# Is alcoholism a disease? **URL:** \ **Category:** Great Debates\ **Created:** [March 31, 2009, 1:53pm UTC](https://boards.straightdope.com/t/is-alcoholism-a-disease/491424 "2009-03-31T13:53:31Z")\ **Posts on this page:** 9\ **Page:** 7
**Author:** ![BrandonR](https://avatars.discourse-cdn.com/v4/letter/b/779978/32.png) [@BrandonR](https://boards.straightdope.com/u/BrandonR)\ **Post date:** [April 6, 2009, 5:32pm UTC](https://boards.straightdope.com/t/is-alcoholism-a-disease/491424/121 "2009-04-06T17:32:49Z")
> [@Mr.Kobayashi](#): > > They have no choice in the matter; it is a chemical dependency that is out of their hands. Alcoholics can no more kick alcohol than can heroin addicts think “You know what, this stuff’s bad for me, I think I’ll give it a miss from now on”. And yes, I believe many would class drug addiction as a disease. To respond to the point that drinking is a choice, well, no it isn’t. That is what defines alcoholism, it’s no longer about want, but need, in order to stave off withdraw symptoms. Note the word dependent in the following cites for withdraw symptoms; This is the height of ridiculousness. People have no choice in becoming an alcoholic? How is it that the rate for alcoholism amongst people who refrain from drinking is 0%? It’s like saying people have no choice in catching STDs but that’s obviously false if they are abstinent (barring diseases caught from your mother at birth). You have to drink in order to be an alcoholic. Drinking is a choice. Therefore, being an alcoholic is a choice. Even if you’re more genetically predisposed to becoming addicted to it, you must start drinking to set it off. Again, to me saying that drug addicts are suffering from diseases is insulting to those with diseases whose ultimate control is out of their hands. You can’t kick the bubonic plague by convincing yourself you don’t need it. You can’t kick it with a 12-step program. Ultimately the responsibility of getting rid of alcoholism is upon the user. I think I’m done debating this topic because it seems to be moving nowhere. To me, again, an addiction is not a disease because it starts and stops via a choice by the user. I don’t consider heavy coffee drinkers to have diseases because they’re addicted to the caffeine. I don’t consider smokers to have diseases because they’re addicted to the nicotine. ---
**Author:** ![Mr.Kobayashi](https://avatars.discourse-cdn.com/v4/letter/m/4af34b/32.png) [@Mr.Kobayashi](https://boards.straightdope.com/u/Mr.Kobayashi)\ **Post date:** [April 6, 2009, 5:38pm UTC](https://boards.straightdope.com/t/is-alcoholism-a-disease/491424/122 "2009-04-06T17:38:17Z")
> [@BrandonR](#): > > Not sure where you live, but where I live very few words have distinct crystal-clear definitions. Just about everything can be debated to have a slightly different definition. There are no absolutes in language. :rolleyes: > > To Binary, nope no family issues or any other problems. I just think it’s unfair and rude to group a willing habit into the same group of other health issues which people have no control over. What you described is an addiction. Regardless of what your signals tell you, not drinking won’t kill you. Often it’s quite the opposite. > > What other diseases can you name whose treatment involves joining self-help groups or other non-medical mental exercises? What other diseases can one (theoretically) cure themselves with no medical intervention and overcoming mental cravings? I think you may be underestimating the compulsion, which, judging from your ‘theoretically’ disclaimer you already know. You may find these articles interesting; > [@](#): > > [Addiction and the Brain’s Pleasure Pathway: Beyond Willpower](http://www.hbo.com/addiction/understanding_addiction/12_pleasure_pathway.html) > > by Nora D. Volkow, M.D. > > Summary > > ``` > * Addiction can develop **despite a person's best intentions and in spite of their strength of character.** > > ``` > [@](#): > > Modern science has taught that it is much too simplistic to set biology in opposition to behavior or to pit willpower against brain chemistry. In fact, drug addiction and alcoholism involve inseparable biological and behavioral components. Many people also still believe that drug addiction is simply a failure of will or of strength of character This could not be further from the truth as research contradicts that position completely. [http://ezinearticles.com/?Drug-Addiction-and-Alcoholism:-Willpower-or-a-Disease-of-the-Brain?&id=154945](http://ezinearticles.com/?Drug-Addiction-and-Alcoholism:-Willpower-or-a-Disease-of-the-Brain?&id=154945) > [@](#): > > Addiction, or chemical dependence, is no longer regarded as an illness of the mind, but rather a true physical disease of the body. But why is it so important to recognize addiction to mind altering chemicals such as alcohol as a disease? > > As a result of the accepted disease model of alcoholism and addiction, the stigma is slowly being lifted and many who were afraid to get help are now finding themselves able to reach out to doctors, family, and friends in hopes of an answer. At the same time, those close to the addicted are able to stop placing blame on themselves and realize that the disease in others is no more their fault than cancer would be. > **[Find How-to instructions, Inspiration and Other Ideas to Try](https://suite101.com/)** > > Suite101 is the go-to source for how-tos, home inspiration, DIY, and other ideas to try. Our team of experts is here to help you improve your home and life. Let's explore our site below: Home Improvement Discover expert home improvement instructions,... And so on and so forth. Again, if it were as simple as just having the willpower to kick it I doubt nearly as many would die from alcohol related causes. ---
**Author:** ![Mr.Kobayashi](https://avatars.discourse-cdn.com/v4/letter/m/4af34b/32.png) [@Mr.Kobayashi](https://boards.straightdope.com/u/Mr.Kobayashi)\ **Post date:** [April 6, 2009, 5:45pm UTC](https://boards.straightdope.com/t/is-alcoholism-a-disease/491424/123 "2009-04-06T17:45:23Z")
> [@BrandonR](#): > > This is the height of ridiculousness. People have no choice in becoming an alcoholic? How is it that the rate for alcoholism amongst people who refrain from drinking is 0%? It’s like saying people have no choice in catching STDs but that’s obviously false if they are abstinent (barring diseases caught from your mother at birth). You have to drink in order to be an alcoholic. Drinking is a choice. Therefore, being an alcoholic is a choice. Even if you’re more genetically predisposed to becoming addicted to it, you must start drinking to set it off. > > Again, to me saying that drug addicts are suffering from diseases is insulting to those with diseases whose ultimate control is out of their hands. You can’t kick the bubonic plague by convincing yourself you don’t need it. You can’t kick it with a 12-step program. Ultimately the responsibility of getting rid of alcoholism is upon the user. > > I think I’m done debating this topic because it seems to be moving nowhere. To me, again, an addiction is not a disease because it starts and stops via a choice by the user. I don’t consider heavy coffee drinkers to have diseases because they’re addicted to the caffeine. I don’t consider smokers to have diseases because they’re addicted to the nicotine. Insulting to those only you classify as having a ‘disease’, but that’s an argument of semantics and not reality. I suggest you re-read my linked articles, alcoholism is not something you get overnight. It slowly develops into the dependency from what people consider to be healthy intakes of alcohol. As stated in my links, the required amount becomes more and more, the dependency stronger, the withdraw symptoms worse as time goes on. Your comparison with STDs is almost apt but not for the reasons you think; sexual intercourse is a normal and widespread practice, STDs are an unintended consequence. Drinking alcohol is a normal and widespread practice, alcoholism is an unintended consequence. Neither can be helped beyond swearing off the causes to begin with, but I direct you to the Constitution of the United States to see where that idea goes wrong. The debate is moving nowhere because of a narrow and incorrect view of the definition of disease, I think. ---
**Author:** ![sleestak](https://avatars.discourse-cdn.com/v4/letter/s/919ad9/32.png) [@sleestak](https://boards.straightdope.com/u/sleestak)\ **Post date:** [April 6, 2009, 5:46pm UTC](https://boards.straightdope.com/t/is-alcoholism-a-disease/491424/124 "2009-04-06T17:46:21Z")
> [@BrandonR](#): > > I think I’m done debating this topic because it seems to be moving nowhere. Actually, I think you were done debating this topic before you opened this thread as it appears that you are willfully ignoring every citation and piece of information that has been provided to you. Since you decided that ‘disease’ means whatever you want it to and not the definition that the medical profession uses there really isn’t any point in talking to you. Slee ---
**Author:** ![SenorBeef](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/senorbeef/32/2220_2.png) [@SenorBeef](https://boards.straightdope.com/u/SenorBeef)\ **Post date:** [April 6, 2009, 8:46pm UTC](https://boards.straightdope.com/t/is-alcoholism-a-disease/491424/125 "2009-04-06T20:46:40Z")
A few questions to clarify the argument: If a person who has the genetic component to metabolize alcohol differently never or rarely drinks, are they an alcoholic? Based on the alcoholism as disease arguments, this would seem logical that it’s the case, since that’s the physical component that is responsible for the disease. Is a person who has no genetic component to make them metabolize alcohol differently, but nonetheless chooses the immediate gratifaction of alcohol use over long term problems it causes, abuses alcohol regularly to the point where it’s damaging their life, are they an alcoholic? Are other addictions (smoking, cocaine, whatever) different from alcohol addiction? I never hear of anyone referred to as a cocaineaholic. Do these things have a genetic component? What makes alcohol addiction special? ---
**Author:** ![sleestak](https://avatars.discourse-cdn.com/v4/letter/s/919ad9/32.png) [@sleestak](https://boards.straightdope.com/u/sleestak)\ **Post date:** [April 6, 2009, 11:51pm UTC](https://boards.straightdope.com/t/is-alcoholism-a-disease/491424/126 "2009-04-06T23:51:18Z")
> [@SenorBeef](#): > > A few questions to clarify the argument: > > If a person who has the genetic component to metabolize alcohol differently never or rarely drinks, are they an alcoholic? Based on the alcoholism as disease arguments, this would seem logical that it’s the case, since that’s the physical component that is responsible for the disease. Is someone with the genetic components for diabetes (or insert other inherited disease here) a diabetic even though they are not symptomatic? > [@](#): > > Is a person who has no genetic component to make them metabolize alcohol differently, but nonetheless chooses the immediate gratifaction of alcohol use over long term problems it causes, abuses alcohol regularly to the point where it’s damaging their life, are they an alcoholic? Yes. There are two parts to addiction, physical and mental. Anyone can get physically addicted to alcohol. It would be interesting to find out if there are differences in recovery rates for people without the genes vs. with… > [@](#): > > Are other addictions (smoking, cocaine, whatever) different from alcohol addiction? I never hear of anyone referred to as a cocaineaholic. Do these things have a genetic component? What makes alcohol addiction special? I do not know enough about other addictions to give a valid answer though I will note that a reasonable number of alcoholics use and get addicted to other drugs. (BTW, it is not cocaineaholic, it is cokehead, and that is what NA is for 🙂 ) I’ll see if I can find anything on this. Slee ---
**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:** [April 7, 2009, 1:50am UTC](https://boards.straightdope.com/t/is-alcoholism-a-disease/491424/127 "2009-04-07T01:50:32Z")
> [@BrandonR](#): > > I don’t care how much an alcoholic craves alcohol, the fact that it’s up to that alcoholic to go to the store, willingly purchase alcohol, take it home, open the bottle, and pour it in their mouth is proof positive that it’s not a disease because it’s willingly brought upon themselves and it can be ridden of by not doing all the steps I just mentioned. Tell an AIDS victim to get rid of their disease by going to a self-help group and see how far that gets you. And again, most will NOT admit they are alcoholics! You’re not going to have an alcoholic say, “Oh, I can’t not drink-I’m addicted, I can’t help it!” They’ll tell you, “I do NOT have a problem-I can stop any time I want.” Or, “I’m not drunk-I’m fine.” I find your comments EXTREMELY offensive and incredibly ignorant. I’m not an alcoholic, but I lost someone I loved dearly to this disease. And there’s nothing I hate more than people who refuse to believe it IS a disease, because somehow, it seems, they’d rather judge a person. It almost seems to say, “You’re an alcoholic because you’re weak, you’re a loser-you don’t need help. You don’t have a disease-you’re just a wretch.” ---
**Author:** ![DoctorJ](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/doctorj/32/2904_2.png) [@DoctorJ](https://boards.straightdope.com/u/DoctorJ)\ **Post date:** [April 7, 2009, 4:04am UTC](https://boards.straightdope.com/t/is-alcoholism-a-disease/491424/128 "2009-04-07T04:04:01Z")
> [@SenorBeef](#): > > A few questions to clarify the argument: > > If a person who has the genetic component to metabolize alcohol differently never or rarely drinks, are they an alcoholic? Based on the alcoholism as disease arguments, this would seem logical that it’s the case, since that’s the physical component that is responsible for the disease. To pick up on **sleestak** ’s comparison, if a person who is predisposed to Type II diabetes maintains an extremely healthy lifestyle, the diabetes is likely to never manifest itself. That person is not a diabetic, just as I wouldn’t call the person in your example an alcoholic. But it doesn’t mean diabetes isn’t a disease. > [@](#): > > Is a person who has no genetic component to make them metabolize alcohol differently, but nonetheless chooses the immediate gratifaction of alcohol use over long term problems it causes, abuses alcohol regularly to the point where it’s damaging their life, are they an alcoholic? I think most people would call that person an alcoholic. It’s possible to become dependent on alcohol even if you’re not particularly predisposed to doing so. To use the diabetes analogy again, people who have no genetic predisposition to type II diabetes but who maintain an unhealthy weight and lifestyle will often develop it. Just because something came about through one’s own actions, it doesn’t mean it isn’t a disease. People abuse alcohol for lots of different reasons, and everyone reacts to it differently. What makes one an alcoholic is an overwhelming need to drink alcohol that defies good sense. > [@](#): > > Are other addictions (smoking, cocaine, whatever) different from alcohol addiction? I never hear of anyone referred to as a cocaineaholic. Do these things have a genetic component? What makes alcohol addiction special? Not all addictions are the same. For instance, the vast majority of people who smoke cigarettes regularly develop an addiction, while the vast majority of people who drink alcohol do not. Cocaine is a different animal entirely, in that the dependence is almost entirely psychologic (which is not to say it’s any less real or serious than other addictions–it’s just different). ---
**Author:** ![sleestak](https://avatars.discourse-cdn.com/v4/letter/s/919ad9/32.png) [@sleestak](https://boards.straightdope.com/u/sleestak)\ **Post date:** [April 7, 2009, 4:24am UTC](https://boards.straightdope.com/t/is-alcoholism-a-disease/491424/129 "2009-04-07T04:24:34Z")
Just a follow up. [Link about cocaine and genetics](http://news.bbc.co.uk/2/hi/health/4792618.stm). > [@](#): > > The latest study, funded by the Medical Research Council, identified a specific variation in the genetic code controlling production of the DAT protein. > > People carrying two copies of this particular variant were 50% more likely to be cocaine dependent. [Link](http://www.sciencedaily.com/releases/2008/10/081002211720.htm) about heroin and genetics. > [@](#): > > Sometimes, small changes do add up. In the case of addictive diseases, tiny variations in a few genes can increase or decrease the likelihood of some people developing a dependency on heroin. Now, by examining a select group of genetic variants in more than 400 former severe heroin addicts, Rockefeller University researchers have identified several genetic variations in American and Israeli Caucasians that influence the risk for becoming addicted to one of the world’s most powerful substances. [Link](http://www.technologyreview.com/Biotech/18279/)about nicotine addiction. > [@](#): > > “When you look at substance-abuse disorders and antisocial behavior, these are the last vestiges of the belief that mental impairments are related to moral will,” says Tracy Gunter, director of forensic psychiatry at the University of Iowa and a coauthor of the study. “And one of the exciting things in this work is [that] it’s beginning to form ideas that folks with these disorders are biologically different.” Slee [Previous page](https://boards.straightdope.com/t/is-alcoholism-a-disease/491424.md?page=6)