# alcholism **URL:** \ **Category:** Great Debates\ **Created:** [July 22, 2005, 3:04am UTC](https://boards.straightdope.com/t/alcholism/313580 "2005-07-22T03:04:20Z")\ **Posts on this page:** 20\ **Page:** 2
**Author:** ![MsRobyn](https://avatars.discourse-cdn.com/v4/letter/m/90ced4/32.png) [@MsRobyn](https://boards.straightdope.com/u/MsRobyn)\ **Post date:** [July 22, 2005, 11:24pm UTC](https://boards.straightdope.com/t/alcholism/313580/21 "2005-07-22T23:24:47Z")
> [@Indygrrl](#): > > 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. I have read up on the other methods. I’ve been sober for over 12 years now, and much of that time has been spent outside AA. There are ways to stay sober that don’t involve AA that work equally well. I’m not arguing that AA doesn’t work; I’m simply saying that there are other ways. But I will ask again. Do you have numbers from a neutral source that compares success rates for AA to other groups using standard definitions? Robin ---
**Author:** ![rfgdxm](https://avatars.discourse-cdn.com/v4/letter/r/c0e974/32.png) [@rfgdxm](https://boards.straightdope.com/u/rfgdxm)\ **Post date:** [July 23, 2005, 12:28am UTC](https://boards.straightdope.com/t/alcholism/313580/22 "2005-07-23T00:28:02Z")
> [@MsRobyn](#): > > I have read up on the other methods. I’ve been sober for over 12 years now, and much of that time has been spent outside AA. There are ways to stay sober that don’t involve AA that work equally well. I’m not arguing that AA doesn’t work; I’m simply saying that there are other ways. Definitely so. Read the 12 steps. They can be a serious problem for an absolute atheist. ---
**Author:** ![II\_Gyan\_II](https://avatars.discourse-cdn.com/v4/letter/i/bbe5ce/32.png) [@II\_Gyan\_II](https://boards.straightdope.com/u/II_Gyan_II)\ **Post date:** [July 23, 2005, 1:52am UTC](https://boards.straightdope.com/t/alcholism/313580/23 "2005-07-23T01:52:00Z")
> [@tomndebb](#): > > 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. I haven’t read the the entire results section yet, but based on below quote, are you sure abstinence is their only metric? I think the second checks on controlled drinking. > [@](#): > > Analyses were confined to the primary outcome variables, percent days abstinent (PDA) and drinks per drinking day (DDD). > [@](#): > > because we have not yet recognized the chemical or genetic conditions that compel them to continue abusing alcohol. Can you flesh this out? What constitutes a biological condition that compels one to keep drinking? ---
**Author:** ![lekatt](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/lekatt/32/7269_2.png) [@lekatt](https://boards.straightdope.com/u/lekatt)\ **Post date:** [July 23, 2005, 3:10am UTC](https://boards.straightdope.com/t/alcholism/313580/24 "2005-07-23T03:10:08Z")
> [@MsRobyn](#): > > I have read up on the other methods. I’ve been sober for over 12 years now, and much of that time has been spent outside AA. There are ways to stay sober that don’t involve AA that work equally well. I’m not arguing that AA doesn’t work; I’m simply saying that there are other ways. > > But I will ask again. Do you have numbers from a neutral source that compares success rates for AA to other groups using standard definitions? > > Robin Numbers are hard to find, if you look at the Mental Health people’s statistics for 12 step programs it is only a 5% success rate. If you look at AA statistics it is a 25% success rate now, but used to be a 75% success rate. As usual with these things no one can agree and everyone has their own axe to grind. I did find another study: [http://www.niaaa.nih.gov/press/1996/match.htm](http://www.niaaa.nih.gov/press/1996/match.htm) This was done by the government in 1996, didn’t find any statistics on the first page, but did find an interesting statement: > [@](#): > > “The researchers recruited 1,726 patients for two parallel study arms–one with alcohol dependent patients who received outpatient therapy and one with patients who received aftercare therapy following inpatient or day hospital treatment–that involved identical matching hypotheses and identical randomization, assessment, and followup procedures. Twenty-five therapists administered the therapies over a 12-week period in individual counseling sessions that adhered strictly to manuals developed for the trial.” > > “The single confirmed match reported today is between patients with low psychiatric severity and 12-step facilitation therapy. Such patients had more abstinent days than those treated with cognitive-behavioral therapy.” So the 12-step program wins according to the government study. I have friends and family in the AA program and all were successful. My family member is now been sober for over eight years. I highly recommend the program. Due to the nature of my web site, I get questions from recovering alcholics from time to time. They say my page on forgiveness helps them a lot, and I know it has been copied and distributed at a least one AA group. ---
**Author:** ![lekatt](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/lekatt/32/7269_2.png) [@lekatt](https://boards.straightdope.com/u/lekatt)\ **Post date:** [July 23, 2005, 3:27am UTC](https://boards.straightdope.com/t/alcholism/313580/25 "2005-07-23T03:27:07Z")
> [@rfgdxm](#): > > Definitely so. Read the 12 steps. They can be a serious problem for an absolute atheist. I have never met an absolute atheist. During the times in my life when death seemed imminent, I and all others in the same situation prayed and acknowledged a higher intelligence. Sort of a “no atheists in foxholes” type thing. Later in life I volunteered to work in hospices. Among the dying patients I talked with were no atheists. I am no saying it’s impossible to be dying and still be an atheist, just that I have not experience this. But the 12 step programs speak to our spiritual nature, that is why they are successful. It is possible to go through the program as an atheist and still be helped. Yes, spiritual values and techniques are valuable aids to cope with life. Basically they turn a person from fear to love. Love is fearless. ---
**Author:** ![tomndebb](https://avatars.discourse-cdn.com/v4/letter/t/b9e5f3/32.png) [@tomndebb](https://boards.straightdope.com/u/tomndebb)\ **Post date:** [July 23, 2005, 3:55am UTC](https://boards.straightdope.com/t/alcholism/313580/26 "2005-07-23T03:55:02Z")
> [@](#): > > What constitutes a biological condition that compels one to keep drinking? The same one that causes people to continue to smoke tobacco, shoot heroin, or continue any other health-threatening consumption of narcotic or narcotic-like substances. As I have said, the rate for “willpower” overcoming these (apparent?) addictions is so low, even in the face of imminent health problems, loss of life, or loss of job and family, that I suspect that we are dealing with more than one phenomenon that we have placed under the umbrella of “alcoholism.” ---
**Author:** ![MsRobyn](https://avatars.discourse-cdn.com/v4/letter/m/90ced4/32.png) [@MsRobyn](https://boards.straightdope.com/u/MsRobyn)\ **Post date:** [July 23, 2005, 4:30am UTC](https://boards.straightdope.com/t/alcholism/313580/27 "2005-07-23T04:30:13Z")
> [@lekatt](#): > > Numbers are hard to find, if you look at the Mental Health people’s statistics for 12 step programs it is only a 5% success rate. If you look at AA statistics it is a 25% success rate now, but used to be a 75% success rate. As usual with these things no one can agree and everyone has their own axe to grind. > > I did find another study: > > [http://www.niaaa.nih.gov/press/1996/match.htm](http://www.niaaa.nih.gov/press/1996/match.htm) > > This was done by the government in 1996, didn’t find any statistics on the first page, but did find an interesting statement: > > So the 12-step program wins according to the government study. What the study said was that the 12-step model works in people without severe mental illness, which more or less jibes with my own experiences. Those with severe mental illness often had to get that under control before addressing their alcoholism; often, just treating the underlying illness took care of the drinking because these people would self-medicate their mental symptoms with alcohol or other drugs. Unfortunately, one or two of the people I knew with mental illness were talked out of their medications by well-meaning but ignorant members who convinced them that AA was all they needed and that they would be better off without the drugs that were keeping them sane enough to attempt AA. Not surprisingly, they relapsed. Robin ---
**Author:** ![II\_Gyan\_II](https://avatars.discourse-cdn.com/v4/letter/i/bbe5ce/32.png) [@II\_Gyan\_II](https://boards.straightdope.com/u/II_Gyan_II)\ **Post date:** [July 23, 2005, 4:30am UTC](https://boards.straightdope.com/t/alcholism/313580/28 "2005-07-23T04:30:16Z")
> [@tomndebb](#): > > The same one that causes people to continue to smoke tobacco, shoot heroin, or continue any other health-threatening consumption of narcotic or narcotic-like substances. That’s not a fleshing out, that’s a cop-out. I’m not asking for analogues. > [@](#): > > As I have said, the rate for “willpower” overcoming these (apparent?) addictions is so low, even in the face of imminent health problems, loss of life, or loss of job and family, that I suspect that we are dealing with more than one phenomenon that we have placed under the umbrella of “alcoholism.” That’s not really true. Among addicts, there are a small proportion, who repeatedly recycle among treatment programs without achieving sustainable recovery, but many addicts succeed after couple of programs. An interview with the head of a Dutch treatment center (or some government official i.e. someone of authority) noted that 90% of cocaine dependents succeed after a good intervention, and 40-50% for heroin. It depends on the substance. ---
**Author:** ![LH75](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/lh75/32/4438_2.png) [@LH75](https://boards.straightdope.com/u/LH75)\ **Post date:** [July 23, 2005, 12:50pm UTC](https://boards.straightdope.com/t/alcholism/313580/29 "2005-07-23T12:50:27Z")
friend msrobyn > [@](#): > > Unfortunately, one or two of the people I knew with mental illness were talked out of their medications by well-meaning but ignorant members who convinced them that AA was all they needed and that they would be better off without the drugs that were keeping them sane enough to attempt AA. Not surprisingly, they relapsed. while i realize that this is strictly anecdotal, this happens to my nephew periodically. he needs medication for his clinical depression, and has been in AA for ten years or so. once in a while, he is talked into the idea that his medications are “mood altering substances” and he quits taking them. before long, he is out of work, and in extreme cases, becomes suicidal. so far, the family has managed to get him hospitalized for these cases, and back on his meds. we may not be this lucky forever. ---
**Author:** ![Ludovic](https://avatars.discourse-cdn.com/v4/letter/l/7ab992/32.png) [@Ludovic](https://boards.straightdope.com/u/Ludovic)\ **Post date:** [July 23, 2005, 1:25pm UTC](https://boards.straightdope.com/t/alcholism/313580/30 "2005-07-23T13:25:49Z")
> [@tomndebb](#): > > 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)? What’s this “serious danger” of which you speak? I never drink without aiming to get drunk. And that’s only once every couple months or so. ---
**Author:** ![dalej42](https://avatars.discourse-cdn.com/v4/letter/d/67e7ee/32.png) [@dalej42](https://boards.straightdope.com/u/dalej42)\ **Post date:** [July 23, 2005, 2:04pm UTC](https://boards.straightdope.com/t/alcholism/313580/31 "2005-07-23T14:04:04Z")
I started a [thread](http://boards.straightdope.com/sdmb/showthread.php?t=323423&highlight=disease) on this very topic a couple of weeks ago. ---
**Author:** ![tomndebb](https://avatars.discourse-cdn.com/v4/letter/t/b9e5f3/32.png) [@tomndebb](https://boards.straightdope.com/u/tomndebb)\ **Post date:** [July 23, 2005, 3:39pm UTC](https://boards.straightdope.com/t/alcholism/313580/32 "2005-07-23T15:39:43Z")
> [@](#): > > That’s not a fleshing out, that’s a cop-out. I’m not asking for analogues. What is the physical condition that causes a heroin addict to continue and how does it differ from that of any other addicting substance? If you know that heroin, tobacco, etc. have a particular mechanism that differs from that of alcohol, I would be interested to see it. > [@](#): > > That’s not really true. It was according to the .pdf that you keep referring to. None of their numbers approached 50%. I am not sure what your point is in this discussion. Do you claim that all alcoholism is only learned behavior? I do not believe that we have identified the specific situation, yet, but there are a number of studies showing a genetic predisposition that strongly indicate that it is not merely “learned”: [Genetic predisposition to organ-specific endpoints of alcoholism.](http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8986199&dopt=Citation) [What is inherited in the predisposition toward alcoholism? A proposed model.](http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10443977&dopt=Citation) [Replication of the Stockholm Adoption Study of alcoholism. Confirmatory cross-fostering analysis](http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&list_uids=8694681&dopt=citation) (This one even identifies separate _types_ of alcoholism, something that I have suggested from my first post.) This is not to say that alcoholism occurs without some trigger behavior, but that is a separate claim from the notion that it is simply “learned.” * * * > [@](#): > > What’s this “serious danger” of which you speak? I never drink without aiming to get drunk. And that’s only once every couple months or so. Nor have I claimed that you are alcoholic. Since the definition **s** of alcoholism vary from group to group, I am not about to classify anyone. There is a group of people (whether conditioned by AA rhetoric or because they actually have a chemical imbalance or for some other reason), who cannot take a drink without risking getting drunk or lapsing into a pattern of daily drunkeness. That specific group was the one I addressed. ---
**Author:** ![II\_Gyan\_II](https://avatars.discourse-cdn.com/v4/letter/i/bbe5ce/32.png) [@II\_Gyan\_II](https://boards.straightdope.com/u/II_Gyan_II)\ **Post date:** [July 23, 2005, 4:20pm UTC](https://boards.straightdope.com/t/alcholism/313580/33 "2005-07-23T16:20:34Z")
> [@tomndebb](#): > > I am not sure what your point is in this discussion. Your original remark was, > [@](#): > > because we have not yet recognized the chemical or genetic conditions that compel them to continue abusing alcohol. I’m interested in the fleshing out of the mechanism of this ‘compulsion’. > [@](#): > > Do you claim that all alcoholism is only learned behavior? Rather that alcoholism can be ‘unlearned’, and that the disease metaphor where the individual is subservient to the behaviour, is wrong. The biology does not **precede** the behaviour. ---
**Author:** ![tomndebb](https://avatars.discourse-cdn.com/v4/letter/t/b9e5f3/32.png) [@tomndebb](https://boards.straightdope.com/u/tomndebb)\ **Post date:** [July 23, 2005, 5:25pm UTC](https://boards.straightdope.com/t/alcholism/313580/34 "2005-07-23T17:25:29Z")
> [@II Gyan II](#): > > Your original remark was, > > > [@](#): > > > > because we have not yet recognized the chemical or genetic conditions that compel them to continue abusing alcohol. > > I’m interested in the fleshing out of the mechanism of this ‘compulsion’. Well, my actual original remark was > [@](#): > > **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**. In other words, I was pretty much up front that I perceive more than one condition labeled “alcoholism” and that I am not sure what all different triggers there may be. Now, I don’t have a problem with the notion of “unlearning” _alcoholic behavior_. My only criticism is of the claim that (all) alcoholism is, itself “learned.” We have a substantial body of evidence to a genetic link to alcoholism. We have testimony from the medical community that other chemical addictions are physical. Setting aside alcoholism as some special case that is only learned seems to me to be counterproductive. There are, of course, persons who believe that no addictions are physical. Stanton Peele has made a career of fighting the establishment on that point. I do not know, however, whether the rest of the psych and med communities consider him a respected heretic or dismiss him as a kook. The stuff of his that I have read has been persuasive, but I am still troubled by the genetic correlations and the studies on rats and mice that indicate a physical component. ---
**Author:** ![II\_Gyan\_II](https://avatars.discourse-cdn.com/v4/letter/i/bbe5ce/32.png) [@II\_Gyan\_II](https://boards.straightdope.com/u/II_Gyan_II)\ **Post date:** [July 23, 2005, 5:51pm UTC](https://boards.straightdope.com/t/alcholism/313580/35 "2005-07-23T17:51:52Z")
> [@tomndebb](#): > > We have testimony from the medical community that other chemical addictions are physical. > … > but I am still troubled by the genetic correlations and the studies on rats and mice that indicate a physical component. Which is besides the point. The (philosophical) mystery is whether biology drives the mind or just reflects it. Besides Stanton Peele, there’s also the Rat Park experiments from the 80s. Even if you get a perfect & simple correlation, i.e. all individuals with gene X eventually become alcoholics if exposed to alcohol, does that mean that gene X causes alcoholism or just that those alcoholics have gene X? What I’m still asking you is, assume a person who has a genetic marker correlated with alcoholism, how does this person become an alcoholic? What’s the narrative? ---
**Author:** ![tomndebb](https://avatars.discourse-cdn.com/v4/letter/t/b9e5f3/32.png) [@tomndebb](https://boards.straightdope.com/u/tomndebb)\ **Post date:** [July 23, 2005, 6:17pm UTC](https://boards.straightdope.com/t/alcholism/313580/36 "2005-07-23T18:17:55Z")
> [@](#): > > What I’m still asking you is, assume a person who has a genetic marker correlated with alcoholism, how does this person become an alcoholic? What’s the narrative? First they take a drink. Then, depending on the variety of alcoholism to which they succumb, either they grow into a reliance on alcohol to avoid psychological problems, or they simply use alcohol until it overwhelms their resistance to limit themselves, or they are caught up by a desire to consume more, beginning with that first drink. There may be some learned behavior in the first two possibilities with no learned behavior in the last. ---
**Author:** ![II\_Gyan\_II](https://avatars.discourse-cdn.com/v4/letter/i/bbe5ce/32.png) [@II\_Gyan\_II](https://boards.straightdope.com/u/II_Gyan_II)\ **Post date:** [July 23, 2005, 6:35pm UTC](https://boards.straightdope.com/t/alcholism/313580/37 "2005-07-23T18:35:24Z")
> [@tomndebb](#): > > or they are caught up by a desire to consume more, beginning with that first drink. > > There may be some learned behavior in the first two possibilities with no learned behavior in the last. When you say, “caught up by a desire”, is this some sort of inevitability? ---
**Author:** ![lekatt](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/lekatt/32/7269_2.png) [@lekatt](https://boards.straightdope.com/u/lekatt)\ **Post date:** [July 23, 2005, 7:21pm UTC](https://boards.straightdope.com/t/alcholism/313580/38 "2005-07-23T19:21:47Z")
> [@tomndebb](#): > > First they take a drink. Then, depending on the variety of alcoholism to which they succumb, either they grow into a reliance on alcohol to avoid psychological problems, or they simply use alcohol until it overwhelms their resistance to limit themselves, or they are caught up by a desire to consume more, beginning with that first drink. > > There may be some learned behavior in the first two possibilities with no learned behavior in the last. Every time you do something you are learning. That’s why people practice, and practice to become good piano players, sports figure, or even mathmaticians. While it may be true that some like the taste of alcohol on the first drink, they still have to practice to become an alcholic. The process is by choice. Most people know the risks of bad habits, but they do them anyway for different reasons. How does one know if a gene leans toward alcholism. I don’t place any faith in genes telling us how someone will grow up and behave. It is the spiritual self that makes the decisions, not the body. I remember one scientist announced he had found the gene that caused dumbness. How do we define dumbness. I found an interesting quote from the Big Book on alcholism. [http://www.aa.org/bigbookonline/en\_appendiceII.cfm](http://www.aa.org/bigbookonline/en_appendiceII.cfm) This is the way people learn to overcome their dependencies. But first and formost they much be willing to accept the fact they are responsible for their problems due to the earlier choices they made. If one goes around telling people their addictions are not their fault, then one yanks the problem out of their hands and gives them an excuse for remaining where they are. Not good strategy. ---
**Author:** ![hlanelee](https://avatars.discourse-cdn.com/v4/letter/h/3bc359/32.png) [@hlanelee](https://boards.straightdope.com/u/hlanelee)\ **Post date:** [July 23, 2005, 7:52pm UTC](https://boards.straightdope.com/t/alcholism/313580/39 "2005-07-23T19:52:28Z")
**Disease or just a habit?** This is a question for doctors and lawyers and statisticians and benefits providers. For the individual that may be asking this question, the answer is usually **It is a PROBLEM!!!** because, usually when someone is asking ths question alcohol, or some other substance abuse has caused a problem. The individual needs to find someone who has successfully dealt with this problem. I found help in AA 18 years ago, I go back frequently because I am scared not to and it’s really cheap (but not easy) and it works. One morning I woke up in jail after a night of really heavy drinking and realised that it was a problem for this one drunk. The fact that my father died drinking and driving and his mother died from cirrhosis of the liver made me realize that drinking had never done anything positive for me in my life and if I did not **STOP** I would likely die an alcoholic death also. For the record: **This drunk has never known a deity** and AA has worked for me. Don’t drink, do the right thing. Atheism is an excuse. ---
**Author:** ![sleestak](https://avatars.discourse-cdn.com/v4/letter/s/919ad9/32.png) [@sleestak](https://boards.straightdope.com/u/sleestak)\ **Post date:** [July 23, 2005, 7:56pm UTC](https://boards.straightdope.com/t/alcholism/313580/40 "2005-07-23T19:56:03Z")
> [@II Gyan II](#): > > When you say, “caught up by a desire”, is this some sort of inevitability? I’ll jump on this one. If you talk to a lot of alcoholics, which I do since I am a recovering alcoholic, the story is almost always the same. The majority of people, in my experience, who are alcoholics had an intense reaction the first time they drank. They say things “like when I had my first drink I felt complete” or “I finally found the answer” or “I felt it click, I finally felt whole”. Since they had such an intensely good feeling come from drinking it becomes highly likely that they will try and recreate that feeling. The first time I drank I was 9. My I stayed with my sister and her new husband. I drank until I was sick and passed out. You’d think that drinking that much and getting sick would make one not want to drink, at least for a while. Not I. I woke up the next morning and snuck some more wine. After that I snuck vodka/whiskey/beer from my parents anytime I could. Being 9, that wasn’t all that often. But if it was possible I’d do it. That’s the way it went untill I was old enough to get my own alcohol, then it was off to the races. Is it inevitable? No. Is it highly likely that the person who reacts the way I did will become alcoholic? Yes. Slee [Previous page](https://boards.straightdope.com/t/alcholism/313580.md?page=1) [Next page](https://boards.straightdope.com/t/alcholism/313580.md?page=3)