ABSTRACT
Concepts of use and abuse have therefore been open to equally wide interpretations. The non-appearance of any cut-and-dried account of alcohol abuse has often been bemoaned by people in the field who believe ‘the lack of firm definition has been a stumbling block to understanding and progress’. Controversy over what constitutes alcohol use and abuse is not just a contemporary phenomenon. Throughout history, some commentators have praised the effects of alcohol whilst others have criticized very same effects. The disease concept of alcoholism was also appealing to other groups for different reasons. Those who drank heavily but considered themselves ‘normal’ drinkers were reassured they were not becoming alcoholics, since they were not physiologically or biochemically anomalous. Conceptualizing alcoholism as a biochemical anomaly assumes its pathology can be eradicated simply in terms of abstinence. Pattison’s review has shown that even total abstinence over a period of years is not in itself proof of improvement in the patient’s general health and functioning.
