Alcoholism vs. Alcohol Abuse

Just what is alcoholism? Is it just drinking too much? Or is there more to it than that? Webster's Ninth New Collegiate Dictionary defines alcoholism as "a continued excessive or compulsive use of alcoholic drinks ¼ associated with excessive and usually compulsive drinking."

Alcohol abuse refers to the misuse of alcohol resulting in problems to the abuser and those he or she may affect. Abuse does not necessarily indicate alcoholism. Alcoholism involves developing a dependency on alcohol and follows a somewhat predictable progression of symptoms.

Dr. James Royce defines alcoholism as "a chronic illness or disorder characterized by some loss of control over drinking, with habituation or addiction to the drug alcohol, or causing interference in any major life function; for example, health, job, family, friends or the law" (Alcohol Problems and Alcoholism, p. 10).

He summarizes regarding addiction: "Addiction is a physiological [physical] dependence or need, with its familiar signs of increased tolerance initially, cellular adaptation, and withdrawal symptoms. One physically needs a drink to function."

Four Phases of Alcoholism

This progression typically proceeds through four stages:

1. Social Drinking—Social drinking suggests drinking for stress relief, which results in mood change. It may begin as a result of peer pressure, to go along with the crowd or to alleviate boredom or stress.

2. Seeking the Mood Change—This leads to drinking for the purpose of achieving mood change. Drinking habits begin to fall into personal patterns (certain times of the day, in private, etc.) and psychological manifestations. Chief among these is the denial of any dependence in order to protect developing behavioral patterns.

3. Constantly Seeking the Mood Change—Phase 3 involves a regular pattern of drinking for the desired effects. This may take the form of regular, ongoing daily drinking or sporadic episodes of drunkenness followed by periods of abstinence (often labeled as "periodic drinking").

Obsessive and compulsive drinking leads to violations of one's fundamental ethics, values and moral standards. The drinker resorts to entrenched denial defenses to justify this misconduct in response to the objections of family members and other significant persons.

4. Addiction—The cells of the body adapt rapidly to the increasing ingestion of alcohol, resulting in a higher level of "tolerance." This means the person is able to consume more beverage alcohol without obvious physical effects or showing signs of impaired behavior. Regardless of the appearance of continued ability to hold a job, keep the family "intact" etc., the increased intake of alcohol causes cellular damage that will eventually exact its toll on the body, even causing organ failure.

Increased tolerance also demands that the person must drink more to achieve the effects sought in stage 1. The nervous system adapts to the escalating level of alcohol, resulting in physical dependence (see definition above). Drinking beyond tolerance levels results in drunkenness. Suddenly abstaining or drinking less than the tolerance level throws the cells of the body into acute distress, which produces varying withdrawal symptoms including "delirium tremens" (commonly referred to as "DTs"). The syndrome of physical dependence or addiction is now in full swing.

The growing need for alcohol becomes the focus of the victim's life. The alcoholic's world begins to function around the chemical. It becomes companion, conversational item, basis of jokes and determines choice of companions. The half case of beer or the several half gallons of "cooking wine" become the first grocery items into the basket. The liquor store becomes very important when the Friday night errands are done prior to the beginning of God's Sabbath. A picnic just wouldn't be a picnic without the cooler full of a favorite alcoholic beverage.

Many nonalcoholics go through these same motions but not on a consistent basis. They can enjoy an alcohol-free gathering. The dependent person will make sure he or she has a few before attending such an occasion and/or find ways to leave early or steer the group to a "watering hole," itself a term to hide the reality of their dependence.
As time goes by, the sufferer develops whatever means necessary to maintain his supply of alcohol, including lying, hiding bottles, sneaking drinks, even stealing. Family life, job performance and health all suffer from the progression. The alcoholic family member becomes a habitual source of uncertainty, causing embarrassment and shame, often missing scheduled appointments, always promising never to do it again.

Frustrated family members often lash out in anger or make threats or impassioned pleas for abstinence. This drives the alcoholic deeper into the delusional world of denial, shame and self-pity. Psychologically isolated, the alcoholic addictively reaches for what he or she considers as friend and source of stabilization—alcohol. This convoluted progression continues to spiral downward and out of control, leaving emotional trauma and estrangement of relationships in its path.

What we have just described is also called chemical dependency. Dr. James Milam, author of Under the Influence, describes this phenomenon as "a progressive, ongoing chronic illness characterized by increased tolerance which results in loss of control over the chemical, resulting in continued use in spite of negative consequences."

Disease or Moral Weakness?

This brings up a controversial point. Many believe alcoholics simply lack willpower to stop drinking. Yet the medical profession almost unanimously considers alcoholism an illness or disease. Is it a sickness or is it a sin?

Those who are able to drink in moderation may wonder why others seem unable to stop drinking, despite the negative consequences. Some conclude that the person is simply weak-willed or lacking in character.

However, researchers have noted that a genetic predisposition to alcohol addiction afflicts a minority of the population (about 10 to 15 percent of Anglo-Americans). In other words, some people carry a natural tendency to addiction that is triggered by alcohol. In some cases this addiction blossoms with the first drink.

Because this phenomenon has a documented pathology, alcoholism has been classified as an "illness." The American Medical Society, considering that alcoholism fits the description, declared it so in 1956.

Classifying alcoholism as an illness does not convey permission for continuing inappropriate and destructive drinking behavior. The disease concept of alcoholism offers an explanation, not an excuse. It simply defines the problem in order to determine proper treatment. Treatment methods emphasize: number one, the primary need to stop ingestion of the chemical; and number two, the need to accept responsibility for the consequences of one's behavior. For an alcoholic, already carrying a heavy load of guilt, the concept of personal responsibility is much less difficult to bear than more guilt and shame.

Medical classification of alcoholism as a primary disease has opened insurance coverage for many victims who might otherwise not be able to afford the clinical treatment that is so effective in helping to restore thousands to healthy productivity.

Biblical Teaching About Alcohol Abuse

The Bible clearly labels drunkenness as one of the "works of the flesh" (Galatians 5:19-21), and warns that no "drunkard" will inherit the Kingdom of God (1 Corinthians 6:10).

However, the context of Galatians 5 is noteworthy. In verse 13 Paul admonishes the Galatians "not to use liberty as an opportunity for the flesh" (Galatians 5:13). This speaks to heretical religious beliefs of the time based on a false concept of religious liberty. Expositor's Bible Commentary summarizes the heresy as, "The more we sin, the more will God's grace be required to meet the situation, and this will in turn contribute the more to his glory" (see Romans 3:8). Romans 6 and 2 Peter 2 also address this false teaching.

The word in Galatians 5:13 translated "opportunity" ("occasion," KJV) is significant. Wuest explains: "It is a military term speaking of a base of operations. In our Galatian passage it means ‘the cause, occasion, or pretext' of a thing. Paul exhorts the Galatians not to make their liberty; a base of operations from which to serve sin. Their liberty was not to be used as a spring-board from which to take off with the intention of sinning" (Word Studies in the New Testament, Vol. 1, p. 150).

So Paul is simply disarming the argument that one may continue unrepentant sinful behavior (including drunkenness), using a false concept of "liberty" as a "spring-board." To consider these passages as a condemnation of someone struggling with a physiologically-based chemical addiction would be most unfortunate, as well as counterproductive to the victim, who desperately needs love and support in his or her struggle for sobriety.

Alcoholism is a physical condition compounded by developed, entrenched psychological patterns that protect the addiction.

However, much of the behavior associated with alcoholism, including becoming intoxicated, is sin; and all sin must be repented of. No unrepentant sinner will be allowed entry into the Kingdom of God. A repentant sinner will abhor his sin and make every effort, with God's help, to stop sinning. For an alcoholic, this means abstinence and seeking established and proven treatment methods to gain sobriety. More about that in the next article in this series.