A simple and informal definition of alcohol dependence is that it is a condition resulting from the prolonged and usually intense consumption of alcohol which has resulted in psychological and/or physiological dependence on alcohol consumption. This dependence results in significant problems in one or more areas of the person’s life.
A more specific and formal definition of alcohol abuse can be formulated using the Diagnostic and Statistical Manual, 4th Edition, of the American Psychiatric Association, (DSM-IV, 1994).
Using the DSM-IV criteria for substance dependence but applying it to the case where the substance is specifically alcohol, the diagnosis of alcohol dependence is made when one or more of the following occurs over a one year period:
Research has shown important differences between alcohol abuse and alcohol dependence (Hartford and Muthen, 2001). For example, in alcohol abuse there is no significant psychological or physiological dependence on alcohol whereas dependence and associated symptoms are characteristic of alcohol dependence. Also because of these differences in the nature of alcohol abuse and alcohol dependence, there are critical differences between the treatments of these two distinct conditions.
The lifetime prevalence for alcohol dependence was found to be 5.4% in a large epidemiological study carried out recently in the United States (Kessler et al, 2005). Hence alcohol dependence is a bit less than half as prevalent as alcohol abuse which had a lifetime prevalence of 13.2% in this same study.
The presence of an addiction of some kind has long been held as a main secondary symptom of codependency. Other names for codependency are developmental trauma and complex PTSD.
There is indeed a lot of evidence that many individuals, who abuse or become dependent to any substance be it alcohol or illicit drugs, have often been exposed to previous trauma during their childhood or thereafter.
For example, a study of borderline personality disorder, a severe form of what many call codependence, in patients with recent deliberate self-harm in Hong Kong, found they were more likely to suffer from a current alcohol and substance use disorder Wong (2010).
Also, research by Boriskin (2008) found that 25 to 50 percent of clients with a substance use disorder also meet the conditions for a diagnosis of post traumatic stress disorder (PTSD).
Hence there is strong reason to conclude that a person who experienced repeated or prolonged trauma during their childhood (and hence is likely codependent) is at greater risk of developing drug/alcohol abuse or dependence in adulthood.
Fortunately there are a number of effective treatments for alcohol dependence. It is to be noted that there are important differences in the treatment of alcohol abuse and dependence (Hartford and Muthen, 2001). Treatment approaches include the following:
Boriskin, J. A. (2008, March). Effective treatments of complex PTSD and addiction. Paper presented at the meeting of Addiction, Trauma, and Co-Occurring Disorders, San Diego.
Harford, T. C., & Muthen, B. O. (2001). The dimensionality of alcohol abuse and dependence: A multivariate analysis of DSM-IV symptom items in the National Longitudinal Survey of Youth. Journal of Studies on Alcohol, 62, 150–157.
Kessler, Ronald C., Berglund, Patricia, Demler, Olga, Jin, Robert, Merikangas, K. R., Walters, Ellen E., (2005). Lifetime Prevalence and Age-of-Onset Distributions of DSM-IV Disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, Vol. 62(6), 593-602.
Wong, Hiu-Mei; Leung, Henry Chi-Ming; Chow, Lai-Yin; Kam, Wai-Kwo & Tang, Alan Ka-Lam. (2010) Prevalence of borderline personality disorder and its clinical correlates in Chinese patients with recent deliberate self-harm. Journal of Personality Disorders, 24(6), 800-811.