The Myth of Alcoholism as a Disease

[Miles]

Undoubtably? A lot of doctors would disagree there...

Perhaps those doctors are in the first stage of alcoholism, denial.

[Sean]

Nah...they're all junkies.

[Andrew D]

Perhaps the difficulty is that addiction to alcohol (or coffee or tobacco or methamphetamine or whatever) is itself a symptom. Addiction to alcohol (etc.) due to habituation (which itself can be the result of many things) may be one thing. Addiction to alcohol (etc.) due to a wiring problem may be something else entirely.

[Sean]

Doesn't matter how you're wired Andrew. Nobody is born with alcoholism, they still need to take that first drink. That is a choice.

[rubato]

One could say the same about a fatal allergic reaction to shellfish.





yrs,
rubato

[Rick]

One could say the same about a fatal allergic reaction to shellfish.





yrs,
rubato

Don't really think that's analogous.

I know a person that has had a reaction just sitting next to someone eating shellfish.

I don't know of anyone getting drunk sitting next to a drunk...

[Crackpot]

sitting next to someone smoking a joint on the other hand...

[Rick]

sitting next to someone smoking a joint on the other hand...

Never been proven...

[Crackpot]

Never caught a contact?

[Rick]

Never caught a contact?

Never been around it when I wasn't an actual participant LOL...

[loCAtek]

My BF has been a teetotaler for life; never has been drunk - ever.

Which is why he is/was often invited along to clubbing or to parties: 1)He's a fun, sexy guy, and 2) He's glad to be the 'designated driver' for his buddies.

Knowing him well, I see his behavior change with a 'contact high', when the party gets started. He'll be just as uninhibited and loose, as if he were imbibing, as everyone else.

..Just that when it's time to go home- he gets the keys.

[loCAtek]

From Alcoholics Anonymous and the Disease Concept of Alcoholism

At the time of the birth and youth of Alcoholics Anonymous, from 1934 through its selfproclaimed “Coming of Age” in 1955, the understandings that “the alcoholic” was a person who “had alcoholism” and that alcoholism was a disease were commonplace in the professional literature.

As a report of the Scientific Committee of the Research Council on Problems of Alcohol put it in 1938:
“An alcoholic should be regarded as a sick person, just as one who is suffering from tuberculosis, cancer, heart disease, or other serious chronic disorder.” Those doubting that "disease" was the orthodoxy before Alcoholics Anonymous came onto the scene should hie themselves to a good library and read "Drinking and Alcoholism," by Genevieve Parkhurst, in the July 1937 Harpers Magazine.5 From the mid-1940s on, at first from a base within Yale University’s Center of Alcohol Studies, the National Committee on Education on Alcoholism -- later the National Council on Alcoholism

-- actively pushed this understanding under the guiding hand of Mrs. Marty Mann.6 Few in that era questioned the terminology or its assumptions: alcoholism-understood-as-disease “worked” and thus passed the pragmatic criterion of truth that ruled the age of World War II and its immediate aftermath. What it “worked” at doing, as Dwight Anderson had set forth even before Ms. Mann arrived on the scene, was to elicit the kind of attention and concern that led to help for the alcoholic (Anderson 1942).

[Andrew D]

Doesn't matter how you're wired Andrew. Nobody is born with alcoholism, they still need to take that first drink. That is a choice.

But that is not alcoholism. Most people who take that first drink are not and/or never become alcoholics.

Alcoholism is the inability to refrain from taking the second drink, and the third, and the fourth ....

That is not a choice. In some cases, it may result from other choices, but that is not the same thing. (My catching a cold may result from my choosing to sit out on my back patio all night in nothing but a long T-shirt, but that does not mean that I chose to catch a cold.)

In other cases, the inability to refrain from taking the second drink, etc., may not result from any choices at all. It may be a wiring problem. And a person who has that wiring problem may very well have been born with it.

As far as I have seen, there is no way for a person to know in advance whether he or she does or does not have that particular wiring problem. So it strikes me as implausible to say that by virtue of doing a perfectly ordinary thing -- choosing to take that first drink -- a person has chosen what is most causally the result of a wiring problem which that person had no way of knowing that he or she even had.

[Sean]

I think you missed my point Andrew. Put simply, a person who never takes that first drink will never become an alcoholic. The rest can just as easily be put down to an addictive personality as to some conveniently labelled 'disease'.

As you said, it may be a wiring problem. This is one theory, I have another. It applies to every alcoholic I have personally known. These are people who enjoyed drinking too much. After a while their addiction took hold and they became dependant on alcohol to get them through each day. This to me is no different to anybody is dependant on nicotine, heroin or any other drug.
And yet alcoholics are the only group of addicts we are expected to sympathise with as they have an "incurable disease". The rest are just smokers or junkies. It doesn't make sense to me.

[Rick]

When you "say" wiring are you talking about a physiological change brought on by the consumption of a substance?

Gambling is often referred to as an addiction...

[Scooter]

The rest can just as easily be put down to an addictive personality as to some conveniently labelled 'disease'.

And why is addictive personality any less a disease than other psychological disorders?

And yet alcoholics are the only group of addicts we are expected to sympathise with as they have an "incurable disease". The rest are just smokers or junkies.

According to whom? Someone looking for an excuse for their alcoholism? Where does this notion come from that alcoholism is seen as a disease while other addictions are not?

[Sean]

The rest can just as easily be put down to an addictive personality as to some conveniently labelled 'disease'.

And why is addictive personality any less a disease than other psychological disorders?

Disorder Scoot, not disease. The two words are sometimes used interchangeably and erroneously.

And yet alcoholics are the only group of addicts we are expected to sympathise with as they have an "incurable disease". The rest are just smokers or junkies.

According to whom? Someone looking for an excuse for their alcoholism?

I'm a smoker. I am addicted to nicotine. Would you describe me as having an incurable disease?

[Scooter]

Disorder Scoot, not disease. The two words are sometimes used interchangeably and erroneously.

I repeat the definition of disease from a medical dictionary which I posted earlier:

Main Entry: dis·ease

Pronunciation: \diz-ˈēz\

Function: noun

: an impairment of the normal state of the living animal or plant body or one of its parts that interrupts or modifies the performance of the vital functions, is typically manifested by distinguishing signs and symptoms, and is a response to environmental factors (as malnutrition, industrial hazards, or climate), to specific infective agents (as worms, bacteria, or viruses), to inherent defects of the organism (as genetic anomalies), or to combinations of these factors

Explain to me how addiction does not fit that definition.

I'm a smoker. I am addicted to nicotine. Would you describe me as having an incurable disease?

I would describe you as having a treatable disease which will quite likely kill you if you do nothing to treat it. The same way I would describe alcoholism or addiction to any other substance.

[Sean]

Disorder Scoot, not disease. The two words are sometimes used interchangeably and erroneously.

I repeat the definition of disease from a medical dictionary which I posted earlier:

Main Entry: dis·ease

Pronunciation: \diz-ˈēz\

Function: noun

: an impairment of the normal state of the living animal or plant body or one of its parts that interrupts or modifies the performance of the vital functions, is typically manifested by distinguishing signs and symptoms, and is a response to environmental factors (as malnutrition, industrial hazards, or climate), to specific infective agents (as worms, bacteria, or viruses), to inherent defects of the organism (as genetic anomalies), or to combinations of these factors

Explain to me how addiction does not fit that definition.

You're asking me to prove a negative. Can you show me where it does fit?

I'm a smoker. I am addicted to nicotine. Would you describe me as having an incurable disease?

I would describe you as having a treatable disease which will quite likely kill you if you do nothing to treat it. The same way I would describe alcoholism or addiction to any other substance.

A treatable disease. Yet alcoholism is said to be an incurable disease. Why would that be?
And no, I do not agree that I have a disease of any description. I have an addiction.

[Scooter]

Can you show me where it does fit?

Addiction results in impairment of a variety of physical and mental functions.
Addictions to various substances manifest distinguishing signs and symptoms.
Addiction is a response to both environmental factors (the substance to which one is addicted) and inherent defects in the organism (the propensity to become addicted).

A treatable disease. Yet alcoholism is said to be an incurable disease. Why would that be?

Treatable and curable are not the same thing. Once an addict, always an addict, regardless of whether he/she has managed to avoid the addictive substance.

And no, I do not agree that I have a disease of any description. I have an addiction.

That's your choice. Perhaps you could accept that others might see it differently, and not solely as a means of excusing their own behaviour or their decision not to seek treatment.