Is alcholism a “disease” or a geneticly caused problem?
I hope you’re not saying those are mutually exclusive categories.
Neither, it is learned behaviour that can be unlearned anytime the alcholic really wants to do so.
So is self-delusion.
Cite?
Alcoholism isn’t a single “disease” - it’s more a range of symptoms that affect individuals in different ways.
In some cases there’s a strong genetic predisposition, in others it’s environmental, for others it’s psychological.
I loosely agree with lekatt here.
Desire to stop drinking could be more important than therapy (Abstract; PDF of full paper).
Note that I don’t adopt the caricature that once you desire to stop, you have omnipotent and instant power to do so. But the desire is instrumental.
A diabetic must have the desire to adhere to a strict regimen of diet, exercise and insulin to control his condition, but that doesn’t mean diabetes isn’t a disease.
What the linked paper suggests, is that desire is instrumental, rather than just conducive to recovery.
Disease is an unfortunate metaphor for addictions. Addiction is a mental phenomenon (even if grounded in a physical substrate, like all other phenomenons of the mind). Cognitive science has not yet resolved whether the mind is an epiphenomenon or causally potent. If the latter, which is the prevailing view, mental disorders may be self-tackled, like this study shows.
However, he did not merely say that a strong desire was required to assist in overcoming alcoholism, he specifically claimed that it was learned behavior and that it could be “unlearned anytime the alcholic really wants to do so.” This is nothing but sanctimonious posturing that ignores any number of other aspects of the condition.
First, it does not have to be “learned” in any way. I have known people who were pretty much alcoholic from the first time they took a drink. Second, it ignores the fact that there are a number of genetic traits that are reasonably good predictors of alcoholism.
This is not to say that alcoholism is a deterministic genetic condition. One problem we have with discussing alcoholism is that we identify it by the symptoms. Throughout the last 30+ years, I have seen and read enough on the topic to have developed a strong impression that there is not one single “alcoholism.” There seem to be several different conditions, some of which are “mere” emotional responses to situations, others are “psychological crutches” and others are truly physically induced conditions. However, since we only began looking at the medical aspect about 30 yarsa ago, we have not yet identified the ways in which we can identify the different forms of alcoholism, so we have some people excusing it as “merely” genetic" and other people willing to condemnthe sufferers by claiming they could “unlearn it” if they “wanted” to.
Some people are alcoholic from their first drink. How is that a learned behavior?
The big book of Alcoholics Anonymous explains alcholism better than anything I’ve read on it. I’m sure it’s online somewhere if the OP wants to check it out.
Desire is probably the most important factor is quitting, however. Ultimately, alchoholics drink because they want to. In ordr to stop drinking they must to stopm (or to do someting else which requires them stopping) more than the drink. This is not to say it’s an easy road.
This is basically the idea behind interventions. Under the prsumption that alchoholics do actually love their families more than their drink, they attempt to set one directly against the other.
In a sense, that’s what the linked paper says, as well.
Where ‘zero treatment’ refers to people who signed up but dropped out before the first class, and ‘full treatment’ refers to those who completed their program. In essence, and in cliché, when there’s a will, there’s a way.
You learn with every drink, first, last, doesn’t matter. But it is better if you never take that first drink. Then you will have nothing to unlearn.
By far the most effective program for alcholics is AA. They teach a 12-step spiritual program that works very well. So well that many “knock-off” groups have appeared for gamblers, drug addiction, those with depression and many other undesirable habits.
http://www.alcoholics-anonymous.org/default/en_services_aa.cfm?pageid=46
I am downloading their 12-step program now.
I recommend living it instead.
However, the paper is addressing only a specific form of treatment (in four flavors with a staggering failure rate, each) without ever addressing the separate issues regarding types of alcoholism. They simply say that if one attempts to get some alcoholics to quit drinking and one establishes various support systems to encourage them in abstinence, the greatest predictor of success for all four flavors (three programs vs going it alone) is a desire on the part of the alcoholic to quit.
So what does it say about alcoholics who may have a chemical dependence? Nothing.
What does it say about emotional drinkers? Nothing.
What does it say about alcoholism being a learned behavior? Nothing.
What does it say about certain genetic situations being good predictors of who may become alcoholic? Nothing.
Does it distinguish between “problem drinkers” (who may need to reduce consumption, but may be able to drink in controlled situations) and alcoholics (who cannot ever take that “first drink” without a serious danger of becoming drunk)? No, it does not. In fact, its sole criteria for success was abstinence, ironic given its source and that without the American AA bias, researchers in Great Britain and Europe have found that some problem drinkers can control their drinking without abstinence.
This was my point, earlier. There appear to be multiple forms of conditions that we loosely identify under the umbrella “alcoholism” and we do not yet have enough information to distinguish among them. Given our disheartening record in treatment (or in convincing those who suffer it to pluck up some “willpower”), it seems to me that when we do find a person who has “overcome” alcoholism through “willpower” we may very well be dealing with some subset of alcoholics and that many others are “lost” because we have not yet recognized the chemical or genetic conditions that compel them to continue abusing alcohol.
The paper also make no silly claim that it is simply “learned” behavior a claim based on no evidence beyond a serious bent toward moralizing.
Do you have any neutral numbers (i.e. not from AA) about AA’s success rate measured against other programs?
I would submit that AA appears to be more successful because it’s the program most used by rehabs and mental-health practitioners in treating alcoholism and other compulsive behaviors.
Robin
Read up on the other methods, there’s a reason why those places all use AA and NA. They work when nothing else will, and that’s the truth.
The first time I smoked a cigarette I coughed, my throat hurt, and I felt light-headed, almost sick. The first time I drank whisney, it burned my throat, brought tears to my eyes and tasted awful. You have to learn to drink and smoke, learn to overcome the distastful aspects of it. No one makes you do it. It is a choice, in my case, because everyone else was doing it. You get off the same way you got on. By overcoming the habit.
Still the best way is to never start. There is no such thing as not abusing the substances, both are poisons to the body.
Two points:
I never had a bad experience of “raw throat” or choking or anything else when I first began drinking (beer, wine, or whiskey), and aside from some varieties of alcoholic drinks, (e.g., gin which I still do not drink), I enjoyed the taste of each of the drinks I tried, so it is not always necessary to learn to drink.
HOWEVER, even if one did have to learn to drink, that is not the same thing as suffering alcoholism. I have consumed a variety of alcoholic beverages over the course of 30+ years. I have only gotten drunk a couple of times. I do not plan my day around the consumption of alcohol. I do not drink every day. I do not spend hours dreaming about my next drink. I have never let the wish to have a drink lead me to abandon responsibilities to my family or my employer. And my experience is the norm, not the unusual.
On the other hand, I have known kids who began binge drinking on their very first access to alcohol and it immediately dominated their lives. There was no “habit” to be broken, but a compulsion to consume the alcohol that they felt with their first drink.
There is a qualitative difference between an alcoholic and a person who is not alcoholic and claiming that the alcoholism is a learned behavior makes no sense. The “binge on the first drink” user did not “learn” anything. S/he simply discovered an overwhelming appetitite on her or his first experience with the stuff. Even there, not every kid who begins bingeing is necessarily alcoholic. Some kids quit bingeing (but not necessarily drinking) when they leave school and get a job. Some kids quit bingeing (but not necessarily drinking) when they see how much money they are spending. Some kids never quit bingeing.
I am sure that it is possible for some people to have learned to drink excessively under some circumstances. For some (unknown) number of people, alcoholism may, indeed, be a learned behavior. However, they do not seem to be a majority of the alcoholics I’ve known and the “learning” notion does not explain every alcoholic person, even if it is true for some number.
Claiming that it is simply a learned behavior is nothing more than a way to feel morally superior to those who are “unwilling” to “unlearn” it.
Regarding the OP:
Could you distinguish what you mean between a disease and a genetic problem?
As noted, my personal impression (not yet supported by any studies) is that alcoholism is an umbrella word covering several related conditions with different possible triggers. However, while it is clearly not an allopathogenic disease that one can communicate to another person through infection, we identify diabetes as a disease, even though is has a strong genetic component in the Type I form and a probable genetic component in the Type II form. So why do you ask an either/or question regarding alcoholism?