatment, there is still the possibility of relapse or drinking again.

Certain situations, places, and people may compel an alcoholic to start drinking again after they have been abstinent for a long time. This is relapse. Other people may be able to handle or manage those circumstances, places, or people without an alcoholic beverage. Alcoholism is a progressive illness but not necessarily an irreversible one.

Alcoholism Does Not Need to Define You

Alcoholism does not need to define you or someone you care about. While it may be very challenging to struggle with alcohol use, the chains of addiction can be broken, and freedom from substance use is entirely possible.

Alcohol is the most commonly abused and addictive substance in the country. It affects 18 million people. Many factors of your or another’s life contribute to alcoholism, such as genetics, mental health, and environment. Anxiety and depression are two mental health conditions that can lead to alcoholism. Society and its ills can contribute to alcoholism. So, you may be wondering: how is treatment for alcohol and drug abuse different from mental health treatment?

Get Help for Alcoholism at Arete Recovery

Arete Recovery specializes in both mental health treatment and alcohol abuse. If you or the person you care about begins treatment at Arete, an assessment of your or their mental health occurs, along with an assessment of overall health and substance use history. If a dual diagnosis is found—when a mental health disorder and substance use disorder are diagnosed—both are treated.

Treatment varies from one person to the next. Even if different people have the same diagnosis, they will have different needs, goals, and objectives in treatment.

Arete Recovery does not subscribe to the “cookie-cutter” approach to mental health treatment. When the person is directly involved in creating their own treatment plan, services that support them, and goals, their outcomes are greater.

Different resources and tools are used to increase your experience as you beat your own path to recovery. Medication, if needed, counseling, education, and support are all significant resources for someone in mental health treatment.

Alcohol use disorder treatment begins with medically supervised detoxification, which is a process to eliminate all foreign substances from the body. Once detox is complete, you will be given the above-mentioned assessments and given the opportunity to provide input about what therapies will best meet your goals and objectives. 

You may be put in an inpatient treatment program where you will stay for up to 90 days. Outpatient treatment is an option when inpatient treatment ends.

Arete’s alcohol rehab program is designed to help you find the root of your addiction and learn different methods of dealing with it other than alcohol use. Our accredited and experienced staff are caring and supportive and want you to live a life free from alcohol or other substance use. You are not alone along your journey to living without alcohol abuse.

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