Alcohol dependence is classified as a disease in the WHO (World Health Organization) diagnostic system ICD according to DSM-5 (psychiatric diagnostic manual). Examples of diagnostic codes: Episodes of harmful alcohol use get code 6C40.0, pattern of harmful use - 6C40.1 etc.., read more at https://icd.who.int/browse/2025-01/mms/en#1676588433
Alcoholism, now commonly referred to as alcohol dependence, is a chronic, progressive illness that develops over time. The progression can vary from person to person, but often follows a pattern characterised by increased drinking behaviour and eventually physical and psychological dependence.
The typical stages:
- Experimentation and social drinking. Often begins with informal drinking in social settings. There are no problems associated with drinking at this stage.
- Increased consumption and risky drinking. Drinking becomes more frequent and the person may begin to drink to cope with stress and emotions. Tolerance to alcohol increases, meaning larger amounts are needed to achieve the desired effect.
- Problematic drinking / abuse. (Early stage of addiction). Drinking is beginning to cause consequences in daily life, such as problems at work, in relationships, or with the law. The person may start to hide their drinking habits and gradually loses control over their intake.
- Addiction. (Critical phase). This is the core stage of alcoholism.
- Compulsive useA strong, compulsive urge to drink.
- Loss of controlCannot limit the amount of alcohol consumed.
- Physical dependenceThe body adapts to alcohol. Withdrawal symptoms (tremors, sweating, nausea, anxiety) occur when one abstains from drinking.
- PrioritisingDrinking becomes more important than other activities and commitments.
- Chronic alcoholism (End-stage)At this stage, drinking is dominant. Physical and mental health are severely impaired, and the person may experience serious medical conditions such as liver damage (cirrhosis), brain damage, or heart disease. Social isolation is common, and life revolves exclusively around maintaining alcohol intake.
Key characteristics of the development:
- Gradual progressionIt rarely happens overnight; it's a slow transition from moderate use to addiction.
- DenialA common part of the illness is that the person denies they have a problem, even when the consequences are obvious. To them, we say: Try more controlled drinking. Enter into a written agreement, with yourself or your closest relatives, about how much or how little you should drink on given occasions. Be honest when assessing the outcome!
- Need for professional helpAlcoholism is a medical condition that can be treated, but it often requires professional intervention and support to be managed effectively.
A fate worse than death?
Alcoholism is a progressive disease which, if not arrested, can lead to premature death - or perhaps worse - Korsakoff's syndrome, a condition of a living, brain-dead vegetable.