Alcoholism is generally defined as the consistent and excessive consumption of and/or preoccupation with alcoholic beverages to the extent that this behavior interferes with an individual's normal personal, family, social, or work life. Alcoholism can potentially result in psychological and physiological conditions, as well as, ultimately, death. Alcoholism is one of the world's most costly drug use problems. With the exception of nicotine addiction, alcoholism is more costly to most countries than all other drug use problems combined.[citation needed]
While alcohol abuse is a prerequisite for what is defined as alcoholism, the biological mechanism of alcoholism is uncertain. For most people, alcohol consumption poses little or no danger of addiction. Other factors generally contribute for alcohol use to develop into alcoholism. These factors may include a person's social environment, emotional health and genetic predisposition.
Many terms are applied to a drinker's relationship with alcohol. Use, misuse, heavy use, abuse, addiction, and dependence are all common labels used to describe drinking habits, but the actual meaning of these words can vary greatly depending upon the context in which they are used. Even within the medical field, the definition can vary between areas of specialization. The introduction of politics and religion further muddles the issue and exacerbates ambiguity.
Use refers to simple use of a substance. An individual who drinks any alcoholic beverage is using alcohol.
Misuse, problem use, and heavy use do not have standard definitions, but suggest consumption of alcohol beyond the point where it causes physical, social, or moral harm to the drinker. Social and moral harm are highly subjective and therefore differ from individual to individual.
The term abuse has a variety of possible meanings. Within psychiatry, the DSM-IV has a specific definition involving a set of life circumstances which take place because of substance use. Within politics, abuse is often used to refer to the illegal use of any substance. Within the broad field of medicine, abuse sometimes refers to use of prescribed medication in excess of the prescribed dosage or to use of a prescription drug without a prescription. Within religion, abuse can refer to any use of a poorly regarded substance. The term is often avoided because it can cause confusion due to audiences that do not necessarily share a single definition.
Dependence also has multiple definitions, but is not as commonly used as abuse outside of the medical profession. Physical medicine considers dependence to be the body's physical adaptation to the persistent presence of alcohol. Psychological medicine considers dependence to be a person's mental reliance upon something to maintain their mental status quo. These two are occasionally differentiated as physical and psychological dependence. Within the field of psychiatry, alcohol dependence is the term referring to alcoholism. As a result, a diagnosis of alcohol dependence does not necessarily indicate the presence of physical dependence.
The precise definition of addiction is debated, but in general it refers to any condition which causes a person to continue behaviors demonstrated as harmful to that person. For alcoholism, that behavior is the consumption of alcoholic beverages. Some conditions which contribute to alcoholism include physical dependence, neurochemical conditioning, and a person's perception that alcohol benefits them psychologically or socially.
Remission is often used to refer to a state where an alcoholic is no longer showing symptoms of alcoholism. The American Psychiatric Association considers remission to be a condition where the physical and mental symptoms of alcoholism are no longer evident, regardless of whether or not the person is still drinking. They further subdivide those in remission into early or sustained, and partial or full. Others (most notably Alcoholics Anonymous) use the term recovery to describe those who have completely stopped consumption of alcohol.
Substance use disorders are a major public health problem facing many countries. "The most common substance of abuse/dependence in patients presenting for treatment is alcohol."[1] In the United Kingdom, the number of 'dependent drinkers' was calculated as over 2.8 million in 2001.[2]
Within the medical community, there is broad consensus regarding alcoholism as a disease state. Outside the medical community, there is considerable debate regarding the Disease Theory of Alcoholism. Proponents argue that any structural or functional disorder having a predictable course, or progression, should be classified as a disease. Opponents cite the inability to pin down the behavioral issues to a physical cause as a reason for avoiding classification.
Effects
The primary effect of alcoholism is to encourage the sufferer to drink at times and in amounts that are damaging. The secondary damage caused by an inability to control one's drinking manifests in many ways.
It is common for a person suffering from alcoholism to drink well after physical health effects start to manifest. The physical health effects associated with alcohol consumption are described in Alcohol consumption and health, but may include cirrhosis of the liver, pancreatitis, polyneuropathy, alcoholic dementia, heart disease, increased chance of cancer, nutritional deficiencies, sexual dysfunction, and death from many sources.

Social effects
The social problems arising from alcoholism can be significant. Being drunk or hung over during work hours can result in loss of employment, which can lead to financial problems including the loss of living quarters. Drinking at inappropriate times, and behavior caused by reduced judgment, can lead to legal consequences, such as criminal charges for drunk driving or public disorder, or civil penalties for tortious behavior. An alcoholic's behavior and mental impairment while drunk can profoundly impact surrounding family and friends, possibly leading to marital conflict and divorce, or contributing to domestic violence. This can contribute to lasting damage to the emotional development of the alcoholic's children, even after they reach adulthood. The alcoholic could suffer from loss of respect from others who may see the problem as self-inflicted and easily avoided.

Alcohol withdrawal
Alcohol withdrawal differs significantly from withdrawal from other drugs in that it can be directly fatal. While it is possible for heroin addicts, for instance, to die from other health problems made worse by the strain of withdrawal, an otherwise healthy alcoholic can die from the direct effects of withdrawal if it is not properly managed. Heavy consumption of alcohol reduces the production of GABA, which is a neuroinhibitor. An abrupt stop of alcohol consumption can induce a condition where neither alcohol nor GABA exists in the system in adequate quantities, causing uncontrolled firing of the synapses. This manifests as hallucinations, shakes, convulsions, seizures, and possible heart failure, all of which are collectively referred to as delirium tremens. All of these withdrawal issues can be safely controlled with a medically supervised detox.

Screening

Several tools may be used to detect a loss of control of alcohol use. These tools are mostly self reports in questionnaire form. Another common theme is a score or tally that sums up the general severity of alcohol use.
  • The CAGE questionnaire, named for its four questions, is one such example that may be used to screen patients quickly in a doctor's office.
Two "yes" responses indicate that the respondent should be investigated further. The questionnaire asks the following questions:
  1. Have you ever felt you needed to Cut down on your drinking?
  2. Have people Annoyed you by criticizing your drinking?
  3. Have you ever felt Guilty about drinking?
  4. Have you ever felt you needed a drink first thing in the morning (Eye-opener) to steady your nerves or to get rid of a hangover?[5][6]
The CAGE questionnaire, among others, has been extensively validated for use in identifying alcoholism. It is not valid for diagnosis of other substance use disorders, although somewhat modified versions of the CAGE are frequently implemented for such a purpose.
  • A number of free websites provide anonymous self-screening for harmful or hazardous alcohol use, including AlcoholScreening.org
More info:
http://en.wikipedia.org/wiki/Alcoholism