Alcohol misuse: tackling the UK epidemic - London

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BMA Board of Science
Glossary
Note
An alcoholic beverage is a drink containing ethanol (ethyl alcohol). For this report, the term
alcohol refers to ethanol rather than the broader definition of alcohol that incorporates other
compounds including methanol, propanol and butanol.
Alcohol abuse
A term in wide use but of varying meaning. The Diagnostic and Statistical Manual of Mental
Disorders, 4th edition (DSM-IV) defines psychoactive substance abuse as a maladaptive pattern of
substance use leading to clinically significant impairment or distress, as manifested by one (or
more) of the following, occurring within a 12-month period:
recurrent substance use resulting in a failure to fulfil major role obligations at work, school,
home (eg repeated absences or poor work performance related to substance use;
substance-related absences, suspensions, or expulsions from school; neglect of children or
household)
recurrent substance use in situations in which it is physically hazardous (eg driving an
automobile or operating a machine when impaired by substance use)
recurrent substance-related legal problems (eg arrests for substance-related disorderly
conduct)
continued substance use despite having persistent or recurrent social or interpersonal
problems caused or exacerbated by the effects of the substance (eg arguments with spouse
about consequences of intoxication, physical fights). 1
The term is not used in the World Health Organisation (WHO) International Classification of
Diseases 10th revision (ICD-10), where harmful and hazardous use are the equivalent terms. In
common usage, the term ‘abuse’ is sometimes used to refer to any use at all, particularly of illicit
drugs. In other contexts, abuse refers to persistent or sporadic excessive drug use inconsistent with
or unrelated to acceptable medical practice. 2
The term alcohol abuse is used predominantly in the
United States of America (USA).
Alcohol misuse
The use of alcohol for a purpose not consistent with legal or medical guidelines. 2
Alcohol dependence syndrome
Alcohol dependence syndrome is classified by the ICD-10 as a cluster of behavioural, cognitive,
and physiological phenomena that develop after repeated alcohol use and that typically include a
strong desire to consume alcohol, difficulties in controlling its use, persisting in its use despite
harmful consequences, a higher priority given to its use than to other activities and obligations,
increased tolerance, and sometimes a physical withdrawal state. 2
Alcoholism
A term of common use and variable meaning, generally taken to refer to chronic continual
drinking or periodic consumption of alcohol which is characterised by impaired control over
drinking, frequent episodes of intoxication, preoccupation with alcohol, and the use of alcohol
despite adverse consequences. 2
Alcoholism is not included as a diagnostic term in ICD-1O.
Alcohol misuse: tackling the UK epidemic