Is alcoholism a disease or something else?

[xjx388]

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

I am saying choice is biology. I think I made that pretty clear when I said:

...everything we think and feel and do is the complex interplay of our neurons and neurotransmitters. So, every choice we make is the result of chemicals reacting in our brains (to put it simply).

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

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

Because you asked this question:

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?

And the answer is they don't. Sheesh, why ask a question that you don't want an answer to?

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

This is just silly. The article you quoted was talking about noncompliance and legal liability. It doesn't call noncompliance a disease and neither did I. And it didn't demonstrate anything about choices, nor was it trying to. Stop trying to twist the article to suit your agenda. Maybe you should instead focus on finding a study or two showing how a person's choices are somehow separate from the biological structure that created them . . .

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

OK, first of all . . . ewww! Secondly, when you say "I use my biology to make that decision," is the "I" separate and apart from the biology?

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

Well, there are over 800,000 hits for "biology," so I guess I win! A better thing to look for on PubMed, and certainly more germane to this thread, is "Executive Function Alcoholism." Executive function is what most of us think of when we think about the ability to "make a choice." This study shows that:

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.

Hmmmm. . .

Or this one (I apologize for the length, but it's a pretty good summary of how brain chemistry leads to alcoholism):

The fundamental problem in addiction is the destructive nature of the substance abuse and the inability to stop. The frontal regions of brain control behaviors including planning and organization, motivation for goal directed activity, weighing consequences of future actions and impulse inhibition, known collectively as executive functions. The PFC projects to ACC and OFC, with all 3 projecting to the VS, a dopamine rich area important for expression of behaviors. Frontal cortical damage occurs with binge drinking intoxication. Dysfunction in specific regions of brain contributes to an imbalance between craving-limbic drive and frontal cortical attention and executive functions, particularly reflection and inhibitory control. PFC, ACC and OFC all contribute to executive functions and inhibition of impulses. Impulsive behaviors result from impaired executive functions since they include actions that are poorly conceived, prematurely expressed, unduly risky or inappropriate to the situation, which often result in undesirable consequences. Thus, addiction is likely due in part to increased impulsiveness from the loss of frontal cortical inhibition of impulses and increased limbic drive.
The discovery of a key role of the frontal cortex in addiction provides new approaches to therapy. Adolescent age and genetics are clear risk factors for neurodegeneration that could inform strategies to reduce drinking in high-risk populations and thereby prevent the progressive neurodegeneration and impulsive-addictive changes. Further, existing therapies for addiction involve frontal cortical activation. Naltrexone, a pharmacotherapy for alcoholism, increases OFC activity. 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. In any case, there is substantial evidence that addiction is related to loss of frontal lobe function and increased impulsivity.

Wow. So alcoholism is biology.

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

Yup, their brains are really messed up aren't they?

Unless, of course, you are arguing that we have no choices about occupation.

Do we? What if I want to make a living as a Basketball player? Not likely. No. I am limited to what my brain chemistry
and body type suit me for, along with what roles society will allow me to fill. But that's a discussion for another thread, which I have no interest in participating in!

 

[Uncayimmy]

I am saying choice is biology. I think I made that pretty clear when I said:

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

I have no idea what you're trying to say. "Choice is biology?" What kind of meaningless nonsense is that? I Googled that exact phrase. There were 160 hits. Not a single hit on the first page used it the context you did. It was typically, "As far as my major goes, my first choice is biology."

Explain what you mean.

ETA: Nevermind. I don't really care to know.

Because you asked this question:

And the answer is they don't. Sheesh, why ask a question that you don't want an answer to?

Huh? You're just playing word games now after repeatedly avoiding a direct question. You're also lying. I have presented examples of distinguishing choice and biological urges, and now you're claiming they don't exist. What a waste of time this is.

This is just silly. The article you quoted was talking about noncompliance and legal liability. It doesn't call noncompliance a disease and neither did I. And it didn't demonstrate anything about choices, nor was it trying to. Stop trying to twist the article to suit your agenda. Maybe you should instead focus on finding a study or two showing how a person's choices are somehow separate from the biological structure that created them . . .

You said said choice is not a practical matter for doctors. I demonstrated that non-compliance - a choice - is a very important factor. Now you're trying to argue that choices, which by definition are only available to organisms, are somehow inseparable from organisms. It simply makes no sense.

OK, first of all . . . ewww! Secondly, when you say "I use my biology to make that decision," is the "I" separate and apart from the biology?

Now you want to play a philosophical game?

Your posts are sheer nonsense. You keep making ridiculous claims, evading questions, ignoring evidence and deliberately misconstruing statements as addressing point B when they were in direct response to point A.

Your arguments fly in the face of what science actually understands. Scientists understand what choice is, and you don't in any meaningful way. They spend a lot of effort to figure out how to influence choices. So do many other fields (ever hear of marketing?). In the end, nothing of value comes out of your arguments except obfuscation.

It's pointless.

 

[littleroundman]

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

Oh, right, so introducing stories about your depression, what your doctor said, about your sleep problems, what THAT doctor said the relationship between your weight, Coke and "choice" and then including them in a discussion about alcoholism, THAT'S not a straw man argument in action,

R-I-G-H-T, just so we have that clear.

Oh, and look, SURPRISE, SURPRISE,

Not "It seems TO ME" but "It seems"

To whom, Yimmy, to whom ????

It certainly doesn't "seem" to me, otherwise I wouldn't have said it

Mr "straw man argument personified" then reverts to the old "I used the word "seems" in another sentence, so the examples you have given don't apply"

HeHe, he's good at this "winning" on internet forums, I have to concede.

Tell us, "Yimmy" of all the people within the United States who have been diagnosed with, claim to have or are identified by others as having, alcohol related problems, whether or not the term "alcoholic" can be applied, how many can you show are examples of your stance ????

Some ???

All ???

Many ????

Most ?????

Are you saying that within the total amount of people involved, there is not ONE person whose problem (however you define problem) with alcohol is not caused by means other than "choice" ???

IOW, is it at all possible that an alcohol related problem can "sneak up on" what could be defined as a "normal" drinker at such a rate that by the time it was identified, it is already too late to "just say no"

If people can show "adverse reactions" to such apparently innocuous substances as peanuts and shellfish in increasingly large numbers, is it at least possible that similar reactions could result from the consumption of alcohol IN SOME PEOPLE ????

 

[Uncayimmy]

Oh, right, so introducing stories about your depression, what your doctor said, about your sleep problems, what THAT doctor said the relationship between your weight, Coke and "choice" and then including them in a discussion about alcoholism, THAT'S not a straw man argument in action,

Uh, no. I said it "seemed" like you were talking about blame, and you called that a straw man. What you describe was written before I made that comment, and it really had little to do with "blame" in my mind. It had to do with xjx's claims that doctors do not distinguish biological urges from choice. It certainly wasn't directed at you.

I won't address the rest of your rant. I asked you some simple questions. You chose to answer them or not. You can still change your mind. It's your choice.

 

[Gandalfs Beard]

The thread so far (especially after He Who Shall Not Be Named joined in):

The Professor Speaks:

It's a Choice Stupid: Just say No: Straw Man:

The Doctor is in:

It's a Disease Stupid:

Fight to the Death:

Non-sequitur:

Can't we all just get along?:

No!:

Great Movie:

GB

 

[xjx388]

I have no idea what you're trying to say. "Choice is biology?" What kind of meaningless nonsense is that? I Googled that exact phrase. There were 160 hits. Not a single hit on the first page used it the context you did. It was typically, "As far as my major goes, my first choice is biology."

Well, let's see here . . . let me Google "Biological drives and choice are not mutually exclusive" Wow, only one hit! And it's what you posted here! Talk about meaningless nonsense . . .

Look, your hand-waving is duly noted and recorded here for eternity. I notice you totally ignored the two papers I linked to which talked about the exact biological mechanisms in play regarding alcoholism (and addictive behavior in general). It's all in the pre-frontal cortex. Reduce blood flow there and -BOOM it's harder to stay abstinent. Dysfunctions in certain parts of the PFC result in reduced executive function which leads to impulsivity which leads to addiction. It's all right there. Alcoholics make the decisions they make because their brains are wired to make those decisions. Simple as that.

Huh? You're just playing word games now after repeatedly avoiding a direct question.

I refuse to answer a question that is demonstrably (by your own technique of Google nonsense discrimination) nonsense.

I have presented examples of distinguishing choice and biological urges, and now you're claiming they don't exist. What a waste of time this is.

Eating and breathing are not choices. You have "voluntary" control over them to some extent, but your brain chemistry will determine what and how much you "voluntarily" put in your mouth or how long you "voluntarily" hold your breath. Absent outside intervention, you will act the way your brain tells you to.

Now you're trying to argue that choices, which by definition are only available to organisms, are somehow inseparable from organisms. It simply makes no sense.

Well, that's a straw man. But it does help illustrate a good point. Do trees, amoebas, dogs and rats have choices? They are all organisms, right?

Now, I asked you a direct question:

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

Your answer was (in response to a similar question):

Now you want to play a philosophical game?

Aha! Now you understand! Talking about choice is nothing but a philosophical game. A game which you initiated by bringing up choice in the first place. Now you don't want to play anymore because you can't find a single shred of evidence that backs up your claims.

Your posts are sheer nonsense. You keep making ridiculous claims, evading questions, ignoring evidence and deliberately misconstruing statements as addressing point B when they were in direct response to point A.

Frustrating, ain't it?

Your arguments fly in the face of what science actually understands. Scientists understand what choice is, and you don't in any meaningful way.

I just showed you two studies where scientists are telling us what they know about choices: The prefrontal cortex regulates behavior. Google that!

 

[xjx388]

GB: You owe me a new keyboard!

 

[littleroundman]

I won't address the rest of your rant. I asked you some simple questions. You chose to answer them or not. You can still change your mind. It's your choice.

HeHeHeHeHe,

yeah, SURE, that's why you won't address the rest of my post.

Carry on, I'm sure SOMEONE believes that's the reason.

It's funny,

but I can't find the section in the forum rules which requires posters to reply to UncaYimmys' questions and but absolves Yimmy from returning the courtesy.

That's the way, Yimmy,

when all else fails, revert to the "I'm your intellectual superior, and I don't deign to answering questions from such obviously inferior posters" gambit.

Let's all talk about biology, depression, weight loss, semantics, choice and "blame"

Let's NOT talk about the fact that, given the number of people involved NOBODY can or has possibly provide a singular answer to the OP question.

Not me, not UncaYimmy, not the most eminent expert on the planet.

NOBODY can point at a group of subjects of that size, and issue a definitive statement of ANY description which will apply, without reservation, to each and every one of the group.

 

[Uncayimmy]

Well, let's see here . . . let me Google "Biological drives and choice are not mutually exclusive" Wow, only one hit! And it's what you posted here! Talk about meaningless nonsense . . .

Oh, this is just too precious to ignore. The reason you won't find such a statement is that nobody except you conflates biological urges and choices resulting in somebody else needing to correct such a ridiculous idea!

Look, your hand-waving is duly noted and recorded here for eternity. I notice you totally ignored the two papers I linked to which talked about the exact biological mechanisms in play regarding alcoholism (and addictive behavior in general). It's all in the pre-frontal cortex. Reduce blood flow there and -BOOM it's harder to stay abstinent. Dysfunctions in certain parts of the PFC result in reduced executive function which leads to impulsivity which leads to addiction. It's all right there. Alcoholics make the decisions they make because their brains are wired to make those decisions. Simple as that.

Skeptical Greg already told you that strict behaviorists do not deny such things. In fact, it's an integral part of the philosophy.

Eating and breathing are not choices. You have "voluntary" control over them to some extent, but your brain chemistry will determine what and how much you "voluntarily" put in your mouth or how long you "voluntarily" hold your breath. Absent outside intervention, you will act the way your brain tells you to.

Well, at least we have your ridiculous claim out in the open. Tell me, what experiment would you devise to falsify this claim?

Now, I asked you a direct question:

It's a ridiculous question because the language is unscientific.

Aha! Now you understand! Talking about choice is nothing but a philosophical game. A game which you initiated by bringing up choice in the first place. Now you don't want to play anymore because you can't find a single shred of evidence that backs up your claims.

No, you dismiss every bit of evidence while simultaneously refusing to describe any evidence that you would find satisfactory. Choice is integral to science and is simply there. There are branches of sciences that deal with choice extensively. They don't try to "prove" that it's there. It's there by definition.

http://www.ncbi.nlm.nih.gov/pubmed/21111093
BACKGROUND: The rapid increase of obesity and diabetes risk beginning in youth, particularly those from disadvantaged communities, calls for prevention efforts.

OBJECTIVE: To examine the impact of a curriculum intervention, Choice, Control & Change, on the adoption of the energy balance-related behaviors of decreasing sweetened drinks, packaged snacks, fast food, and leisure screen time, and increasing water, fruits and vegetables, and physical activity, and on potential psychosocial mediators of the behaviors.

DESIGN: Ten middle schools were randomly assigned within matched pairs to either intervention or comparison/delayed control conditions during the 2006-2007 school year.

SUBJECTS/SETTING: Students were from low-income New York City neighborhoods; 562 were in the intervention condition, and 574 in the comparison condition.

INTERVENTION: Students received the 24 Choice, Control & Change lessons that used science inquiry investigations to enhance motivation for action, and social cognitive and self-determination theories to increase personal agency and autonomous motivation to take action.

MAIN OUTCOME MEASURES: Self-report instruments to measure energy balance-related behaviors targeted by the curriculum and potential psychosocial mediators of the behaviors.

STATISTICAL ANALYSES: Analysis of covariance with group (intervention/control) as a fixed factor and pretest as covariate.

RESULTS: Students in intervention schools compared to the delayed intervention controls reported consumption of considerably fewer sweetened drinks and packaged snacks, smaller sizes of fast food, increased intentional walking for exercise, and decreased leisure screen time, but showed no increases in their intakes of water, fruits, and vegetables. They showed substantial increases in positive outcome expectations about the behaviors, self-efficacy, goal intentions, competence, and autonomy.

CONCLUSIONS: The Choice, Control & Change curriculum was effective in improving many of the specifically targeted behaviors related to reducing obesity risk, indicating that combining inquiry-based science education and behavioral theory is a promising approach.

Meaningless my ass.

 

[Locknar]

Things seems to be getting a bit heated discussion wise, so this seems a good place to remind everyone to keep your posts civil/polite, on topic, and address the argument not the arguer (ie. Rule 0, Rule 11, Rule 12).

Replying to this modbox in thread will be off topic  Posted By: Locknar

 

[littleroundman]

CONCLUSIONS: The Choice, Control & Change curriculum was effective in improving many of the specifically targeted behaviors related to reducing obesity risk, indicating that combining inquiry-based science education and behavioral theory is a promising approach.

Meaningless my ass.

Once again,

we STILL have only "many" and "promising"

applied to all "whatever the OP defines as "alcoholics" it is STILL not shown that "choice" applies to ALL involved.

"choice" as the cause could apply to as many as 99% of the people under discussion, and STILL be only a majority.

 

[Uncayimmy]

Once again,

we STILL have only "many" and "promising"

applied to all "whatever the OP defines as "alcoholics" it is STILL not shown that "choice" applies to ALL involved.

"choice" as the cause could apply to as many as 99% of the people under discussion, and STILL be only a majority.

Huh? That study was on teaching people to make better decisions about eating habits. It was presented as evidence that researchers do look at choice. I have no idea where you're trying to go with your response.

 

[littleroundman]

Huh? That study was on teaching people to make better decisions about eating habits. It was presented as evidence that researchers do look at choice. I have no idea where you're trying to go with your response.

Of course you don't.

You just go right along providing evidence that "choice" is the only reason for "alcoholism" without defining "alcoholism" or acknowledging that multiple reasons for "alcoholism" exist.

Oh, and while you're at it, keep putting up diversionary-straw-man-arguments- which-you-claim-aren't-straw-man-arguments-because-YOU-say-they-aren't.

Now you've "proven" to your own satisfaction that ONE group of researchers considered "choice" in ONE research project.

A survey, BTW, in which "choice" was only ONE of several results obtained.

Now, can we FINALLY get back to discussing why "choice" is, in your opinion, the ONLY reason for the many millions of people affected by what is colloquially known, at least within the United States, as "alcoholism" ???

 

[Uncayimmy]

You just go right along providing evidence that "choice" is the only reason for "alcoholism" without defining "alcoholism" or acknowledging that multiple reasons for "alcoholism" exist.

What is your definition of alcoholism?

Oh, and while you're at it, keep putting up diversionary-straw-man-arguments- which-you-claim-aren't-straw-man-arguments-because-YOU-say-they-aren't.

Oh, and while you're at it, keep claiming diversionary-straw-man-arguments- which-you-claim-are-straw-man-arguments-because-YOU-say-they-are.

Now you've "proven" to your own satisfaction that ONE group of researchers considered "choice" in ONE research project.

Honestly, I'm flabbergasted that you think choice is not an area of research. I can only conclude that you have a vastly different concept of what choice really is.

Now, can we FINALLY get back to discussing why "choice" is, in your opinion, the ONLY reason for the many millions of people affected by what is colloquially known, at least within the United States, as "alcoholism" ???

You are using language I have not used. I said that alcoholism requires a physical and mental capability combined with motor action under voluntary control to consume alcohol. Do you disagree? If so, please provide a definition in your own words.

 

[littleroundman]

What is your definition of alcoholism?

yada, yada, yada, AND, what's more, even MORE yada.

Oh, dear,

here we go again, more forum sport from UncaYimmy.

Responding to questions with questions,

accusing others of using straw man arguments while...........

using a word such as "alcoholism" without enclosing the word within quotation marks then demanding.....................

Here's the thing "Yimmy" I'm not arrogant enough to have a singular definition for a condition affecting so many people, neither am I set in my beliefs enough to assume there are only one or two "causes"

Which is why I'm careful to use the quotation marks around the word to indicate that I am not using the word in its' commonly accepted sense.

To be sure, I can dig up any number of meaningful definitions from any number of reputable sources, which only serves to remind me there is NO singular definition which is applicable to any more than a percentage of those to whom the word refers.

Perhaps it's only me, but I'm damned if I can think of a single, solitary group of similar size as that which is being referred to as "alcoholics" where I can even BEGIN to consider the members of the group as being effected by a single condition with a singular cause.

ESPECIALLY not when "alcoholism" isn't contracted instantaneously as the result of a conscious decision and ESPECIALLY when there are many more times more people who can and do ingest far greater quantities of alcohol without becoming "alcoholics" (note the use of the "" there Yimmy) and even MORE especially when the onset of "alcoholism" (note ") can be both cumulative and symptomless.

 

[Uncayimmy]

Once again, I never said that choices were the "cause" of whatever it is you're talking about. I said that choices are integral to whatever definition you choose because whatever it is, it's first and foremost a behavior that requires conscious activity. I never said that people choose to be alcoholics and then make decisions to make it happen. I said that it's the sum of a series of conscious choices. There's a big difference. I'm sure someone could do it if they wanted to.

At this point, I can see no benefit of carrying on the discussion with you. Best wishes.

 

[littleroundman]

At this point, I can see no benefit of carrying on the discussion with you.

Of course you can't.

Otherwise you'd have to admit you've engaged in a process of troll like arguing for arguments' sake on a subject in which your original contention has been exposed as being based solely on a purely personal belief and/or barely disguised contempt for those to whom the term "alcoholic" is applied.

I note, also, your penchant for disguising your heavily opinionated theories behind the cloak of enlightened "critical thinking" has not been confined to this thread and/or topic.

A fact which, due to my "newbie" status on this forum, I was unaware of, prior to your first post in this thread.

In fact, the discussion has given me a new appreciation for Harry Potters' "He whose name shall not be mentioned"

 

[Dancing David]

Addiction is a set of behaviors engaged in despite a wish to stop and a knowledge of the high negative consequences.

 

[Skeptical Greg]

Once again, I never said that choices were the "cause" of whatever it is you're talking about. I said that choices are integral to whatever definition you choose because whatever it is, it's first and foremost a behavior that requires conscious activity. I never said that people choose to be alcoholics and then make decisions to make it happen. I said that it's the sum of a series of conscious choices. There's a big difference. I'm sure someone could do it if they wanted to.
............

I posted this in a " Quit Smoking " thread ..

The steps involved in smoking:

• Purchase cigarettes
  
• Open pack
  
• Take one out
  
• Put it in your mouth
  
• Engage ignition source
  
• Apply to end of cigarette
  
• Inhale

Failing to execute any one of those steps will result in not smoking..

Pick one .

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....

 

[xjx388]

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.