Why “alcoholic” is a Loaded Word

Those of us who drink socially can probably relate to “having one too many” on occasion. But what if our drinking becomes a problematic pattern? We might deny it to avoid the label “alcoholic.” After all, the word alcoholic conjures up images of raging drunkenness, hitting rock-bottom and anti-social behaviour. Plus it’s a life sentence: “once an alcoholic, always an alcoholic.”

But the word “alcoholic” is not a medically accurate term—the World Health Organization does not use it because of its generalized, non-medical definition. It’s an archaic English word that originally meant “of or pertaining to alcohol”. By 1872 its meaning had become “caused by drunkenness” and by 1910, it was the more derogatory and judgmental “habitually drunk.” This archaic term has become a problem within the medical community and those seeking to understand and treat their own consumption because of its negative and ill-defined connotations.

The correct medical term for high-risk drinking is alcohol use disorder, as defined by the American Psychiatric Association’s current diagnostic manual. In cases of alcohol abuse, a doctor or mental health professional will make a diagnosis based on a number of criteria, including:


Tolerance: Needing to drink more to get an effect (buzzed or drunk).

Withdrawal: Symptoms after you’ve stopped drinking, such as insomnia, sweating, nausea, or anxiety.

Difficulty stopping once you’ve started: Consuming more alcohol or drinking over a longer period of time than you intended.

Loss of control: Trying to cut down or control drinking unsuccessfully.

Craving: Having a strong desire to drink.

Continued use despite consequences: Continuing to drink alcohol despite knowing that it causes problems socially, physically, or psychologically (e.g., depression or anxiety).

If alcohol is causing problems in your life and you’ve experienced two of these criteria in the past 12 months, your doctor would diagnose you as having an alcohol use disorder. Read How much alcohol is too much? to see where you fit on the spectrum of alcohol consumption.

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Dr. Terri-Lynn MacKay is a licensed Clinical Psychologist who has specialized in the treatment and research of mental health and addictive disorders since 2003. She leads a team of licensed professionals who practice client-centered, compassionate, evidence-based care. She is an Adjunct Professor at the University of British Columbia and the University of Manitoba. She is an active contributor to her community through volunteer activities such as Big Sisters of BC Lower Mainland.