I knew that I had just read something about this. It seems that there might be a genetic link to, if not alcoholism, then at least to drinking. Check out this http://www.discover.com/jun_00/breakhomo.html
Well I guess noboby who posted had seen the 20/20 segment or realizes that for all intents and purposes alcoholism IS CONSIDERED a disease by the medical community. Naturally like all people doctors have their own views and biases. But for decades now it has been covered under most major medical insurance as treatable. As for treating the underlying condition…what underlying condition…50 million people who are drinking to much or have a drinking problem are either bipolar, depressed etc. Come on now! Well, they may be depressed after they have lost a couple of spouses, kids, jobs, and their license to drinking but don’t tell me that everyone who drinks has a mental disorder. After 30 years of washing your brain in vodak I’d say that’s a big yes, but everyone? You’re saying that these 50 million should be on say…zoloft, lithium, or prozac instead?
Studies have shown that there appears to be a genetic predisposition to drug and alcohol abuse. Has anyone questioned whether or not there is an actual alcoholic gene or if the disease is so widespread because of society’s indiffernce or a combination of the two? Let’s face it if 50 million people have an alcohol problem there must be at least 50 million more who drink socially without a major problem. My dad the “retired drunk” says that people in our family should never take the first drink. It’s the tad of Native American in our ancestry. You know indians and fire water don’t mix. That’s fine, perhaps there is a genetic connection. But there is also a societal connection. Many serious alcoholics will admit that they have been drinking since their teens. They resist changing their lifestyle. So who taught them that drinking was so much fun in first place?
And hey do me a favor and don’t patronize me about whatever you think you might know about life. Because if you don’t think that we all have a vested interest in this subject as a society then you are wearing blinders. The cost of alcohol abuse in our society is severe.
Need2know
Those two situations aren't the same. We have a person who has a disease that **makes** him drink. He can't help it if his **disease** forces him to drink alcohol. It isn't his fault that alcohol impairs his judgement to the point where he cannot decide whether or not to drive.
Marc
NeedstoKnow:
First let me tell you I wholeheartedly agree that alcoholism is a problem and definately needs to be treated. I don’t think anyone here is questioning that. I am only questioning the science of causality in alcoholism, so when I am disagreeing with you it is only on scientific points.
I wish I knew how to do that quote thing, so pardon if these posts are a bit messy:
quote:
for all purposes alcoholism IS CONSIDERED a disease by the medical community.
~~sorta…it is (sorta) reimbursable is what you are saying I believe. The medical community does not consider alcoholism to be the same kind of disease as, say, Parkinson’s Disease (a true genetic illness). But you can get reimbursement for it. You can also get reimbursement for a number of psychological problems including phobias and personality disorders which have no genetic/biological component. Again it is all how you define “disease”
quote:
50 million people who are drinking to much
quote:
You're saying that these 50 million should be on say...zoloft, lithium, or prozac instead?
~~~quite possibly, and in fact that often ends up being a treatment of choice when they enter therapy. I am not really big, personally, on doping everyone up. But the empirical data is pretty clear in demonstrating that mental illness and personality disorders are primary to alcohol abuse. Doesn't mean they were bipolar, but take a look at the DSM-IV symptomatology for Borderline Personality Disorder, and tell me that doesn't fit a fair share of substance abusers. Some of the rest may be depressed, bipolar, as you noted, or perhaps even be antisocial.
quote:
should never take the first drink
~~~which if you have Borderline PErsonality Disorder makes since since they don't have the self-control to stop. They are not forced to by their genes, they just don't have the personality strength to manage their own behavior rationally. but as an alternative I once again suggest you look at the Controlled Drinking literature by L. Sobell. This pretty clearly demonstrates that once you increase the coping skills, drinking alcohol does not need to be problematic.
quote:
You know indians and fire water don't mix
~~~Wwhhaaaaaattt???? And you think this has to do with genetics and not the century and a half of genocide, discrimination and social isolation they have experienced. If all these Indians were genetically alcohol, WHAT exactly were they doing before we were kind enough to bring them alcohol? Thems must have been some pretty seriously jonesing Indians.
quote:
Many serious alcoholics will admit that they have been drinking since their teens. They resist changing their lifestyle.
~~~finally I agree with you here, and this personality trait may be part of the problem.
quote:
don't patronize me
~~~I hope you don't think that I am trying to patronize you, and I appologize if it seems that way. But I don't believe that ignoring the real cause of alcoholism (namely personality problems, poor coping skills, sometimes mental illness, etc.) is the answer. This is just a new form of denial, to explain things away as a "disease" meaning a disease over which the individual has no control/responsibility.Needs2Know:
Again I have to ask, what exactly is it that you think we should be doing that we are not doing now? There are lots of organizations attempting to help with this problem.
MGibson:
Okay then, how about mental illness? We certainly don’t refrain from arresting the mentally ill when they commit crimes, as you implied should be the case for alcoholics if alcoholism is a disease:
Sure, we have the concept of “diminished responsibility” for the mentally ill which affects sentencing, but we also have mandatory treatment and restraint. We certainly don’t consider that it’s perfectly okay for people to go around committing crimes partly because of factors they have no control over, and we aren’t obliged to take that kind of “hands-off” approach to alcoholics if we call alcoholism a disease. We’re not forced to admit the “right” of an alcoholic to endanger others by driving drunk any more than we’re forced to admit the “right” of a sociopath to murder his neighbors. Yeesh.
Kimstu
MGIBSON:
Alcoholism is not a disease that MAKES someone drink. Alcoholism is a set of cognitions and behaviors marked by poor impulse control, low self-esteem, oftentimes depression, self-destructive behavior, oftentimes narcissistic ideation, poor coping skills and poor problem solving. Alcoholics are not victims (at least not in the sense that Parkinson’s Disease, cancer, or even Depressives are victims) but antagonists of their own problems. They need treatment so that they can recognize their own self-destructive thoughts and behaviors and change them.
Think of it this way: if there were no alcohol, there would be no alcoholism (and that’s coming from an alcoholic).
I agree. That's why I think it is silly to call alcoholism a disease.
Marc
Hmmm, let me see if I understand.
A disease does NOT cause alcoholism, rather alcoholism is the cause of a disease?
I didn’t see the 20/20 on alcoholism, but as a member of Alcoholics Anonymous, I can make the following observations:
First, no one forced me to drink. I chose to drink, which means I chose to accept the consequences of my actions while drunk.
Second, there is a vast gap between AA as it is taught in treatment centers and AA as it was developed in the thirties and forties. The professionalization of substance-abuse treatment has infected Alcoholics Anonymous with concepts like co-dependency, denial, formal relapse-prevention training, the disease model, and so forth, that were never really addressed by the founders of AA. Granted, these were around before treatment centers, but the TCs helped infuse them into standard AA doctrine. I think it’s important to say at this point that I did not go through any kind of treatment center.
AA was, and is, a program that was designed to allow one alcoholic to help another alcoholic to stay sober. The 12 Steps are simply suggestions to help the recovering alcoholic put right what he wrecked while drinking, with himself, his God, and his fellow man. The rest is just window-dressing.
Robin M.
Looks like AA is going to be in the limelight for the next couple of weeks anyway. Must be due to this little confilct that is apparently going one between the AA proponents and a few other treament option types. Sometime this week there will be a program on I think, (not sure) A & E, think it’s called “Inside AA”.
Avalon…I wasn’t addressing you when I asked not to be patronized. Your points are good ones, except for the cormorbidity thing, I just find it terribly hard to believe that MOST alcoholics are also suffering from some other mental disorder. Oh yeah and the 50 million I think came from the program, is it inflated, maybe?
Need2know
If I can throw in couple more observations about this whole thing.
From what I’ve seen, AA is popular with treatment centers because it’s cheap (meetings are free, donations are optional) and accessible. I have yet to go to any town that didn’t have at least one meeting. Not many other organizations can say the same thing.
Second, I’ve looked into other alcohol programs and such, and for the most part, they can’t make a case without tearing into AA in the process. A lot of the Rational Recovery website, for example, is dedicated to “proving” AA to be a “cult”. That, to me, is not a responsible program.
When lives are at stake, organizations professing to be there to help alcoholics recover shouldn’t resort to pissing contests to attract members.
Finally, and this is my own perspective coming from 7 years of sobriety in AA, I have never been forced into believing anything I did not want to believe. I don’t go along with some of the spiritual aspects of the Steps, because they disagree with my own concept of a Higher Power and my religion, and some of the treatment-center psychobabble leaves me a little cold.
The bottom line is that alcoholism is a deadly, mysterious problem. The physical side effects of excessive alcohol consumption can, and do, kill. Clearly, there needs to be a lot more research done before any definitive solution can be developed. Until then, as the AA expression says, let’s Live and Let Live and let each person decide the appropriate course of action.
Robin
I believe that is the problem msrobyn…there are very few options! What the program was addressing was the fact that AA is not for everyone…obviously by the statistics not for quite a lot of people. So what can be done for those that AA is not successful.
Needs2know
Again, in my experience, there is an element of free will involved. A significant proportion of those who can’t be helped by AA WON’T be helped. They’ve been sent by the courts, by a school, employer, parents, etc. They’re a warm ass in a chair for the duration of their sentence.
One thing I was thinking about in the shower is that AA just turned 65 this weekend, and although understanding of alcoholism and related disorders has increased significantly, AA itself has not. It was founded primarily to deal with men who drink too much, causing problems with their families and communities.
Finally, there is the ethical and moral question of free will, or do we HAVE to help the alcoholic who may not want to be helped. I work for the Veterans Affairs department, and a lot of the patients who come in for treatment of physical problems related to excessive alcohol intake. They’re offered a variety of treatments for their alcoholism, yet most of them don’t want it. NOTHING is going to work for the person who doesn’t want to be helped. Forcing people who don’t want help is a waste of time, energy, resources, and money.
Finally, for families of alcoholics, I strongly suggest either Al-Anon or counseling or both. The alcoholic is going to do what the alcoholic is going to do, and the family needs to take care of itself, emotionally. Being married to an alcoholic sucks, but you still need to take care of yourself.
Robin