The words "alcohol dependence" or "addiction" are often used without definition. So, let's first look at an addiction definition. As used in this web site, alcohol or drug addiction means that a person's alcohol or other drug use has reached the point that the person cannot use without loss of control over use of the substance and/or cannot use without producing adverse consequences in significant life areas, and has developed a psychological and/or physical dependence upon the substance. An addicted person will continue to use the substance in the face of adverse consequences.
The term alcohol or drug dependence is often used interchangeably with addiction, but here I use the term dependence to mean physical dependence on a substance, meaning that stopping use of the substance will result in withdrawal symptoms. A person can develop dependence on a substance without developing addiction; the best example of this physical dependence would be the person who takes a narcotic analgesic (pain killer such as oxycodone or morphine) as prescribed by a doctor long enough to be physically dependent on the drug, a natural, inevitable consequence of chronic use of such a drug. Under these circumstances, abruptly stopping use of the substance will result in the withdrawal syndrome typical for the class of substance involved. Most persons with addiction (for ex., alcoholism) are NOT physically dependent on their drug and will not experience the full blown physical withdrawal for the substance. They will experience cravings, sleeplessness, and other symptoms caused by their psychological dependence on the drug.
Alcohol or other drug problems fall within two diagnostic categories: abuse or addiction (as I said, often called dependence). Abuse basically means the person has developed a pattern of use of the substance in the face of adverse consequences in significant life areas (medically, financially, legally, problems in relationships). Addiction is summarized in the first paragraph on this page.
Alcoholism and other drug addictions are devastating disorders which negatively impact affected individuals and all who care about them, physically, emotionally and mentally, and spiritually. For persons diagnosed with full blown addiction, I favor an abstinence based treatment model, meaning a model whose basic ultimate (it may take a while to get there) goal is abstinence from use of alcohol or other drugs. This model should include education, cognitive behavioral counseling, and use of Twelve Step (for ex., AA) spiritually based principles. Online addiction treatment can be helpful in itself and/or as part of a comprehensive treatment program that includes traditional face-to-face counseling and other treatment interventions.
For persons whose alcohol or other drug use has not yet reached the severity of an addiction diagnosis, but indicates abuse, I favor interventions aimed at educating the individual about addiction, about his/her risk factors for developing addiction, and at helping the person to see if he/she can control drug or alcohol use. In Person and Online interventions such as those offered here on this site can be helpful at this stage.
See Cautionary Information. Successful treatment of persons with full blown alcohol or other drug addiction may require a comprehensive treatment program beyond that offered by a simple outpatient treatment program or online or telephone addiction support services. Such a comprehensive program should be staffed by helping professionals from many disciplines. Staff should include physicians to address medical issues such as withdrawal, mental health professionals such as psychiatrists or psychologists, to treat co- or pre-existing psychiatric disorders that may be present, and last but not least, certified, licensed addiction counselors, preferably a significant number of whom are in long term recovery themselves. Such a Treatment Program should also provide individual and group counseling, educational groups, and, as important as any of the treatments, access to Twelve Step self-help groups such as Alcoholics Anonymous, Narcotics Anonymous, Al-Anon and Nar-Anon (for loved ones), and ACOA (Adult Children of Alcoholics), to name but a few. An evaluation will reveal the extent of the treatment required.
More on Definitions