# Alcoholism is a disease, but we really don't think so **URL:** \ **Category:** Miscellaneous and Personal Stuff I Must Share\ **Created:** [August 29, 2014, 1:39am UTC](https://boards.straightdope.com/t/alcoholism-is-a-disease-but-we-really-dont-think-so/696822 "2014-08-29T01:39:32Z")\ **Posts on this page:** 20\ **Page:** 2
**Author:** ![Shagnasty](https://avatars.discourse-cdn.com/v4/letter/s/9dc877/32.png) [@Shagnasty](https://boards.straightdope.com/u/Shagnasty)\ **Post date:** [August 29, 2014, 3:52am UTC](https://boards.straightdope.com/t/alcoholism-is-a-disease-but-we-really-dont-think-so/696822/21 "2014-08-29T03:52:24Z")
> [@Flyer](#): > > 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. That is true but you cannot single out alcoholism for those traits either. It applies to many health and behavioral issues that people engage in including conditions like diabetes, heart conditions, some cancer, obesity and even things like repetitive orthopedic injuries obtained through sports plus hundreds of others. That is the reason I say that the OP has a generally good point because there is absolutely no known line you can draw that differentiates alcoholism from other activities that people engage in when looking at it from either a disease or behavioral model. I understand why it is a practical problem but you have to be really careful about singling it out as a unique problem when it isn’t. The most effective treatments are essentially the same as for many other mental/behavioral disorders and I am not just talking about 12 step programs. Almost all treatments that are effective at all for alcoholics are also used to treat other conditions. Alcoholism is a shockingly common problem and easily hidden. Some of the people that have it including people here are established and well-respected professionals and some of the most moral people you would ever meet otherwise except for that one issue that they cannot beat. It could be your doctor, boss or professor just as easily as it could be the panhandler on the street. The good news is that medical science views it as a true disease and there are some breakthroughs in drug therapy that have been approved in the past few years. It appears that alcoholism is often caused by a problem in the feedback loop to opiate receptors in the brain. Alcohol is not an opiate itself but it acts on those receptors indirectly. Researchers found that alcoholics and even their young children tend to have abnormal brain scans for certain patterns (in the case of the kids, it was before they even ever had a first drink). There are two ‘drugs’ on the market today that can fight alcoholism even in the formerly chronically addicted sometimes with very dramatic results: Naltrexone and Campral that can be used together or individually. If you have an alcoholic close to you, ask your doctor about those because they may work when nothing else does. I put ‘drug’ in quotes because they are more of an anti-drug in the recreational sense. They don’t cause any type of high and the side-effects are minimal to zero. They work by helping to correct the abnormal brain feedback loops that many alcoholics have genetically and try to fix on their own by drinking with predictable (non)success and lots of heartache. ---
**Author:** ![tapu](https://avatars.discourse-cdn.com/v4/letter/t/49beb7/32.png) [@tapu](https://boards.straightdope.com/u/tapu)\ **Post date:** [August 29, 2014, 3:55am UTC](https://boards.straightdope.com/t/alcoholism-is-a-disease-but-we-really-dont-think-so/696822/22 "2014-08-29T03:55:08Z")
Maybe the supposed moral failing is just the part of the science we haven’t figured out yet. ---
**Author:** ![Ranger\_Jeff](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/ranger_jeff/32/2065_2.png) [@Ranger\_Jeff](https://boards.straightdope.com/u/Ranger_Jeff)\ **Post date:** [August 29, 2014, 3:55am UTC](https://boards.straightdope.com/t/alcoholism-is-a-disease-but-we-really-dont-think-so/696822/23 "2014-08-29T03:55:56Z")
IANAL or a LEO, but isn’t DWI/DUI a criminal offense whether the driver is an alcoholic or not? Should alcoholics get a pass because they have a disease? ---
**Author:** ![Guinastasia](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/guinastasia/32/5751_2.png) [@Guinastasia](https://boards.straightdope.com/u/Guinastasia)\ **Post date:** [August 29, 2014, 4:10am UTC](https://boards.straightdope.com/t/alcoholism-is-a-disease-but-we-really-dont-think-so/696822/24 "2014-08-29T04:10:35Z")
Flyer, re-read my post. > [@jtgain](#): > > 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 know that, and I didn’t think you were being snarky. I just think it might help people understand it better if you compare addiction to say, depression rather than diabetes. And yes, a mental illness is a disease. And once again – don’t ever, EVER tell an alcoholic, “just stop drinking”. Tell them to go and get help. Alcohol withdrawal can and will kill a person. My great-aunt almost died that way. ---
**Author:** ![Tom\_Tildrum](https://avatars.discourse-cdn.com/v4/letter/t/e95f7d/32.png) [@Tom\_Tildrum](https://boards.straightdope.com/u/Tom_Tildrum)\ **Post date:** [August 29, 2014, 4:21am UTC](https://boards.straightdope.com/t/alcoholism-is-a-disease-but-we-really-dont-think-so/696822/25 "2014-08-29T04:21:14Z")
> [@jtgain](#): > > 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. People who drive even though they know they have a poorly-controlled seizure disorder are [sometimes](http://www.tampabay.com/news/publicsafety/drivers-seizure-history-could-lead-to-charges-in-fatal-tampa-crash/1198731) [convicted](http://archives.explorehoward.com/news/60641/manslaughter-conviction-driver-with-epilepsy/) of vehicular manslaughter. ---
**Author:** ![The\_Second\_Stone](https://avatars.discourse-cdn.com/v4/letter/t/bbe5ce/32.png) [@The\_Second\_Stone](https://boards.straightdope.com/u/The_Second_Stone)\ **Post date:** [August 29, 2014, 5:04am UTC](https://boards.straightdope.com/t/alcoholism-is-a-disease-but-we-really-dont-think-so/696822/26 "2014-08-29T05:04:04Z")
I have a roommate (two actually) who are alcoholics. The one with the worse level of the disease never drives and doesn’t have a driver’s license. The other one is a steady rate drinker who generally knows when it is safe to drive as he rarely binges. Both of these guys say they can quit, but I doubt it. The one who doesn’t drive gets so wasted so regularly that he will kill himself. He does love getting passed out drunk for his weekend, at least the first 24 hours of it. ---
**Author:** ![Eyebrows\_0f\_Doom](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/eyebrows_0f_doom/32/3119_2.png) [@Eyebrows\_0f\_Doom](https://boards.straightdope.com/u/Eyebrows_0f_Doom)\ **Post date:** [August 29, 2014, 5:52am UTC](https://boards.straightdope.com/t/alcoholism-is-a-disease-but-we-really-dont-think-so/696822/27 "2014-08-29T05:52:47Z")
> [@jtgain](#): > > Imagine the familiar conversation: > > 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? Because the alcoholic \*\*can \*\*stop drinking. The quadriplegic cannot just get up. ---
**Author:** ![tapu](https://avatars.discourse-cdn.com/v4/letter/t/49beb7/32.png) [@tapu](https://boards.straightdope.com/u/tapu)\ **Post date:** [August 29, 2014, 1:06pm UTC](https://boards.straightdope.com/t/alcoholism-is-a-disease-but-we-really-dont-think-so/696822/28 "2014-08-29T13:06:08Z")
> [@Eyebrows\_0f\_Doom](#): > > Because the alcoholic \*\*can \*\*stop drinking. The quadriplegic cannot just get up. That’s what’s up for debate. (The former.) ---
**Author:** ![TriPolar](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/tripolar/32/3008_2.png) [@TriPolar](https://boards.straightdope.com/u/TriPolar)\ **Post date:** [August 29, 2014, 1:36pm UTC](https://boards.straightdope.com/t/alcoholism-is-a-disease-but-we-really-dont-think-so/696822/29 "2014-08-29T13:36:39Z")
Alcoholism is the disease. It is urge to drink. The drinking itself is a symptom of the disease and many people feel that alcoholics can control that behavior and have no sympathy for their plight. They might compare it to a diabetic who refuses to take insulin. For alcoholism as well as other addictions it is not at all that clear cut. ---
**Author:** ![StGermain](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/stgermain/32/2868_2.png) [@StGermain](https://boards.straightdope.com/u/StGermain)\ **Post date:** [August 29, 2014, 1:47pm UTC](https://boards.straightdope.com/t/alcoholism-is-a-disease-but-we-really-dont-think-so/696822/30 "2014-08-29T13:47:34Z")
A disease can sometimes result in criminal behavior. A person infected with HIV who knows this and still goes out and has unprotected sex with strangers unaware of his status can be arrested. I believe that a non-compliant person with TB can be involuntarily quarantined for the public good. You can’t use the fact that you’re an alcoholic as a get-out-of-jail-free card, absolving you from the consequences of your actions. It’s not illegal to be an alcoholic - it’s illegal to drive while impaired. The justice system come into play not because a person drinks, but because of their actions after they drink. To use your wheelchair analogy - it’s not illegal to be in a wheelchair, but if you roll your chair over to someone and start whacking them with a baseball bat, you’re going to be arrested. StG ---
**Author:** ![kayaker](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/kayaker/32/441_2.png) [@kayaker](https://boards.straightdope.com/u/kayaker)\ **Post date:** [August 29, 2014, 1:55pm UTC](https://boards.straightdope.com/t/alcoholism-is-a-disease-but-we-really-dont-think-so/696822/31 "2014-08-29T13:55:35Z")
> [@Ranger\_Jeff](#): > > IANAL or a LEO, but isn’t DWI/DUI a criminal offense whether the driver is an alcoholic or not? Should alcoholics get a pass because they have a disease? Yep. I know plenty of people who have had DUIs yet are not alcoholic.For many, drinking is a lifestyle choice,not a necessity. ---
**Author:** ![kayaker](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/kayaker/32/441_2.png) [@kayaker](https://boards.straightdope.com/u/kayaker)\ **Post date:** [August 29, 2014, 1:59pm UTC](https://boards.straightdope.com/t/alcoholism-is-a-disease-but-we-really-dont-think-so/696822/32 "2014-08-29T13:59:29Z")
> [@StGermain](#): > > A disease can sometimes result in criminal behavior. What is the current thinking on XYY males and criminal behavior? Should someone’s genetic makeup be an excuse? ---
**Author:** ![BMalion](https://avatars.discourse-cdn.com/v4/letter/b/e274bd/32.png) [@BMalion](https://boards.straightdope.com/u/BMalion)\ **Post date:** [August 29, 2014, 2:10pm UTC](https://boards.straightdope.com/t/alcoholism-is-a-disease-but-we-really-dont-think-so/696822/33 "2014-08-29T14:10:23Z")
> [@Ranger\_Jeff](#): > > IANAL or a LEO, but isn’t DWI/DUI a criminal offense whether the driver is an alcoholic or not? Should alcoholics get a pass because they have a disease? No! I crawled into a bottle for a year after my divorce but I never drove after a drink, my choice. ---
**Author:** ![Shodan](https://avatars.discourse-cdn.com/v4/letter/s/9f8e36/32.png) [@Shodan](https://boards.straightdope.com/u/Shodan)\ **Post date:** [August 29, 2014, 2:36pm UTC](https://boards.straightdope.com/t/alcoholism-is-a-disease-but-we-really-dont-think-so/696822/34 "2014-08-29T14:36:55Z")
> [@jtgain](#): > > Imagine the familiar conversation: > > 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? Because an alcoholic saying “I _can’t_ stop drinking” is not true in the same way that a quadraplegic saying “I _can’t_ walk” is true. Regards, Shodan ---
**Author:** ![Hari\_Seldon](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/hari_seldon/32/5173_2.png) [@Hari\_Seldon](https://boards.straightdope.com/u/Hari_Seldon)\ **Post date:** [August 29, 2014, 2:36pm UTC](https://boards.straightdope.com/t/alcoholism-is-a-disease-but-we-really-dont-think-so/696822/35 "2014-08-29T14:36:59Z")
> [@outlierrn](#): > > We put Typhoid Mary in isolation. She didn’t choose her condition, but she wouldn’t stop hurting people. True but she promised not to work in food service and reneged on the promise. If an alcoholic drinks, that’s his problem and I recognize the addiction. If he drives that’s my problem—and he’s not addicted to driving. Fuck him. ---
**Author:** ![Eyebrows\_0f\_Doom](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/eyebrows_0f_doom/32/3119_2.png) [@Eyebrows\_0f\_Doom](https://boards.straightdope.com/u/Eyebrows_0f_Doom)\ **Post date:** [August 29, 2014, 2:40pm UTC](https://boards.straightdope.com/t/alcoholism-is-a-disease-but-we-really-dont-think-so/696822/36 "2014-08-29T14:40:47Z")
> [@tapu](#): > > That’s what’s up for debate. (The former.) Are you actually serious? You think there is debate that someone can stop drinking? So all the alcoholics who have stopped and have turned their lives around are… what? Imaginary? I guess that also means people can’t stop smoking or doing drugs either. No one \*ever \*quits anything addictive. ---
**Author:** ![AnaMen](https://avatars.discourse-cdn.com/v4/letter/a/dfb087/32.png) [@AnaMen](https://boards.straightdope.com/u/AnaMen)\ **Post date:** [August 29, 2014, 3:02pm UTC](https://boards.straightdope.com/t/alcoholism-is-a-disease-but-we-really-dont-think-so/696822/37 "2014-08-29T15:02:16Z")
Alcoholism is not a disease, it’s an addiction. Yes, I’m sure it’s very hard (understatement, I know) to stop doing the thing you are addicted to, but telling people a big challenge is not just difficult, but impossible and outside of their control is not only false, but counterproductive. Alcoholics have successfully stopped drinking (though according to some, remain “alcoholics” forever), so it is possible. The moral failing is not moving getting rid of your addiction that has a negative effect on others to your top priority. ---
**Author:** ![UltraVires](https://avatars.discourse-cdn.com/v4/letter/u/ecccb3/32.png) [@UltraVires](https://boards.straightdope.com/u/UltraVires)\ **Post date:** [August 29, 2014, 3:03pm UTC](https://boards.straightdope.com/t/alcoholism-is-a-disease-but-we-really-dont-think-so/696822/38 "2014-08-29T15:03:25Z")
> [@StGermain](#): > > A disease can sometimes result in criminal behavior. A person infected with HIV who knows this and still goes out and has unprotected sex with strangers unaware of his status can be arrested. I believe that a non-compliant person with TB can be involuntarily quarantined for the public good. You can’t use the fact that you’re an alcoholic as a get-out-of-jail-free card, absolving you from the consequences of your actions. > > It’s not illegal to be an alcoholic - it’s illegal to drive while impaired. The justice system come into play not because a person drinks, but because of their actions after they drink. To use your wheelchair analogy - it’s not illegal to be in a wheelchair, but if you roll your chair over to someone and start whacking them with a baseball bat, you’re going to be arrested. > > StG I think there is a difference. The HIV infected person who has unprotected sex with someone has made a conscious choice, a choice unaffected by his disease of HIV, to expose someone to his disease. Just like a person in a wheelchair beating someone with a baseball bat. His spinal cord affliction doesn’t affect his conscious choice to beat someone with a bat. When an alcoholic “chooses” to drink and drive, his choice is made under the influence of an intoxicating substance that he has ingested as part of his disease. IOW, the disease leads to the drink which leads to the decision to drive. But for the disease, there would not be the DUI. Now, I’m not suggesting a blanket immunity for alcoholics. I’m not sure where I stand on the criminal penalties. But any argument that boils down to “he should be punished because he chose X” when X is related to alcohol sort of begs the question and exposes the belief that the alcoholic has a meaningful choice about drinking. ---
**Author:** ![Marley23](https://avatars.discourse-cdn.com/v4/letter/m/45deac/32.png) [@Marley23](https://boards.straightdope.com/u/Marley23)\ **Post date:** [August 29, 2014, 3:08pm UTC](https://boards.straightdope.com/t/alcoholism-is-a-disease-but-we-really-dont-think-so/696822/39 "2014-08-29T15:08:21Z")
> [@jtgain](#): > > 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’m not seeing the confusion. It’s a disease, but it’s not the same as an infection caused by accidental exposure to a virus. It’s a disease that affects judgment and behavior, so it does occupy a middle ground. I think the main point of calling it a disease is that you are acknowledge it’s not just a personal failing or that the person really likes to drink. People are responsible for their behavior but they’re not entirely responsible for diseases that affect their brains - this is even more obvious in the way we talk about depression and suicide today, I think. And yes, they’re also responsible for recognizing that they have problems. > [@](#): > > 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.” Being in a wheelchair doesn’t hurt anyone. Alcoholism can. And like other people said, a paraplegic isn’t going to get up and walk no matter what you do. It’s possible that a person with a behavioral disorder will be encouraged to seek help if you take a hard line on their behavior. Or failing that, you won’t be enabling their behavior. ---
**Author:** ![RivkahChaya](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/rivkahchaya/32/8919_2.png) [@RivkahChaya](https://boards.straightdope.com/u/RivkahChaya)\ **Post date:** [August 29, 2014, 3:10pm UTC](https://boards.straightdope.com/t/alcoholism-is-a-disease-but-we-really-dont-think-so/696822/40 "2014-08-29T15:10:13Z")
If a diabetic goes too long without eating, doesn’t check his blood, or take his shots, and causes an accident, he doesn’t get a pass because he is diabetic. I have a condition that causes me to get frequent bladder infections, but I don’t get to exceed the speed limit or run red lights when I have one because I really, really need to pee. If a diabetic is not handling his or her condition well, like, not following her diet, checking her sugar, or taking her insulin, and her spouse leaves her, I wouldn’t be shocked, because a person like that can be as moody and abusive as an alcoholic. We had a disabled child receiving services from our agency once, whose (single) mother seemed to have a diabetic crisis twice a year, just before spring break, and right after Christmas, meaning that when her kids were home from school, she’d be in the hospital. We usually had to find 24hr staff for the kid, and that meant someone was in the house for the other kids too. About the fifth time in a row this happened, we found a person who would take the disabled kid into her home, rather than have staff staying in the kids home. The mother refused, saying she didn’t want her kid in a “strange place.” We said fine, but we’d fulfilled our contractual obligations; the person who was willing to take the kid was an employee trained to work with him. Now she was on her own. Suddenly, she was better, was coming home, begging for her regular respite care staff, and never had another crisis requiring hospitalization again. So, it was a little like a stealth intervention. We couldn’t actually accuse her of not taking her insulin or eating candy to bring on a crisis, but we could give her a solution that she didn’t want. Is addiction a disease? Some people get addicted, and some people don’t, which means that some people probably have a predisposition to it, and some people don’t. I know someone who has never taken a drink in her life, because both her parents are alcoholics, and she worries that she has inherited whatever makes them addicted to alcohol. I think it probably has elements of a disease, but I also think the OP is wrong in suggesting that diseases absolve people of responsibility for crimes. Even mentally ill people don’t always get a pass. Someone who is diagnosed with PBD or OCD, or even autism must be examined to determine whether they know right from wrong, and if so, whether they are capable of conforming their behavior to what they know is right. It’s only when the answer to one of those is “No,” they they are even allowed to attempt to use an insanity defense, and those don’t always succeed. Even when they do, the person may be shut up for life, just in a mental hospital, not a prison. Drunk drivers often do get offered rehab as a way of getting a reduced sentence, particularly if it is a first offense, and no one was seriously hurt. A disease does not need an infectious agent. There are plenty of genetic diseases, and alcoholism (or, addiction) may be one of them. I have a lot of trouble wrapping my brain around it personally, I confess, because I don’t tend to get addicted to things. But people who have studied the subject extensively say it is. ETA: being in a wheelchair can be caused either by a disability, or a disease. Parkinson’s is a disease. Having been paralyzed in an accident is a disability. [Previous page](https://boards.straightdope.com/t/alcoholism-is-a-disease-but-we-really-dont-think-so/696822.md?page=1) [Next page](https://boards.straightdope.com/t/alcoholism-is-a-disease-but-we-really-dont-think-so/696822.md?page=3)