Alcoholism, also called alcohol syndrome has been recognized as a disease since 1968. A distinction is made between alcohol dependence and alcohol abuse. ICD-10 defines six criteria of which at least three have to apply for at least a month (or, if shorter, apply repeatedly over a year) to diagnose alcohol dependence syndrome (F10.2):
- A strong or compulsive craving to drink alcohol
- Reduced ability to control the quantity, the beginning or end of of drinking (i.e. more alcohol is regularly consumed than planned or alcohol is consumed over a longer period than planned, or there is a constant desire and attempt to reduce alcohol use—without lasting success)
- Physical withdrawal symptoms after stopping or reducing alcohol use
- Demonstrated tolerance (greater amounts of alcohol are necessary to get the desired effect)
- Preoccupation with alcohol (i.e. other interests are neglected in favor of drinking)
- Continued substance use despite health and social consequences for the person despite the fact that an awareness exists or could exist of the type and extent of the damage (e.g. hepatic diseases such as hepatic cirrhosis, deterioration of cognitive functions, loss of drivers license or job, separation from life partner, withdrawal of the circle of friends, etc.)
The term “alcohol abuse” is used if an alcohol dependence syndrome does not yet apply while the respective person (or his social environment) suffers physical or psychological damage as a result of his alcohol use (e.g. accident or loss of drivers license). It also includes negative consequences for interpersonal relationships. Frequent complications in connection with the above-mentioned addictions are intoxication, withdrawal symptoms, psychotic disorders, also misperceptions and delusions (e.g. hallucinations) as well as amnesic syndrome, personality and behavioral changes. The symptoms are mostly not found at the same time and may often develop slowly. What matters is that neither an absolute quantity nor the regular use nor the absence of physical withdrawal symptoms can confirm or exclude the presence of an alcohol syndrome.
The continued use of alcohol results in a number of secondary disorders such as alcoholic polyneuropathy (damage of nerves), pancreatitis, gastritis and gastric ulcers, liver tissue damage including cirrhosis and many more. It can even lead to organ failure. The development of malignant tumors is also attributed to the use of alcohol. There is no threshold below which the use of alcohol would be harmless. However, the expected damage depends on a number of protective or mutually reinforcing factors (e.g. the simultaneous consumption of other toxic substances or malnutrition).