More on Defining Alcoholism
Columns - On the Web
Written by Stuart Gitlow, MD   
Friday, 05 October 2007
For several months, this column focused on the difficulties experienced at Wikipedia with respect to the public entry there on alcoholism. I spoke of the debates among participants and contributors to Wikipedia regarding not only content of the entry but even the basics of definition. A good deal of bandwidth was taken with discussion as to what the very first line of the entry would be. How can one easily reduce “alcoholism” to a single sentence that comfortably fits into the paradigm for physicians, sociologists, clinicians, and the lay-public? The National Institute on Alcohol Abuse and Alcoholism (NIAAA) presents its perspective on alcoholism on a website targeting college drinking as a culture that needs to be altered. The site includes an FAQ at: http://www.collegedrinkingprevention.gov/OtherAlcoholInformation/facts/q-a.aspx#question1

There, NIAAA has defined alcoholism as a disease that includes four symptoms: craving, loss of control, physical dependence and tolerance. This is an unfortunate opening of the FAQ, since alcoholics do not necessarily have any of these four symptoms. Let me give two examples:




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