I think self-medicating definately can and will lead to alcoholism. I think there is a difference though, between the two. If you stop the drug/drink and can handle it without withdrawals... physical/emotional....ive been told, you're probably not an alcholic. One can lead to the other, staying clean and not using substances to alter your reality is the best thing to do for yourself. But if you've had history of abuse and mental illness, trying not to self-med. can be one rough road. Now i can have a glass of wine (which ive done once in the last year) but a few years ago I couldn't have just one. I was self-medicating down a ugly path. been clean for a year except the wine. moderation is key on this arguement.