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August 26, 1992, Vol 268, No. 8 >
ARTICLE | August 26, 1992

The Definition of Alcoholism FREE

Robert M. Morse, MD; Daniel K. Flavin, MD
[+] Author Affiliations

A complete list of the participants in this project appears at the end of this article.

Reprint requests to National Council on Alcoholism and Drug Dependence, 12 W 21st St, New York, NY 10010 (Dr Flavin).


JAMA. 1992;268(8):1012-1014. doi:10.1001/jama.1992.03490080086030
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References

To establish a more precise use of the term alcoholism, a 23-member multidisciplinary committee of the National Council on Alcoholism and Drug Dependence and the American Society of Addiction Medicine conducted a 2-year study of the definition of alcoholism in the light of current concepts. The goals of the committee were to create by consensus a revised definition that is (1) scientifically valid, (2) clinically useful, and (3) understandable by the general public. Therefore, the committee agreed to define alcoholism as a primary, chronic disease with genetic, psychosocial, and environmental factors influencing its development and manifestations. The disease is often progressive and fatal. It is characterized by impaired control over drinking, preoccupation with the drug alcohol, use of alcohol despite adverse consequences, and distortions in thinking, most notably denial. Each of these symptoms may be continuous or periodic.

(JAMA. 1992;268:1012-1014)

REFERENCES

1 +
Criteria Committee, National Council on Alcoholism.  Criteria for the diagnosis of alcoholism. Ann Intern Med . 1972;;77:249-258.
2 +
National Council on Alcoholism/American Medical Society on Alcoholism Committee on Definitions.  Definition of alcoholism . Ann Intern Med . 1976;;85:764.
3 +
Gordis E.  Alcoholism and scientific progress. Alcohol Health Res World . 1989;;13:298-300.
4 +
Cloniger CR.  Neurogenetic adaptive mechanisms in alcoholism. Science . 1987;;236:410-416.
5 +
Cloniger CR, Bohman M, Sigvardsson S.  Inheritance of alcohol abuse: cross-fostering analysis of adopted men. Arch Gen Psychiatry . 1981;;38:861-868.
6 +
Naranjo CA, Sellers EM, Lawrin MO.  Modulation of ethanol intake by serotonin uptake inhibitors. J Clin Psychiatry . 1986;;47( (suppl) ):16-22.
7 +
Lê AD, Khanna JM, Kalant H, LeBlanc AE.  Effect of modification of brain serotonin (5-HT), norepinephrine (NE) and dopamine (DA) on ethanol tolerance. Psychopharmacology (Berl) . 1981;; 75:231-235
8 +
World Health Organization.  Nomenclature and classification of drug- and alcohol-related problems: a WHO memorandum. Bull World Health Organ . 1981;;59:225-242.
9 +
American Psychiatric Association, Committee on Nomenclature and Statistics. Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised . Washington, DC: American Psychiatric Association; 1987;.
10 +
World Health Organization. Mental Disorders: Glossary and Guide to Their Classification in Accordance With the Ninth Revision of the International Classification of Diseases . Geneva, Switzerland: World Health Organization; 1978;.
11 +
Edwards G, Gross MM.  Alcohol dependence: provisional description of a clinical syndrome. BMJ . 1976;;1:1058-1061.
12 +
National Institute on Alcohol Abuse and Alcoholism. Seventh Special Report to the US Congress on Alcohol and Health . Rockville, Md: US Dept of Health and Human Services; 1990;.
13 +
Wikler A.  Dynamics of drug dependence: implications of a conditioning theory for research and treatment. Arch Gen Psychiatry . 1973;;28:611-616.
14 +
Campbell EJM, Scadding JG, Roberts RS.  The concept of disease. BMJ . 1979;;2:757-762.
15 +
Criteria Committee, National Council on Alcoholism.  Criteria for the diagnosis of alcoholism. Am J Psychiatry . 1972;;129:127-135.
16 +
American Psychiatric Association, Committee on Nomenclature and Statistics. Diagnostic and Statistical Manual of Mental Disorders, Third Edition . Washington, DC: American Psychiatric Association; 1980;.
17 +
Kleber HD.  The nosology of abuse and dependence. J Psychiatr Res . 1990;;24( (suppl 2) ):57-64.
18 +
Grant BF.  DSM-III-R and ICD-10 classification of alcohol use disorders and associated disabilities: a structural analysis. Int Rev Psychiatr . 1989;;1:21-39.
19 +
Jellinek EM. The Disease Concept of Alcoholism . New Haven, Conn: Hillhouse Press; 1960;:33-41.
20 +
Morse RM.  The disease concept controversy: is there a cure? Subst Abuse . 1989;;10:75-76.
21 +
Meyer RE.  Overview of the concept of alcoholism.  In: Rose RM, Barrett JE, eds. Alcoholism: Origins and Outcome . New York, NY: Raven Press; 1988;:1-14.

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1 +
Criteria Committee, National Council on Alcoholism.  Criteria for the diagnosis of alcoholism. Ann Intern Med . 1972;;77:249-258.
2 +
National Council on Alcoholism/American Medical Society on Alcoholism Committee on Definitions.  Definition of alcoholism . Ann Intern Med . 1976;;85:764.
3 +
Gordis E.  Alcoholism and scientific progress. Alcohol Health Res World . 1989;;13:298-300.
4 +
Cloniger CR.  Neurogenetic adaptive mechanisms in alcoholism. Science . 1987;;236:410-416.
5 +
Cloniger CR, Bohman M, Sigvardsson S.  Inheritance of alcohol abuse: cross-fostering analysis of adopted men. Arch Gen Psychiatry . 1981;;38:861-868.
6 +
Naranjo CA, Sellers EM, Lawrin MO.  Modulation of ethanol intake by serotonin uptake inhibitors. J Clin Psychiatry . 1986;;47( (suppl) ):16-22.
7 +
Lê AD, Khanna JM, Kalant H, LeBlanc AE.  Effect of modification of brain serotonin (5-HT), norepinephrine (NE) and dopamine (DA) on ethanol tolerance. Psychopharmacology (Berl) . 1981;; 75:231-235
8 +
World Health Organization.  Nomenclature and classification of drug- and alcohol-related problems: a WHO memorandum. Bull World Health Organ . 1981;;59:225-242.
9 +
American Psychiatric Association, Committee on Nomenclature and Statistics. Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised . Washington, DC: American Psychiatric Association; 1987;.
10 +
World Health Organization. Mental Disorders: Glossary and Guide to Their Classification in Accordance With the Ninth Revision of the International Classification of Diseases . Geneva, Switzerland: World Health Organization; 1978;.
11 +
Edwards G, Gross MM.  Alcohol dependence: provisional description of a clinical syndrome. BMJ . 1976;;1:1058-1061.
12 +
National Institute on Alcohol Abuse and Alcoholism. Seventh Special Report to the US Congress on Alcohol and Health . Rockville, Md: US Dept of Health and Human Services; 1990;.
13 +
Wikler A.  Dynamics of drug dependence: implications of a conditioning theory for research and treatment. Arch Gen Psychiatry . 1973;;28:611-616.
14 +
Campbell EJM, Scadding JG, Roberts RS.  The concept of disease. BMJ . 1979;;2:757-762.
15 +
Criteria Committee, National Council on Alcoholism.  Criteria for the diagnosis of alcoholism. Am J Psychiatry . 1972;;129:127-135.
16 +
American Psychiatric Association, Committee on Nomenclature and Statistics. Diagnostic and Statistical Manual of Mental Disorders, Third Edition . Washington, DC: American Psychiatric Association; 1980;.
17 +
Kleber HD.  The nosology of abuse and dependence. J Psychiatr Res . 1990;;24( (suppl 2) ):57-64.
18 +
Grant BF.  DSM-III-R and ICD-10 classification of alcohol use disorders and associated disabilities: a structural analysis. Int Rev Psychiatr . 1989;;1:21-39.
19 +
Jellinek EM. The Disease Concept of Alcoholism . New Haven, Conn: Hillhouse Press; 1960;:33-41.
20 +
Morse RM.  The disease concept controversy: is there a cure? Subst Abuse . 1989;;10:75-76.
21 +
Meyer RE.  Overview of the concept of alcoholism.  In: Rose RM, Barrett JE, eds. Alcoholism: Origins and Outcome . New York, NY: Raven Press; 1988;:1-14.

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