Is alcoholism a disease or something else?

[Dancing David]

didn't know the NIH basis there decisions on what the AA thinks.
The CDC for that matter also.

Have you posted more than FAQ?

And if you recall, which I am not sure of, the citation of the CDC is to the DSM-IV, which does not call alcohlism, or alcohol dependence a disease. (You will note that I hope) You did not respond to this the last time either.

You wil note here that the NIH does not refer to PTSD as a dosease:
http://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd/index.shtml

So why one and not the other

 

[Jeff Corey]

Alcoholism is classified as a disease in both ICD-10 and DSM-IV. Therefore it is one until further notice. Get it, will you?

"He that is good with a hammer tends to think everything is a nail."
Abraham Maslow (1956)

 

[Dancing David]

I was not attacking the alcoholic, just merely proposing that it was due to lack of self discipline.

And that is moralizing, conditioning is a real thing, it is teh application of teh discipline, not its precense of lack thereof that is crucial.

That's not saying "they can just stop it if they try harder" because clearly there's reasons why they choose self-destructive paths.

I guess actually in most cases it's probably more of a disorder where they're self-medicating with alcohol, rather than just the inability to stop themselves.

Not all or evena majority of cases.

Does a disorder count as a disease?

Well that is the question that some are avoiding.

I would argue not, in this case. There is not always a strong biological prediposition and precense of withdrawal symptoms, so it is more akin to other behavioral disorders. If someone is self medication bipolar disoder then the bipolar disorder is an illness, not teh alcohol dependance.

 

[godofpie]

I just wanted to take a moment to say thanks to all the participants (even the ones I disagree with) of both this thread and the "Why do some people insist AA is not Religious?" When I first joined this forum 2+ years ago one of the first things I looked for was threads on AA or alcoholism. I found some posts from Tricky and a short thread on the subject but that was it. I have learned so much from you all. Through (relatively) civil discourse we have provided sources and arguments from all angles and anyone that should stumble across this thread will have a wealth of information and points of view.
You guys rock! (Even the ones I disagree with)

 

[Gandalfs Beard]

didn't know the NIH basis there decisions on what the AA thinks.
The CDC for that matter also.

That's because you don't know the history of AA and the Disease Model in the US.

I don't quite understand how it's even possible to conflate the sin model with the disease model. Questions about validity (of either model) aside, as well as questions regarding your assertion that this conflated model represents either AA's position or the "generally accepted model", aren't those viewpoints rather mutually exclusive?

Of course you know that it's possible to conflate the two models. We've discussed it at length on the other thread. AA has a religious model of addiction (i.e. a Sin Model), yet they disingenuously claim that its a Disease Model (hence the conflation). The Disease Model caught on in the medical community in the US and the rest is history (which doesn't mean that the US medical community conflates it with a Sin Model). Some Behaviourists prefer a Behavioural Disorder Model (ask Dancing David).

In some addiction cases the Disease Model may be more appropriate, and in others the Behavioural Disorder Model may be more appropriate. If an addict believes in God/Higher Power then AA's Sin Model might be for you. In some cases None of the Above are Appropriate because the alleged "addict" might not actually be an addict.

Alcoholism is classified as a disease in both ICD-10 and DSM-IV. Therefore it is one until further notice. Get it, will you?

I suppose because you've got Dr. in front of your Username I'm supposed to take your word for it on your Authority that the Disease Model is always the applicable model. Who do you think you are? Dr House? Oh...wait...that's who your fictional namesake wants to be.

Anyone who hasn't already and wants to can go to the "Why do people insist AA isn't a religion?" thread if they want to and join the discussion there. But if you post before bothering to actually read the posts there you can't expect your arguments to be given much credibility.

GB

 

[Dymanic]

AA has a religious model of addiction (i.e. a Sin Model), yet they disingenuously claim that its a Disease Model (hence the conflation).

con-flate
-verb
to fuse into one entity; to merge.

In repeatedly referring to "AA's Sin/Disease model", you seem to be conflating (or is it merely confusing?) an alleged bait-and-switch tactic with a model which represents a conflation of two fundamentally incompatible viewpoints. I'd be interested in seeing how you see AA accomplishing that awkward merging. What, the disease of alcoholism is punishment for sin? Kinda like the way some people view AIDS? Where's the evidence for that? Feel free to quote AA literature on the subject.

The Disease Model caught on in the medical community in the US and the rest is history (which doesn't mean that the US medical community conflates it with a Sin Model).

I'm glad we can at least agree that "the generally accepted model here" does not automatically equate to "what most ordinary folks in the may US think is so".

 

[MikeSun5]

The fact that you disagree with my posts does not mean that I misquoted.

You're right. I apologize for saying you misquoted. You quoted exactly what you aimed to quote, it just didn't mean/say what you thought it did.

 

[Gandalfs Beard]

con-flate
-verb
to fuse into one entity; to merge.

In repeatedly referring to "AA's Sin/Disease model", you seem to be conflating (or is it merely confusing?) an alleged bait-and-switch tactic with a model which represents a conflation of two fundamentally incompatible viewpoints. I'd be interested in seeing how you see AA accomplishing that awkward merging. What, the disease of alcoholism is punishment for sin? Kinda like the way some people view AIDS? Where's the evidence for that? Feel free to quote AA literature on the subject.


I'm glad we can at least agree that "the generally accepted model here" does not automatically equate to "what most ordinary folks in the may US think is so".

Goodness, one would think that "bait and switch" isn't functionally equivalent to "merging." Sometimes being Pedantic is just missing the point. But you often seem to do that intentionally.

GB

 

[Dymanic]

Sometimes being Pedantic is just missing the point.

Maybe I am being pedantic -- but then, the urgency some seem to feel in regard to this "disease" business strikes me as a bit pedantic as well. As you know, it's not a detail that deeply interests me. I find it useful to refer to alcoholism as a "disease" whether it meets someone else's definition or not. I'm not going to go pages with you on this. Just curious to see how you resolve the contradiction, since you appear to be the one who created it.

 

[Mahaha]

I just wanted to take a moment to say thanks to all the participants (even the ones I disagree with) of both this thread and the "Why do some people insist AA is not Religious?" When I first joined this forum 2+ years ago one of the first things I looked for was threads on AA or alcoholism. I found some posts from Tricky and a short thread on the subject but that was it. I have learned so much from you all. Through (relatively) civil discourse we have provided sources and arguments from all angles and anyone that should stumble across this thread will have a wealth of information and points of view.
You guys rock! (Even the ones I disagree with)

Wow, cool post.

Now, let me tell you what I think. Sometimes people say similar things without realizing it, or maybe they say things that aren't necessarely mutually exclusive.

Sometimes people overestimate genes. There is no gene specific for alcoholism (I mean, a gene that in a certain variant makes you susceptible to be dependant on alcohol), but it is absolutely conceivable that there is a gene that makes you more prone to certain mindsets (key factor in succumbing to alcoholism) or maybe makes your receptors more susceptible to become desesintized. The result is the same but there is a very important difference.

I believe that many discoveries involving genetics are focused on such genes. Obviously, everyone's receptors can desesitize, so if you put enough alcohol in anyone's bloodstream for enough time, they will become dependant on alcohol.

Since there are no definitive conclusions about what genes do what in this regard, it is for now impossible to do a DNA test and say that you are more susceptible than others to get addicted to some substance.
But for all the genetics involved, everyone is at least partly responsible for what they decide to do and how to react to their bodily manifestations. Alcoholism is not something you contract overnight, and if you are conscious and careful you have a chance to fight the urges, especially at the beginning.

DISCLAIMER: I don't mean to discount anyone's experience. I deeply empathize with anyone who has gone through or is going through such problems. I've had experiences too, and I understand it's some difficult ****.
I just said all of the above to get to the following.

Can't you just stop arguing about who's definition is the best fitting for alcoholism? And can't you recognize an in fieri body of scientific evidence when you see it?
While not discounting the efforts of those who quit and the role of personal responsability, we can recognize that it is possible that some people are alcoholics because they were more at risk.

It is a problem that involves emotions, biology, social condition, personal idiosincrasies and neuro-/psycho- logical aspects, and therefore is way too hard to define in one single way.

Peace, everybody!

 

[Gandalfs Beard]

Maybe I am being pedantic -- but then, the urgency some seem to feel in regard to this "disease" business strikes me as a bit pedantic as well. As you know, it's not a detail that deeply interests me. I find it useful to refer to alcoholism as a "disease" whether it meets someone else's definition or not. I'm not going to go pages with you on this. Just curious to see how you resolve the contradiction, since you appear to be the one who created it.

"Bait and switch" is functionally equivalent to "merging," i.e. conflating. Sin=Disease in the AA model, just as it is in the Christian model it's based on. See, no contradiction.

GB

 

[Dancing David]

Wow, cool post.

Now, let me tell you what I think. Sometimes people say similar things without realizing it, or maybe they say things that aren't necessarely mutually exclusive.

Sometimes people overestimate genes. There is no gene specific for alcoholism (I mean, a gene that in a certain variant makes you susceptible to be dependant on alcohol), but it is absolutely conceivable that there is a gene that makes you more prone to certain mindsets (key factor in succumbing to alcoholism) or maybe makes your receptors more susceptible to become desesintized. The result is the same but there is a very important difference.

I believe that many discoveries involving genetics are focused on such genes. Obviously, everyone's receptors can desesitize, so if you put enough alcohol in anyone's bloodstream for enough time, they will become dependant on alcohol.

Since there are no definitive conclusions about what genes do what in this regard, it is for now impossible to do a DNA test and say that you are more susceptible than others to get addicted to some substance.
But for all the genetics involved, everyone is at least partly responsible for what they decide to do and how to react to their bodily manifestations. Alcoholism is not something you contract overnight, and if you are conscious and careful you have a chance to fight the urges, especially at the beginning.

DISCLAIMER: I don't mean to discount anyone's experience. I deeply empathize with anyone who has gone through or is going through such problems. I've had experiences too, and I understand it's some difficult ****.
I just said all of the above to get to the following.

Can't you just stop arguing about who's definition is the best fitting for alcoholism? And can't you recognize an in fieri body of scientific evidence when you see it?
While not discounting the efforts of those who quit and the role of personal responsability, we can recognize that it is possible that some people are alcoholics because they were more at risk.

It is a problem that involves emotions, biology, social condition, personal idiosincrasies and neuro-/psycho- logical aspects, and therefore is way too hard to define in one single way.

Peace, everybody!

Um just for clarification, there is at this time no biological mechanisms that leads to a certain mindset.

The factors and there are many which are considered biological predisposition vary in nature and scope, they are no definitive by any means:
-response to alcohol (being the main one, type II alcoholism is partly defined by a high tolerance to alcohol)
-studies referenced by Zerospeaks about the level of alcohol consumption and deterioration
-probanding studies that show a high level of family association in some alcoholics
-mechanisms that accentuate withdrawal symptoms

But as noted earlier in the thread by another poster, just like some cancers the presence of lack of a specific gene trait will not always lead to the alcohol addiction. There will be a train of other events as well.

Then there are the factors that also lead to alcohol addiction:
-co morbid mental illness (especially bipolar disorder)
-biological predispositions that cause the person to feel irritable, have difficulty sleeping, etc...
-family transmission of coping skills and tolerance for negative effects of alcohol addiction
-acute stress disorder and posttraumatic stress disorder

But you are quite correct and I agree with you that alcoholism is multivariate and not from a single cause, there are those with no family history who become addicted, there are those with family history that do not become addicted, there are those who have withdrawal symptoms and those who do not. Those two indicate right there that it is not a single cause.

 

[Dymanic]

"Bait and switch" is functionally equivalent to "merging," i.e. conflating.

I disagree. Substituting one thing for another is NOT the same as combining two things into one, and it's not even functionally equivalent to that. The challenge you face here is to either show how AA accomplishes this merging or abandon your "Sin=Disease" model of AA's model and go with bait-and-switch as an alternative to that. (It will end up looking like "Sin=>Disease" or "Disease=>Sin", depending on which one you see AA using as the "bait").

Either way, perhaps a good place to start would be with those passages of AA's Big Book where the word "sin" appears.

 

[Gandalfs Beard]

I disagree. Substituting one thing for another is NOT the same as combining two things into one, and it's not even functionally equivalent to that. The challenge you face here is to either show how AA accomplishes this merging or abandon your "Sin=Disease" model of AA's model and go with bait-and-switch as an alternative to that. (It will end up looking like "Sin=>Disease" or "Disease=>Sin", depending on which one you see AA using as the "bait").

Either way, perhaps a good place to start would be with those passages of AA's Big Book where the word "sin" appears.

That's right, when in doubt resort to sophistry.

One need look no further than all the passages in which the Christian God appears: Capitalized Personal Pronouns and Christian Synonyms: Creator, Maker, Father, Heavenly Father, His, Him. All told these references add up to about 400 references to the Christian God in the Big Book (and it is common knowledge that in Christianity Disease and Sin are equivalent).

And the Big Book is nicely prefaced by The Doctor's Opinion by William D Silkworth MD to give it a patina of medical credibility. "Bait and Switch" or "Conflate", in this case either will suffice, they are both happening simultaneously, hence for the purposes of our conversation they are functionally equivalent.

And just in case there is any doubt about Dr Silkworth's views on the "merging" of the Disease and Sin models of Alcoholism:

Shortly before his death, the author [Dr Silkworth] spent an hour with Dr. Norman Vincent Peale, friend of A.A., the Rev. Sam Shoemaker, and Bill Wilson. Dr. Peale told me of the conversations he had with Bill Wilson about Bill's conversion. However, until 1997, I had never heard the following account by Peale about Dr. William Duncan Silkworth. It can be found in Norman Vincent Peale, The Positive Power of Jesus Christ (New York: Foundation for Christian Living, 1980), pp. 60-61. It appears under the title "The Wonderful Story of Charles K.":

Charles, a businessman in Virginia, had become a full-fledged alcoholic; so much so that he had to have help, and fast, for his life was cracking up. He made an appointment with the late Dr. William Duncan Silkworth, one of the nation's greatest experts on alcoholism, who worked in a New York City hospital [the Charles Towns Hospital]. Receiving Charles into his clinic as a patient, the doctor gave him treatment for some days, then called him into his office. "Charles," he said, "I have done everything I can for you. At this moment you are free of your trouble. But there is an area in your brain where you may hold a reservation and that could, in all likelihood, cause you to return to your drinking. I wish that I might reach this place in your consciousness, but alas, I do not have the skill."

"But, doctor," exclaimed Charles, "you are the most skilled physician in this field. When I came to you it was to the greatest. If you cannot heal me, then who can possibly do so?" The doctor hesitated, then said thoughtfully, "There is another Doctor who can complete this healing, but He is very expensive."

"That's all right," cried Charles, "I can get the money. I can pay his fees. I cannot go home until I am healed. Who is this doctor and where is he?"

"Oh, but this Physician is not at all moderate as to expense," persisted Dr. Silkworth. "He wants everything you've got. He wants you, all of you. Then He gives the healing. His price is your entire self." Then he added slowly and impressively, "His name is Jesus Christ and He keeps office in the New Testament and is available whenever you need Him."

http://silkworth.net/silkworth/dickb_aatribute.html

http://silkworth.net/dickb/great_physician.html

So please spare me your continual sophistry Dymanic.

It's for your own good you know. Think of all the room you'll have for an actual argument based on the facts if quit your addiction to Sophistry. Just here to help.

GB

 

[Dymanic]

I'm learning a lot here

The word "sin" does not appear in the Big Book, nor does the name "Jesus Christ", but the absence of any mention of a thing in a given book is not a barrier to concluding that the book is in fact based on that very thing.

Adherents to a particular set of ideas are fully bound by the beliefs expressed by its earliest contributors, even when one of its most central ideas is that no such obligation exists.

Common knowledge has value as evidence.

Substitution is equivalent to conflation. (Or not, but they can co-exist simultaneously.)

To question the logic of any of this is sophistry.

You're just a wealth of knowledge, GB.

 

[Gandalfs Beard]

The word "sin" does not appear in the Big Book, nor does the name "Jesus Christ", but the absence of any mention of a thing in a given book is not a barrier to concluding that the book is in fact based on that very thing.

Adherents to a particular set of ideas are fully bound by the beliefs expressed by its earliest contributors, even when one of its most central ideas is that no such obligation exists.

Common knowledge has value as evidence.

Substitution is equivalent to conflation. (Or not, but they can co-exist simultaneously.)

To question the logic of any of this is sophistry.

You're just a wealth of knowledge, GB.

So you're still pretending, despite ALL EVIDENCE TO THE CONTRARY that AA isn't based on Protestant Theology. The evidence I posted above speaks for itself. Where's yours?

Oh, that's right...you don't need evidence to back up your assertions. Silly me.

GB

 

[zerospeaks]

"Um just for clarification, there is at this time no biological mechanisms that leads to a certain mindset."

So we have decided to throw out genetics, epigentics, and the theory of evolution?

A creationist on youtube tried to make this same assertion in an effort to claim that god gave us our behaviors, instincts.
He could not have been more wrong.
I actually posted this video in this thread earlier.
http://www.youtube.com/watch?v=BR13mDHqISo

I also posted an article earlier explaining that Obesity (as in the desire to eat too much) is passed on genetically.

Where do you think our mindsets come from? Deepok Choprah?

 

[jiggeryqua]

(and it is common knowledge that in Christianity Disease and Sin are equivalent).

I didn't know that. Perhaps I'm not common enough.

 

[Mahaha]

Um just for clarification, there is at this time no biological mechanisms that leads to a certain mindset.

Ok, that's my bad... that part of the phrase was meant to be very generic. What I meant was: obviously everythin in our body is biologic, and even character has an ereditary component (even if we don't know for sure how much it is felt against environmental pressure); so, since alcoholism can derive a lot from your own psychology, your character is to be considered an important part of how and why you develop an addiction.

To sum up, I was just reenforcing the point: it is hard to discern all of the factors, we still don't know them all, and while some are very specific (like the ones you very correctly pointed out), we can't be sure of how much other aspects of you biology/psychology intervene.

Did I just come out more confusing than before...?

 

[Dancing David]

So we have decided to throw out genetics, epigentics, and the theory of evolution?

A creationist on youtube tried to make this same assertion in an effort to claim that god gave us our behaviors, instincts.
He could not have been more wrong.
I actually posted this video in this thread earlier.
http://www.youtube.com/watch?v=BR13mDHqISo

I also posted an article earlier explaining that Obesity (as in the desire to eat too much) is passed on genetically.

Where do you think our mindsets come from? Deepok Choprah?

What do you think a mindset is? Wow are you just out for a fight? Define the term mindset. Since when is 'mindset' a valid idea of science. So you tell me what a 'mindset' is and we can talk.

I agree about instincts we humans have none after six weeks.