# 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:** 3
**Author:** ![Little\_Nemo](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/little_nemo/32/3120_2.png) [@Little\_Nemo](https://boards.straightdope.com/u/Little_Nemo)\ **Post date:** [August 29, 2014, 3:12pm UTC](https://boards.straightdope.com/t/alcoholism-is-a-disease-but-we-really-dont-think-so/696822/41 "2014-08-29T15:12:48Z")
> [@jtgain](#): > > 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. No, I disagree. When the person is drunk, his decisions are under the influence of an intoxicating substance. But he was not under the influence when he made the decision to have that first drink. That was a conscious decision he made while sober. ---
**Author:** ![Doctor\_Jackson](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/doctor_jackson/32/32_2.png) [@Doctor\_Jackson](https://boards.straightdope.com/u/Doctor_Jackson)\ **Post date:** [August 29, 2014, 7:52pm UTC](https://boards.straightdope.com/t/alcoholism-is-a-disease-but-we-really-dont-think-so/696822/42 "2014-08-29T19:52:03Z")
> [@jtgain](#): > > 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. If a mentally ill person quits taking their meds and commits a crime, they are still subject to criminal prosecution. If the legal system believes that the disease caused the actions, there is the option of involuntarily committing the person to a hospital until “cured”, then to prison to finish any remainder of the sentence. Perhaps something similar would work for DUI? Sentence of X time incarcerated, at least Y portion to be spent in custodial rehab. ---
**Author:** ![MrsTime](https://avatars.discourse-cdn.com/v4/letter/m/d26b3c/32.png) [@MrsTime](https://boards.straightdope.com/u/MrsTime)\ **Post date:** [August 29, 2014, 11:19pm UTC](https://boards.straightdope.com/t/alcoholism-is-a-disease-but-we-really-dont-think-so/696822/43 "2014-08-29T23:19:51Z")
> [@Little\_Nemo](#): > > 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. Exactly! ---
**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, 11:22pm UTC](https://boards.straightdope.com/t/alcoholism-is-a-disease-but-we-really-dont-think-so/696822/44 "2014-08-29T23:22:06Z")
> [@Little\_Nemo](#): > > No, I disagree. When the person is drunk, his decisions are under the influence of an intoxicating substance. But he was not under the influence when he made the decision to have that first drink. **That was a conscious decision he made while sober.** (emphasis added) But that is more question begging. The disease concept means that he did not make a free, conscious choice to start drinking. ---
**Author:** ![UltraVires](https://avatars.discourse-cdn.com/v4/letter/u/ecccb3/32.png) [@UltraVires](https://boards.straightdope.com/u/UltraVires)\ **Post date:** [August 30, 2014, 12:48am UTC](https://boards.straightdope.com/t/alcoholism-is-a-disease-but-we-really-dont-think-so/696822/45 "2014-08-30T00:48:38Z")
> [@Marley23](#): > > 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. > > 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. It seems like you are saying that alcoholism is 1/2 of a disease. How can a person with a mental disorder be “responsible” for recognizing that disorder? As to your second point, alcoholism can hurt someone in ways that require civil commitment that I mentioned above. As far as “hurting” a loved one in the way that they have to take care of you or are upset by seeing you that way, its the same as cancer or paralysis, UNLESS one thinks it is simply a matter of choice. ---
**Author:** ![Napier](https://avatars.discourse-cdn.com/v4/letter/n/ce73a5/32.png) [@Napier](https://boards.straightdope.com/u/Napier)\ **Post date:** [August 30, 2014, 12:53am UTC](https://boards.straightdope.com/t/alcoholism-is-a-disease-but-we-really-dont-think-so/696822/46 "2014-08-30T00:53:42Z")
I think the question of control misses part of the problem, because the whole pattern of making a horrible choice to drink is a product of the disease as well as a cause of the next round of symptomatic behavior. It’s very much an issue that alcohol and withdrawal directly mess with the decision making organ in your body. As to whether this amounts to some kind of excuse for alcoholics to ignore the law, well, does it matter? Being an active alcoholic is hell as it is. I think it’s best for all concerned to let the law come down on alcoholics such that the legal consequences get thrown onto the hellish stack that is already pressuring the alcoholic. Some eventually find their own bottom and climb back up to the world of the living somehow. Others die. If there was a better cure, one that was compassionate like the treatments for most diseases are, that would be really nice. If. It’s a disease you can get yelled at for having. I don’t think we should be pissed off, especially, at alcoholics. But the ones that mess up too badly should face jail or whatever, like everybody else who does whatever they did. It should evoke pity, not fury, though. The comments about it having been a choice to try alcohol in the very first place are probably mostly invalid. Any commenter who has ever tried even a single drink has no right to poke at anybody else for doing so. Sober 27 years, by the way. ---
**Author:** ![minlokwat](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/minlokwat/32/2844_2.png) [@minlokwat](https://boards.straightdope.com/u/minlokwat)\ **Post date:** [August 30, 2014, 12:54am UTC](https://boards.straightdope.com/t/alcoholism-is-a-disease-but-we-really-dont-think-so/696822/47 "2014-08-30T00:54:13Z")
If one insists on calling alcoholism a disease, can I insist you put the words “self-inflicted” before it? ---
**Author:** ![DingoelGringo](https://avatars.discourse-cdn.com/v4/letter/d/9d8465/32.png) [@DingoelGringo](https://boards.straightdope.com/u/DingoelGringo)\ **Post date:** [August 30, 2014, 12:55am UTC](https://boards.straightdope.com/t/alcoholism-is-a-disease-but-we-really-dont-think-so/696822/48 "2014-08-30T00:55:30Z")
> [@Guinastasia](#): > > 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. That brings us to the problem I had with Alcoholics Anonymous. It is based on the premise that drinking is a sin. The 12 steps are based on that premise though they sing the song that it is a disease. ---
**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 30, 2014, 12:57am UTC](https://boards.straightdope.com/t/alcoholism-is-a-disease-but-we-really-dont-think-so/696822/49 "2014-08-30T00:57:44Z")
> [@jtgain](#): > > (emphasis added) But that is more question begging. The disease concept means that he did not make a free, conscious choice to start drinking. Yes, he did. When he was sober, he made the (sober) decision to take the first drink of the day, _knowing_ it would lead to more. And if he drove to a bar to take that first drink, he knew _before_ he was impaired that he had to get home again, that he’d likely be drunk and therefor impaired. He could indulge his addiction in his own living room, not endangering anyone but himself. He made the choice to go out. StG ---
**Author:** ![DingoelGringo](https://avatars.discourse-cdn.com/v4/letter/d/9d8465/32.png) [@DingoelGringo](https://boards.straightdope.com/u/DingoelGringo)\ **Post date:** [August 30, 2014, 12:59am UTC](https://boards.straightdope.com/t/alcoholism-is-a-disease-but-we-really-dont-think-so/696822/50 "2014-08-30T00:59:31Z")
> [@tapu](#): > > Which way we wanna go with lung cancer in that one? Depends on how much one smokes. ---
**Author:** ![tapu](https://avatars.discourse-cdn.com/v4/letter/t/49beb7/32.png) [@tapu](https://boards.straightdope.com/u/tapu)\ **Post date:** [August 30, 2014, 1:01am UTC](https://boards.straightdope.com/t/alcoholism-is-a-disease-but-we-really-dont-think-so/696822/51 "2014-08-30T01:01:14Z")
> [@Eyebrows\_0f\_Doom](#): > > 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. You might want to look up some recidivism rates. Don’t got to AA for the data, though. ---
**Author:** ![tapu](https://avatars.discourse-cdn.com/v4/letter/t/49beb7/32.png) [@tapu](https://boards.straightdope.com/u/tapu)\ **Post date:** [August 30, 2014, 1:04am UTC](https://boards.straightdope.com/t/alcoholism-is-a-disease-but-we-really-dont-think-so/696822/52 "2014-08-30T01:04:13Z")
Oo! Here’s a good one: [http://www.soberforever.net/currenttreatdoesnt.cfm](http://www.soberforever.net/currenttreatdoesnt.cfm) All treatment programs incl AA found to have around 3% success rate. ---
**Author:** ![dracoi](https://avatars.discourse-cdn.com/v4/letter/d/90db22/32.png) [@dracoi](https://boards.straightdope.com/u/dracoi)\ **Post date:** [August 30, 2014, 1:09am UTC](https://boards.straightdope.com/t/alcoholism-is-a-disease-but-we-really-dont-think-so/696822/53 "2014-08-30T01:09:16Z")
> [@jtgain](#): > > (emphasis added) But that is more question begging. The disease concept means that he did not make a free, conscious choice to start drinking. But at some point, it was a choice. Or a failure to remove a choice. For example, if you hired someone to follow you around and that person’s only job was to prevent you from drinking, that’d probably stop the drinking, right? Or let’s say you choose to live in a locked room in a monastery surrounded by monks who will never allow you to drink. These are both conscious decisions that can absolutely 100% prevent drinking. Of course, they’re a little extreme and I’m not sure I’d recommend them until everything else has failed. But if I’m talking to that guy with five DUIs who’s ruined everything in his life, I’m going to start thinking he’s just not that committed to taking care of his disease if he continues to live in places where he has alcohol. See, I’m not denying that the disease might control someone’s behavior to a significant degree. But this doesn’t completely absolve them from any moral responsibility. In fact, let’s think about that wheel-chair bound person again. Let’s tell him “If you only do these three very difficult things, you’ll walk again.” If that person responds with “Oh, but that would be so inconvenient. It’s too much work. I don’t want to.” isn’t it fair to call THAT a moral failing? It’s now a choice, and the person has decided that being wheelchair bound is preferable to curing the disease. Their failing is not the disease itself, it’s just basically laziness because they won’t do what’s required to fix it. At some point, that’s the same failing that I’ll ascribe to an alcoholic. ---
**Author:** ![tapu](https://avatars.discourse-cdn.com/v4/letter/t/49beb7/32.png) [@tapu](https://boards.straightdope.com/u/tapu)\ **Post date:** [August 30, 2014, 1:13am UTC](https://boards.straightdope.com/t/alcoholism-is-a-disease-but-we-really-dont-think-so/696822/54 "2014-08-30T01:13:40Z")
They hired a lotta people to keep Betty Ford from getting drunk at one point, and she drank her fucking hairspray. (may be apocryphal, but makes the point) ---
**Author:** ![Little\_Nemo](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/little_nemo/32/3120_2.png) [@Little\_Nemo](https://boards.straightdope.com/u/Little_Nemo)\ **Post date:** [August 30, 2014, 1:20am UTC](https://boards.straightdope.com/t/alcoholism-is-a-disease-but-we-really-dont-think-so/696822/55 "2014-08-30T01:20:42Z")
> [@tapu](#): > > Oo! Here’s a good one: [http://www.soberforever.net/currenttreatdoesnt.cfm](http://www.soberforever.net/currenttreatdoesnt.cfm) > > All treatment programs incl AA found to have around 3% success rate. That’s a site for another rehabilitation program. So their figures on the effectiveness of AA might be biased. ---
**Author:** ![tapu](https://avatars.discourse-cdn.com/v4/letter/t/49beb7/32.png) [@tapu](https://boards.straightdope.com/u/tapu)\ **Post date:** [August 30, 2014, 1:22am UTC](https://boards.straightdope.com/t/alcoholism-is-a-disease-but-we-really-dont-think-so/696822/56 "2014-08-30T01:22:26Z")
> [@Little\_Nemo](#): > > That’s a site for another rehabilitation program. So their figures on the effectiveness of AA might be biased. Look further if you like but pretty much any addiction counselor will tell that 3% is the general effectiveness rate. ---
**Author:** ![Strinka](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/strinka/32/512_2.png) [@Strinka](https://boards.straightdope.com/u/Strinka)\ **Post date:** [August 30, 2014, 1:29am UTC](https://boards.straightdope.com/t/alcoholism-is-a-disease-but-we-really-dont-think-so/696822/57 "2014-08-30T01:29:03Z")
> [@Eyebrows\_0f\_Doom](#): > > Because the alcoholic \*\*can \*\*stop drinking. The quadriplegic cannot just get up. This is basically what it comes down to. Something can only be a moral failure if it’s a choice. A quadriplegic obviously can’t simply will himself to get better, so it’s not a moral failing for him to not get better. But if an alcoholic can simply choose to get better, then not getting better is a moral failure. However, whether something is a choice is not as simple as many people think. Usually whether something is a choice is presented as a simple binary. Either it is a choice, or it’s not. It think it’s a spectrum. It’s possible for something to be sort of a choice. That’s not always clear, because most things we encounter on a day-to-day basis fall clearly on one end of the spectrum or the other. I think addiction is a good example of something that falls in between. Another example would be OCD. Is it a choice for someone with OCD to perform their compulsions? It seems to me that it’s somewhere between completely voluntary and completely involuntary. Somewhat tangentially related, [this](http://lesswrong.com/lw/2as/diseased_thinking_dissolving_questions_about/) is a very good article about why we consider different conditions diseases or not, and why we treat them differently. ---
**Author:** ![BigT](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/bigt/32/12044_2.png) [@BigT](https://boards.straightdope.com/u/BigT)\ **Post date:** [August 30, 2014, 1:31am UTC](https://boards.straightdope.com/t/alcoholism-is-a-disease-but-we-really-dont-think-so/696822/58 "2014-08-30T01:31:30Z")
> [@dracoi](#): > > In fact, let’s think about that wheel-chair bound person again. Let’s tell him “If you only do these three very difficult things, you’ll walk again.” If that person responds with “Oh, but that would be so inconvenient. It’s too much work. I don’t want to.” isn’t it fair to call THAT a moral failing? It’s now a choice, and the person has decided that being wheelchair bound is preferable to curing the disease. Their failing is not the disease itself, it’s just basically laziness because they won’t do what’s required to fix it. At some point, that’s the same failing that I’ll ascribe to an alcoholic. You can’t apply the logic of a physical disease to a mental one. You can’t so clearly separate what is the disease and what isn’t. By your logic, a depressed person who can’t make themselves do what they need to do to get better has nothing to do with depression. Yet it does, entirely. And, guess what one of the symptoms of alcoholism is? That’s right, depression. In fact, I’d argue that the disease part of alcoholism is usually depression or anxiety or some other mental illness. I would actually guess that most alcoholics are self-medicating some problem that predates their alcohol use. ---
**Author:** ![Little\_Nemo](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/little_nemo/32/3120_2.png) [@Little\_Nemo](https://boards.straightdope.com/u/Little_Nemo)\ **Post date:** [August 30, 2014, 1:31am UTC](https://boards.straightdope.com/t/alcoholism-is-a-disease-but-we-really-dont-think-so/696822/59 "2014-08-30T01:31:36Z")
> [@jtgain](#): > > (emphasis added) But that is more question begging. The disease concept means that he did not make a free, conscious choice to start drinking. I disagree. Alcoholism can make you really crave alcohol but it can’t make you drink alcohol. That’s still a free, conscious choice you make. ---
**Author:** ![tapu](https://avatars.discourse-cdn.com/v4/letter/t/49beb7/32.png) [@tapu](https://boards.straightdope.com/u/tapu)\ **Post date:** [August 30, 2014, 1:34am UTC](https://boards.straightdope.com/t/alcoholism-is-a-disease-but-we-really-dont-think-so/696822/60 "2014-08-30T01:34:36Z")
I’m still waiting for the cure. 🙂 [Previous page](https://boards.straightdope.com/t/alcoholism-is-a-disease-but-we-really-dont-think-so/696822.md?page=2) [Next page](https://boards.straightdope.com/t/alcoholism-is-a-disease-but-we-really-dont-think-so/696822.md?page=4)