Is Alcoholism a disease?

I’ve had the standard disease theory of alcoholism pounded into my head over many years. Yet, I still question it. Why is it so wrong to suggest that having a drink is simply a matter of willpower? I drink alcohol on a regular basis, yet I’ve never had a drink by accident. There are also many times I decide not to drink. I can certainly see someone deciding not to drink because after they’ve had their first one, their decision making skills are lost and they might decide to drink 10 more.

Alcohol is not cunning nor baffling. We know the chemical formula. It is powerful, but most people don’t drink to intoxication on a regular basis. Is there actually a disease of alcoholism or is there simply a group of people who decide to abuse alcohol on a regular basis?

If the research has been done and it demonstrates that people become physically addicted to alcohol, I’d say it’s not as simple as that. You do need the willpower to quit, but perhaps you’re underestimating how tempting it is for an alcoholic to drink.

You’ve misunderstood what alcoholism is. Being an alcoholic doesn’t necessarily mean you get hammered all the time. It means you’re dependent on alcohol and need a drink to be ‘normal.’ A friend of mine recently overheard a college girl say that she needed a drink every night or else her hands started shaking. That might be a better example.

  I suggest that taking the first drink is always a matter of will and that if you have the "Dis-ease" of alcoholism it sets off a craving for more alcohol. In my experience having the "standard disease theory of alcoholism pounded into my head" also didn't help because when I did drink again after 9.5 years of sobriety I'd been told if an alcoholic does go back to drinking the end is ALWAYS Jails, Institutions,or Death, one of the usual rote recited lines in any standard A.A. meeting.   I understand that someone who's been "nipped by the wringer" and is pretty damn shakey ( I had to sit on my hands my first meetings) dosn't do a lot of thinking for themselves, unfortunately it becomes a way of "recovery" for a lot of people, One Day at a Time,Day in and Day out. My suggestion is to make it  specific and personal to ones self,where am I in my drinking? Do I just say screw it and drink to get drunk?or do I drink to get blind?Can I garantee my behavior once I have a drink? I don't think anyone has ever had a drink by accident,yet I don't think a person who drinks to the point of passing out and then wakes up searching for the bottle is making the decision to be in that condition. Bottom line is, if drinking sets off a hellish little thirst for more and once you drink you have no damn off button, who the hell cares if you call it a disease or THIQ imbalance, or an allergy,or your friend Harvey the Six Foot Rabitt

Alcohol is not a disease, but we treat it using the disease model.

This statement leads me to believe that, despite having it “pounded into your head,” you have never actually understood the specific claim made.

The point is not that imbibing alcohol leads directly to alcoholism. The point is that those persons who are geneticlly predisposed to alcoholism will discover an almost insurmountable craving if they begin to consume alcohol. A person who does not have that genetic trait will not lose control to alcoholic cravings.

If your response to alcohol is accurate as described in the OP, then it would seem that you do not carry a gentic predisposition to alcoholism, in which case your anecdotal testimony is irrelevant to a discussion of alcoholism.

It is true that we still know very little about the actual mechanics of alcoholism. A case can also be made that the amazing (relative) success of Alcoholics Anonymous in the U.S. (when compared to previous treatment programs) has, perhaps, allowed their mantra that “one drink is too many and a thousand are not enough” to distort the direction that research has taken in this country. I have seen reports that some studies in Europe distinguish between “problem drinkers” and “alcoholics,” a distinction that is rarely permitted in the U.S.

However, there do appear to be genuine genetic links to alcoholism, so the fact that an individual can take it or leave it adds nothing to the discussion. Most people can consume enormous quantities of sugar with no greater danger than a loss of teeth. This does not make diabetes a disease of “willpower.”

Genetic predisposition to organ-specific endpoints of alcoholism.
We searched for alcoholism AND genetic and found 4045 total results including 3,251 books and 659 journal articles.

Genetic predisposition just makes it easier, as I understood it.

Alcoholism runs in families.


There is research showing that Native Americans in the US have lower tolerance to alcohol due to the fact that alcohol was introduced to their society rather late. (Which goes to show the genetic factor in the way bodies deal with alcohol)

Another link

Purely ancedotal. I’m a recovering alky (one year and four months and a couple days since my last drink). Before my problem got bad I had no idea that there were any alcoholics in my family. After it was clear I had a problem and entered treatment I found out that my uncle, a couple cousins(male and female) a couple great grandfathers, and a great grandmother were or are alcoholics. The number of alcoholics in my family is far larger than the 10%* usually given as the percentage of the population that are alcoholic.

As far as the whole ‘willpower’ thing goes, for most alcoholics there is no such thing when it comes to alcohol. For, most once they get started it just doesn’t stop. I was fine until I had my first drink. After I had my first drink I couldn’t stop. The kicker is that from the moment I woke up the only thing I could think about wa a drink. There are alcoholics who can ‘control’ their drinking. My uncle is, as far as I can tell, one of this type. He drinks everyday. Alot. I’ve seen him put it away. And that is coming from someone who would put down a couple cases of beer everyday with out thinking about it. Yet he never lost his job, never lost his family, he never ended up on the street but he has to drink. I’ve talked to him about it and he knows he has a problem but, for him, it isn’t bad enough yet for him to want to fix it.

Alcoholism has a gentic factor, it’s chornic, it’s progressive and it’s fatal. It is also uncurable. Recovering alcoholics are in remission. They aren’t cured. I’ve seen too many alcoholics in my short time of sobriety get sober, get their life back then take a drink go right back to where they started. As far as I know that pretty much meets the definition of a disease.


*I have heard the 10% number from numerous sources. I have no idea if it is valid.

Having a drink is a matter of willpower. Alcoholics don’t have a drink by accident. Alcoholics can decide not to have a drink. After they have had a drink, however, they will have 10 more, (give or take, mostly give). That’s where alcoholism sets in: One drink and you’re drunk.

How, exactly, are these statements mutually exclusive?

This is a question of intrest only to insurance companies and lawyers and social workers. For the individual, the question should be, “Does the consumption of alcohol cause me problems?”, i.e. problems at work, problems with money, problems with the law, etc. If the answer is, “Yes, I have a problem”, then the best course of action is to find someone else with the same problem that has dealt with it and ask them how they did it.

Word of advice: If you are not careful you might die before you find the answer!!!

There are plenty of alcoholics who are binge drinkers. They don’t need a drink every night. Or every month. Some people binge once a year.

I would have a problem labelling someone who binge drinks once a year an alcoholic.

That certainly stretches the definition of alcoholic, does it not?


Stanton Peele is the strongest proponent of the belief that “addictions” are not really medical problems. You may find much of his material interesting reading.

An alcoholic only needing to drink once a year :dubious:

That sounds like somebody who every now and then made an ass out of themselves of just go wild on drink. That’s not alcoholism.

Alcoholism is like drug addiction you need to drink to function.

I ‘binge’ drink quite a bit as most time I go to the pub i would drink in excess of 5 pints. If I’m drinking at home I would drink 6-10 bottles. That is pretty much normal over here and wouldn’t be looked on as strange at all. However I never have felt I needed a drink to function or get any symptoms if I don’t drink for a while so I’m not an alcoholic just a heavy drinker (In US terms anyway).

Actually it is drug addiction :smack:

Neither alcoholism or drug addiction are diseases.

They are the end result of a voluntary action, and that’s the key - voluntary.

i voluntarily started smoking and now have cancer - am i not suffering from a disease?

Piffle. A person who has a compulsion to perform any action is not performing that action voluntarily. Making a claim that it is voluntary is simply a way to avoid providing assistance to a person in need by blaming them for their own problems and pretending that it is a matter of will power or personal morality. If you choose to provide no medical assistance to an addict, that is your personal choice and may be quite defensible. Making the spurious claim that it is just their own fault is a way to prevent others from offering help and is a denial of the medical evidence that your “will power” claim is nonsense. That opposes the spirit of the Straight Dope where we should be fighting ignorance, not promoting it.

Isn’t a simpler explanation that lack of willpower and poor impulse control run in families? Why single out alcohol specifically when we have little in the way to support the idea specific to that one trigger substance?

AA is definately a real problem in discussing this issue. The basic philosophy was developed long before we had any solid research methodologies, and even putting the directly spiritual components aside, the basic ideology of the problem and the solution is basically an only slightly modified version of evangelical Christianity. Which is not itself necessarily a bad thing, but I think that structure makes the program far more compelling to people who want to promote and defend it than it really proves to be in practice, and it’s dogmas radically distort the actual research and findings of how alcohol affects people.

The really troubling thing is that it’s unclear that any particular method of treatment or response to alcoholism is better than any other. AA, for all it is touted as, is remarkably unsuccessful when there’s random assignment to the program (the people most likely to join and stick with it normally are those most committed to changing anyway). But even when there is matched assignment between program and person, there doesn’t seem to be any great advantage (this is what the controversy over Project MATCH was all about).

Honestly, if asked what sort of program to suggest to someone, I’d be at a loss. Behavioral therapy with possibly the addition of anti-craving drugs makes the most sense to me. Out-patient treatment programs are becoming far more used than in-patient, but it’s not clear if the underlying cause is effectiveness or insurance costs.

Would you then say that lung cancer is not a disease when a smoker gets it (they smoked voluntarily); that black lung disease isn’t a disease (they mined coal voluntarily), and that mesothelioma isn’t a diease (they worked near asbestos voluntarily)?