TIMES ARE A CHANGING –
April 10, 2026 – The term conjures outdated stereotypes about an illness that afflicts 28 million Americans. The term “alcoholic” harkens back to an old model of substance use that sees it as a permanent feature of your personality or even a moral weakness. The term was used in the 1950s and ‘60s, in very early diagnostic systems for psychiatric disorders when we didn’t even have a way of measuring it. Decades of research later, we now have a much better understanding of alcohol problems, how to measure them, and how to treat them effectively.
As our understanding of the illness has evolved, so too has our terminology. Over that time, there’s been a big push away from “alcoholism” as a stigmatizing term that implies the illness is a feature of the person’s identity or personality. Starting in the 1980s, the term was changed to either alcohol abuse or alcohol dependence, and more recently, in 2013, it was changed again to alcohol use disorder.
But that said, there are a lot of people who find it helpful, given the significant impact the disorder has had on their life, to identify as “alcoholic.” It’s an interesting push-pull from the perspective of stigma: We’ve really moved away from the term as a field, but there are some people who find it powerful as individuals.
Historically, there was this idea that once you cross a certain threshold, once you’re “an alcoholic,” abstinence is the only option. But the data just doesn’t support that. There are many different paths.
