Is alcoholism a disease or something else?

[Zelenius]

Disease or not, we can all agree that alcoholism is a serious problem. The idea that alcoholism is a disease was largely popularized by Alcoholics Anonymous, to my understanding. Many doctors and alcohol/drug addiction specialists agree that alcoholism is a disease.

However, not everyone agrees with this idea. Some critics of the alcoholism is a disease concept will claim it only makes alcoholics more helpless and dependent on AA or mostly worthless treatments that use the disease model as their starting point(sadly, most alcoholics never recover, no matter what approach they use). Obviously, how you view alcoholism, if you see it as a disease or not else can influence your approach to recovery. No doubt alcoholism is at least a "condition" that can have serious medical consequences. It is important to know if it is really a disease or not, since seeing it as a disease may have some influence on a person's recovery. Based on the statistics provided by another thread on this subject, it appears AA has a 5% success rate. This is corroborated by evidence from other websites. Is this because they use the disease model or something else?

For the record, I am not an alcoholic and almost never consume alcohol. For some reason I just don't find it enjoyable and I don't like the taste. Needless to say, this is one of the reasons I find alcoholism so perplexing. Alcoholism doesn't run in my family.

Like most people, I've had alcoholic friends and acquaintances, and one of them died recently, sadly. He wasn't a close friend, but this is one of the reasons I started this thread, to know why he drank himself to death.

As a non-expert, I tend to learn more toward alcoholism not being a disease, but being a "condition". I admit I could be wrong, since I am not an expert on the subject, haven't studied it all that thoroughly and have never had to live with an alcoholic. I'm aware that alcoholism runs in families and some "alcoholism genes" have been identified by science, but not everyone with these genes becomes an alcoholic, and some people without the genes are alcoholics.

Now, it seems to me(as well as some alcoholism experts) what we call "alcoholism" is really a form of self-medication; it seems most, if not all, alcoholics suffer from depression or have anxiety issues or psychological problems, based on my readings and experience. Alcohol is their way of coping. If alcohol weren't available, they might use other drugs or maybe none at all.

I could be wrong about this, as I said I am not an expert. I am not here to be judgmental of alcoholics or to condemn them. I'm not necessarily "better" than alcoholics just because I don't have a problem with alcohol.

 

[drkitten]

Disease or not, we can all agree that alcoholism is a serious problem. [...] As a non-expert, I tend to learn more toward alcoholism not being a disease, but being a "condition".

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

I'm aware that alcoholism runs in families and some "alcoholism genes" have been identified by science, but not everyone with these genes becomes an alcoholic, and some people without the genes are alcoholics.

Well, that's also true for schizophrenics. For that matter, it's also true for phenylketonuria (PKU). So what? Everyone agrees that these are diseases.

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

 

[Dancing David]

Alcoholism is a set of behaviors (substance dependence) concerning alcohol, it is a disease as it may be a focus of medical treatment, it is not a disease in the sense that other things are diseases. It is a behavioral disorder, some people do have a biological predisposition to dependence upon alcohol

 

[Weak Kitten]

I always thought that alcoholism was a genetic proclivity with a high probability of being carried by any children of said alcoholic.

I had several children of alcoholics as teachers in my high school. They were extremely competent, together and above all sober people. One of them had a sibling who had tried simply being a social drinker and had unintentionally collapsed into alcoholism. She never touched a drop out of fear of following her sibling's fall.

 

[drkitten]

Alcoholism is a set of behaviors (substance dependence) concerning alcohol, it is a disease as it may be a focus of medical treatment, it is not a disease in the sense that other things are diseases. It is a behavioral disorder, some people do have a biological predisposition to dependence upon alcohol

Still not seeing what the distinction you're trying to make is.

When the medics say "alcoholism is a disease," they're comparing it with the "alcoholism is a moral failing" camp that was the dominant motif for oh-so-many centuries. Preachers would talk from the pulpit about the sin of drunkenness and then invite everyone up to the rails for communion, because "everyone knew" that the only reason someone would drink to excess was because they were reprobates and a stern talking-to would let them see the light and become social drinkers like everyone else.

No, alcoholism is not a moral failing; it's like a disease in that it's a biological condition that's largely beyond the control of the alcoholic.

If you want to suggest that it's not a disease and not a moral failing, what is it -- and why is your proposed difference relevant?

 

[Zelenius]

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



Well, that's also true for schizophrenics. For that matter, it's also true for phenylketonuria (PKU). So what? Everyone agrees that these are diseases.

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

If it is a disease that implies it is more biological, that there isn't anything outside of some future medical intervention that can "cure" it. The disease model of alcoholism seems to explicitly or implicitly downplay the social factors that may be playing a role. In my experience, it has often been the most hopeless of alcoholics who exclaim it's a disease, while the ones who have been sober for a long time see it as more of a "choice" or something that can be overcome by learning to live without alcohol.


This seems to mirror my thinking on the subject pretty well. And no, I do not consider alcoholism to be a "moral failing" either. Most if not all alcoholics may in fact have a disease, but it isn't alcoholism. This disease may be bipolar disorder or an anxiety disorder and they are self-medicating with alcohol. The alcohol may in fact worsen the disease they have, leading to a vicious cycle which is nearly impossible to escape from.

In my opinion.

 

[zerospeaks]

Well, like my fellow Atheist Christopher Hitchens, I have always thought alcoholism is good fun. Though it can be a chain at times....

No it is not a disease. It is the dependence on a substance which you WILLINGLY DECIDE to put in your body.

If someone came down with an addiction to alcohol without drinking alcohol, I would call that a disease/disorder.

 

[Weak Kitten]

I have dyslexia. With hard work and effort, and the careful use of spell checking software, I can cope at normal levels. Does that mean dyslexia is a choice?

It is important to have people understand that these are things that the person has no control over. If alcoholism is viewed as a disease then people are less likely to try to pressure some poor alcoholism prone individual into social drinking. These days you can just say something like, "My dad was an alcoholic." and people will back off. It wasn't always like that and the social change came because medicine put alcoholism into terms average people could understand.

 

[Emet]

I found what I thought was an interesting commentary:

Managing alcoholism as a disease
By Thomas R. Hobbs, Ph.D., M.D

The debate on whether alcoholism is a disease or a personal conduct problem has continued for over 200 years. In the United States, Benjamin Rush, MD, has been credited with first identifying alcoholism as a "disease" in 1784. He asserted that alcohol was the causal agent, loss of control over drinking behavior being the characteristic symptom, and total abstinence the only effective cure. His belief in this concept was so strong that he spearheaded a public education campaign in the United States to reduce public drunkenness.

<snip>

Alcoholism should not be judged as a problem of willpower, misconduct, or any other unscientific diagnosis. The problem must be accepted for what it is—a biopsychosocial disease with a strong genetic influence, obvious signs and symptoms, a natural progression and a fatal outcome if not treated.

http://www.physiciansnews.com/commentary/298wp.html

 

[Vortigern99]

Well, like my fellow Atheist Christopher Hitchens, I have always thought alcoholism is good fun. Though it can be a chain at times....

It's good fun until it kills you and/or destroys your health by giving you liver disease, or a host of other ailments which are diseases.

No it is not a disease. It is the dependence on a substance which you WILLINGLY DECIDE to put in your body.

Once you begin to "willingly decide to put into your body" a substance which you know and understand is killing you, the condition becomes something more than mere "dependence on a substance". Call it a behavioral or mental disorder if you like, it is a disease of the mind.

If someone came down with an addiction to alcohol without drinking alcohol, I would call that a disease/disorder.

That makes no sense to me, perhaps you can clarify.

 

[zerospeaks]

Alcoholism should not be judged as a problem of willpower, misconduct, or any other unscientific diagnosis. The problem must be accepted for what it is—a biopsychosocial disease with a strong genetic influence, obvious signs and symptoms, a natural progression and a fatal outcome if not treated.

*Cough BULLCRAP *Cough

Once again, as an alcoholic, I willingly choose to put alcohol in my body.
In fact, this thread has made me want a cold one, I was gonna wait till 7 but nevermind.

Sure, I may have a genetic predisposition to enjoying, wanting, craving, depending on alcohol, but I can stop whenever I want by NOT DRINKING.
Which I don't want to do right now.

-SPECIAL NOTE-
I smoked for ten years. When I finally wanted to stop I stopped. Cold Turkey, my willpower was stronger then the cravings because I DECIDED TO NOT PUT NICOTINE IN MY BODY ANYMORE.
Alcohol will be the same, or I will burn up my liver, esophagus, or something else before I decide to quit.

-Addendum-

My brother is an alcoholic and he has let it completely destroy his life, he lives at a homeless shelter now and would rather be drunk then anything. He does not want help, he wants to drink.
What is the difference between him and I? I choose to not drink during the day and to go to work sober. I do not allow the alcohol to interfere with my life in that way.

 

[zerospeaks]

That makes no sense to me, perhaps you can clarify.

Dependence on alcohol [Withdrawal symptoms] can be measured by the receptors (I forgot which ones) that become desensitized or whatever you want to call it, overtime because you flood it with alcohol which binds to them so much that your brain reduces manufacturing of the natural chemical that normally would bond to them.

Let's say someone had a condition where you brain starts to reduce that chemical without the introduction of an outside chemical....Your brain would have a disease, a disorder.

 

[zerospeaks]

I apologize for my many typos today, I am tired from battling creationists on FB.

 

[MikeSun5]

In my experience, it has often been the most hopeless of alcoholics who exclaim it's a disease, while the ones who have been sober for a long time see it as more of a "choice" or something that can be overcome by learning to live without alcohol.

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

I have dyslexia.

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

It is important to have people understand that these are things that the person has no control over.

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

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

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

 

[Weak Kitten]

I brought up dyslexia because I have run into people throughout my life who flat out told me that I was being lazy. That it was just me wanting extra time on written exams or access to a computer to answer essay questions.

It just feels wrong to blow off an entire group with something that feels like the same excuse. I may be wrong but I want to give alcoholics the benefit of doubt.

 

[zerospeaks]

"I brought up dyslexia because I have run into people throughout my life who flat out told me that I was being lazy. That it was just me wanting extra time on written exams or access to a computer to answer essay questions."

and I had a teacher try to tell me it was wrong to write with my left hand and she would not accept my work if it was written with my left hand.
What's your point?

 

[lionking]

Whether it's a disease or a condition, some people are more prone to drink to damaging excess tham others. I can't drink "moderately" or "socially", I either drink too much or not at all. At the moment I am not drinking and haven't for nearly two months. I know I'm fitter and healthier, but am almost certain that I will drink again, probably in the weeks before Christmas (and then give up again in the new year).

 

[FattyCatty]

<snip>
No, alcoholism is not a moral failing; it's like a disease in that it's a biological condition that's largely beyond the control of the alcoholic.

If you want to suggest that it's not a disease and not a moral failing, what is it -- and why is your proposed difference relevant?

I agree with this, but I would say it is a disease, not it's like a disease.

If it is a disease that implies it is more biological, that there isn't anything outside of some future medical intervention that can "cure" it. <snip>

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

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

There are some who disagree, including a couple who also reject any mental illnesses as diseases. I don't agree.

<snip>
No it is not a disease. It is the dependence on a substance which you WILLINGLY DECIDE to put in your body.

If someone came down with an addiction to alcohol without drinking alcohol, I would call that a disease/disorder.

How do you know ahead of time that you will be one of the people who "came down with an addicition to alcohol" when it doesn't happen until you drank? Are you saying that nobody should ever drink?

I have dyslexia. With hard work and effort, and the careful use of spell checking software, I can cope at normal levels. Does that mean dyslexia is a choice?

It is important to have people understand that these are things that the person has no control over. If alcoholism is viewed as a disease then people are less likely to try to pressure some poor alcoholism prone individual into social drinking. These days you can just say something like, "My dad was an alcoholic." and people will back off. It wasn't always like that and the social change came because medicine put alcoholism into terms average people could understand.

I agree, some things you have no choice about. You are talking about management because there is no cure for the condition you have.

 

[zerospeaks]

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

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

 

[lionking]

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

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

Whether it's technically a disease or not, I do believe that some people use this argument as a copout.