Alcoholism, or alcohol dependence is a medical term with a deliberately more precise meaning than the problems that can occur, sometimes as one-offs, through an uncharacteristic binge.

In alcohol dependence a number of features come together in the behaviour of the person affected.
  • Drinking begins to take priority over other activities. It becomes a compulsion.
  • Tolerance develops, so it takes more alcohol to produce drunkenness.
  • Withdrawal symptoms such as anxiety and tremor develop after a short period without a drink, and are reduced by taking more alcohol.
Often alcohol dependence remains undetected for years. Both the availability of alcohol and the way it is used (the social patterns) appear to be major factors in influencing the likelihood of a person becoming alcohol dependent.
There may also be a genetic component, because alcohol dependence clusters in some families. However, it’s hard to be sure that this is not because of learned behaviour.

Mental health and alcoholism

Mental health problems are common with alcoholism. Each can lead to or reinforce the other.

Depression is a common cause of alcoholism as the depressed person seeks a way out of their problems or a relief from insomnia. Unfortunately, alcohol is itself a depressant, so the problem is only compounded.

Anxiety can be temporarily relieved by alcohol, but this may lead to repeated intake and dependence.
Without adequate attention to the mental health needs of a person with alcohol dependence, little progress will be made. Often alcoholism remains unsuspected even by the doctor, and it may come to light only when medical tests are done for other reasons.

Written by Dr D. Rutherford, GP