Question: If alcoholism has a high death rate, why is it classified as a mental illness? I thought people died of physical disorders. Answer: They do, so alcohol combines the elements of both mental illness and physical disease. Alcoholism is classified as a substance abuse disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM-III). Mental and emotional symptoms of alcoholism exist long before the grave physical complications of the disease appear. The mental symptoms consist of loss of control (taking in larger amounts of alcohol over a longer period of time than the person intends); persistent desire to drink (one or more unsuccessful efforts to cut down or control drinking); continued drinking in spite of adverse social, occupational, or legal consequences; and frequent intoxication or withdrawal symptoms when expected to fulfill major obligations at work, school, or home. These are all behavioral or mental symptoms, which, unless interrupted permanently by treatment, will inevitably lead to physical complications of alcoholism. Cirrhosis of the liver, chronic brain deterioration, and other grave organic consequences occur as a result of long-term heavy drinking, but the core of the disease is the cluster of behavioral symptoms that constitute the mental disorder called alcoholism. Consequently, the treatment of alcoholism targets the mind rather than any physical system. So alcoholism and all other substance abuse disorders are mental disorders, with a high physical complication rate. "Sober Days" ran in the Palm Springs daily newspaper, the Desert Sun, for several years in the 1990s-2000s. The popular Q&A column was written by Dr. James West, the Betty Ford Center’s first medical director. He remained with the Betty Ford Center until 2007, when he retired at age 93.