Alcoholism has been considered a moral problem since the dawn of recorded history. Around the turn of the century alcoholism began to be treated as a psychiatric illness, although the moral overtones remained. Since most cultures accepted drinking as OK, the attitude was usually not “The drinker is bad,” but that “The drunk is bad.” People who “disgraced” themselves after drinking too much were assumed to have some kind of moral weakness and lack of will power.

Disease Concept

AA’s phenomenal success changed public opinion: alcoholism began to be perceived as a disease, and the alcoholic as a sick rather than a bad person. The medical profession had almost given up on treating the alcoholic by 1935, partly because of very poor success rates. Today alcoholism is usually treated as an addictive disease, with generally good results (eventually) in roughly half the cases.

Similarity to Other Addictions

Almost everything known about the identification, development, or treatment of alcoholism has its parallel in any other addiction. While each addiction has its differences, they are almost trivial in the long run. Therapists must know the jargon and the painful emotions and circumstances of each specific addiction, but the disease itself seems the same for all addictions.

Biological Components

Two trends in the study of addiction stand out. One is the investigation and incorporation of current physical, neurochemical research into the theory of addiction. You may have read articles about biochemistry, opiate receptors, and maybe even the role endorphins, serotonin, and other neurotransmitters play in addictive behavior.

The Family

The other trend is a growing awareness of the impact that family, especially family of origin, has on people. Concerns about Adult Children of Alcoholics, codependency, abuse, and incest echo this trend in the treatment of addiction.


Alcoholism and chemical dependency treatment have traditionally focused on the substance or drug that is ingested, injected, or otherwise taken into the body from outside. This emphasis has fostered the belief that addiction comes from outside the body.

To understand addiction better, you must also consider addiction to the biochemical changes that occur within the body, whether induced by the drug, by excitement, or by other biological processes.


Some of these biochemical changes can take place in the bodies of those around the active addict, regardless of whether the addict or the others are using external drugs. These physical effects combine with emotional, mental, and spiritual factors to produce the disease or syndrome known as codependency (see the module on Codependency for more information).

Alcoholism, see also: Addiction, Addiction model (PEMS), Adolescents, Alcohol, Alcoholics Anonymous, Binge history, Bingeing, Biochemistry, Blackouts, Celebrations, Craving, Drugs, Family, History of Twelve-Step groups, Hunger & appetite, Moodifiers, Nutrition, Prevention of addiction, Progression.

Updated 18 Oct 2015

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Addictionary 2 by Jan & Judy Wilson

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