Is alcoholism a disease or something else?

[Uncayimmy]

What part of "fight it out between yourselves" did you not understand? I'm not about make an unsupportable Categorical Statement one way or the other . Pick a fight with someone that isn't willing to meet you halfway.

Seems to me like you already made a categorical statement when you said that there is a category of people who do not have the ability to make decisions. Since we're talking about alcoholics, I'm assuming we're excluding people in (say) comas.

I say that choice exists for a human when he possesses the means and is presented with the opportunity. If a person is physically capable of picking up a glass and drinking from it, he has the physical means. If he understands that one glass contains water and another glass contains alcohol, he has the mental capacity. If I put him at a table with a glass containing alcohol, I say he's presented with a choice.

Some will drink it, some won't. How do you distinguish between those who cannot and those who can but do not? You say both exist, so surely you must know.

You have not answered my questions several times and may not this time. How can I tell the difference between whether you cannot or can simply do not?

 

[xjx388]

First off, I didn't ask you. I asked someone who understands that choice exists, not you, who wishes it a way. Second, biological drives and choice are not mutually exclusive, so why would anyone pay to research distinctions between two things that are already distinct?

Well you did post your question on a publicly accessable forum. Next time, try a PM then.

Doctors do not make distinctions between biological drives and choices? Interesting. How do you know this?

I'm very, very smart. Seriously though, if a patient presents saying, "I can't control my drinking," doctors don't say, "Well, that was your chioice." They also don't say, "You can't help yourself." They just help them find a way to control it.

 

[Gandalfs Beard]

Seems to me like you already made a categorical statement when you said that there is a category of people who do not have the ability to make decisions. Since we're talking about alcoholics, I'm assuming we're excluding people in (say) comas.

I say that choice exists for a human when he possesses the means and is presented with the opportunity. If a person is physically capable of picking up a glass and drinking from it, he has the physical means. If he understands that one glass contains water and another glass contains alcohol, he has the mental capacity. If I put him at a table with a glass containing alcohol, I say he's presented with a choice.

Some will drink it, some won't. How do you distinguish between those who cannot and those who can but do not? You say both exist, so surely you must know.

You have not answered my questions several times and may not this time. How can I tell the difference between whether you cannot or can simply do not?

Ask someone that's willing to put up with you.



GB

 

[Uncayimmy]

Well you did post your question on a publicly accessable forum. Next time, try a PM then.

Yes, I did ask in a public forum. I asked someone holding position X to explain position X. I did not expect someone holding position Y to tell me what question I should have asked. Why didn't you answer the question I actually asked you? Here it is again:

Biological drives and choice are not mutually exclusive, so why would anyone pay to research distinctions between two things that are already distinct?

I'm very, very smart. Seriously though, if a patient presents saying, "I can't control my drinking," doctors don't say, "Well, that was your chioice." They also don't say, "You can't help yourself." They just help them find a way to control it.

I asked you how you know you that doctors don't distinguish between biological urges and choices. All you did was just tell me what you somehow magically know doctors say. How do you know?

Your make-believe, one-sided conversation doesn't even establish that a biological urge exists. It seems to acknowledge that choices exists but is concerned mostly with phrasing. Drinking alcohol is a learned behavior. A person can consume so much alcohol that the body responds with biological urges (we call it withdrawal), and that, it would seem to me, is a something extremely important for a doctor to know since it could lead to death.

As for choices, it would seem to me that a doctor would advise a patient about how to make better choices. A choice requires opportunity. A person with difficulty controlling the desire to drink alcohol should avoid having the opportunity to drink. I would think a doctor would address this issue at length to advise on strategies for avoiding having the opportunity (and thus the choice) to drink alcohol.

I cannot imagine a doctor not distinguishing between withdrawal and (say) living with roommates who drink. Since you claim they don't, I am asking how you know. Seems like a simple question, so I'm puzzled as to why you don't answer it.

 

[xjx388]

I asked you how you know you that doctors don't distinguish between biological urges and choices. All you did was just tell me what you somehow magically know doctors say. How do you know?

Well, I associate with doctors every day. I'm a curious dude so I ask a lot of questions. ESPECIALLY, when I'm arguing with someone on the Internet.

I cannot imagine a doctor not distinguishing between withdrawal and (say) living with roommates who drink. Since you claim they do, I am asking how you know. Seems like a simple question, so I'm puzzled as to why you don't answer it.

Typical UY argument: You set-up an elaborate straw man then ask me to defend it. I said that doctors don't care if alcoholism is a choice or not, they just treat it. They look at where they are on the spectrum of alcoholism and go from there.

 

[Uncayimmy]

Well, I associate with doctors every day. I'm a curious dude so I ask a lot of questions. ESPECIALLY, when I'm arguing with someone on the Internet.

So, you've actually asked multiple doctors if they distinguish between biological urges and choices? I'm just trying to be clear here.

Typical UY argument: You set-up an elaborate straw man then ask me to defend it. I said that doctors don't care if alcoholism is a choice or not, they just treat it. They look at where they are on the spectrum of alcoholism and go from there.

I did not set up a straw man. You wrote:

...how would a researcher define Choice in a way that it could be distinguished from some kind of biological drive? And practically speaking, Doctors don't make such distinctions. They Just treat the patient.

I followed that by asking, "Doctors do not make distinctions between biological drives and choices? Interesting. How do you know this?"

You did not deny that my clarification was correct. I then asked twice the following question (which you conveniently snipped from your reply):

Biological drives and choice are not mutually exclusive, so why would anyone pay to research distinctions between two things that are already distinct?

You still haven't answered. Please answer.

My "straw man" is to present to you a scenario with a biological drive (withdrawal) and choices (being present around alcohol) to clarify that a doctor would not distinguish between the two. If you don't want to clarify, that's your choice.

In my experience doctors distinguish between the two. My sleep doctor diagnosed me delayed sleep phase syndrome. He asked me what hours I would prefer to sleep, and described to me the behaviors I must choose to align my biological urges with my preferences. There was no other treatment besides telling me what decisions to make.

I'm also being treated for depression. At a follow-up appointment my doctor noticed my weight loss. She asked if it was intentional or not - did I choose to lose weight or did it just happen. I told her that during my physical the blood work indicated that I should drastically reduce my Coke consumption, so I did. The weight loss was a direct result of that. Again, a choice versus a biological effect of the depression being an important distinction to make.

So, on the surface your claim makes no sense to me unless its basis is purely within the realms of using language that assigns blame in what appears a judgmental manner. If so, just say so instead of conflating biological urges with conscious choices and pretending that doctors don't recognize the difference.

 

[Dr. Tobias Fünke]

And just because you put 'Dr.' in front of your 'J. Random D00d' , doesn't mean you aren't appealing to authority and popularism. If you read what I wrote and tried to understand maybe we could have a discussion.

I explained when I consider it to be a disease, you could try to explain yourself more than pretending some sort of consensus in the medical community you haven't even presented evidence for.

At least a sentence or two of why you would define it as a disease.

“Because some FAQ from the AMA calls it a disease and because some FAQ from the CDC calls it a disease’, were already presented.

"Dr. Tobias Fünke" is my forum alias - you get that, don't you?
http://en.wikipedia.org/wiki/Tobias_Fünke#Tobias_F.C3.BCnke
As to your other points:

I think "alcohol withdrawal can kill you" and "I have seen people die from other causes whose symptoms were masked by the symptoms of withdrawal" aren't especially ambiguous or hard to get as, say, reasons why I define it as a disease. As in "at least a sentence or two"
Alcoholism itself can, of course, kill you by a myriad of ways.
To me it's like "depression is not getting out of bed" and "anorexia is not eating enough". Those kill people, too.

Alcoholism being listed in the ICD (you know what the "D" means, right?) as a "mental disorder" hints at some form of consensus. At least to me.

 

[littleroundman]

So,

are we now saying "depression" is:

1) A singular condition
2) The same in all cases
3) The same as "alcoholism"

and, are we also agreeing that:

1) UNCAYIMMYS' doctor is the same as ALL doctors ??

2) Because UNCAYIMMYS' doctor uses the behaviour modification model to treat UNCAYIMMYS' particular sleep disorder, then that is the ONLY method which can/should be utilized ??

3) "Sleep disorders" CAN have multiple sources, including disease, psychology, physiology, genetic predisposition, lifestyle and multiple other "causes" whereas "alcoholism" is a choice ???

4) The phrase "in my experience" has some relevance when discussing a condition affecting some 17 MILLION US residents and God knows how many doctors, researchers and interested others ???

5) Are we also in agreeance that "UncaYimmy" is not exhibiting what could be considered as being classic symptoms of his diagnosed depression, in that: "Without treatment, depression can continue to cause cognitive distortions in the patient, such as negative filtering, personalization and catastrophizing"???

 

[Dancing David]

Isn't it amazing ????

Estimates of between 10 and 17 MILLION people with "alcoholism" within the US alone, yet, according to some of the "critical thinkers" here, every damn one of them is the same.

.

Isn't it amazing that your open with such a big straw man? Who said that all alcoholics are the same in this thread?

ETA: Sorry if you were adressing one particular poster I have on IGNORE then I apologise , carry one.

 

[Dancing David]

"Dr. Tobias Fünke" is my forum alias - you get that, don't you?
http://en.wikipedia.org/wiki/Tobias_Fünke#Tobias_F.C3.BCnke
As to your other points:

I think "alcohol withdrawal can kill you" and "I have seen people die from other causes whose symptoms were masked by the symptoms of withdrawal" aren't especially ambiguous or hard to get as, say, reasons why I define it as a disease. As in "at least a sentence or two"

So you don't know why you call it a disease? Okay?

Alcoholism itself can, of course, kill you by a myriad of ways.
To me it's like "depression is not getting out of bed" and "anorexia is not eating enough". Those kill people, too.

Nice false dichotomy lurking in there some where, alcoholism has consequences that are sometimes lethal, so does driving a car, that does not make driving cars a disease now does it.

Alcoholism being listed in the ICD (you know what the "D" means, right?) as a "mental disorder" hints at some form of consensus. At least to me.

Oh a consensus that is is what 'a focus of treatment' or a 'disorder', which I called it what ? Hmmmm.

Thanks for playing, have you read the ICD-10 criteria? You will note that all of the criteria for addiction, except for the withdrawal signs (not required for the threshold) are what? Hmmmm?
Behaviors.

So why not show that there is a consensus it is a disease in the medical community?

 

[Dr. Tobias Fünke]

@Dancing David:

I won't be able to convince you so we'll just have to agree to disagree, then.

Regards,
Dr. Tobias

ETA: lots of people are not killed by coronary heart disease or the flu. I'm pretty sure nobody is ever killed by Morbus Bechterew, arthrosis, carpal tunnel syndrome or acne...

 

[Uncayimmy]

So,

are we now saying "depression" is:

1) A singular condition
2) The same in all cases
3) The same as "alcoholism"

and, are we also agreeing that:

1) UNCAYIMMYS' doctor is the same as ALL doctors ??

2) Because UNCAYIMMYS' doctor uses the behaviour modification model to treat UNCAYIMMYS' particular sleep disorder, then that is the ONLY method which can/should be utilized ??

3) "Sleep disorders" CAN have multiple sources, including disease, psychology, physiology, genetic predisposition, lifestyle and multiple other "causes" whereas "alcoholism" is a choice ???

4) The phrase "in my experience" has some relevance when discussing a condition affecting some 17 MILLION US residents and God knows how many doctors, researchers and interested others ???

5) Are we also in agreeance that "UncaYimmy" is not exhibiting what could be considered as being classic symptoms of his diagnosed depression, in that: "Without treatment, depression can continue to cause cognitive distortions in the patient, such as negative filtering, personalization and catastrophizing"???

Suffice it to say your post is full of straw man arguments and not worth addressing. I'm happy to defend arguments I make, but I'm simply not interested in defending those I do not.

On a side note, delayed sleep phase syndrome and advanced sleep phase syndrome in and of themselves are not actually problems. There's nothing inherently unhealthy about either. The "problem" is that those with either condition are out of synch with the rest of the world. The social demands of sleeping on a schedule relatively in synch with the majority of the world are what "cause" the problem, especially for those with DSPS. We end up not getting adequate sleep, which is unhealthy. Many people with DSPS are able to adopt lifestyles that coincide with their sleeping habits, and for many years that's what I did. However, I have children now, and the school bus is going to come at 7:15AM no matter what.

There are no "medical" treatments for DSPS. Basically, resetting the clock involves chronotherapy and/or light therapy. Beyond that one needs to practice good sleep hygiene.

You, like many when it comes to discussing issues of behavior, seem more concerned with concepts of blame than anything else. Either one raises the drink to one's lips or one does not. It's only the repeated exercise of this choice that we call alcoholism. It's a behavior. Like all behaviors, benign or not, there are numerous influences. That's just life.

 

[xjx388]

So, you've actually asked multiple doctors if they distinguish between biological urges and choices? I'm just trying to be clear here.

Yes, although not in so many words. I've had many discussions like the one in this thread with doctor friends.

Let me expand and clarify my meaning: As a practical matter, doctors don't make distinctions between which diseases/conditions/syndromes/disorders are choices and which ones are not. They really don't even bother with worrying about if something is technically a disease or not (except in the context of "will the insurance cover it" -a whole 'nother ball of wax). These are all nice subjects for a discussion board, but really, the only question that matters to doctors is: "Does my training and experience give me the tools I need to treat this?" If it's within their scope of practice, they treat it.

So my answer to the question that is the title of this thread is: It doesn't matter, unless you are trying to argue about whether medical insurance should or should not cover it.

As a purely philosophical point, we can discuss choices if you want. Do alcoholics "choose" to drink? Well, I define a choice as: a conscious decision. Ok, what is consciousness? I think it is a biologically derived state of self-awareness. Our consciousness is entirely derived from our neurochemistry; i.e., everything we think and feel and do is the complex interplay of our neurons and neurotransmitters. So, every choice we make is the result of chemicals reacting in our brains (to put it simply). Our neurochemistry, in turn, is the result of our genetics, our environment, our upbringing, our society -uncountable numbers of variables. So I guess you could say that an Alcoholic "chooses" to drink. But that choice is entirely determined by their neurochemistry. Luckily, humans are smart enough to understand their biology and find ways to manipulate it. Thus we have the fields of Medicine and Psychology.

 

[Uncayimmy]

Yes, although not in so many words. I've had many discussions like the one in this thread with doctor friends.

The issue here is the words. They have meaning. You seem to be conflating choice with biological urges. If you do not understand the difference, then you are doomed to misinterpret any discussion on the subject.

Why do you keep snipping out this question and not answering it?

Biological drives and choice are not mutually exclusive, so why would anyone pay to research distinctions between two things that are already distinct?

Let me expand and clarify my meaning: As a practical matter, doctors don't make distinctions between which diseases/conditions/syndromes/disorders are choices and which ones are not. They really don't even bother with worrying about if something is technically a disease or not (except in the context of "will the insurance cover it" -a whole 'nother ball of wax). These are all nice subjects for a discussion board, but really, the only question that matters to doctors is: "Does my training and experience give me the tools I need to treat this?" If it's within their scope of practice, they treat it.

Is such a statement even of any value? Basically you're saying that if a patient comes to a doctor, the doctor treats the patient if there is something that the doctor can offer. Well, duh! That's their chosen vocation.

Perhaps you were trying to say that a doctor doesn't distinguish between biological urges and choices when choosing to treat a patient or not. I don't believe that was even under discussion. While that may be true for accepting a patient (abortion related treatments an exception), physicians do terminate patient relationships. See this article from Physican's News:

http://www.physiciansnews.com/law/499saxton.html
However, patients who are continually noncompliant or unwilling to follow the treatment path you have prescribed puts you and them at great risk and is an appropriate circumstance to consider discharge. Attempts should be made to let those patient know the consequences of their actions, both to their health and to your relationship with them. Often this will be effective, but if the behavior continues, discharge would be the next step.

So my answer to the question that is the title of this thread is: It doesn't matter, unless you are trying to argue about whether medical insurance should or should not cover it.

It matters to treatment.

As a purely philosophical point, we can discuss choices if you want. Do alcoholics "choose" to drink? Well, I define a choice as: a conscious decision. Ok, what is consciousness? I think it is a biologically derived state of self-awareness. Our consciousness is entirely derived from our neurochemistry; i.e., everything we think and feel and do is the complex interplay of our neurons and neurotransmitters. So, every choice we make is the result of chemicals reacting in our brains (to put it simply). Our neurochemistry, in turn, is the result of our genetics, our environment, our upbringing, our society -uncountable numbers of variables. So I guess you could say that an Alcoholic "chooses" to drink. But that choice is entirely determined by their neurochemistry. Luckily, humans are smart enough to understand their biology and find ways to manipulate it. Thus we have the fields of Medicine and Psychology.

The process of making decisions is a matter of biology. It has to be by definition because something without biology cannot make choices (a rock, for example). Again, what's the value in such a statement of the obvious?

 

[xjx388]

Why do you keep snipping out this question and not answering it?

Biological drives and choice are not mutually exclusive, so why would anyone pay to research distinctions between two things that are already distinct?

Since biology determines choice the question makes no sense. They just research the biology.

Is such a statement even of any value? Basically you're saying that if a patient comes to a doctor, the doctor treats the patient if there is something that the doctor can offer. Well, duh! That's their chosen vocation.

Now you're getting it. It's of value because it answers your question whether doctors make the distinction as a practical matter.

Perhaps you were trying to say that a doctor doesn't distinguish between biological urges and choices when choosing to treat a patient or not. I don't believe that was even under discussion. While that may be true for accepting a patient (abortion related treatments an exception), physicians do terminate patient relationships. See this article from Physican's News:

It matters to treatment.

The article is saying that if a patient is noncompliant, even after a doctor's best efforts, then the doctor needs to terminate the relationship because of the liability risk. It has nothing to do with treatment. It has to do with getting sued after the patient dies or is harmed by their own noncompliance. Totally irrelevant.

The process of making decisions is a matter of biology. It has to be by definition because something without biology cannot make choices (a rock, for example). Again, what's the value in such a statement of the obvious?

The concept of "choice" or "personal responsibility" is central to the "it's not a disease" crowd. So if we agree that the choices we make are rooted in our biology, then do we really have a choice about anything we do? If you say yes, then you have to posit some part of our mind that is not a part of our biology yet has control over our biology . That is not a very scientific idea, though.

 

[Uncayimmy]

Since biology determines choice the question makes no sense. They just research the biology.

The question was, "Biological drives and choice are not mutually exclusive, so why would anyone pay to research distinctions between two things that are already distinct?"

Biology is the mechanism by which choice is made. Without biology, there is no choice. To say that biology determines choice is either silly or meaningless.

Biological drives influence choice. You seem to be arguing that they are the same. Are you? Are you saying there is no difference between a biological urge and a choice?

Now you're getting it. It's of value because it answers your question whether doctors make the distinction as a practical matter.

What practical matter? There are countless "practical matters" with which physicians deal. Choosing to accept a patient is but one. That has never been under discussion, so why are you bringing it up?

The article is saying that if a patient is noncompliant, even after a doctor's best efforts, then the doctor needs to terminate the relationship because of the liability risk. It has nothing to do with treatment. It has to do with getting sued after the patient dies or is harmed by their own noncompliance. Totally irrelevant.

This is beyond ridiculous. How can a patient's compliance with prescribed treatment have "nothing to do with" treatment? Are not the doctor's "best efforts" part of the treatment? More importantly, it demonstrates that patient choice is a "practical matter" for physicians. If they don't choose to be compliant, does that mean they have a disease? Does somebody know the Latin for "refuses to do what the doctor says" so that we can name this newly discovered disease? I mean, obviously it's biological.

The concept of "choice" or "personal responsibility" is central to the "it's not a disease" crowd. So if we agree that the choices we make are rooted in our biology, then do we really have a choice about anything we do? If you say yes, then you have to posit some part of our mind that is not a part of our biology yet has control over our biology . That is not a very scientific idea, though.

(emphasis added)
That's just a ridiculous notion. It is widely understood that we can use our biology to control our biology. When I pick a scab, I use my biological processes to locate, grip and remove the scab. I use my biology to make that decision (without biology, there is no choice). My biology is then altered. That's voluntary and subject to awareness.

I can also stop breathing, a biological process that has both voluntary and involuntary control. I can stop breathing until I pass out. Once that happens, the autonomic processes take over, and my body resumes breathing. I have no awareness of this. Once I pass out, I have no choice about breathing.

If I eat a pizza, that's voluntary. I have no control or even awareness of what my digestive system does with it. I lose control over that pizza until it's time to evacuate my bowels. I can voluntarily choose not to evacuate them at a given place or time. If I can't, that is considered a disease. We can defecate while asleep, so clearly there is involuntary as well as voluntary control. Likewise, if I hold it in for too long, I can actually create a condition in which I cannot voluntarily evacuate my bowels. At that point medical intervention is required.

You've said before that choice is not a very scientific idea. That's utter nonsense. Choice is integral to medical science. The word "choice" returns over 180,000 hits in PubMed. Why would they use this word so often if it had no meaning? Doctors make choices for treatment, for crying out loud.

That doctors are in a good position to work with people who make bad choices is not in question. Truth is, studies show that many physicians inadequately screen for alcohol/substance abuse issues in their patients. I consider this a problem. Why wait for the biological repercussions to hit before addressing the decision making?

Do you know what profession has the lowest rate of obesity? Professionals in diagnostic medicine (about 1/3 of the national average). Note: I couldn't find numbers for alcohol that broke out medical professionals, or I would have used them. I don't want to discuss obesity, only choices.

Is that any surprise? Physicians have to make choices for the long term in order to even become physicians. They have to forgo parties to study. They have to forgo sleep. They learn to make decisions without immediate gratification.

In their practice, they do the same thing. There is no immediate gratification to (say) lowering someone's cholesterol. It takes time to see the numbers move. After that it takes even more time for a benefit, if any, to be realized. They need to look at 10-year risk rates to make decisions, so it's no wonder they take more care in deciding what goes into their bodies.

Interestingly, health care workers such as nurses had much higher rates. Again, not a surprise, because a nurse's job typically involves much more immediate gratification. This is certainly not the only factor that influences choice, but it goes to show that choices are an integral part of the science. Unless, of course, you are arguing that we have no choices about occupation.

 

[Dancing David]

@Dancing David:

I won't be able to convince you so we'll just have to agree to disagree, then.

Regards,
Dr. Tobias

ETA: lots of people are not killed by coronary heart disease or the flu. I'm pretty sure nobody is ever killed by Morbus Bechterew, arthrosis, carpal tunnel syndrome or acne...

As I have stated I do not feel that in and of itself alcoholism is a disease, it is however a focus of medical treatment. So as such it can be calld a disease, just like if I overeat and carry my morbid obesity I will develop Typre II diabetes (I am prediabetic, have elevated triglycerides, my mother and her father both developed Type II diabetes.).

While Type II diabetes is a disease by the classical usage, overeating, is not. That is the way I think about it.

Disease is defined widely and in an idiomatic fashion which is why I asked for the defintion you were using.

 

[Dancing David]

Do alcoholics "choose" to drink?

Yes they do, aside from the moot ontological issue of free will and in fact modifying choices is a huge part of Cognitive Behavioral Thearpy.

Now the consequences of not using are the issue that drives many addictions.

Good luck there with UY!

 

[littleroundman]

Suffice it to say your post is full of straw man arguments and not worth addressing.

and

You, like many when it comes to discussing issues of behavior, seem more concerned with concepts of blame than anything else

Hmmn,
the master of the invalid argument invokes the straw man defense, how predictable.

"Blame" has nothing to do with it.

The fact is, you have not produced a single, solitary reason as to how ANY argument or ANY theory, yours, mine or anybody elses, can be successfully applied to all 17 MILLION people in the US defined as being "alcoholic"

The best anyone could possibly claim that their particular flavour of explanation applies to is "most" or "many" or "the largest proportion of"

Heck, you can't even provide a definition of what constitutes an "alcoholic" which could be applied to anything more than a majority of the 17 MILLION people.

You can go 'round and 'round the Mulberry bush forever,
you could even "win" the debate, at least in your own mind, but, until you can prove that your winning theory applies to every one of the millions of people involved, then the answer to the OP original question:

Is alcoholism a disease or something else?

is

Alcoholism is a disease AND something else

 

[Uncayimmy]

the master of the invalid argument invokes the straw man defense, how predictable.

It's not a straw man to say that it "seems" like someone is saying something.

"Blame" has nothing to do with it.

Fine. See how easy that was?

The fact is, you have not produced a single, solitary reason as to how ANY argument or ANY theory, yours, mine or anybody elses, can be successfully applied to all 17 MILLION people in the US defined as being "alcoholic"

Actually, I did. Every single person called an alcoholic must be capable of consuming alcohol by invoking voluntary motor control to make it happen and doing so under their own awareness. That's really all I've said.

Heck, you can't even provide a definition of what constitutes an "alcoholic" which could be applied to anything more than a majority of the 17 MILLION people.

Can you please explain, then, how the 17 million number was derived? Your statement seems self-contradictory. How can we count people when they don't all have something in common?

You can go 'round and 'round the Mulberry bush forever,
you could even "win" the debate, at least in your own mind, but, until you can prove that your winning theory applies to every one of the millions of people involved, then the answer to the OP original question: is

Alcoholism is a disease AND something else

Well, sure, if you define disease in a way that will result in a knee-jerk reaction of, "That's not a disease!" Or stated another way, the definition will include things which medical professionals will not treat.

So, what's your test for disease? What criteria do you use? From there we can look at other things to see if they fit the criteria. Call it LittleRoundMan's Postulates.