[Alcoholism as an illness]

Formerly the term alcoholism has been defined only by alcohol-related conditions. About 20 years ago a WHO committee recommended to differentiate between alcohol abuse and alcohol dependence. The new classifications and manuals followed this proposal: Criteria for alcohol abuse are still alcohol sequelae whereas alcohol dependence is characterized by tolerance and withdrawal syndrome as well as by some specific behavioral states e.g. impaired alcohol control, consumption despite problems. For easier and safer diagnosis of alcoholism some tests have been developed. Most of them use questionnaires and/or clinic and lab data. Two of the tests are mentioned in some detail. Special reference has been given to the 200 years old disease concept of alcoholism which is still under discussion. The debate should start with a general definition of disease. A comprehensive biopsychosocial model will be developed. The last chapter deals with the conditions for the development of alcoholism. A triangle model serves for the explanation of the complicated circular relations between drug (alcohol)-individuum-social background.