Is alcoholism a disease or something else?

[bookitty]

Would you like me to send you my password? It would make it easier for you to post on my behalf.



Yes, severe, chronic alcohol abuse can cause brain damage. That's one of the reasons for people to stop drinking in the first place. Your link does not support the conclusion that impulse control problems are a direct result of the damage or that people do not have the functionality needed to remain sober. What's the test for that, by the way? How do you know someone doesn't have the functionality to remain sober? And what do you mean by remain sober? A day? Week? Month? Not drink at all? Please explain.

The treatments for impulse control disorders, regardless of cause, include pharmacology and cognitive behavior therapy. And, of course, the decision to get treatment is a choice is as well. What is your recommendation for these people who are not capable of controlling their impulses?

And finally, I'm not really sure why you're bringing up brain damage unless you have an incredibly over-simplified concept of what I have been arguing.

Ah the majestic dance of the shifting goalposts. So now it is only alcoholics who are not chronic that can be expected to control their drinking with the magical power of choice?

As for the rest, might I refer you to the conclusion of the article.

Evidence is accumulating that cognitive deficit is an important predictor of outcome following treatment. In the management of states of frontal lobe changes, attention should be paid to remedying nutritional deficiency and the general principles of rehabilitation should be borne in mind.

 

[xjx388]

Your link does not support the conclusion that impulse control problems are a direct result of the damage or that people do not have the functionality needed to remain sober.

This has been provided to you already. Review this post. Here are the pertinent papers I cited in that post.

Inhibition and working memory deficits, associated with low levels of CBF <cerebral blood flow> in the medial frontal gyrus, are related to the difficulty of maintaining short-term abstinence from alcohol.

and

In any case, there is substantial evidence that addiction is related to loss of frontal lobe function and increased impulsivity.

If you want to willfully ignore evidence that is presented to you, then what's the point of this?

 

[bookitty]

As I reposted a few posts back, none of the self-labeled behaviorists such as myself deny these issues exist. As I stated, they are integral to better modifying behavior. I don't understand why you are repeating back to me what I already know and have acknowledged. What is your point?

You have prescribed the same treatment for three different medical disorders - obesity, depression and alcoholism. If the patient really, really wants to change, all they need to do is make that choice to not over eat, to take a bit of exercise or to not pick up that drink. It's basically The Secret. No matter what neurological, biological, genetic or medical issues may have contributed to the condition, thinking happy thoughts is the way to overcome them.

 

[Uncayimmy]

This has been provided to you already. Review this post. Here are the pertinent papers I cited in that post.

and

If you want to willfully ignore evidence that is presented to you, then what's the point of this?

First off, what I said was that Bookitty's link did not support her contention. That remains true, and that's all that I was addressing. Second, your citation does not support the contention that a person lacks the functionality to abstain. In fact, your link specifically states, "Abstinence from alcohol induces brain regrowth and return of some cognitive abilities. Addiction therapies focused on enhancing abstinent brain activity and growth could become new approaches to treating addiction."

If you want to jump in on her behalf, then answer these questions:

What's the test for determining somebody does not have the functioning to control their impulses? How do you know someone doesn't have the functionality to remain sober?

And what do you mean by remain sober? A day? Week? Month? Not drink at all? Please explain.

The treatments for impulse control disorders, regardless of cause, include pharmacology and cognitive behavior therapy. And, of course, the decision to get treatment is a choice is as well. What is your recommendation for these people who are not capable of controlling their impulses?

Better still, answer the question I asked you about your uncle:
At what point did you decide it was impossible? How did you arrive at that conclusion?

As I have repeatedly stated, of course there are biological factors. Why you and others keep bringing it up is beyond me. I mean, seriously, how many times are you going to do it? 50? 100? How many times do I have to say that I know they exist? 500? 1,000?

Nobody has established a test for "impossible" to control. It remains an unsupported claim. I, by contrast, have defined choice. That has not been refuted.

 

[Skeptical Greg]

You have prescribed the same treatment for three different medical disorders - obesity, depression and alcoholism. If the patient really, really wants to change, all they need to do is make that choice to not over eat, to take a bit of exercise or to not pick up that drink. It's basically The Secret. No matter what neurological, biological, genetic or medical issues may have contributed to the condition, thinking happy thoughts is the way to overcome them.

What other therapies appear to be working ?

(No one has claimed " Thinking Happy Thoughts ", is effective treatment. Just another strawman from the " can't help themselves " team ... "

 

[Gandalfs Beard]

You spend an inordinate amount of time claiming (incorrectly) what other people believe. At this point I can only conclude that you are intentionally lying. Here's what I said about choice:



I never claimed it was "all about" choice without any other factors such as neurological disorders. What I did write was this:



And again here:



In response to RJordan claiming that I am "denying" biological influences, I wrote:



As for what medical professionals can do, I wrote this:


Please stop misrepresenting my position.

I was wondering how long it would take you to resort to the tactic of claiming that I am "lying" and "misrepresenting" your position.

I am not misrepresenting your position in the least.

I never said you didn't take other factors into consideration.

But then you turn right around and DISMISS these other factors as merely "influences" when you claim that "addicts" ALWAYS have a choice--due to the fact that they have "Voluntary Motor Control".

This is exactly the same sort of sophistry that you employed on the "Calories" thread.

There are numerous examples that you "always bring it back to personal choices" (as I recall you yourself stating, in your own words, on the "Calories" thread). These are just the most blatant examples:

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.

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.

That help starts with the person understanding it's about making choices. By that I don't mean it's simply a matter of sitting at home alone with a bottle of Early Times and choosing not to pour a shot. It's about choosing to change your life so you're not sitting at home alone with a bottle of Early Times in the first place. It's about seeking out the whatever assistance is needed to get to that person's root problem or at least what that person needs to do to succeed. If they need to take Antabuse to condition themselves, so be it. If they need therapy, so be it. If they need detox and a stay at a clinic, so be it. Those are all choices.

Once the person gets into treatment, it's still a matter of choice to follow the treatment. People get kicked out of treatment centers all the time for not following the rules.

The choice model never breaks down, even if we use the legal system to enforce treatment. The person still has to make choices to follow the treatment and continue with new behaviors after "successful" treatment. If someone chooses to start drinking again, the "disease" is back.

This is precisely why the discussion matters. You're taking the onus off the individual to alter their behavior (there is no gene that makes people buy a bottle of Early Times and drink shots until they pass out) and putting it on medical professionals. The best the medical profession can do is offer assistance to people willing to make changes. Calling it a disease that is "impossible" to control for some people is the best excuse to keep drinking.

I hope you're joking, but I can't tell. We humans have all sorts of impulses. We don't have to act on them.

So the argument, as always in your posts, keeps coming back to "Choice". Your claim that "Addicts" can always make choices is an argument that is unsubstantiated.

As I've stated before, you and I are in agreement when it comes to "habituated" or "abusive" behaviour in regards to alcohol consumption. Sure, behaviour modification may be beneficial to those that are able to act volitionally.

But when we are talking about REAL "Addiction," the whole point is that the Addict has no volitional control over his or her urges/impulses (that's why it's called "Addiction"), nor are some people even able to volitionally control ACTING on those urges/impulses.

In some people, it's not simply a matter of "biological" or socio-psychological influences, it's actually a matter of a neuro-biological malfunction that LITERALLY removes one's ability to make decisions, or volitionally control their behaviour patterns. More and more studies are demonstrating that neuro-biology not only affects behaviour, but actually determines behaviour.

And the fact is, you can't actually provide a study to back up your assertion that ALL people ALWAYS have a choice (you certainly haven't provided one yet). This is YOUR Extraordinary Claim.

It's quite apparent to most people, whether in the medical community or not, that one cannot empirically demonstrate that your assertions regarding choice are applicable to every single person on the planet.

If you can come up with even ONE study that can empirically demonstrate that ALL people ALWAYS have Choices, regardless of the influences, I'll give it due consideration. But I'm not going to hold my breath waiting for it.

--------------------------------------------------------------------------

Now, as to whether neuro-biological disorders or malfunctions can or should be labelled a "disease", I really don't give a Rat's Arse. It's not as important as distinguishing psychological problems that result in behavioural disorders from physiological problems that result in behavioural disorders.

I agree with you up to a point that "disease" is not always the best way to describe behavioural disorders (and I have never been a fan of the over-use of the "Disease Model" in the US either), but when the disorder is physiologically based, it DOES fall under most definitions of "disease," unless you are using a really narrow definition that only considers Infectious Diseases as "Disease." And denying this is the case is not credible.

GB

 

[littleroundman]

UncaYimmy,

the OP question was:

Is alcoholism a disease or something else?

Given the fact the OP didn't specify a singular definition of the word "alcoholic" or in any way indicate the number, ethnicity or location of people who could possibly be included under the word "alcoholic" would you care to clarify your position so that there is no possibility of any misunderstanding among the JREF membership as to the reason for your participation in this particular thread ???

Is alcoholism a disease or something else?

 

[Uncayimmy]

I never said you didn't take other factors into consideration.

That's not the way it seems. If you say that's not what you meant, so be it. Unless, of course, you'd rather I quote a dozen posts and highlight that which makes me think you said it, then hound you for post after post claiming, "That's not what you said! That's not what you said!"

Your choice.

But then you turn right around and DISMISS these other factors as merely "influences" when you claim that "addicts" ALWAYS have a choice--due to the fact that they have "Voluntary Motor Control".

I don't dismiss them. I acknowledge them as the influences they are. I never use the word "merely" to describe them. That's your own creation.

There are numerous examples that you "always bring it back to personal choices" (as I recall you yourself stating, in your own words, on the "Calories" thread). These are just the most blatant examples:

That thread is closed. Please do not bring it up here.

So the argument, as always in your posts, keeps coming back to "Choice". Your claim that "Addicts" can always make choices is an argument that is unsubstantiated.

I defined choice already, and I've repeated that definition to you. Interestingly, you ignored it both times.

But when we are talking about REAL "Addiction," the whole point is that the Addict has no volitional control over his or her urges/impulses (that's why it's called "Addiction"), nor are some people even able to volitionally control ACTING on those urges/impulses.

Tell me the test for volitional control. I say if there person is physically capable and has the awareness of what he's doing, it volitional. What test do you employ to decide it's not? That's what it boils down to. Answer the question.

 

[tempesta29]

So the argument, as always in your posts, keeps coming back to "Choice". Your claim that "Addicts" can always make choices is an argument that is unsubstantiated.

As I've stated before, you and I are in agreement when it comes to "habituated" or "abusive" behaviour in regards to alcohol consumption. Sure, behaviour modification may be beneficial to those that are able to act volitionally.

But when we are talking about REAL "Addiction," the whole point is that the Addict has no volitional control over his or her urges/impulses (that's why it's called "Addiction"), nor are some people even able to volitionally control ACTING on those urges/impulses.

What your argument presupposes is that at no point in history has an addict ever chosen anything but to continue abusing. If you're claiming that an addict can never truly make a choice regarding substance abuse then you must also be claiming that at no point in history has an addict ever chosen not to abuse. Certainly this cannot be true.

If the addict isn't making the choice, then who is? A demon?

 

[xjx388]

Let's review the thread together and see if we can find out what UY's actual position is. His first post on this thread was a series of questions:

So, given that you believe some can make choices, what research led you to conclude that that some people cannot? What type of experiments did they perform?

As a practical matter, how does treatment for those people different from those who can make choices but choose otherwise? How does a doctor in his practice distinguish one from the other?

Note that there is no explicit statement of his position here, just attacks on someone else's position veiled as questions. This is a common tactic and it goes on for many of his first posts here. We don't actually get to hear his position until he says this:

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.

So, to summarize, UY thinks that if someone has normal motor function and can tell the difference between alcohol and water, then this person has the ability to choose. After this, he goes on to another common tactic: The personal anecdote purported to illustrate an analogous condition, in this case Delayed Sleep Phase Syndrome, Depression and Weight-Loss. I find it best to ignore these because they can derail the subject at hand. The next statement we get from UY is:

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.

So, we now know that he defines alcoholism as the repeated exercise of the choice to raise a drink to one's lip. Would you say that's fair so far, UY, based on your statements?

Following this is a lot more of his questions, anecdotes and irrelevant citations. Not one of the studies he cites support his position as he's stated it in his own words. The next time he makes any kind of definitive statement is this:

Biological drives influence choice.

and

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.

So biology influences choice and at the same time is the mechanism by which choices are made but it's silly or meaningless to say that biology determines choice. Talk about silly and meaningless . . . So I ask him to clarify his statement with this question of my own:

Now, you say that biology influences choice. Ok, so what else influences choice? What, in your view, is the ultimate mediator of choice?

His answer was:

I have no idea what you're trying to say. "Choice is biology?" What kind of meaningless nonsense is that. . .

So he dodged a direct question about how he defines choice. So we don't have any clue how UY thinks choices are made or what is making the choice if not the biological functioning of the brain. All the while of course, he ignores the evidence I've presented showing how the Pre-Frontal Cortex is responsible for executive function and exactly how impairments in the PFC's functioning lead to addictive behaviors and relapse.

Finally, I made the most compact statement of my position I could come up with:

Yes, few human beings are totally powerless to stop their behaviors. But certainly, we can agree that there is a spectrum of "ability to stop" from "totally powerless" to "no problem." And I think that current scientific knowledge points to the idea that the thing that determines where a person lies on that spectrum is their biology (genetic predispositions, brain chemistry, etc.) as shaped by their environment (social, economic, familial, etc. influences).

UY's response to this position?

The sticking point is the term powerless. All definitions of alcoholism (in my opinion) require two elements: Awareness and motor control. If either is missing, I don't believe any set of behaviors could be called alcoholism. If both are present, then I don't see how it's possible to be powerless.

Now, notice the highlighted part of that statement. This is the core of UY's stance. He doesn't believe that it's possible to be powerless. I presented two papers that start to give an idea of exactly how it's possible to be powerless. UY has presented exactly zero studies to support his belief. He keeps saying stuff like:

The choice model never breaks down, even if we use the legal system to enforce treatment. The person still has to make choices to follow the treatment and continue with new behaviors after "successful" treatment.

without even once citing a shred of evidence that a "choice model" even exists. As he himself admits, it's his own belief. And that's fine, UY you can believe what you want. But if you are on this thread expecting to convince me or anyone else, you have to present evidence that your beliefs are rooted in reality. You haven't done this thus far, so all your objections that "I defined choice already, and I've repeated that definition to you," ring a little hollow.

UY, if you think I've misrepresented your position, you are free to clarify it. I suspect you won't because you can't, but no one else can do it for you. And maybe a little real evidence that your position is anything other than your own belief would be nice.

 

[xjx388]

What your argument presupposes is that at no point in history has an addict ever chosen anything but to continue abusing. If you're claiming that an addict can never truly make a choice regarding substance abuse then you must also be claiming that at no point in history has an addict ever chosen not to abuse. Certainly this cannot be true.

If the addict isn't making the choice, then who is? A demon?

Not a demon, the addict's neurophysiology. If the addict's neurophysiology (as detailed in the studies I've posted twice on this thread) isn't making the the choice then what is?

 

[xjx388]

Tell me the test for volitional control. I say if there person is physically capable and has the awareness of what he's doing, it volitional. What test do you employ to decide it's not? That's what it boils down to. Answer the question.

There are many tests for "volitional control." But it's not called volitional control, it's called Executive Function. EF is controlled by the Prefrontal Cortex. The papers I linked to earlier give an excellent summary of this, especially as it pertains to addiction. There are numerous studies linked from those showing how impairments in the PFC lead to all sorts of uncontrollable behaviors like hyperphagia (overeating), compulsive gambling and substance abuse. It also explains how certain genetic patterns lead to reduced functioning in the PFC. The "tests" you are asking about are all in the papers linked in that article, such as the Cambridge Risk Task. I think it's beyond the scope of this thread to go into lengthy detail, but the tests you ask about are out there.

 

[xjx388]

That thread is closed. Please do not bring it up here.

Oh sure, UY but it's OK for you to use my former username and link to other threads talking about the little controversy in "Calories" thread. Nice double standard.

 

[Gandalfs Beard]

What your argument presupposes is that at no point in history has an addict ever chosen anything but to continue abusing. If you're claiming that an addict can never truly make a choice regarding substance abuse then you must also be claiming that at no point in history has an addict ever chosen not to abuse. Certainly this cannot be true.

But when we are talking about REAL "Addiction," the whole point is that the Addict has no volitional control over his or her urges/impulses (that's why it's called "Addiction"), nor are some people even able to volitionally control ACTING on those urges/impulses.

A) Show me where I made the claim that "an addict can NEVER truly make a choice regarding 'substance abuse' (which is NOT the same as 'addiction' by the way)."

B) Demonstrate how my argument "presupposes that at no point in history has an addict ever chosen anything but to continue abusing." (Which you can't, as I didn't make the assertion in point A) that you claim I made).

If the addict isn't making the choice, then who is? A demon?

As your premises regarding my statement are false, your facetious conclusion has no merit.

GB

 

[Gandalfs Beard]

Oh sure, UY but it's OK for you to use my former username and link to other threads talking about the little controversy in "Calories" thread. Nice double standard.

You beat me to it.

I was going to point out that UY brought up the "other" thread in the context of this one, thus opening himself up to my comparing the points he made in that thread to the points he made in this thread.

GB

 

[LotusMegami]

http://lesswrong.com/lw/2as/diseased_thinking_dissolving_questions_about/

Dissolve the question. Is doesn't matter. "Disease" is just a word. Labeling alcoholism as a disease or a behavior does not change the reality of the situation or the potential solutions. It's just bickering over semantics.

 

[Gandalfs Beard]

I never said you didn't take other factors into consideration.

That's not the way it seems. If you say that's not what you meant, so be it. Unless, of course, you'd rather I quote a dozen posts and highlight that which makes me think you said it, then hound you for post after post claiming, "That's not what you said! That's not what you said!"

Your choice.

What research led you to conclude that ALL people CAN make choices. The fact is, there is no research to suggest that ALL people CAN make choices. So now you don't have the other thread to play on you want to come and **** this one up too?

I've made my positions plain.

It's a reasoned approach that recognizes that not all people are equal in terms of the ability to choose to modify their behaviour patterns (as if people CHOSE to have Depression and OCD ). It's an approach that recognizes that the definition of terms "addiction" and "disease" are mutable.

And it's an approach that recognizes SOME people CAN modify their behaviour patterns. And its an approach that recognizes that the jury is still out in terms of making categorical statements that are applicable to all people across the board one way or the other.

But apparently very few on this thread are willing to admit that there might be some truth to "both" sides of this debate.

If the "Free Willies" and the "Powerless over Alcohol/addictioners" want to make unsupportable Categorical Statements on either side, FINE. Battle it out between yourselves.

Nope, I didn't say "you didn't take other factors into consideration" in that post.

In regards to your last paragraph, a person who can't make choices themselves cannot resolve their alcohol problem themselves. A family member would have to make the decision for the alcoholic or addict to get them the medical help necessary. If such a person has no family or friends to help them get treatment, their situation might never be resolved, and they might end up in a Gutter, in Jail, or Dead.

I do agree that the "Sin" model is not equivalent to the "Choicer" model, but that there is some overlap. I didn't intend my statements to imply any more than that.

I am glad to see that by attempting to further clarify my views on the subject, that we have finally been able to reach some common ground though.

Nope, didn't say it there either.

Exactly.

I know I'm on a bizarre thread when I partly agree with both UncaYimmy and AlBell.

Definitely not in this post

For all my beefs with AA (and I have plenty), I think the First Step is true for SOME people. In other words, for SOME people, controlling Alcohol Drinking IS impossible without intervention and help (regardless of the numerous factors that may play into that).

Why is it so hard for you to just admit that this is the case, and that you're not Psychic enough to know that for every single "Alcoholic" saying "it's impossible" is the "best excuse"?

...Or for that matter, to admit that you are not smarter than those in the medical field that think Genetic Predisposition DOES play a role in SOME people who DO find it impossible to control their drinking?
The very fact that you put it in terms like "best excuse" belies your contention that you have "no moral issues with alcohol or alcoholics." This is the same kind of double-talk argument that you used on the other thread that drives people crazy.

You claim you have "no moral issue", but that fat people and drunk people have "no excuse" not to make choices, which boils down to "it's all their own fault."

It's no wonder that AlBell sarcastically called you on it: "...damn moral degenerates."

This is exactly what I'm talking about when I bring up the socio-political background assumptions that stigmatize people for the problems they face. SOME people don't even realize they are making a snap moral judgment when that is precisely what they are doing.

To be fair, I can see why you might think the highlighted section implies that I am claiming you don't take other factors into consideration. But in actuality I was making a claim about your implications regarding your superiority to medical professionals.

And I didn't actually say here that you "didn't take other factors into consideration." Rather, I was suggesting that you took the factor of Genetic Predisposition into consideration (possibly as an "influence"), but rejected it as having a role in the complete lack of Impulse Control in SOME people.

Not precisely MA, but here's a few Malaria Support Groups (I don't know if they give out pins for being Malaria Free after a year though):

http://malaria.stanford.edu/aboutus.html:
I wonder if Stanford's Anti-Malaria programme directs Californians (and other "Americans") who have contracted Malaria to Supportive Groups?

http://www.dailystrength.org/c/Malaria/support-group



Hmmm...perhaps those that travel to Sub-Saharan Africa are engaging in Risky "Behaviour" that may lead to Malaria. Wait...didn't someone just say that "behaviour is not a part of the definition of 'traditional' disease"?

Thank God there are support groups for people with Malaria.

http://www.mdjunction.com/malaria



"Preventable and Treatable," ...that almost sounds like people who don't take adequate precautions "chose" to contract Malaria. Maybe if they don't get treatment they "chose" not to because they are capable of "voluntary motor action."

I think it is problematic to label all forms of "addiction" as "disease".

But frankly, some of the examples certain posters used to ontologically distinguish between "disease" and "not disease" just demonstrates that under certain circumstances the term "disease" might be reasonably applicable to any physiological disorders which are also associated with "Risky Behaviour" patterns.

There are no fast and hard rules that apply to whether or not some dysfunctions are labelled "disease." And if someone brings up an example of a "traditional" disease, it's fair enough to point out the fallacy of making such a dubious distinction.

Perhaps if everyone wore HAZMAT suits to work, school, and shopping, we could end the "Risky Behaviour" patterns that lead to "Traditional Disease" epidemics.

Nope, nothing in this post that implies I said you don't take other factors into consideration. I was just facetiously pointing out the fallacies in your choice of Terms of Definition.

So--by definition--an Impulsive Alcohol Drinker is engaging in involuntary behaviours. Glad to finally get some agreement on that.

Not in this post either...

Believe it or not, some people still associate AIDS with "Risky Behaviour" patterns. And remarkably some people still question whether or not AIDS is a "traditional disease" precisely because of that. Same goes for a lot of Sexually Transmitted diseases.

And believe it or not, certain biological mechanisms exist which cause people to impulsively (involuntarily) drive to a liquor store, buy some Early Times (whatever that is) and then go on a shooting spree.

Or maybe Schizophrenia, Psychotic episodes, and/or Neurological Dysfunctions (caused either by Genetics and/or Brain Damage) that impede Impulse Control should under no circumstances be classified as "diseases."

If you don't like me skewering your analogies with your own words and definitions, maybe you should come up with some new ones.

No statement or implication here that you don't take other factors into consideration. In fact, I was pointing out that you DO take other factors into consideration, only to discount them when the science suggests that these factors can impede, inhibit, or even demolish Volitional Choices and Impulse Control.

Let me refer you back to my post #595 and xjx388's posts.

But just to be absolutely clear (in case some people forget my position) not all "addictions" are equal, or necessarily diseases.

And that Socio-Political/Economic factors DO play a role in how certain conditions are labelled and treated in the Medical Community.

Nope, nothing in this post that says you don't take other factors into consideration.

Slam-Dunk!!!

Not here either.

If you'd stop using definitions that undermine your own arguments, you wouldn't have LOST that round.

Maybe I just re-quote you again.

Nope...

PS: Clearly your arguments DON'T stand on their own merits.

Nada...

Typo: It should have read: Maybe I should just re-quote you again.


Honestly, unless YOUR definition of "Disease" only refers narrowly to Pathogens then you'd have a point (but not a strong one as the Medical Community and the Dictionary Definition disagree with you).

But the definition of "Disease" you've been using seems to have something to do with "involuntary motor control."

As usual, whether you are talking about fat people or drunks, your argument boils down to:

1) It's ALWAYS a Choice (i.e. it's your own damn fault--with all the moral connotations such a statement has), therefore it's not a disease.

2) I'm smarter than all the scientists and medical professionals who disagree with me.

That's it in a nutshell. That's all you've really got.


It just so happens I agree with you insofar as those who DO have the ability to control their impulses can learn to modify their behaviour patterns.

I also happen to agree with you that applying the term "Disease" to those who have a Behavioural problem is a mis-application of the term.


But the fact is you AREN'T a Medical Professional, and you're NOT PSYCHIC, therefore you have no grounds on which to claim "It's ALWAYS a choice."

And given the Neuro-Biological Dysfunctions that can (and DO) limit, or inhibit IMPULSE CONTROL in some people, for all intents and purposes, the definition of "Disease" that includes Physiological Malfunctions IS applicable.

Your paraphrased Statement #1 is an EXTRAORDINARY claim (it's always a choice), therefore the burden is on YOU to provide extraordinary evidence.

So far I am neither impressed by your claimed medical expertise, nor your psychic abilities.

And before you falsely accuse me of "personalizing," you should remind yourself that YOU are the one who has made it all about YOU (your Statement #2 as I paraphrased above).

I made a number of assertions in this post, but none of them can reasonably construed as implying that you don't take other factors into consideration. I just keyed in on the parts of your argument that I find problematic. And I also pointed out some parts of your argument I agree with...which I think is rather fair of me, all things considered.

Another insulting comment touting your expertise.



This study regarding Stress, Alcohol and GABA receptors indicates that researchers were able to determine that some alcohol dependent persons had alcohol craving severity cues that exceeded water cues by at least 50%:



In case some people are wondering what the term "cues" refers to, it relates to laboratory methods of determining the varying strength of "cravings" :

I didn't say or imply in this post that you don't take other factors into consideration.

That's exactly my point.

The thing is UncaYimmy seems to think that habitual behaviour patterns related to "alcoholism" is all about "Choice," not neuro-biological dysfunction (or any number of other factors that might limit or inhibit Impulse Control. But he has yet to present any evidence that actually backs up his confirmation bias.

This is another post that at first glance might seem to accuse you of not taking other factors into consideration, but in reality I am pointing out that you don't think those factors limit or inhibit Impulse Control (i.e. Volition or Choice).

Great, so you won't mind if I tell you that you don't understand what the research says!

Did you even READ what you just wrote?

The only distinction I see between the highlighted statements is that the second highlighted statement says that the cravings of Alcoholics (i.e. alcohol dependent people) will be 50% STRONGER for alcohol than for water.

Then you bluster that "of course that is the expected reaction," after previously telling us that you don't even believe the NIH statement. There's no emoticon strong enough to indicate how ridiculous I think your cognitive dissonance is.

So, an article published at the same NIH site about an NIH study on the same site misrepresented the study and NIH didn't catch it?

Nothing here that states or implies that you don't take other factors into consideration.

Is your distinction between "Disease" and "Disorder" based on the narrow definition of "Disease" as caused by Pathogens?

If OCD is Neurologically (Physiologically) based, then what purpose is served by not acknowledging the broader definition of "Disease" as it relates to any physiological malfunctions?

As to your contention that OCD is a Behavioural Disorder rather than a Physiological Disorder, do you have Proof? Or is this just an assertion based on traditional psychological assumptions, and your confirmation bias misreadings of current research?

Is Tourette Syndrome a Behavioural Disorder or a Physiological Disorder? NIMH studies show these disorders may be related.

So UncaYimmy, more data comes in every day that reveals that "Disorders" previously believed to be Psychological (Behavioural) Disorders are more than likely Physiologically based.

What are you going to do with yourself when you can't tell people that it's their own fault they are drunks or fat anymore?

Here I posted some abstracts, and asked some questions that you never answered. But I didn't state or imply that you don't take other factors into consideration.

I make a habit of re-reading threads I post on to catch things I sometimes miss. This particular link that UncaYimmy posted is particularly interesting, as UY claims it as his source for his "Traditional definition of disease."

I don't quite get it though. UncaYimmy claims that Addiction is a "Behavioural Disorder," a "Choice," not a Disease, in the "traditional sense." Is UY being Ironic, Satirical? Did he hope none of us would actually read the link? I don't know.

But here is what the link leads to:



This is very puzzling.

UncaYimmy, why did you use THIS link to source your "traditional definition of disease"?

Not only does it define Addiction as a Disease, but it makes the same distinction that I make between TRUE "addiction" and substance abuse (and I would also argue "use" in general). In other words, The "Traditional definition of disease" supports my position that not all "addictions" are "diseases," not all substance use and abuse qualify as actual addiction. It doesn't support your contention that ALL "addiction" is Behavioural, but it does recognize that SOME patterns of use/abuse are Behavioural.

In fact Point #4 Directly contradicts the phrase you attached to it:



As you can plainly see, Point #4 of Your "traditional definition of disease" includes PRECISELY the criterion of "buying a bottle of Early Times and drinking shots until you pass out."

I'm really gobsmacked.

It's one thing to misread Research Articles and Abstracts--but THIS????

I would think you were just being deceitful by only posting the first sentence and then posting an argument that directly contradicts the rest of the paragraphs; but you posted the link too, giving us all a chance to read it in its entirety.

Way to TOTALLY botch your argument UncaYimmy!!! D'oh

Kudo's to Bookitty for being the first to catch this.

Here I was pointing out the absurdity of you sourcing this link as your source for THE "Traditional Definition of Disease". But nothing that implies you don't take other factors into consideration.

Why don't you stop wasting our time claiming something is a "Traditional definition of disease" and then pretending that's not what you meant after the fact.

If I hadn't re-read your exchange with Bookitty, I would have been so wrapped up in my own argument with you I would have missed this.

Thankfully, the links I posted fully support the claims in the "Traditional definition of disease" that YOU chose to post.

Same point as the last point.

Which brings us up to the current posts...

But then you turn right around and DISMISS these other factors as merely "influences" when you claim that "addicts" ALWAYS have a choice--due to the fact that they have "Voluntary Motor Control".

I don't dismiss them. I acknowledge them as the influences they are. I never use the word "merely" to describe them. That's your own creation.

Griping about the word "merely" is a semantic Red Herring. You don't dispute my point that you only claim the "other factors" as "influences" on choices (which "addicts" ALWAYS have according to you).

That thread is closed. Please do not bring it up here.

Too late, a number of people including you have discussed the points from the other thread in the context of this thread.

I defined choice already, and I've repeated that definition to you. Interestingly, you ignored it both times.

Conveniently it's YOUR definition....

Tell me the test for volitional control. I say if there person is physically capable and has the awareness of what he's doing, it volitional. What test do you employ to decide it's not? That's what it boils down to. Answer the question.

....and you have defined choice (volitional control) to suit YOUR purposes. You are the one making the claims that ALL "Addicts" ALWAYS have choices by your definition.

What test do YOU employ to decide that ALL "Addicts" ALWAYS have choices?

Answer the question.

GB

 

[littleroundman]

Answer the question.

Good luck with that,

despite repeated requests,

the OP is STILL looking for an answer to his question.

 

[Gandalfs Beard]

http://lesswrong.com/lw/2as/diseased_thinking_dissolving_questions_about/

Dissolve the question. Is doesn't matter. "Disease" is just a word. Labeling alcoholism as a disease or a behavior does not change the reality of the situation or the potential solutions. It's just bickering over semantics.

The link leads to a very interesting blog post that deals with most of the issues raised on this thread.

But it doesn't really claim that semantics don't matter. Quite the opposite actually. In fact it makes the point that how we employ words like "disease" and "choice" matter a great deal in how we treat each other, and to what solutions we employ to deal with our Dysfunctions.


GB

 

[Dancing David]

every single person involved in the "alcohol" related research field is only in it for the money. Not "a few" or "the majority" or "a small amount of" but the whole group.

They have also never been to the budget meeting of a treatment center, most are funded through state grants and are switching to IOP for that reason.