Beyond alcoholism: Modern perspectives on alcohol dependence and problems

Twenty years ago, 'alcoholism' was pronounced dead but reports of its death seem to have been greatly exaggerated. This paper will firstly trace the history of the alcoholism concept from its origins in the 19th Century to the present day and will briefly describe its main disadvantages for explaining, treating and preventing alcohol-related problems. The paper will then describe perspectives on alcohol dependence that can be seen as alternatives to alcoholism, including the Alcohol Dependence Syndrome which, it will be argued, merely replicates the alcoholism concept in disguised form. It will then be suggested that the true alternative to alcoholism is the public health perspective on alcohol problems in which alcohol dependence is seen as continuous in degree throughout the population of regular drinkers and alcohol-related problems are disaggregated. The paper will conclude with a review of the implications of this view for the field of alcohol problems theory and practice.