Addiction means many things to many people. Some of us imagine skid row drunks; some of us imagine those intent on "unwinding" at the end of every day with a "few"'; some of us remember Uncle Joe who used to binge every month or so and end up in the hospital some times; some know better, imagining the "guy next door" who's been in recovery for some time and goes to AA regularly. There are many faces of addiction, some you wouldn't expect to find, and there is still (unfortunately) a stigma attached to being an alcoholic or addict even though it's been clearly designated a disease by the British and American Medical Associations.
No-one asks to be born with a vulnerability or pre-disposition to any disease - whether it be diabetes or alcoholism - but that's the way some people arrive. They may not be responsible for the disease they have, but once they have it, they are (I believe) responsible for taking care of it.
In the addiction treatment field it is generally agreed that someone is addicted when they drink or use drugs and suffer negative consequences and, despite those negative consequences, continue to drink or use drugs. "Negative consequences" can range from heaving hangovers to multiple convictions for driving while intoxicated to loss of relationships to being jailed.
One of the hardest things to do is acknowledge there is a problem and ask for help. If you call me, you are promised complete confidentiality, no-one else will ever know you've called. If you need more help than I can provide, you'll be referred to a medical professional, to a treatment center, or simply get you connected to an AA (Alcoholics Anonymous) meeting near your home.
The first goal for any alcoholic or drug addict who has acknowledged they have a problem, seek help and want to quit is abstinence from all mood and mind altering drugs. Initial referral will always be to a medical doctor for a physical check-up as some people will need to be medically monitored as they detox from alcohol or their other drug of choice.
I approach ongoing treatment somewhat differently than the mainstream because, as mentioned elsewhere, I take into account the body-mind-spirit connection and the somatic nature of the disease. I define addiction this way: Hard wired in the brain through chemistry and/or trauma, addiction is a felt sense of yearning for more, a habitual action stored and acted out by the body.
Every alcoholic and addict is engaged in certain habitual practices that keep them in the routines of drinking and using. I help my clients identify what these habitual practices are and shift them to new practices supporting a clean and sober lifestyle. For example, if someone is in the practice of dropping by the bar for a drink on the way home, this is a habit that needs to be extinguished immediately for success to be achieved. Together we would look at what alternative habit could be replaced here - perhaps a 6.00 pm AA meeting; meeting a friend for coffee instead; going for a swim or to the gym; making other appointments for that time period... whatever works to keep them away from the bar.
There are other more subtle habitual practices stored in the body that are less conscious and more unconscious. For example, suppose every time someone feels sad (which reminds them of the sadness they feel about being divorced and not seeing their children as often) they start to feel uncomfortable in their own skin, look around for something to do, turn on the TV, amidst the adverts see one for beer or wine or vodka and "find" themselves pouring a drink, then we need to look at all the levels triggering the desire to drink - sadness, discomfort, desiring distraction, being bored, being stimulated visually by alcohol, and checking out mentally. Any one of these states could have created the drinking scenario, let alone a string of them, so I help people become present to what's happening so they can make different choices. I do this by having them become present to their bodily sensations and responding to those sensations differently.