Is alcoholism a disease or something else?

xjx388 said:
SG: 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).

This is true of any condition of the human body that responds to changes in behavior: Atherosclerosis, Diabetes, Obesity, Addiction, etc. And how easy or difficult it is for a person to change the "offending" behavior determines how much outside intervention (from helpful tips and education to medical treatment and psychological therapy, etc) is necessary.

That's all I'm really saying.
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Oooh! This next scene should be good. I can't wait for SG's response to such a reasonable point.

:popcorn1

GB
 
Gandalfs Beard said:
Oooh! This next scene should be good. I can't wait for SG's response to such a reasonable point.
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I've read the entire thread now. Dancing David, Skeptical Greg and MikeSun5 have all made similar points. DD has written the equivalent of the above several times. 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. If the person is powerless, then no treatment will work except perhaps a paralytic.

I think this link posted by MikeSun5 many, many pages ago is excellent.

http://www.ncbi.nlm.nih.gov/pubmed/1545723
OBJECTIVE: To expound the argument that alcoholism (or "problem drinking") is not best regarded as a disease.

SUMMARY: Excessive drinking can cause physical disease and involve physical dependence without therefore being a disease itself. The "disease concept" of alcoholism is not needed to justify medical intervention or a caring approach to those who are dependent on alcohol. There is a specific and a general version of the disease concept of alcoholism. The specific disease concept, associated mainly with the Fellowship of Alcoholics Anonymous, is contradicted by empirical evidence and unhelpful for preventive and treatment responses to problem drinking, especially for the effort to detect and modify problem drinking at an early stage. The more general disease concept shares these disadvantages and is also ineffective in engendering sympathetic attitudes towards problem drinkers among the general public. It is more useful to view problem drinking as the result of the interaction between the individual's personality and the social context in which he or she has learned how to drink.

CONCLUSION: For an effective and compassionate societal response to problem drinking, the disease model of alcoholism should be replaced by a social learning perspective.
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Telling people that they have a "disease" and that they are "powerless" is not helpful.
 
Skeptical Greg said:
I posted this in a " Quit Smoking " thread ..




A similar list of choices could be made for any addictive behavior, and the list could be expanded in many situations.

Of course, the degree of difficulty in the execution of those choices will vary with the choice and the individual; but it's clear that few human beings, if any, are totally powerless when it comes to addictive behavior.
As the simple example above shows, we usually have to go to a lot of trouble to satisfy our cravings....
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Well that the point of relapse prevention planning, but 'on the way to the liquor store' is usually a little late to change the choices, until the individual has had a lot of practice.

But essentially that is the point of relapse prevention planning, make choices long before the bottle is in your hand.
 
xjx388 said:
SG: 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).

This is true of any condition of the human body that responds to changes in behavior: Atherosclerosis, Diabetes, Obesity, Addiction, etc. And how easy or difficult it is for a person to change the "offending" behavior determines how much outside intervention (from helpful tips and education to medical treatment and psychological therapy, etc) is necessary.

That's all I'm really saying.
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I think the ability to make choices is multivariate, conditioning plays a part, so does cognitive impairment and distorted thinking, much less deluisons.

There are many motivators to choices as well, panic attacks are a great motivator. In my experience it is usually something along of the lines of discomfort that drives the addiction, but I have known many a person far down teh path to make a stop and stick with it.

Part of replapse prevention planning involves life skills and activities to encourage health.
 
UncaYimmy said:
Telling people that they have a "disease" and that they are "powerless" is not helpful.
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There are big bucks to be made in Addiction Treatment Centers. You should open one with all that expertise you bring to the table. :rolleyes:
 
AlBell said:
There are big bucks to be made in Addiction Treatment Centers. You should open one with all that expertise you bring to the table. :rolleyes:
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Ah, yes. AA tells you that you must admit you are powerless over alcohol and ask Sky Daddy to take over. Is that evidence of Sky Daddy?

We can test for this power. Take 300 people currently abusing alcohol. Individually present them with shot glasses labeled vodka and water. Control for sensory cues (smell, for example). Leave them alone with a TV or something for a few hours. See which, if any, shot glass they drink from.

The kicker? Randomly assign which glass contains what such that sometimes it's only water in both, only vodka in both, labeled improperly or labeled properly. If they are "powerless" over alcohol, we should detect it, no? The alcohol should draw them with it's magical powers. Maybe we can even use it to detect genetic predispositions!

Maybe we can try the same experiment with AA people. Sky Daddy should help them pick the right shot glass, yeh? For ethical reasons we'd need to come up with a way to prevent the vodka from being consumed accidentally, but otherwise, wouldn't that be strong evidence that Sky Daddy is at work?
 
UncaYimmy, it seems like your knowledge of psychology and addiction is sadly lacking.


Great example of why I dislike the concept of Free Will though. There are people that love to use it as an excuse to not address serious problems. "Addiction? It's a choice, so there's no reason why society should do anything about it!" Lame.
 
Drachasor said:
UncaYimmy, it seems like your knowledge of psychology and addiction is sadly lacking.


Great example of why I dislike the concept of Free Will though. There are people that love to use it as an excuse to not address serious problems. "Addiction? It's a choice, so there's no reason why society should do anything about it!" Lame.
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Yeah,

one wonders why so many otherwise intelligent, ethical and dedicated people would spend so much time, money and effort researching and treating a problem which can be so easily rectified.

WAIT !!!!

I KNOW !!!!!

They're all in it for the money, OF COURSE, how could I be so naive.

Just think,

all that wasted time, effort, money and dedication, all that human misery, and here we have the answer right in front of our faces.

Billions of people involved and each and every one of them exactly the same.

All those different "addictions" with a singular "cure"

AMAZING !!!!!
 
Drachasor said:
UncaYimmy, it seems like your knowledge of psychology and addiction is sadly lacking.
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I'm sure it that it seems that way to you. You're wrong, though.

Great example of why I dislike the concept of Free Will though. There are people that love to use it as an excuse to not address serious problems. "Addiction? It's a choice, so there's no reason why society should do anything about it!" Lame.
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Your like or dislike of a concept is irrelevant. That some people choose to use it as a reason not to help people is an emotional one. Unfortunately for you, free will is a central concept in treatment. Otherwise, why bother with anything other than Pavlovian treatments?
 
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@Drachasor:

It's not like I've invented these concepts and no experts agree, your hand waving not withstanding. Here's an article from Psychology Today written by a clinician:

http://www.psychologytoday.com/blog...self-responsibility-and-the-importance-choice
One of the central facets of addiction is the unwillingness to take responsibility. Without exercising the all-important watershed of self-responsibility, breaking the compulsive cycle that leads to addictive behavior is all but impossible. Systems like AA or the Minnesota Model, which allow the abdication of self-responsibility to The Program, The Meeting, The Sponsor and even God, are, from this perspective, clearly suspect and, as the numbers bear out, considerably -- and understatedly -- less than successful.

In this moment, the heads of 12 Step proponents are exploding, for I have blasphemed. Before you do explode, however, consider that, if you have maintained some semblance of sobriety for any extended period coincident to participating in a 12 Step-type program, you constitute less than 5% of all those who entered into that program within the 12 month period of your initial participation, and 95% of your brethren left that program sometime in those same 12 months. Given that the Harvard Medical School reports spontaneous remission of alcoholic behavior at 50%, rethinking the Holy Grail of AA and its sister systems, with their historically less than 5% success rate, might be worthwhile.

<snip>

In all the years that I have personally lived and worked with addicts, whether as a friend, a professional, an educator or a spiritual teacher, I have not once witnessed someone come to their sobriety -- or at the very least some semblance of that sobriety -- without first saying, "I just don't want to be that person any more." Granted, this observation is anecdotal, but it speaks to the very essence of choice; choice driven by a willingness to change, which, in turn, drives interior transformation and, ultimately, the reclamation of personal power.
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Maybe it's just a warped sense of humour at work, but, given the size, scale and diversity of the threads' subject matter, the absolute absurdity of the "one or two sizes fits all" and "the solution is simply a matter of........" schools of thought is keeping me in absolute stitches.

And that was BEFORE the subject was expanded to include "addictions" and "smoking"

This has become one of the most effective (and funniest) ways of exposing the difference between "critical thinking" and barely disguised bigotry I can remember seeing.
 
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Drachasor said:
UncaYimmy, it seems like your knowledge of psychology and addiction is sadly lacking.


Great example of why I dislike the concept of Free Will though. There are people that love to use it as an excuse to not address serious problems. "Addiction? It's a choice, so there's no reason why society should do anything about it!" Lame.
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Some of us believe in the concept of choice and treatment, at the same time. :)
 
littleroundman said:
Maybe it's just a warped sense of humour at work, but, given the size, scale and diversity of the threads' subject matter, the absolute absurdity of the "one or two sizes fits all" and "the solution is simply a matter of........" schools of thought is keeping me in absolute stitches.
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I do believe you are amusing yourself since those claims seem little more than your own invention. I searched the thread for the word solution. Besides your claim above, only Dancing David used that word.

Dancing David
That [The only coping mechanism we know right now is for people with that disease to not drink at all.] is the only way to break and dependancy cycle. For an abuse problem it may not be the long term solution, but it is always the start for a while.
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Dancing David, like many others, has stated that it's a set of behaviors influenced by physiological and psychological factors (including genetic predisposition). He, like many others, stated it simply when he wrote, "People who are addicts need to choose not to use, which takes, [sic] effort, practice and support." (emphasis added)

I really have no idea where you are getting this one size fits all and simple solution stuff.

This has become one of the most effective (and funniest) ways of exposing the difference between "critical thinking" and barely disguised bigotry I can remember seeing.
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If you think that saying that addicts need to choose not to use and that identifying the factors that influence them and then teaching them how and helping them to cope after they have made the choice to seek such assistance is bigotry, then a bigot I am.

What I personally find amusing is the number of straw man arguments and projections. It seems that when somebody says it's a choice, they must be saying that addicts are bad people not deserving of assistance. There's no doubt that some people believe that, but lots of people, myself included, have been accused of saying as much without actually saying it. When they deny it, the accuser remains undaunted. Here's a tip: I have no problems speaking my mind. If I wanted to condemn addicts, I would have no qualms about stating it clearly and forcefully.
 
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Oh, so you're a cyclist then Yimmy.

I never would have guessed.


Practice your backpedaling often, then ?????
 
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littleroundman said:
Oh, so you're a cyclist then Yimmy.

I never would have guessed.


Practice your backpedaling often, then ?????
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Quote any post of mine in this thread you believe contradicts the post in which you believe I am backpedaling. Click Search This Thread (upper right corner of post area), select Advanced, and type UncaYimmy in the User Name field to find my posts. Anything less is just bluster.
 
The answer to the OP question is and has always been "Alcoholism is both a disease AND many, many "something elses"
 
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