Is alcoholism a disease or something else?

[Weak Kitten]

This is awesome! It's not my fault, I have a disease.
I have no control over whether I drink or not, it is the disease!!
Alright! Now I can shift the blame to the disease, I am going to drink up tonight!

....and my wife can't get mad.... cuz I have a disease... I can't help it.

That's not what any of us are saying. What we are saying is that the extreme addiction that occurs in some people but not in others is a disease. The only coping mechanism we know right now is for people with that disease to not drink at all.

What I was trying to say is that by categorizing it as a disease, or more accurately a genetic predisposition, you can begin to work with it. People who know they have a chance of being alcoholic can know in advance to avoid alcohol. And those who have already suffered from it can be viewed as people struggling with a real problem, rather than just wusses who don't have enough self control.

When outsiders see it as a disease it changes their behavior too. They become more willing to help people with their coping mechanisms, like offering fruit juice at the office party or being understanding when someone asks to have the get together somewhere other than a bar. People are willing to help someone with a recognized disease, they tend to blow you off if they think it's just a mater of weakness.

 

[zerospeaks]

If you tell me it is a disease you are telling me it is a condition I can not control.

 

[FattyCatty]

That's not what any of us are saying. What we are saying is that the extreme addiction that occurs in some people but not in others is a disease. The only coping mechanism we know right now is for people with that disease to not drink at all.

What I was trying to say is that by categorizing it as a disease, or more accurately a genetic predisposition, you can begin to work with it. People who know they have a chance of being alcoholic can know in advance to avoid alcohol. And those who have already suffered from it can be viewed as people struggling with a real problem, rather than just wusses who don't have enough self control.

When outsiders see it as a disease it changes their behavior too. They become more willing to help people with their coping mechanisms, like offering fruit juice at the office party or being understanding when someone asks to have the get together somewhere other than a bar. People are willing to help someone with a recognized disease, they tend to blow you off if they think it's just a mater of weakness.

Thank you for saying it better than I could.

The fact that alcoholism is a disease doesn't absolve alcoholics from responsibility; it gives them a chance to treat or manage their illness, before drinking does them further harm. It gives them more ways to look at the problem, more places to find help (e.g., doctors, therapy, education). In this, it is similar to diabetes, I think.

 

[lionking]

The only coping mechanism we know right now is for people with that disease to not drink at all.

I think this is the problem with the "disease" argument. I can't think of any diseases which can be cured by stopping certain behaviour. Stopping smoking won't cure the lung cancer the smoker has.

I might be wrong about this and welcome rebuttal.

ETA, some diseases, like diabetes, can be managed with changed behaviour. But if an alcoholic doesn't drink at all, I would argue that he or she no longer has the disease.

 

[FattyCatty]

If you tell me it is a disease you are telling me it is a condition I can not control.

No. You can't control that you have the condition; you can control how you react to that.

It's saying that you need to manage the disease -- as Weak Kitten said, the only way we know to manage the disease right now is by not drinking. And you can get help to do that.

 

[zerospeaks]

the only way we know to manage the disease right now is by not drinking.

I don't want to be not drinking I enjoy drinking.
Even Hitchens said that knowing he would get esophageal cancer he STILL would have lived the life he did because he enjoyed the drink and smoke.

 

[FattyCatty]

I think this is the problem with the "disease" argument. I can't think of any diseases which can be cured by stopping certain behaviour. Stopping smoking won't cure the lung cancer the smoker has.

I might be wrong about this and welcome rebuttal.

ETA, some diseases, like diabetes, can be managed with changed behaviour. But if an alcoholic doesn't drink at all, I would argue that he or she no longer has the disease..

You don't "cure" alcoholism. I think that's why diabetes is a similar example. As with alcoholism, changing or stopping certain behaviour is the way to manage the disease. As with alcoholism, even when you have it under control, you are not "cured." You will always have the disease, and always have to manage it, no matter how well you are doing right now.

 

[Weak Kitten]

I think this is the problem with the "disease" argument. I can't think of any diseases which can be cured by stopping certain behaviour. Stopping smoking won't cure the lung cancer the smoker has.

I might be wrong about this and welcome rebuttal.

ETA, some diseases, like diabetes, can be managed with changed behaviour. But if an alcoholic doesn't drink at all, I would argue that he or she no longer has the disease.

No no, you have a point. Disease really isn't the correct term but most people just don't know what to do about "genetic proclivity" or "predisposition". You wouldn't call a missing leg or some other condition which requires special attention a disease. Heck, I wouldn't even call dyslexia a disease!

It's a convenient term though since it tells people that this is something they have to take into account when interacting with the person. It triggers a lot of social behavior which would not get properly triggered otherwise. You could call it a "condition" but that word doesn't always work as well. The important part is getting people to react in positive ways which help the alcoholic or potential alcoholic deal with their position.

 

[FattyCatty]

I don't want to be not drinking I enjoy drinking.
Even Hitchens said that knowing he would get esophageal cancer he STILL would have lived the life he did because he enjoyed the drink and smoke.

It's entirely your choice, with any disease, to ignore it and suffer the consequences.

 

[zerospeaks]

"It's entirely your choice, with any disease, to ignore it and suffer the consequences."

I'm going to ignore Parkinsons.

 

[lionking]

You don't "cure" alcoholism. I think that's why diabetes is a similar example. As with alcoholism, changing or stopping certain behaviour is the way to manage the disease. As with alcoholism, even when you have it under control, you are not "cured." You will always have the disease, and always have to manage it, no matter how well you are doing right now.

Where is your evidence that alcoholism can only be managed and not cured (apart from AA, that is)? I don't consider alcoholism to be incurable. I am not drinking now, and if I keep it up, I would take great offence to someone calling me an alcoholic.

 

[MatildaGage]

If it is a disease that implies it is more biological, that there isn't anything outside of some future medical intervention that can "cure" it. The disease model of alcoholism seems to explicitly or implicitly downplay the social factors that may be playing a role.

I never understand why there is a persistent debate about addiction being a disease when the same debate is nonexistent about similar conditions.

Diabetes is a disease sometimes wholly, and almost always partly caused by behavior/social factors. No one seems to have a problem calling it a disease.

Drug and alcohol addictions are biological, just not necessarily of biological origin.

Definitions of disease on the Web:

* an impairment of health or a condition of abnormal functioning [wordnetweb.princeton.edu/perl/webwn]

* A disease or medical condition is an abnormal condition of an organism that impairs bodily functions, associated with specific symptoms and signs. It may be caused by external factors, such as infectious disease, or it may be caused by internal dysfunctions, such as autoimmune diseases.[en.wikipedia.org/wiki/Disease]

When I was in school the course about the disease concept taught a specific definition of a disease. That seems to have gone away--I don't know why.

It went something like...a disease:

• has a defined set of symptoms (syndrome)
• usually responds to the same type of treatment (abstinence, therapy)

 

[Fnord]

What is the practical significance of labelling something a "condition" instead of a "disease"?

The same significance of labelling someone "Morally Challenged" instead of a "Pervert", or "Ethically Challenged" instead of a "Criminal". It's a softening of terms to make something wretched and miserable more warm and fuzzy.

What's the actual distinction you're proposing here?

To blur the line between someone who needs to be treated and cured, and someone who only needs to be tolerated and endured.

 

[FattyCatty]

No no, you have a point. Disease really isn't the correct term but most people just don't know what to do about "genetic proclivity" or "predisposition". You wouldn't call a missing leg or some other condition which requires special attention a disease. Heck, I wouldn't even call dyslexia a disease!

It's a convenient term though since it tells people that this is something they have to take into account when interacting with the person. It triggers a lot of social behavior which would not get properly triggered otherwise. You could call it a "condition" but that word doesn't always work as well. The important part is getting people to react in positive ways which help the alcoholic or potential alcoholic deal with their position.

I disagree. As I posted earlier, alcoholism IS a disease.

Alcoholism is a chronic disease; as with diabetes, you don't "cure" it, you manage it. The American Medical Assocation has called it a disease since 1956; in 1991 they gave it a dual classification in both the psychiatric and medical sections. The National Institutes of Health's National Institute on Alcohol Abuse and Alcoholism's position is that alcoholism is a disease. The DSM-IV includes alcohol dependence. The World Health Organization, speaking about chemical and alcohol dependence in 2004, stated "...it is clear that dependence is as much a disorder of the brain as any other neurological or psychiatric illness." http://en.wikipedia.org/wiki/Disease..._of_alcoholism, which also says the following:

In a review in 2001, McLellan et al. compared the diagnoses, heritability, etiology (genetic and environmental factors), pathophysiology, and response to treatments (adherence and relapse) of drug dependence vs type 2 diabetes mellitus, hypertension, and asthma. They found that genetic heritability, personal choice, and environmental factors are comparably involved in the etiology and course of all of these disorders, providing evidence that drug (including alcohol) dependence is a chronic medical illness.

 

[MatildaGage]

xx

 

[MatildaGage]

Incidentally, I have a congenital condition--a potentially deadly condition causing chronic, real problems, which can be seen under a microscope (if that's how you define "real").

It is officially called a disease but medical science says it's actually a disorder.

I couldn't care less which term is used. That's why I don't understand the alcoholism debate--why does it matter?

 

[zerospeaks]

Is smoking crack a disease?

Crackism?

 

[zerospeaks]

My wife has been sternly informing me that I am fighting a losing battle because scientific research is coming to the conclusion that predisposition to addiction is the disease/disorder and it shouldn't be called alcoholism, it should be called "predisposition to addiction" ism.

Apparently here next Neuroscience conference is on this subject.

 

[Brattus]

I second this. Most of the people I've seen who claim it's a disease (yes, I've been to some court mandated AA meetings for silly reasons in the past) are either making excuses for someone they love or not willing to come to terms with the guilt of drinking yourself to oblivion.



Apples and oranges. Alcoholism, like obesity, is NOT a disease. If you can cure it with abstinence, it's not a disease. Compared to a real disease like say, Hodgskin's lymphoma, alcoholism is more like a bad habit.



Hogwash. I'm more inclined to believe in the whole "addictive personality" stuff than the "no control" thing. Alcoholism is a vice, not a disease. Congenital heart disease is something you have no control over.

Alcoholics have something deeper going on... they have psychological problems that need to be addressed, rather than some malady they were suddenly afflicted with. Becoming an alcoholic takes time and money. Every last person I met in AA meetings were coping with an addiction, not an illness. Every single one of them had, upon giving up alcohol, simply transferred their addiction to (what they assumed was) a lesser evil. All of them smoked cigarettes. All of them guzzled coffee. Most of them had found God, and quoted scripture right next to the rhyming slogans of AA.

If only meeting in groups and smoking cigarettes together could make syphillis go away....

This post tells it like it is and answers the thread question quite nicely!

The fact that no one is quoting this post to refute it or offer an alternate idea says a lot about the posters in this thread.

The man said it plain. Those who call it a disease are covering up for loved ones or not wanting to own their personal problem with alcohol.

Matter of fact calling alcoholism a disease is insulting to those people fighting for their lives with real diseases.
Those people are fighting to not be dead. They are not merely trying to manage something so their loved ones or boss won't be mad at them.

 

[zerospeaks]

"The fact that no one is quoting this post to refute it or offer an alternate idea says a lot about the posters in this thread."

Well, my wife got extremely mad at the "Obesity is not a disease" comment and she said with great anger that in fact it was, and the poster obviously did not know what he/she was saying.

My wife doesn't have a profile here so I thought it better not to mention it.