Alcoholism aside, I would suggest to the friend in the OP that they are simply misunderstanding all of the definitions of the word “disease”, and that they are not in a position to define the word as they see fit (similar to the evolution “theory” argument).
I think those things go beyond mere bad decision making. I honestly don’t believe anyone who could help themself would actually put their job, life, reputation, home, etc. at risk repeatedly. That’s the very nature of the addiction; it *must *be fed no what the consequences may be.
Well, we can agree to disagree on what constitutes an addiction vs. not giving a shit. Or having a lack of analytical sense.
If you are really interested in this topic, try reading either Under the Influence or Beyond the Influence. There are entire chapters that go over this (culled from various studies that have taken place over decades), but in essence the deal is that alcoholics, even in the very early stages, metabolize alcohol in a significantly different way than non-alcoholics. In essence, we do not react to in a physically normal way. Also interesting are the stats on incidence of alcoholism as they break down by race/ethnicity (in essence, the longer a given culture or race has been exposed to alcohol the lower the incidence of alcoholism see: Native Americas vs. Italians).
The surprising thing to me, really, is that this is still open for debate.
Good one. I wish I had thought to ask her that.
This.
Another analogy (I’m full of 'em today): is lactose intolerance a disease? Drink milk, get sick. Eat cheese, get sick. Lactose intolerance by itself doesn’t make you sick, but your diet can make you sick. Is eating cheddar a moral failing?
Call it a disease, call it a disorder, call it a “medical condition”-- I think we’re all still talking about something that’s wrong with the human body (at least, the “average” human body-- as Binarydrone notes, there are ethnic disparaties, sometimes wide, in the prevalence of alcoholism, even adjusted for socio-economic status).
That’s the distinction between normal use and addiction. The lactose tolerant can eat cheese and not have an upset stomach; the lactose intolerant can’t. The non-alcoholic can drink alcohol, even lots of it, and not get addicted; the alcoholic can’t.
Ditto drug use. Ditto gambling-- we haven’t spoken much about gambling, but that’s a perfect example of a brain gone awry, one that’s lost its capacity for rational appreciation. Normal people look at gamblers and think, why waste the money, the house always wins, how could they gamble all that money away. The gambler, however, isn’t interested in winning-- they’re interested in gambling, which fires off the pleasure centers in their brain. An addicted gambler would rather be losing than not be “in the game.”
I go to Vegas every once in a while. I play the table games, I usually lose my money, and I walk away. I may have purchased a little “fun” along the way, but my brain switches those pleasure centers off once I leave the casino. Addicted gamblers, however, don’t switch off.
Likewise, alcoholics don’t switch off when they stop drinking. They don’t drink their sorrows away, not like how I would drink myself stupid on account of a sad breakup, or the occasional bad grade. They drink because they need to.
My personal opinion: given the continuing advances in the understanding of genetics, brain chemistry, and neuroscience in general, we’re likely to find a cure for addiction that won’t have anything to do with willpower, morality, a higher power, or support networks. That cure, if and when it comes, won’t stop people from drinking, nor will it stop people from doing stupid things drunk, but it will do much to help those who can’t stop on their own. We’ll all look back at things like AA and wonder what the deal was.
BTW, I have nothing but praise for AA. Absent these kind of biomedical remedies for addiction, AA is a time-tested therapy for addiction. Unfortunately, the success rate is far less than desirable, and ultimately, it reflects a workaround for a biological problem we haven’t solved yet. It’s akin to teaching yourself how to walk on broken legs versus fixing your broken legs.
“Alcoholism is a disease, but it’s the only disease you can get yelled at for having. Damn it Otto, you are an alcoholic. Damn it Otto, you have Lupus. One of these two does not sound right.” - Mitch Hedberg
Would your friend consider OCD a disease? If an alcoholic can “just say no” to his compulsion, can’t a person with OCD do the same?
Moving thread from IMHO to Great Debates.
Tough one. I think it may depend on the perspective. It may be an inherited trait, but it still needs large and frequent consumptions of alcohol to be active, no?
To my friends in AA, NA, etc, it certainly is a disease, at least they are told that, but they DO know they are the ones to stop its progression. It’s not a disease that can be counteracted with an injection, medication, etc.
OTOH, tell someone who just contracted cystic fibrosis or MS that alcoholism is also a disease, they might laugh at the idea.
Well, I put it in IMHO because I was asking for the opinions of others. But I guess it did melt down into a GD thread.
Is obesity a disease? Is type 2 diabetes a disease? Is emphysema a disease? Is hypertension a disease? High cholesterol? Detached retina? Perforated bowel? Ulcers? Tapeworms?
You can’t just redefine the word “disease” willy-nilly to insult people you don’t like. There are hundreds of diseases that can be caused by stupidity or weakness of character or lack of discipline or whatever you want to call it. You can’t just suddenly declare that the word disease doesn’t cover those conditions because you don’t like the people suffering from them. Your friend is very misinformed.
But only if you make the choice to start the activity in the first place! There are lots of alcoholics in my family. I probably have the same gene that causes you to be prone to it, like most of my aunts, uncles, my grandfather, and one of my parents. But because I almost never drink, I don’t crave alcohol. I bet if I start drinking on a regular basis I might NEED to, but since I haven’t, I don’t.
You very well may not have the gene also. My wife comes from a long line of alcoholics and she rarely drinks. But then alcoholism has less to do with the drink than with the behavior - why do alcoholics drink? because it’s fun? Well probably started out that way…
Good for you. Unfortunately the world doesn’t always work the same way.
I have several friends who started drinking as teenagers (two who were given alcohol by their parents, because it’s just what their family did), and now they’re descending into addictive stages of the behavior.
I’m sure a rational adult who knows and understands the situation may be able to make a competent and easy choice. But to expect teenagers who are faced with a still developing brain to make the same rational choices is not the same, same for others who were simply given alcohol and did not realize that their family has a trait for alcoholism, or the child who was given it at an early age because of well… idiotic parenting.
I used to feel the same way as you did: That it’s just a choice you make, and if you’ve got an addictive personality, just don’t touch the stuff! However, over the years slowly I’ve learned that Life doesn’t quite work out that way and it’s not always so clear cut and easy the choices that lead people down the roads they take.
And for what it’s worth, it’s a disease for many of the above stated reasons. Hell, long term abuse of Alcoholism leads to Wernicke-Korsakov’s, and that’s considered by most people and physicians to be a disease, alcoholism could just be considered an early stage/part of that if someone WANTS to really argue up that it’s not a “real” disease for insurance reasonings. -_-
It is genetic*.
Slee
- The fact that it is genetic is not an excuse for an alcoholic to continue drinking. It just makes it a real bitch to stop.
Only because medical science hasn’t discovered how to do so yet doesn’t mean it’s not a disease.
You can use meditation to get over physical pain. You can also take aspirin. With addiction, we’re largely in the “walk it off” stage of treatment, but as our understanding of the biochemistry of the brain improves, there will increasingly be medical remedies (be they drugs, electro-stimulation, cognitive therapies, what have you) that will target the centers of addiction in those suffering from it.
Still skeptical? We already have medical therapies to treat all sorts of addictions-- patches for nicotine, methadone for heroin, even anti-depression/anti-anxiety medications for gamblers. They’re imperfect, and not everyone enjoys success from them. Heck, we’ve all seen the Mirapex commercials warning that taking the drug may increase your propensity to gamble/and or pursue risky sex.
But the larger point is, in combination with traditional anti-addiction therapies, these medicines do better than simply using willpower alone.
Everyone has a story of their Uncle who found Jesus and got off the sauce, or the sister in AA who has discovered she doesn’t need alcohol in her life any longer. This stuff happens.
But the reason we use those techniques isn’t because they’re optimal-- it’s because we don’t have better scientific techniques yet to treat what is a scientific problem, i.e. genetic/biological vulnerability to addiction.
My comments don’t add much to the debate of whether it’s a disease, but maybe I can shed a little light on what alcoholism is and isn’t in my experience.
[ul]
[li]Heard at AA meetings: Take away the alcohol, you still have the ‘ic.’ To me this means that alcoholism is a spiritual malady for which the substance abuse is but a symptom. We’re born with a God shaped hole, and we mistakenly and unsuccessfully try to fill it with worldly things such as sex, food, power, drugs, alcohol.[/li][li]The allergy metaphor is straight out of the Big Book in the Doctor’s Opinion. It’s only half of it, though. The allergy is the physical part (craving) that happens after the alcoholic takes a drink. The spiritual part (obsession) happens before the first drink is consumed. The alcoholic knows that misery will ensue, but is insanely compelled to take that next first drink.[/li]
[li]Willpower has nothing to do with it. That’s covered in the first clause of Step 1: “We admitted we were powerless over alcohol”. When you genuinely believe that, then willpower amounts to exactly dick.[/li]
[li]Alcoholism is progressive, terminal, and incurable.[/li][ol]
[li]Progressive - when the alcoholic stops drinking and then starts again, he picks up again not where he left off, but where he would have been had he never stopped! This has been verified over and over again by sufferers.[/li][li]Terminal - Untreated alcoholism invariably has one of three outcomes: jail, institutions, or death.[/li][li]Incurable - Alcoholics get a daily reprieve contingent on their spiritual condition.[/li][/ul][/ol]
The pro-disaease “side” is taking things a leetle too far, I think. Methinks the gentlemen doth protest too much.
Alchoholism is a behavior. It is a chosen behavior. Getting clean, no matter what your genetics are, is ultimately about choosing to get clean and not going back. Some people are more likely to get in bed with drugs. I do not say it is easy, because of course once you make the habit it’s hard to break, and it poisons your body and brain over time. But it ultimately about making a choice between one thing and another. SUpport from family and friends, I would argue, it and always will be a key factor is succeeding at breaking the addiction, not medical science, because the individual wants to drink (or do drugs, or whatever).
In that sense, it’s not a disease. There’s very little “wrong” with addicts medically. A doctor can’t, and probably never will, be able to “cure” you of the problem.
So, I think the idea that willpower is not an issue is bogus. It clearly is, but of course building someone up so that they choose to excercise their willpower is quite difficult. Willpower is a lot like a muscle.
And your medical credentials are…?