In modern medical terminology, the term “alcoholic” has largely been replaced by more precise diagnostic labels such as Alcohol Use Disorder (AUD) in the DSM-5-TR, or Alcohol Dependence Syndrome and Harmful Use in ICD-10 and ICD-11. These terms describe a chronic disorder characterised by loss of control over drinking, in which a person continues to drink despite clear negative physical, psychological or social consequences.
From a medical perspective, diagnosis is not based on a specific amount consumed, but on the presence of specific symptoms. These include strong cravings, loss of control over drinking, increasing tolerance, withdrawal symptoms, narrowing of life interests to alcohol, and continued drinking despite harm. If a sufficient number of these criteria are met over a defined period, an Alcohol Use Disorder is diagnosed, with severity classified as mild, moderate or severe.
The word “alcoholic” is therefore not a scientific diagnosis; it is a historically evolved colloquial term. Today it usually refers to a person suffering from a clinically recognisable dependence disorder. Current guidelines strongly recommend non-stigmatising language and the use of precise diagnostic terminology.
Medical diagnostic criteria #
Modern classification systems focus on clear behavioural and physiological signs. Typical criteria include:
- strong craving or a strong desire to drink
- loss of control over the start, amount or termination of drinking
- withdrawal symptoms when alcohol intake is reduced
- increasing tolerance (needing more alcohol for the same effect)
- neglect of other interests and activities
- continued drinking despite obvious physical or psychosocial harm
The more of these criteria are present, the more severe the disorder.
Is the term “alcoholic” outdated? #
In medical and scientific literature, the term “alcoholic” is increasingly being replaced by precise diagnostic terms. Outside academia — especially within Alcoholics Anonymous and self-help groups — the word remains widely used and deeply rooted. Many affected individuals consciously use it as a self-description. Clinical terminology and everyday language therefore coexist, and no guideline can fully replace the latter.
How does alcohol dependence develop? #
It arises from a combination of:
- genetic predisposition
- changes in the brain’s reward system
- social and psychological risk factors
- regular drinking patterns that gradually become autonomous
The earlier drinking begins and the more frequently it occurs, the greater the risk of developing full-blown dependence.
Is “alcoholic” an official medical diagnosis?
No. It is a colloquial term. The official diagnoses are “Alcohol Use Disorder” (DSM-5-TR) or “Alcohol Dependence Syndrome” (ICD).
The key signs are loss of control, strong cravings, tolerance, withdrawal symptoms, and continued drinking despite clear harm.How can you recognise alcohol dependence?
The quantity alone is not decisive. What matters is recurring problems and loss of control. Even people with apparently “normal” consumption can develop dependence.Does the amount drunk matter?
Bernd Guzek, MD, PhD #
Physician, author & co-founder of Bye-Bye-Booze
Specialized in biochemical mechanisms of addiction and brain metabolism.
