Primary refers to the nature of alcoholism as a disease entity, in addition to and separate from other path-physiologic states that may be associated with it. Primary suggests that alcoholism, as an addiction, is not a symptom of an underlying disease state. Primary also implies that when this disease coexists with other conditions, therapies applied to them are ineffective until the alcoholism is dealt with.

Disease means an involuntary disability. It represents the sum of abnormal phenomena displayed by a group of individuals. These phenomena are associated with a specific common set of characteristics by which these individuals differ from the norm and which places them at a disadvantage.

Often progressive and fatal means that the disease persists over time and that physical, psychological, and emotional changes area often cumulative and may progress as drinking continues. Alcohol causes premature death through overdose; organic complications involving the brain, liver, heart, and other organs; and by contributing to suicide, homicide, motor vehicle crashes, and other traumatic events.

Impaired control means inability to limit alcohol use or consistently limit, on any drinking occasions, the duration of the episode, the quantity consumed, and/or the behavioral consequences of drinking.

Preoccupation, in association with alcohol use, means excessive focused attention given to the drug alcohol, its effects, and/or its use. The relative value assigned to alcohol by the individual often leads to diversion of energies away from important life functions.

Adverse consequences are alcohol-related problems or impairments in such areas as: physical health (e.g., alcohol withdrawal symptoms, liver disease, gastritis, anemia, pancreatic and neuralgic disorders); interpersonal functioning (e.g., marital problems, child abuse, impaired social relationships); occupational functioning (e.g., scholastic or job problems); and legal, financial, or spiritual problems.

Denial is used here not only in the psychoanalytic sense of a single psychological defense mechanism disavowing the significance of events, but more broadly to include a range of psychological maneuvers designed to reduce awareness of the fact that alcohol use is the cause of an individual's problems rather than a solution to those problems. Denial becomes an integral part of the disease and a major obstacle to recovery.