Glossary
12-step
Any of numerous support group programs based on the 12-step recovery model first articulated by Alcoholics Anonymous in its publication of the same name in 1939. In addition to alcoholism, long-term drug addiction, over-eating, gambling and sex addiction recovery has been established and maintained using the twelve steps. With no dues or fees for membership, and self-supporting through their own contributions, there are estimated to be upwards of 6 million members of various 12-step groups worldwide. Worldwide AA membership alone is estimated at more than 2 million, with AA activity in over 150 countries. The book, "Alcoholics Anonymous" (the Big Book), has sold over 23 million copies in English, and is currently available in 48 languages.
addiction
The disease condition that creates a cycle of dependency upon a drug or other externally-occurring substance. The addicted person progressively experiences the anguish of the disease in direct proportion to his or her acute craving, which is a physiological distress that cannot be willed away. Addiction is a primary disease, so classified because if there is no recovery, the damage it does to organ systems will inevitably bring death.
alcoholism
"Alcoholism is a primary, chronic disease with genetic, psycho-social and environmental factors influencing its development and manifestations." -- The American Society of Addiction Medicine and the National Council on Alcoholism and Drug Dependence.
Definitions of Alcoholism on the Web:
A disease that includes alcohol craving and continued drinking despite repeated alcohol-related problems, such as losing a job or getting into trouble with the law. Symptoms include craving, impaired control, physical dependence, and increased tolerance. (1)
A chronic disorder characterized by dependence on alcohol, repeated excessive use of alcoholic beverages, development of withdrawal symptoms on reducing or ceasing alcohol intake, morbidity that may include cirrhosis of the liver, and decreased ability to function socially and vocationally. Currently believed by many to be a disease with strong genetic links. (2)
chronic
Ongoing, without expectation of cure; long-lasting. A health condition that is recurrent or characterized by long suffering.
depression
An imbalance in brain chemistry, primarily in the neurotransmitters serotonin, dopamine and norepinephrine, that produces a variety of affective and behavioral difficulties for individuals. Symptoms vary widely beyond the traditional "sad and withdrawn" stereotype of people with depression, and will include components of anger, perfectionism, compulsivity, and substance abuse. Among men in the United States, depression may be masked by power-driven achievement and financial success. Like alcoholism, a strong genetic predisposition has been demonstrated for depression. The new class of antidepressant medications, selective serotonin reuptake inhibitors (SSRI), do not act on the central nervous system as sedatives or stimulants, but instead defer the breakdown of the naturally-occuring neurotransmitter, serotonin, in the brain. Serotonin is associated with feelings of well-being, competency and security. Links between alcohol craving and serotonin deficiency have been established by Schukit and other researchers into the physiology of alcoholism.
disease
Disease is a term widely used to denote a condition of body and/or mind that produces illness, unwellness, dysphoria and unhappiness. Most diseases can be identified by the occurrence of predictable symptoms and, when observed over time, result in probable outcomes. Though once common to distinguish between a physical disease and a mental condition, discoveries in biochemistry and neurology over the past fifty years have rendered that way of thinking scientifically obsolete and therapeutically useless. The American Medical Association classified alcoholism as a disease in 1957. The American Psychiatric Association, the American Hospital Association, the American Public Health Association, the National Association of Social Workers, the World Health Organization and the American College of Physicians have also classified alcoholism as a disease.
"Alcoholism is 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, mostly denial. Each of these symptoms may be continuous or periodic." -- (1992 JAMA article, the Joint Committee of the National Council on Alcoholism and Drug Dependence and the American Society of Addiction Medicine)
miracle
"Miracle" is not used here in the conventional religious sense of a divine intervention in a hopeless cause, but more in the sense of a spontaneous awareness that produces awe and delight in experiencing everyday things.
prevention
Prevention is used to denote a social policy stance toward the disease of addiction that emphasizes early intervention on the systemic level, and a radical choice for abstinence from addictive substances on the personal level. Since alcoholism and other drug addiction is not itself a personal choice, but rather an inherited predisposition, there can be no activity undertaken by society or the individual to prevent prevent alcoholism per se, short of reproductive sterilization or complete sexual abstinence.
primary
Addiction is a primary disease, which is to say that the normal progression of deterioration and damage it will inflict upon organ systems is sufficient to cause death. In this respect, addiction is on a par with heart disease, AIDS, and cancer. The fact that the disease progression is life-threatening also means that addiction must be addressed as a primary survival issue. Those symptoms of the disease which often attract the attention and concern of others -- job problems, ancillary health problems, emotional disabilities, relationship problems, legal and financial problems -- will continue to grow worse as long as the primary condition remains unresolved. Seen in this light, it is certainly irresponsible, perhaps even malicious, to treat the symptoms (e.g., perform marriage counseling, provide legal assistance, prescribe medications, etc.) while neglecting to directly address the disease.
progressive
Over time, the disease becomes worse and worse; it is not in the natural course of this disease to just disappear or reverse its downward direction. Every organ system in the body is further damaged as time goes by, which in turn has a deleterious effect on the person's ability to fight off other diseases and maladies. As a result, the average life span of alcoholics and addicts is reduced by twelve years.
recovery
When a person with the disease of alcoholism or other drug addiction stops trying to control their disease by admitting that he or she has lost the ability to control it, then recovery from the disease can begin. Recovery is the state of abstinence combined with active participation in a twelve step recovery program such as Alcoholics Anonymous, Narcotics Anonymous, and Al-Anon. Note that it is possible for some alcoholics/addicts to maintain relatively long periods of abstinence as part of their pattern of use. Such periods, sometimes called dry-drunks and marked by high stress, anger, isolation and depression, are not to be mistaken for recovery, which can be identified by reduced stress, buoyancy, increased sense of well-being, group participation, much improved physical health, and willingness to follow a recovery regimen.
symptoms
Alcoholism and other drug addiction is a biogenically-based disease, with a well defined set of identifiable symptoms that accompany the progression of the disease. As with most diseases, symptoms worsen as the disease progresses through its early, middle and late stages. Early stage symptoms are characterized by physiological abnormalities such as a rapid increase in tolerance, memory blackouts and stimulation effect. Middle stage symptoms are typically associated with losses of life assets -- job problems, other health problems, emotional crises, a pattern of failed relationships, legal and financial problems. Late stage symptoms of alcoholism and other drug addiction are those most commonly associated with the disease by the general public, including liver disease, severe withdrawal reaction, neurological dysfunction, and dramatically decreased tolerance.
transitional living
Transitional living is used to designate a type of supported living environment that can be a bridge between the therapeutic environs of residential treatment and the challenges presented to the newly sober person by independent living. A transitional living environment is designed to be supportive to a person's early recovery and also confrontive when signs of old addicted behaviors appear. Transitional living arrangements are usually group environments, with residents accountable to each other to attend meetings and groups, contribute to the general good on the "house," and help each other learn to absorb the bumps and bruises of early recovery without taking a drink or a drug. Transitional living facilities will usually have a few paid staff on hand who are trained in the recovery process. The transition between living an addict's using life and living a clean and sober life of recovery is never easy for anyone. Transitional living environments are designed to help us gain strength in "walking the walk" of recovery during those critical early weeks and months.
treatment
Treatment programs for alcoholism and other drug addiction must first accept that they, too, are powerless over alcohol/other drugs. There is no cure for addiction, there is only recovery. Treatment consists of providing every necessary support, confrontation and encouragement to "do what it takes" to recover. Treatment is likely to involve individual and group counseling sessions which help to promote insights that remove barriers to recovery. Treatment must necessarily involve considerable education about nutrition, family dynamics, and spirituality. To experience benefit from treatment, an individual must become willing to take time, develop understanding, and practice acceptance. One of the greatest benefits of treatment is that it can provide an effective set of attitudes and tools for getting started, with less fear and greater thoroughness, working a twelve step recovery program.
