The notion of alcoholism has no consensual social or diagnostic definition. In a restricted medical perspective, alcoholism is often used to identify excessive drinking patterns which may--if they are maintained for a longer period of time--cause somatic dysfunctions, particularly of the liver. Within this scope, the prevalence of alcoholism in Switzerland is estimated between one and several hundred thousand cases, depending where the border between normal use and highly risky misuse of alcohol consumption is defined. There are indications that the trend of this rate is actually decreasing. In a more comprehensive scope, alcoholism is conceived as a syndrome of social, mental and somatic problems. In an exploratory study conducted in the canton of Zurich (with approx. 20% of the total Swiss population), within one year, 40,000 to 50,000 persons were identified by different formal instances as "having alcohol problems". Society's reactions towards these perceived "alcoholics" are class specific: the lower classes are identified as "drunkards" and dealt with through public welfare and control, while the middle and upper classes as well as the newly appearing women alcoholics, are perceived as being ill and sent for medical or psychiatric treatment.