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.