We continue what we wrote yesterday and speak about two ways to the reward system: a long one and a short one. However, let’s first separate alcohol dependence from addiction. Conceptually, the definition of alcohol abuse through the addiction shows the American tradition tendency that led to the exclusion of this definition of the alcohol dependence from DSM-5 system. The arguments of this position are clear to me. If there’s a dependence, from what, then? Let’s lay most popular of the arguments here. A diabetic patient takes insulin to survive. A cancer patient takes painkillers, including narcotics. The patients depend on the drugs, but have no addiction to them. The patients take drugs in strictly prescribed amounts. And they don’t want to manipulate them to influence the reward system. On the other hand, presumed an addict is put to conditions preventing him or her to get alcohol, he or she won’t die neither his/her health will suffer much. It means an alcoholic depends not on the ethanol as such, but on his or her desire to take it. Let’s remember the statistical data we showed before. Only 20 per cent of those who try alcohol are liable to the addiction.
Conditionally, those whom we call addicts, who choose to be charmed by alcohol and seek the short way to the reward center can be divided to two big groups. The goal of the first group is to get a thrill out of it. The researchers under some conditions recognize another reason that governs the second group. It’s self-medication. In case of alcohol, an addict suffering from real or imagined mental problems (anxiety, helplessness, loneliness, etc.) take this substance as a tranquilizer to remove daily burdens. That’s the point of the addiction and it can’t be fully described by the vocabulary of the dependence.