Alcoholic beverages have always been part of our way of life—always. Most people enjoy them, and they usually provide pleasure without causing harm; indeed, moderate consumption may even be protective against certain diseases. Alcohol, however, can cause problems, just like other substances. Above certain doses, alcohol is toxic, like all substances. But above all, quite apart from this, alcohol can become attached to a person in a way that is no longer controlled or controllable—that is, it can induce dependence.
Abuse
With alcohol, it is possible to overdo it and become intoxicated. Someone who is drunk generally functions less effectively, runs the risk of hurting themselves, may hurt others, either accidentally or because of increased aggression, or may simply fall asleep. The first time may be a mistake, certainly… but even the first time is a curious kind of mistake. Even more curious is the fact that, after the first mistake, the same thing happens again. For some individuals, in fact, whenever they come into contact with alcohol, getting drunk becomes automatic, even if they then do not drink anything for days. In some countries, habitual drunkenness at the weekend is a ritual.
The fact is that when something is pleasurable, it is easier to overdo it, because after experiencing a little of it, one wants more—especially if one has a certain kind of brain.
Dependence
Someone who abuses a substance does not lose control only when intoxicated; they can still freely decide whether or not to use that substance, and generally do so for pleasure. Someone who is dependent (an alcoholic), on the other hand, loses both freedom and pleasure. We generally speak of drug addiction and alcoholism as two different problems, but this distinction is unjustified. They are both forms of substance dependence. One might say that alcohol is a “light” substance, less risky in every sense, in that if one hundred people drink regularly, only a few will eventually become unable to stop. With hard drugs, on the other hand, many people lose control, often quite rapidly.
An alcoholic is someone who owes their unhappiness and impaired functioning to alcohol, yet is condemned to keep wanting it as though it were instead the key to their happiness. In other words, being an alcoholic does not mean simply being a habitual heavy drinker. The difference lies in the inability to manage alcohol, regardless of why a person enjoys drinking. The habitual drinker chooses to drink habitually; the alcoholic drinks against their own intentions, driven instead by an instinctive urge. Alcoholism consists of a pattern of consumption that continues or recurs despite the intention to control or stop it. The core of the problem therefore lies in the relationship between the individual and alcohol.
Drinking in the morning, drinking heavily, or getting drunk are not, in themselves, sufficient to say that a person is an “alcoholic.” For example, someone who is hospitalized because alcohol has caused them physical problems is not necessarily an alcoholic. If concern about their health seems to them a good reason to stop or reduce their drinking, and they are able to do so, they are not. Someone who drinks habitually but has never had a reason to stop and enjoys drinking is not. Someone who drinks for a period in order to forget or get over a disappointment, and who after a while stops or becomes fed up with alcohol’s side effects and keeps it at a greater distance, is not an alcoholic.
Alcoholism is not easily treated, but there are several effective therapies, and the possibility of combining different strategies to control the desire to drink, together with treatment of any associated psychiatric conditions, can improve the results that can be achieved.