From the Journal of the American Medical Association
Vol. 295 No. 17, May 3, 2006

Alcohol abuse is a pattern of drinking that is accompanied by 1 or more of the following problems: (1) failure to fulfill major work, school, or home responsibilities because of drinking; (2) drinking in situations that are physically dangerous, such as while driving a car or operating machinery; (3) recurring alcohol-related legal problems, such as being arrested for driving under the influence of alcohol or for physically hurting someone while drunk; and (4) having social or relationship problems that are caused by or worsened by the effects of alcohol.

Alcoholism (alcohol dependence) is a more severe pattern of drinking that includes the problems of alcohol abuse plus persistent drinking in spite of obvious physical, mental, and social problems caused by alcohol. Also typical are (1) loss of control—inability to stop drinking once begun; (2) withdrawal symptoms (symptoms associated with stopping drinking such as nausea, sweating, shakiness, and anxiety); and (3) tolerance (needing increased amounts of alcohol in order to feel drunk).

For more AMA information, visit www.jama.com

For additional formation, read "The Doctor's Opinion" by Wm. D. Silkworth, M.D. in Alcoholics Anonymous 1939

On Page 24:1, the Big Book Says: "The fact is that most alcoholics, for reasons yet obscure, have lost the power of choice in drink. Our so-called will power becomes practically nonexistent. We are unable, at certain times, to bring into our consciousness with sufficient force the memory of the suffering and humiliation of even a week or a month ago. We are without defense against the first drink."

In the original manuscript, the same entire paragraph was underlined and the language is stronger:

"The fact is that most alcoholics, for reasons yet obscure, have lost the power of choice in drink. Our so-called will power becomes practically non-existent. We are unable at certain times, no matter how well we understand ourselves, to bring into our consciousness with sufficient force the memory of the suffering and humiliation of even a week or a month ago. We are without defense against the first drink."

Some of us simply accept as fact that we are alcoholics and then move on, taking the steps that empower us to recover. Others want to understand "the problem" better, There may be many reasons for wanting to understand the nature and cause of alcoholism. One reason is the belief that "a problem that is not understood and clearly defined cannot be properly solved."

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A Question posed to Bill W., Co-Founder of AA and principal author of the book "Alcoholics Anonymous":
How do you justify calling alcoholism an illness, and not a moral responsibility? (The Disease Concept)

Bill's Answer: "Early in A.A.'s history, very natural questions arose among theologians. There was a Mr. Henry Link who had written "The Return to Religion" (Macmillan Co., 1937). One day I received a call from him. He stated that he strongly objected to the A.A. position that alcoholism was an illness. This concept, he felt, removed moral responsibility from alcoholics. He had been voicing this complaint about psychiatrists in the American Mercury. And now, he stated, he was about to lambaste A.A. too. Of course, I made haste to point out that we A. A.'s did not use the concept of sickness to absolve our members from moral responsibility. On the contrary, we used the fact of fatal illness to clamp the heaviest kind of moral responsibility on to the sufferer.