We don’t normally associate an addiction to cigarettes with disease. Certainly smoking causes a wide variety of health problems but is the inability to stop smoking indicative of a disease? Is alcohol fundamentally different? I don’t see a difference but perhaps that is more cultural than medical.
If willpower amounts to dick, then you can never get clean. Unless you believe there’s a god that not only tossed you down the hole but will also help you back out. But since AA doesn’t believe that god is the key to sobriety, and we all know that doorknobs can’t stop you from drinking, then we’re back to willpower (with a dash of “reason to live”), aren’t we?
Right you are 
its been awhile since we’ve gone over this there’s been many good debates on this topic over the years! 
My 2cents is willpower exists - taking the words of AA too literally is like taking the words of the bible too literally, soon you’ll be handling rattlesnakes with the latter. But I find those who take the words too seriously are those who either get more bitter over time, or more bitter to those who don’t believe what they do. I’ve known men and women who beat with and without AA, I know others who lost the battle and slipped into the dark.
I just don’t like when people talk in absolutes.
Yes, it’s been a while, hasn’t it? I LOVE YOU, MAN!!!
Probably as good as any of the pro-“disease” posters. Your post was barely insipid, as well as irrelevant. I’ve studied the changes in the body and brain from addiction, particularly drug and alchohol addiction.
I think analogies like this fall flat because the disease is essentially the continuance of a behavior.
You can prevent yourself from getting an STD. However, once you have it, you can’t be rid of the STD by stopping having unprotected sex. You caught it, now you’ve got it.
You can’t decide one day you’re not going to have lung cancer anymore.
The symptoms with STDs can be sores, lung cancer can be diminished lung function, and the symptoms of alcoholism is… drinking. Which one of these doesn’t fit? With alcoholism, if you stop choosing to partake in the “symptom”, you practically don’t have the disease. Yes, I know, the standard AA line is that you’re always an alcoholic, but the reality is that if you never drink again, you never suffer the “symptoms” of alcoholism.
I’m willing to be wrong based on biological science, but my general sense is that the concept alcoholism is a way of turning continued bad decisions into victimhood.
As with other decisions, there are benefits and trade offs. People drink because it makes them feel better. The downsides of drinking can be many - lowered inhibitions to inappropriate behavior, hangovers, health problems, cost, etc. Some people value the instant gratification of drinking over the negative consequences. Some have more of an ability to reject the instant gratification if the view the costs of the consequences are higher. This isn’t that dissimilar to the way people approach anything - things have benefits and consquences and lots of people make bad evaluations and impulsive decisions.
And different people will have different subjective ideas of what the costs and benefits are. Some people may enjoy intoxication thoroughly - for them the benefits are greater than someone who didn’t really enjoy the feeling. For some people the cost is higher - they may hate the control they’re losing over themselves, be less tolerant to the hangovers and other health effects, or the social damage that constant use of alcohol can cause.
So you end up with a variety of results. For people who the benefit of alcohol outweighs the health and social costs of alcohol use (or who make impulsive decisions or decisions which do not properly acknowledge the costs of their instant gratification) can end up abusing alcohol. Those with different values - say, someone who absolutely refuses for their actions to be subservient to any craving - would not be prone to this, even if it were difficult because they enjoyed alcohol use. Is the latter person automatically not a victim of the disease of alcoholism because of their greater personal emphasis on making better long term decisions or retaining complete control of their actions even if they have the same enjoyment of alcohol as someone else?
Is depression a disease?
Slee
the OP’s friend stated that it’s classed as a disease ‘so they can bill insurance?’
I’m pretty skeptical that they could get in in the DSM-IV to bill insurance, anybody wanna defend that statement
Just because there isn’t a “cure” for the issue doesn’t disqualify it as a disease though. Currently there aren’t really any cures for Huntington’s or Parkingson’s disease, we can only try to ease the symptoms or delay the on-set or try to improve the quality of life of people with it. Yet, I doubt there is anyone out there who would try to argue that either of those is not a disease simply because there is no cure. Same with Dystonia, hemiballism, and other movement disorders- many times these disorders are considered idiopathic with no real “known” causes for what’s wrong with the patient, and no standard Go-To method for curing them. Yet, they’re still classified as movement disorders, and it’s understood that there is a pathological basis somewhere for the problems (there are psychological movement disorders as well, but even then- usually there is a physiological response within the basal nuclei creating these disorders), unfortunately the causes aren’t known yet.
I would argue the same could be applied to addictions and alcoholism in general as well. Addictions DO have a neurobiological basis within the brain (within the mesolimbic pathways among others). So it’s not just simply a behavioral issue, but also a physiologic one as well. These are natural pathways that reward us for natural things we do in our daily lives, however, they can be modulated by chemicals, especially long term abuse of chemicals to cause neurological changes within their pathways.
Is alcoholism a disease? I would say yes, ALCOHOLISM is a disease, not drinking alcohol, but the chronic abuse of alcohol to the point of where one could be classified medically as an alcoholic is most certainly a disease. If we were to examine the brain of an alcoholic vs. a normal person or a person who drank in moderation; you most certainly would see a physiological difference in their neural circuitry.
So to say that there is nothing “medically wrong” with an addict is quite untrue.
Their levels of Dopamine production will be out of whack compared to normal, their dopamine receptor levels will be decreased than their previous normal amounts, their neurons would have less arborization and less synapses than a normal person’s neurons. They would also have greater likelihoods of suffering from withdrawal symptoms, which most certainly is a medical issue- as that’s a physical dependency on a substance with visible physical changes occurring when the needs are not met. In such cases, it would not be so simple just to “say No”, when saying no means opening yourself to physical discomfort, pain, and seizures even. That is a point where medical intervention and care is needed and one should most certainly use willpower, and therapy techniques to help fight the addiction, but also medical treatment should most certainly be considered as well to help stave off the negative aspects of withdrawal. (Simple Cite on addiction)
I think the problem lies in what people consider levels of alcoholism or addiction currently. What a lot of the people here are describing is Alcohol Abuse. That’s a very different thing than alcoholism. (Another simplified Citeto explain it better)
When I think of alcoholism, I don’t just think of someone who occasionally has one too many to drink, or may be at risk of abusing alcohol but I think of the person who is ADDICTED to the substance, and who chooses to drink in the face of negative consequences of their actions (whether they are self-aware of it or not). Alcohol abuse- you might be able to argue may or may not be a disease yet, I’d say it’s a precursor that could lead to the disease itself. But Alcoholism in and of itself is a full blown disease. At that point, the behavior has advanced to where it is no longer just a behavior issue but a physiological disorder as well and there most certain IS something medically wrong about the person compared to a normal person’s anatomy.
So for the OP, I would say that medically and physiologically there IS QUITE a difference between an addict and a normal human brain, it’s not just all behaviors only, but physiological changes that drives one’s actions and behaviors as well, and this is most certainly the case in alcoholism. Alcohol abuse now… that’s a grayer area, and probably a better suited thing to debate about if you wish to discuss “willpower” and just simply saying No.
Hope that helps a little bit and maybe makes things easier to clarify for both sides- as I think people are mixing up alcoholism and alcohol abuse.
Also, Mitch Hedburg was right and it’s a damn shame. Alcoholism does have a big negative stigma associated with it, and it is one of the few diseases where you can get yelled at and treated negatively for having it. It’s a damn shame sometimes.
RIP Mitch, RIP.
Is Sarah Palin a disease?
Then do you feel the same way about obesity? If you stop eating to excess and start to exercise the symptoms of obesity will disappear right? Clearly you can’t say you can never eat again, but if you can’t control ‘how much’ you eat is it really that different from an alcoholic? I am quite fit, but I will admit that I could easily go on a food binge if I wasn’t careful. I enjoy eating and I enjoy good food–but I value my good health above that.
My ability to control my food or alcohol intake could be a matter of will power, or is it biological? I personally don’t know, but to deny that the resultant issues aren’t diseases because I can prevent them seems odd. If a person is obese,don’t they have heart issues, high blood pressure, bad knees, etc–those are all very severe health issues caused by obesity. If this person wasn’t obese they wouldn’t have those health issues right?
I am not saying if I personally think that alcoholism is or is not a disease–I don’t think we know enough at this point to determine that–but the definition used by the OP’s friend is flawed in my estimate.
Yes. I don’t believe “obesity” is a disease. It’s a condition, a state of the body. It can be a symptom of a disease, but in itself, no.
Is obesity generally regarded as a disease?
A few scattered points:
–You can avoid getting the flu. All you have to do is live in a hermetically sealed bubble. Interacting with the world opens you up to all sorts of unfortunate consequences.
–It’s worthwhile to separate alcohol abuse from alcoholism. Someone who drinks a case of beer every day for two weeks because he’s bored and thirsty and then quits and never thinks about booze again has clearly abused alcohol, but it’s hard to call him an alcoholic.
A patient once described it to me like this: have you ever had a day when you overslept, so you didn’t get to eat breakfast before you left home, and then you were really busy and skipped lunch? And in the middle of the afternoon, your mind was foggy, your body just wasn’t responding right, and you couldn’t think of anything except finding something to eat?
That’s what alcoholism is like, he said, except that nothing but booze will make it go away, and it’s much, much, MUCH worse.
Sure, an alcoholic can choose not to drink, but can he tell his brain to make the overwhelming cravings go away? Can he tell his body to make the physical withdrawal symptoms go away?
Clearly, that sort of need for alcohol is something that some people have and others don’t. It’s a disordered condition of a bodily system (namely the nervous system), which is a pretty good definition of a disease.
–Calling something a disease doesn’t absolve anyone of responsibility, or at least it shouldn’t. Diabetes is a disease, but you can’t eat everything you want and expect people to feel sorry for you because your body can’t regulate your blood sugar. Alcoholics have a particular cross to bear, and the rest of us should be sympathetic about that, but they ultimately have to bear the cross.
Would that diseases could be stopped by willpower the way that alcohol dependence and abuse can be stopped or mitigated by willpower.
I don’t think it should be considered offensive to suggest that one most certainly can control one’s substance use patterns, because that is exactly what you are doing when your use your willpower to stop drinking. It may not be easy; it may be the hardest thing that some people ever have to do, but at least you have the power to stop drinking. No one has the power to “stop having cancer”.
Alcohol dependence and/or alcohol abuse* can be a horrible, insidious, life-destroying problem. But that does not make it a disease. Diseases don’t clear themselves up through group prayer/fellowship meetings.
*The DSM-IV, which is published by the American Psychiatric Association and provides diagnostic criteria for mental disorders does not list any disorder or condition called “alcoholism”. It does refer to alcohol dependence and alcohol abuse but I don’t believe it ever terms them as “diseases”. JAMA, however, does use the term alcoholism. There appears to be some debate in the scientific community over the disease-model of substance abuse/dependence.
I believe in general this is still open to debate–the issues of defining obesity as a disease has huge implications and thus so far I don’t believe it is classified as anything other then a condition.
However I am still trying to muddle my own way through how something like Bulimia nervosa IS considered a disease and Obesity itself is not. I recognize that Bulmia nervosa has the mental component, but it appears on the surface that is the same issue in both obesity and alcoholism. You aren’t advocating telling someone with Bulimia to just stop binging are you? In essence that is what it appears we are telling alcoholics or obese people to do isn’t it? Some can via willpower alone–but many can’t.
Or how alcoholism can run in families. My own father is a recovering alcoholic-has not drank for 35 years, yet my younger brother died from it. My grandfather and his father also drank heavily. But I don’t have any issues at all with it. Did I find some internal will power that they don’t have? Or is it a mental issue like ** DoctorJ** described in his response?
If it is a mental disorder or a brain disorder does that impact how you would view it? I am curious as to why you wouldn’t want it to be treated as a disease? What is the downside? Or do you view it as a character flaw? As I said I have no bone really in this issue, I am neither obese nor an alcoholic–just a man trying to figure it out all like the rest of you.
Reminiscent of homosexuality … 
People often overlook how culturally based the designation of various tendencies/states-of-being often are.
It’s in the DSM.
Edited to add: Sorry, alcoholism itself isn’t. Abuse and dependence are.
AA teaches that God is the only key to sobriety. Step 2: Came to believe that a power greater than ourselves could restore us to sanity.
In the end, the alcoholic has to accept that there is a God, and it’s not him. If he can’t do that, then he’ll fake it till he makes it. To my knowledge, the amount of atheist AA’s with long-term continuous sobriety is negligible.
It’s a mental illness (obsession) coupled with a physical element (craving). Seems like a disease to me. The only catch is that only the alcoholic can diagnose it by admitting it in Step 1. Until then, he’s just a fuckup.
Willpower (white-knuckling it) is a miserable and usually ineffective method to cure addiction, because for addicts the substance is the solution, not the problem. The alcoholic, in a vicious cycle, uses the alcohol takes away bad feelings: inadequacy, perfectionism, etc. Take away the alcohol, and the feelings are back. Without help, life is still hell.
The way out is the opposite of willpower – surrender.
I don’t have time now to read all the posts here, but I promise I’ll come back and do so.
There’s a couple of very important points I want to make though. All mood-altering drugs (that I know of) to which humans get addicted have a predictable set of withdrawal symptoms. Some are more painful than others. Most will make the patient feel like he/she is going to die if they don’t get a dose of the substance right away.
Of all of them, the most likely to actually KILL you, is alcohol withdrawal.
Simply “going cold turkey” for a heavy drinker or alcoholic without medical supervision is an extremely dangerous thing to do. The liver creates certain chemicals to break down the alcohol, and sets the amount in anticipation of the accustomed alcohol dosage. If the accustomed dosage suddenly stops, these chemicals can actually poison the system since there’s nothing to counteract them. (It’s comparable to what insulin does with sugars.)
Do NOT suggest to an alcoholic or addict that they simply “quit”. Medical help is a necessity.
If you want to know what it feels like to be addicted, hold your breath for 60 seconds. Then keep holding it. You’ll reach a point where your body is screaming for oxygen, and nothing in the world seems important but getting it. If I told you at that point that your child would disown you, or you’d lose your job/house/car if you took a breath, you might be able to hold out a little longer, but eventually your body’s need will override your will to keep holding it and you will take that breath. Your brain will rationalize this any way it has to. It will tell you that I’m an a$$-hole anyway for asking you to do this experiment. It will say I don’t know what you’re suffering, and wouldn’t ask you to if I did understand. . . ad infinitum.
That is how it feels to the alcoholic or addict. It doesn’t feel any different, it doesn’t look any different, even the logic is the same. The drink or drug subverts the pleasure and survival pathways, re-wiring the brain to treat this as a basic need. The longer the drink or drug is in use, and the higher the dosage gets, the stronger the need.
In some cases it’s even worse than that. Many a parent would throw themselves gladly into an inferno to save their child. Heroin and opiates eventually supplant the same brain pathway that governs the Mother/Child bond.
So, yeah, go fight that on your own. Maybe if we shame you enough, you’ll get past it. Or maybe you’ll fight tooth and nail for what looks to you like it’s more important than anything else.
And maybe it will require the combined, concentrated, and consistent efforts of everyone who loves you, a team of medical professionals, and a group of folks who have been through it themselves, to help you fight your way out of the nightmare we call addiction.