Alcoholism is a disease, but we really don't think so

Miscellaneous and Personal Stuff I Must Share
61

You are 100% incorrect on that. That is what lockdown rehab units try to do and they still can’t come close to achieving it. Alcoholics and drug addicts are unbelievably skilled magicians. You can can search everyone and everything coming in and they will still find a source. It is like the whole world is their liquor store or drug dealer. That is the reason lockdown rehab and detox units have to do constant breath, blood and urine tests for the people in their care and they still don’t catch but a fraction of the people still actively using while they are there.

Alcoholics are even better at it than other drug users because it can be hidden in anything and can’t be detected by normal tests after it wears off. These aren’t amateurs with nips of Jack Daniels on a Boy Scout camping trip here. They need small amounts of alcohol in their system to feel normal at all and will do anything to get it. By the time most people need to go to rehab, they already know about any monitoring you can come up with and have a better way to counter it.

62

Extremely easily. About the only ones that have an excuse have personality disorders that make it difficult for them to notice something is wrong, because they don’t realize that other people act differently, or can’t figure out why they should care.

It would be one thing if they lived somewhere where people didn’t know alcoholism was a problem. But they have ample messages telling them that it is. Recognition is definitely something they can do.

Knowing they have a problem is not really the problem. Sure, they can be in denial, but everyone has a responsibility to get out of that.

The problem is people expecting addicts to do things they themselves would not be able to do. Alcoholism is the only addiction where you have to stop completely and can’t gradually work your way down. If you screw up, you’re a horrible person.

63

You can call alcoholism a disease, condition, syndrome or whatever else you want. Those are just imperfect English language words to describe medical symptoms and they are all accurate to some degree.

In the early stages, it may just be a simple addiction (if that isn’t an oxymoron) that describes a behavioral state or a mental illness. However, in the later stages, the whole body and all its organ systems are impacted. The liver is the most obvious one because it gets the responsibility of filtering out all those toxins it doesn’t want until it is overwhelmed and unable to do its job well. It also has about 700 other jobs to do that it can’t very effectively because it is dealing with all the alcohol.

In some late stage alcoholism cases, the liver will fail rather suddenly, in others, it will happen very slowly (years or decades). If the liver can hang in there for long enough, many other organ systems can fail before the liver does. Long-term alcoholics tend to have severe vitamin deficiencies that can impact everything from brain function (especially speech centers) to heart rhythms. The kidneys can also be the first to throw up the white flag and call it quits. Any of those things can kill a person. My neighbor just died from long term alcoholism induced kidney failure for example even though he quit a few years ago. He also got dementia from it and woke me up to collapse into my arms completely confused at 3 am a few months before he died.

None of these people choose to do this to themselves in the popular sense of the word. They can’t stop drinking suddenly without medical intervention because it will be very painful and debilitating for at least a week at best and fatal at worst. The human nervous system has a habit of compensating for whatever it is exposed to for long-periods. If someone drinks, enough for months or years, the organ systems habituate to the suppressive effects and ‘think’ that they will always be there.

However, if you take that away suddenly, you can get anything from cardiac arrest to fatal seizures. Guin was right when she said never try to just tell a long-term alcoholic to stop drinking or take away all their drinks by force. It usually isn’t medically safe. They need to go into a medical detox unit ASAP.

64

Just because something is a choice doesn’t always make it easy. As I said, one doesn’t start out intending to become an alcoholic.

This is a very painful subject for me, and I apologize if I get a wee emotional over it.

65

That was discredited about 20 years ago.

Also paralysis has lots of causes. Some people cannot walk at all. Some people in wheelchairs walk with pain, or are in danger of falling and hurting themselves, and also not being able to get back up. Some people can walk a few steps, very slowly, with a Lofstrand crutch. Some people are an amputee at the thigh, but can get up and hop a few feet, or stand up and get something off a shelf and sit back down, but can’t be fitted with a prosthesis, because they can’t support one. Usually none of these people have diseases, in that they don’t have a condition that is progressing. Some do. Some will get worse, and lose more and more ability to move. Some will die. But most will not.

Just clearing up some terminology.

66

That’s true. Just because something is simple doesn’t make it easy. But just because something is difficult doesn’t make it impossible. The 95% recidivism statistic is a personally terrifying one for me to hear, but I know I have a better shot at that 5% than most people because I often work with alcoholics at various stages in their failing health.

When you’ve cleaned the bloody, grape-jelly looking, fish smelling shit of a man in the end stages of renal failure, and you’ve looked into his yellow eyes and seen how much he suffers, sobriety gets a little easier every day.

We had a CIWA (Alcohol detox protocol) patient on my floor today. Before I go to bed tonight, I’m going to sit and think about her delirious screaming. I’m going to think about this thread, and why I didn’t drink today, wont drink tomorrow, will never drink again.

If the whole world saw the things I’ve seen, I’ll bet that 5% would climb to 10% pretty damn quick. Stats and numbers are nice and clean. I think we should educate people with the blood, shit, and screaming.

67

I’m saying it’s a different type of disease from cancer or a viral infection. I guess you could put it your way if you want to, although I think it downplays the seriousness somewhat. The precise term isn’t that important.

It’s very hard. See also: depression. If you’re clinically depressed, something is wrong with your brain, but you also need your brain to realize “my brain is not functioning properly.” Ultimately we’re responsible for our own behavior, though - that’s an important idea in human society. And it’s also practical. Nobody can make an alcoholic stop drinking; the alcoholic has to decide to do so.

I’m not sure why you keep asking this when you already seem to understand the problem (and other people have explained it). Nobody in their right mind would say “I’m leaving you unless you stop having cancer.” That would be cruel and would have no effect on the person’s behavior or survival. The partner of an alcoholic might say “I will leave you unless you stop drinking” because it could encourage the alcoholic to stop drinking. Many alcoholics relapse, but some do manage to quit. It’s a disease that affects your behavior, but it does not mean there is zero chance you will get sober.

68

It’s not, though I’m not sure it will be understandable. There are two main things that mark an alcoholic as opposed to a social drinker. A social drinker can take it or leave it. An active alcoholic cannot with any sort of consistency control (1) if he drinks, or (2) how much he drinks once he has one. The objective is to not be active in the addiction, but that is way, WAY more difficult than how you make it out to be, if you think it’s a free, conscious decision.

I know lots of people who often found themselves at some point in a day where they were determined not to drink, drunk and asking themselves in despair, “How can this be? How can I be drunk again?” Of course that person knows intellectually that drinking gets him drunk. But the moment and circumstance where they had the first one is something they couldn’t control in their active addiction; it’s something of a mystery to them as well. “How can I be drunk again?” The answer to that is easy, right? Yes, it is, and it’s really hard, too. This can be an absolutely unfathomable and confounding notion to someone who is a social drinker.

I’ll close by saying that I do NOT believe alcoholics should get a pass for their disease (drunk driving, etc.). I believe the consequences of their actions, collectively, are what get them to the point where they work to become in recovery and not active addiction–when they can’t stand it anymore. That’s how it works.

69

Alcoholic brains can’t make free conscious choices about drinking.

Can anybody really think that many millions of people would make free conscious choices to destroy everything they cherish?

70

You’re right - nobody in their right mind would say "I’m leaving you because you have cancer’. But people who are sick or disabled and dependent on other people sometimes become hostile and abusive to their caretakers and saying “I’m leaving you unless you stop (whatever the offensive behavior is )” might change the behavior, even though the person still has the disease or disability. The thing is , that really doesn’t work with drinking. Generally , “I’ll leave you if you don’t stop drinking” is a result of negative behaviors associated with drinking rather than the drinking itself- spending the rent money on booze, becoming violent or argumentative when drunk, losing jobs,spending the weekends drunk on the couch while the lawn goes unmowed, etc. And in my experience, people either don’t or can’t change those behaviors while still drinking.

71

Well, and as long as there is social security disability so that the children of people with cancer don’t starve because the bills for chemo are expensive, but the children of people who spend the rent on booze can get into real trouble, sometimes the other spouse may have no choice but to leave.

BTW, the constant comparisons of alcoholism to disabilities is confusing, because not all illnesses are disabilities, and vice versa. Mental illness, when it is serious, tends to be both, and this seems to be where alcoholism lies. Is this correct?

72

But we really aren’t. If I think that the people at the mall are all aliens from the planet Wombat ready to destroy mankind, so I go in with guns blazing, I am not guilty of murder, nor am I responsible for my actions. I am a very sick person in that respect.

Of course, I am locked up to get treatment for my mental disability for my own safety and those around me, but nobody asks why I “chose” to shoot people.

Many alcoholics recover and many people beat cancer. Saying that “I will leave you unless you stop drinking” is not functionally different (if we go with the disease concept) than “I will leave you unless you stop having cancer.” Drinking is the disease and cancer is the disease.

I could see your point if the person denies having cancer or denies being an alcoholic. (Leaving aside that part of this disease is the denial of alcoholism). But if a person is going to meetings and going to rehab or outpatient treatment, he is trying the same as the cancer patient. Leaving him because he relapses is the same as leaving someone who’s cancer does not go into remission.

Again, unless, we believe that it is simply a choice for the alcoholic to keep drinking.

73

This is the exception that proves the rule. Yes, in some cases people are not considered responsible for their actions. Unless those exceptions apply, we’re considered responsible for what we do. And of course there are levels of responsible in between “100% responsible” and “0% responsible.” You are not responsible for being an alcoholic because that may be caused by factors beyond your control. You are responsible, at least after a point, for being aware that you can’t drink safely. You are responsible for knowing you shouldn’t drink and drive, and that’s irrespective of whether or not you’re an alcoholic.

Not everyone with a mental illness is delusional.

I’m starting to think this entire discussion comes down to you excluding the middle: your position seems to be “either alcoholism is 100% identical to cancer or it isn’t a disease at all.” I don’t think that’s true. And the disease here is not “drinking.” It’s the way the brain of an alcoholic (or any other addict) functions. As a result it’s very difficult for them to control their behavior.

It’s a choice, sure. It’s a choice caused by mental illness, which is why we’re saying the person who makes that choice is not totally responsible for their actions. Again, there’s a middle ground between totally responsible and not responsible at all.

74

Drinking is not the disease, it is a symptom and result of the disease. The urge to drink, and disregard for the consequences of drinking is the disease of alcoholism. The drinking itself can be controlled, though not just by the use of will power in many people. An alcoholic who keeps drinking is like someone with controllable cancer refusing to take their medications. If that cancer patient begins to pass out holding a lit cigarette or drives even though they’ve lost sufficient motor control to do so or may pass out behind the wheel, then I wouldn’t be surprised to see their friends and loved ones leave them. People have a problem with someone who won’t treat a disease that leads to harm to others.

75

Mitch Hedberg actually had a joke about this:

“Alcoholism is the only disease you can get yelled at for having. ‘Damn it, Otto, you’re an alcoholic.’ ‘Damn it, Otto, you have lupus.’ One of those two doesn’t sound right.”

By that point in his life he’d probably been yelled at for his addictions more than once. Unfortunately he couldn’t get those addictions under control.

76

Yeah, and I wonder what percentage of people can truly get those addictions under control in the long term.

Look at all the wealthy people we’ve seen failing at staying sober. Robin Williams, Phillip Seymour Hoffman, Kurt Cobain, … These were people with enormous resources compared to the vast majority of addicts.

Addiction changes your brain. It makes your decision-making function different from non-addicts.

Saying “you always have the choice not to drink” is not helpful in understanding alcoholism, the same way as telling an obese person “you always have the choice not to eat” is unhelpful.

And sometimes I wonder whether an enormous of people aren’t in some way addicted to something, whether it’s an addictive substance like alcohol or nicotine or narcotics or overeating or some kind of brain-stimulating or body-stimulating activity like jogging or sex or watching sports.

In stories about serial killers, we hear that for some of these people, killing becomes a compulsion. They can avoid doing it for some time, but something in their brains makes them crave the act of killing.

I suspect that we might start to discover that a lot of habitual activities are related to some kind of addiction or addiction-like brain process and that for many, many people there is something that becomes very difficult to stop doing.

The question is that when the particular activity becomes a danger to other people, what is the best way to deal with it? What is the best way to make people sot doing it?

I do’t think there’s much argument that criminal prosecution and punishment of serial killers is a no-brainer. But that’s an extreme. Not only is the activity horrific from any moral or ethical or humanistic point of view, but there are plenty of examples that show that serial killers feel no true remorse.

But what happens as we go down the scale for threats to society?

Clearly we have to figure out how to address these issues. But to what extent is it helpful to address them on a blame model?

And to what extent can we blame society as a whole for aggravating the problems? People always talk about Prohibition as a failure, but to a large extent, and contrary to popular belief, Prohibition—whatever else it might have done—was successful in reducing overall alcohol use in America.

But society decided that for X, Y, and Z reasons, the benefits of legalizing alcohol use outweighed this benefit. So, we as a society made that choice knowing that legalization would result in more alcohol use, and thus more alcohol abuse, and thus negative consequences.

Is it then legitimate to externalize the negative consequences? If we as a society decide we want the benefits of alcohol use or use of motorized vehicles or kitchen knives or whatever, shouldn’t we as a society have a society-wide manner of addressing the negative consequences?

77

My understanding is that more and more research seems to indicate that alcohol has lasting effects (not just when someone is under the influence) on the frontal lobe, where the brain processes things like this kind of choice. It’s a part of the brain that develops late (into the early 20’s), so when adolescents engage in heavy drinking–even on only a few occasions, apparently–researchers are starting to believe that it may have long-term effects on how people approach drinking. I think the number is something like 75% of adult alcoholics started drinking heavily in their teens.

78

Well, the ones who do stay sober don’t get nearly as much attention, so I wouldn’t use the popular press as a way of measuring.

79

Alcoholism is one of the few, if not the only disease that is incurable until it is self diagnosed.

Some mental health issues are now responding to chemicals. Not all, not yet, who knows.

I can be cured of most things without my permission ( leave the legal trash out of it, the while whacked me with a clue by four and they operated anyway.) or without my belief before and after.

They took the tumor out, the one I never believed I had and the one I now full 100% believe is not from my body. All the me stuff does not mean anything.

Addiction such as Alcoholism can not be done that way.

A person can be dried out, all alcohol out of their system, by force and kept that way by force. They are not cured. Then still have Alcoholism.

I wanted to improve my life.
I chose to do so.
I still have Alcoholism but I have 23 + years of sobriety. This also = my time pretty close to the time I have been sober. No alcohol in my body.

The difference is I am & are capable of being happy, living a good & useful life and not regret having stopped using alcohol.

Just being sober, clean, whatever is not enough.
You can get sober in many ways, even will power.
sitting on a stump, in church, as an atheist or a Holly Roller or a Catholic.
There is not just one way and no one from AA for example, can tell you different. They are wrong if they say , " You must… ", they are 100% wrong.
Go read all approved literature, you will not see any “You Must…” to get sober.

They have strong opinion on what is needed to get to a state of sobriety which is a different thing.

Many people who are not really alcoholics get sent or just go to AA. It is an actual good way to live but living that way or going to AA meeting does not make you an alcoholic.

The AMA says it is a disease. Go convince them they are wrong, arguing about it does not make it one or not.

Blanket statements are usually wrong.

AA does not say that you can’t get sober or have any sobriety only in AA. If something else works for you, great, go to it. They don’t make $$$ off of people so why would they want more?

Not to say there are no idiots, grumpy old men and shrill ladies that will tell anyone anything because they can. They can not & do not speak for AA.

The biggest problem for people wanting to improve their life due to an addiction is people who have never had an addiction they can’t control. They will try to keep total strangers from getting any help except the ways they THINK is the correct one, will power, jail, hospital, chemicals, what have you. These people are dangerous to an addict that wants to get better. But one that wants to get better & has really tried on or three ways to do it will continue to try because they have self diagnosed.

As to jail or not, that is going to be as society sees it & wants it.

Remember that laws & justice do not have anything in common because laws do not allow common sense.

If you are not or never have been truly addicted to a mood altering substance, all the book learning and advice you have heard or read does not make you able to understand it.

Sat & listened to thousands of speakers, counselors mental health people. Most wanting to keep sobriety and doing so for a length of time, can spot a non addict giving a talk or counsel after about 2 minutes.

They are mostly good & caring people. But they have not been there.

Just as in this thread, they are easy to see. No big deal but IMO all the people who are still making it don’t buy the jargon they spout and what they are doing for people really needing help, they are hurting in a major way. IMO, YMMV MAAOOY

80

Nothing says that just because we can’t do it now, that later we won’t find a medication or some procedure that if given to an alcoholic will take away the alcoholism. Some would say it’s “close”:

https://www.google.com/webhp?sourceid=chrome-instant&rlz=1C1ASUT_enUS525US525&ion=1&espv=2&es_th=1&ie=UTF-8#q=latest%20scientific%20alcoholism%20findings