So, we’ve all heard it said: Alcoholism is a disease. No different than cancer or diabetes, right?
Then why does society almost never treat it that way? If someone gets 5 DUIs or tears up the town on a drunken rampage, we want to send that guy to jail and give him a criminal record. Even under the worst disease that we know, we might lock someone up in a civil commitment, but would never give them a criminal record.
Now, one might say that a DUI is different from simply drinking. True, but a significant aspect of the disease is the use of a substance that loosens inhibitions. Many people black out and have no recollection of driving drunk. That would be mitigation for murder but not for DUI. And it is done because someone has a disease?
Same thing for family members. How many of us have told loved ones in a relationship with an alcoholic: You must look out for yourself. He has shown he will not change. You should leave him.
Yet I have never heard anyone say “He is in a wheelchair. Do you want to be changing diapers for the rest of your life? Leave him.”
However, if alcoholism is simply a disease, the same attitude should prevail. Since it doesn’t, isn’t it because we really, deep down, believe that it is simply a moral failing?
And if it is a moral failing, medical treatment would be worthless. What say you? I’m not really sure, but I think the worst thing that society has done is this half-assed “it’s a disease except when it isn’t” that has lead to despair and confusion among those afflicted.
I can tell you that many people are going to react to your OP badly just through emotional responses alone. However, I think you make some good points and are mostly right. A lot of people will claim that alcoholism isn’t a disease just because they believe intuitively that there is such a thing as pure free will and a strong mind/body dichotomy even if they have argued otherwise on related topics.
I don’t take a strong position on it because I can see both points of view.
However:
There is no definition of ‘disease’ that would exclude alcoholism selectively and not also exclude conditions that almost everyone agrees is a true disease. Try it yourself if you disagree. It is a very easy argument to win.
I would personally categorize it as a subset of disease lumped in with the general category of mental illnesses. Those are not fundamentally different medically or philosophically from any other disease but it does influence how they are they are viewed by others. Bipolar disorder, schizophrenia and many other diseases in that general category are generally not the fault of the afflicted individual but they often do require some social restrictions as part of treatment. We wouldn’t let anyone with a mood stability disorder teach a class on firearms for example just like we wouldn’t let a paranoid schizophrenic lead a CIA mission.
The afflicted person isn’t the only concern. There are public safety and family considerations to deal with. Young children are probably better off if mommy lives somewhere else and has supervised visits if she can’t show up to pick the kids up at school on time and sober.
That’s why I mentioned civil remedies as absolutely appropriate. We wouldn’t let a quadriplegic care for an infant without supervision. Even though the person is utterly without fault. Likewise he couldn’t lead a CIA mission.
But we wouldn’t throw him in jail for failing to care for that infant, or disown him from the family because his last surgery (analogy: last trip to rehab) didn’t work and he still has his disease.
I said very much the same thing to my roomie earlier tonight! I phrased it as,“Some people believe addiction is a disease.” My personal opinion: you can’t get addicted to substances or activities you don’t participate in.
Is this a joke? Things like this are whispered by “concerned” friends and family quite frequently in such circumstances (although they would never publicly admit it).
Father to alcoholic son: We have tried to help you. We have paid for three trips to rehab, yet you continue to drink. You were not raised this way. You have a family to take care of. You need to get better or else you will lose everything and never have a decent job!
We’ve heard it, right? Probably say it to our own kid.
Now, replace the same argument to his quadripalegic son:
We have tried to help you. We have paid for three reconstructive surgeries on your spine, yet you continue to sit in that chair. You weren’t raised to sit around all day. You have a family to take care of. You need to get better or else you will lose everything and never have a decent job!
Sounds absurdly insulting and would be condemned by everyone. Why?
Addiction is more of a mental illness – think of it more like depression, or bipolar disorder.
Here’s how it works: imagine your leg itches. You scratch it, right? Well, suppose you’re in a situation where you know you shouldn’t scratch it, because it’ll become infected. But as the day goes on, it just becomes itchier, and itchier, until you start going insane with the urge to scratch.
That’s what it’s like for an alcoholic. The need to drink is like an itch you need to scratch.
Well, you ask, then why do people start drinking in the fist place? Most people don’t start on planning on become alcoholics. They simply find a drink or two helps them get through the day, or makes them feel better about various problems in their lives, relieves stress, etc. And it just kind of spirals out of control.
That doesn’t necessarily mean you have to enable an addict. Sometimes you do need to push them to get help. (Quitting cold turkey isn’t something an alcoholic should do – it can be fatal.) But it’s also not a moral failing, and people who say it is are speaking out of ignorance.
Is there a meaningful difference between “disease” and “mental illness”? They are both basically the same right?
I realize that there are medically significant differences, and I’m not trying to be snarky, but does it matter to the person afflicted (or to society) if a part of my brain is affected versus say, my lower spine?
I think most people agree alcoholism is a disease. But it’s a disease that can be controlled. If you are an alcoholic, you should not drink just as you should not eat sugar if you are a diabetic.
Not to mention, a person may be unable to stop drinking alcohol because they have an addiction, but the only thing that gets them behind the wheel is recklessness. Society rightfully sees the former problem as something treatable, while the latter is just criminal.
Nobody CHOOSES to get cancer or a mental illness. Not everybody deliberately sets out to get drunk, either.
On the other hand, everybody who gets drunk CHOOSES to have a first drink. If nobody drank, then there wouldn’t be any drunkards.
When you deliberately choose to do something that can have potentially lethal consequences in some form or fashion, then you are held responsible for the consequences, even if you didn’t specifically try to bring about those results.
The fact that it’s a disease does not preclude the possibility that attaching serious penalties to drunk driving may reduce the incidence of this, even among alcohol addicts.
I know a guy - clearly alcoholic - who has managed to stop driving drunk. Spending 5 months in jail for his third DUI had a lot to do with this.
ISTM often a two-pronged approach is taken, in which the alcoholism itself may be recognized as a disease, but not recognizing the condition and refusing to get help is the moral failure. This because unlike other conditions that merely create a burden on the family’s time and material and emotional resources, addictions affect active behavior. The addict may actively make life hell for those trying to care for him and keep them in fear.
People will tolerate and support a “recovering” alcoholic or even a “struggling” but functional one, who can hold a job and behave himself in polite company most of the time and when things go badly is truly pained that he hurts his loved ones and seeks help. They will have no sympathy for the one who just wallows in it and essentially demands to be enabled. Refusing to attend therapy/counseling or to take medication. Checking himself out of rehab as soon as able to walk upright again. Belligerent about refusing to live by your rules in your house yet claiming entitlement to do so while unemployed and spending 18 hours a day in an incoherent state or passed out. Etc. Choice to enable for as long as it takes even if it’s your whole lifetime, or throw him out on the street and let it be on your soul 'cause he is NOT going to go to no program where his will is not the last word.
Take it an order of magnitude higher if the alcoholic is one of those who becomes aggressive or violent or just plain mean and nasty when under the influence. Then the claim becomes that you cannot and should not expose yourself to this danger.
As **Ambivalid **pointed out, yes, people WILL encourage others to seek to “take off their hands” loved ones with a disabling or long-term terminal condition. “You cannot surrender your life to this… he may take years to die, you’ll have given up your youth… you’ll always be worried if today is the day you find him dead… think of all the opportunities you’d be giving up” But it’s not portrayed as an admirable, empowering, liberating “save yourself, he’s toxic!” exhortation.
