Addiction is a disease

[Dancing David]

Here is one example of the research into laboratory tests for level of alcohol use. There are more tests than these, some more sensitive and specific than others. A medical practitioner can make a pretty good call on this disease with current knowledge. Add the history and blood tests to the fact you have a person with a DUI and an accurate diagnosis is well within the capability of modern medicine.

Comparison of the combined marker GGT-CDT and the conventional laboratory markers of alcohol abuse in heavy drinkers, moderate drinkers and abstainers.

With one caveat:

There are those who will meet these criteria but are not alcoholics, they will not evidence addicted behaviors. A person who binge drinks on a regular basis may not be an alcoholic, especialy if they are in a social enviroment that encourages alcohol binges. I come from a family that has type II alcoholism on both sides. I do not evidence it, I have a low tolerance for alcohol and I don't enjoy more than a small amount. However in college i drank very heavily twice a week, not binging, we drank a lot over eight hours. While I am an addict, I was not addicted to alcohol.

But i am in agreement, one of the main problems with alcohol and perscription drug addiction is the prevalence of them in our society. Add to that the almost legal acceptance of alcohol use and driving, and there isa problem. there are many places in the US where you won't be charges with DUI, even if you do it repeatedly. I am thinking of the county i used to work in, the court system and jail there are so overburdened that most DUIs get to spend the weekend in jail and have charges dropped. In violation of the intent of Illinois statute.

 

[Dancing David]

I disagree. Getting pulled over for a DUI is literally luck of the draw. I have driven 100s of times drunk and have gotten two DUIs. Most people tha get DUIs were just in the wrong place at the wrong time.

I am in an alcohol class weekly per my DUI sentence. In a room of about 25 of us, about 4 or 5 say they are alcoholics, the rest are college students that just shoudn't have driven that night, but admit they don't believe they have alcoholism. Of coarse they could be lying, in denial, or haven't reaped enough consequences in their life as a result of drinking, but for the most part, they don't seem to fit the profile.

Its one of the first questions I ask them "do you think you have a problem with drinking?" and most of them say no. But it isn't like its hard to be honest with everyone in there.

You might be suprised by the level of self deception and outright denial.

There is no profile for alcohol addiction, there are some behaviors which accompany and are the addiction.

One of my better friends is a type II alcoholic, he frequently used to drive after consuming very large amounts of alcohol, most of his friends felt that he probably drank more than he should. (I say that because the label of addiction is one person should make themselves.) He sure showed almost all of the addicted behaviors. Well when he was pulled over there was a long litany of why he wasn't responsible for having drank alcohol and driven.(The big one was that the brathlyzer was broken)
I don't think all people in a DUI class are in that category, but many are. The way to sort those with an abuse problem from a dependance is that class, those who reoffend are likely to be addicted.

 

[Dancing David]

Would you call the long term use of prescription drugs like Lipitor an addiction?
The person taking them originally had a choice to start them or change their symptoms through diet and excercise. Those who chose the drugs often cannot come off them without being given serious consequences from their doctors. It's really a dependence, not addiction, but I think the same principles of free choice versus pressure from society apply.

No, a person taking perscription medication as directed is not going to meet the ctiteria of addicted behavior.

They will not do the following:
-have the substance as thier primary relationship
-spend excessive amounts of time using or recovering from use
-lose relationships and jobs due to thier use


Now it is very possible for addicts to be perscribed a medication they are addicted to. I agree a person taking insulin is dependant upon the medication for health. But that is a different beast than substance dependance.

 

[Dancing David]

In this circumstance, dependency is synonymous with addiction. When people in the medical or psychological field speak of developing chemical dependency, they are just using a less abrasive word for addiction.

I would argue that the two are different for a simple reason;

A debatable point exists, does the substance improve the health of the individual or decrease the health of the individual.

Those using perscriptions are hopefully improving their health ( I know there are many cases they are not). the medication should be improving thier levels of functioning.

In substance dependance or mood altering behaviors the addiction will impair functioning and decrease health.

 

[Dancing David]

Not exactly.

The problem with the word 'addiction' isn't the abrasiveness, it's the difficulty in defining the term, just like you're seeing here. It's easier to define 'abuse' and 'dependence', and both people who are abusing or are dependent can be addicts.

Roughly, abuse is abnormal use of the substance even though it interferes with social, occupational or physical functioning. Dependence is that plus tolerance, withdrawal symptoms or a pattern of compulsive use.

I agree, an addict will not always voice the desire to quit. However those with an abuse problem will generaly control thier use after the first serious consequence to thier use, so I would argure that abusers are usualy not addicts. Abusers will have the same criterai as those who are dependant but they usualy get the use under control when they loose a job or relationship due to use.

 

[Dancing David]

ok I guess I got ignored. I tried to find evidence of psychologists deeming addiction a disease, rather than a disorder, and found none. I think the whole AA mantra of addiction being a disease is silly and untrue, but I think psychology is getting a bunch of flack here without a good reason. "disorder" is a very good term for it I think, and as for criminals, a good way to describe them is 'disordered'. Besides biological things that they cant control that contributes to criminal behavior (like schizophrenia) criminality isnt a hopeless, escapeless lifestyle. It can be changed, its certainly not easy to unlearn what you are used to, so disorder sounds just about right considering that.

I dont think its fair to compare schizophrenia to alcoholism either. schizophrenia has biological, observable causes that CANNOT BE CONTROLLED BY THE SUFFERER. Addiction is a series of actions, of choices, that people make. People with diseases cant simply stop having them, they may be able to better their condition with good choices. But I cant see how an action itself can be a disease.

I agree, alcoholism and addiction are not a diaease, they are behaviors which can have a biological vulnerability and a biological basis.

Many have stated the same as you.

 

[Dancing David]

Wow, I have seen this before. I had a boyfriend with this. I had no idea it might be a syndrome but it certainly makes sense. He was an alcoholic. He would be fine one minute, then seconds later totally snap into something like the following.

The relationship didn't last long. A couple experiences like this and it was time to go.



alcoholic jealousy (F10.5)

That is actualy one of the hallmarks of a domestic violence perpetrator, although the alcohol is not required.

It is one of the control and power features.

 

[Dancing David]

I see this already been debated while I've been away. As stated before psychology does not define alcoholism as a disease it is a substance related disorder. For those who know so much about psychology it would be wise to actually pick up a psychology textbook before writing out your opinions.

I see no point to this discussion, addiction is not defined as a disease by the American psychological association and psychology in general. I will provide sources if anyone cares to dispute this.

The disease model is rather prevalent in the practice of peer counselors in the substance abuse field.

 

[ponderingturtle]

I was replying to:So the point of your reply loses me. Defining alcoholism is not as difficult an issue as you suggest. It's a matter of sorting out the people who got drunk at a college party and drove drunk from the people who drink on a regular basis and have an addiction, even one not fully developed. There is no sense sending the idiot who didn't realize boilermakers could have such a rapid affect to inpatient treatment for alcoholism.

Give me a medical history and two tubes of blood and I can tell you if you have an alcohol problem and to what degree you have it. And that makes for nice objective criteria to base a diagnosis on.

And you would likely exclude people who others concider alcoholics.

What actualy is your definition of alcoholic? It seems like drinks often enough to have certain changes, well what kind of behavior is that, and is that something that is recognised by most people who use the term.

 

[ponderingturtle]

Here is one example of the research into laboratory tests for level of alcohol use. There are more tests than these, some more sensitive and specific than others. A medical practitioner can make a pretty good call on this disease with current knowledge. Add the history and blood tests to the fact you have a person with a DUI and an accurate diagnosis is well within the capability of modern medicine.

Comparison of the combined marker GGT-CDT and the conventional laboratory markers of alcohol abuse in heavy drinkers, moderate drinkers and abstainers.

I can accept that everyone who gets those results is an alcoholic, but do all alcoholics have those test results?

Alcoholic is not a much better universaly defined term than disease. All it means is that X individual has some problems with alcohol.

 

[chris epic]

I

I see no point to this discussion, addiction is not defined as a disease by the American psychological association and psychology in general. I will provide sources if anyone cares to dispute this.

Unfortuntely, that statement has as much weight in here as anybody's mundane personal opinion, because its not the APA that is defining the terms on national television; it's celebs and what-not, and unfortunately in this country, celebs have way more pull on society than american tute-my-horn associations. The majority of the television audience is going to listen to Bill O'Reily, Oprah, and coked up Ms USA winners before they will ever listen to anyone with legitimate objectivity and credentials. And besides, there will always be more than one definition to a word, no matter how many or how few there are of a word in the dictionary: that's just a result of time and connation.

 

[Skeptic Ginger]

With one caveat:

There are those who will meet these criteria but are not alcoholics, they will not evidence addicted behaviors. A person who binge drinks on a regular basis may not be an alcoholic, especialy if they are in a social enviroment that encourages alcohol binges.....

I said including a health history and these were only a couple of the tests one would order.

I have a different clinical opinion of a binge drinker whose labs show the effect of alcohol consumption, they have a problem. The drinking pattern differs but the damaging effects of alcohol from DUIs to divorce are still there.

There are binge drinkers who stop at some point and no disease progression occurs. But the binge drinkers who are as excessive as you describe are more likely to continue a lifetime of drinking.

 

[Skeptic Ginger]

I can accept that everyone who gets those results is an alcoholic, but do all alcoholics have those test results?

Alcoholic is not a much better universaly defined term than disease. All it means is that X individual has some problems with alcohol.

You have it backward, the tests are very sensitive meaning heavy alcohol use will always give you the results, but the tests can be a little less specific in that some positive results will be from other causes.

Heavy alcohol use damages the liver pretty universally. The effects on blood cells is related to alcohol's effect on absorption of nutrients and is later to show up.

Quit though and the liver can recover as long as it hasn't gotten to the cirrhosis stage.

 

[Skeptic Ginger]

And you would likely exclude people who others concider alcoholics.

What actualy is your definition of alcoholic? It seems like drinks often enough to have certain changes, well what kind of behavior is that, and is that something that is recognised by most people who use the term.

There are certain markers of alcoholism. I don't have time to list them all.

Features are increased tolerance (because physical changes take place in the liver), obviously some degree of dependence, and interference with one's life such as with relationships and DUIs. The early alcoholic will be harder to diagnose.

This idea of the binge drinker not having a problem is false. But not every binge drinker has a problem, especially the young person who just follows peer groups. But the problem binge drinker will still have indicators of alcoholism beyond the not-problem binge drinker. Tolerance is an early feature, for example.

 

[Dancing David]

And you would likely exclude people who others concider alcoholics.

What actualy is your definition of alcoholic? It seems like drinks often enough to have certain changes, well what kind of behavior is that, and is that something that is recognised by most people who use the term.

These are the questions I used (sort of a scale)

1. Has anyone ever told you that they think you have a problem?
2. Do you have family memebers with an alcohol problem?
3. Patterns (historic) of use, when did you start, how much, when did you start drinking regularly and how much?
4. What are your current patterns of use?
5. How often do you drink a lot more than you intend?
6. Do you drink shortly after waking?
7. Do you drink before work or school?
8. Do you feel you need to drink to socialize or be in social situations?
9. Do you drink to fix a hangover?
10. Have you ever had a balckout or grey out?
11. Have you lost relationships due to drinking?
12. Have you ever had a DUI?
13. Have you lost a job from drinking?
14. Have you lost housing from drinking?
15. What was your tolerance for alcohol when you started, how much can you drink to feel a slight effect, a moderate effect, a strong effect?
16. How much food do you eat in comparison to alcohol?
17. What things have happened because of your use?
18. When was the last time you were sober and for how long?
19. Have you tried to quit in the past?

These are the bald questions, there is a fine art to assesment, you have to start with the easy questions beforre you ask the serious ones, you have to establish rapport with the person and help them not feel threatened, often you have to listen to other clues to get the answers.

But the big ones are
-increased tolerance
-blackouts
-loss of relationships, jobs or housing
-family history (with the others)
-daily heavy use or frequent binging
-sustained negative consequences due to use

 

[Dancing David]

I said including a health history and these were only a couple of the tests one would order.

I have a different clinical opinion of a binge drinker whose labs show the effect of alcohol consumption, they have a problem. The drinking pattern differs but the damaging effects of alcohol from DUIs to divorce are still there.

There are binge drinkers who stop at some point and no disease progression occurs. But the binge drinkers who are as excessive as you describe are more likely to continue a lifetime of drinking.

I agree, I have a number of friends who are heavy regular drinkers, and I think they drink to excess on a regular basis (like once a month or more). They seem to maintain thier lives and can leave the alcohol alone for extended periods. I just wonder what thier blood levels would show during a time of heavy use. There are cycles where they will drink heavily and excessively for a while (like a month or two) and then times where they drink lightly or not at all. I have also had frinds who drank really strong G&T's on a daily basis, with more on the weeknd. Two double or tripple jiggers during they week and more on the weeknd. I could barely drink one.

These people all had very healthy lives.

But i agree with you, elevated liver enzymes will tell you alot, as will thier liver function panel. Probably thier kidney panel as well.

 

[Simone]

Everyone is different in ways that our bodies process alcohol. I'm sure there can be studies of groups of people and the comparisons would be similiar, but how accurate can they really be?

I have a friend that can drink 2 bottles of wine, she hardly eats, never gets a hangover, yes, alcoholism is in her family and she is fine the next day. She has an unrelated liver disease that is hereditary, that if not discovered early enough, the person can die and the diagnosis is often misdiagnosed as liver disease or cirrhosis of the liver. I, on the other hand, also have alcoholism in my family, have had an excess of alcohol at different times, which really isn't alot to some people, usually will be physically ill for 2 days. But I have been told that even tho I didn't appear intoxicated and I functioned pretty normal as one would say, my friend would be clearly drunk and would be staggering.

Another example, I was in a class where individuals drank and were given field sobriety tests. After the tests were given, the individuals were given blood alcohol tests, where they blow into the machine to see what their levels were. The one female, who appeared to be intoxicated the most, who failed her field testing, ( standing on one foot, etc) did poorly on all accounts. Her alcohol level was not legal, but was one of the lowest. The male, who appeared to be the least drunk, passed the field tests, except the eye test that one has no control over. His blood alcohol was 3 times the others. Does this mean he is the seasoned alcoholic? Or just his body processed alcohol differently? Is he a functioning alcoholic?

I know this is a bit off on the "is addiction a disease" track, but with alcoholism, with studies and tests, how can they really determine this unless every single human being is tested?
Addictions come in all forms, and no, it shouldn't be defined as a disease, can you say a sex addict has a disease? Sure, if they had alot of unprotected sex, they get the disease. Alcoholism can create liver disease and so forth, but it alone, no, its not a disease.
I think I am done now.

 

[ponderingturtle]

But the big ones are
-increased tolerance
-blackouts
-loss of relationships, jobs or housing
-family history (with the others)
-daily heavy use or frequent binging
-sustained negative consequences due to use

So you are not an alcoholic if you say have regular binge drinking with out these issues?

 

[athon]

I agree, alcoholism and addiction are not a diaease, they are behaviors which can have a biological vulnerability and a biological basis.

Many have stated the same as you.

*sigh*

I'm going to state this one last time, as the argument is either more convenient when my points are ignored, or people are just plain ignorant.

Give a strict definition for disease, then make your point on whether alcoholism or drug addiction can be described that way.

All well and good to not like the idea, or prefer your own set of definitions that you make up as you go along, but unfortunately language doesn't work that way.

Athon

 

[Skeptic Ginger]

So you are not an alcoholic if you say have regular binge drinking with out these issues?

You will have increased tolerance if you are a regular binge drinker. It is a physical change in the liver.

Studies do show people who develop tolerance more quickly, have a higher rate of subsequent alcoholism.

Regarding the managing one's life without negative consequences, lots of alcoholics manage to keep a low profile. But alcoholism is a disease which a threshold is crossed from whatever level of drinking, to dependence. That person who came home from work every night and sits in a chair drinking a fifth but who has no other serious problems with work or family at some point still crosses a threshold where they would not be happy if that fifth was not available. At some point they would also have significant withdrawal symptoms if they couldn't drink by say 5 pm.

You really have to look at the whole picture and you also have to realize there is a continuum of disease aspects which may or may not all be present.