Except that this is the result of the alchoholic overconsumption, not its cause. Alchoholics may have had nothing wrong before they got addicted, which is a radically different things than it just happening to you.
You could also, say, step on a nail. Doesn’t mean it’s a disease. It’s a problem, and it can be partially treated, but it has to heal and you have to let it heal over time. With addiction, you also have to stop stepping on the nail.
If the nail becomes embedded in the foot, it’s easy to look at it logically, and say “just pull it out.” In reality, very few people could do that, or even sit still and let someone else do it for them. They’d need medical assistance to address the problem and only then could healing begin.
And yes, if they stepped on another nail, they’d be back to square one, with all the same realities intact.
See, I knew that. I just wanted, for once, to hear an AAer say it. Finally.
See? The Truth IS out there!
Oh…and prepare to defend your statement. I think 99.9% of AAers will completely disagree with you. Especially the atheists.
Word. My SIL was told by the doctor to continue drinking until she got to the hospital to begin her withdrawal and treatment. This is standard advice for alcoholics.
It is my understanding that this is not true. All the reading that I have done on this subject (again, I might suggest that you pick up a copy of either Under the Influence or Beyond the Influence. They not only present the findings of decades worth of studies but also cite their sources) suggest that there is a dopamine receptor deficiency as well as detectable differences in DNA before the alcoholic takes the first drink. In other words, that the selective addiction to alcohol has at its roots a physiological cause.
I assume that all of the people that seem so obsessively fixated on having this not be a disease have bought into the notion that this somehow means that the alcoholic is looking to be absolved of responsibility. I mean, that is the talking point being defended here isn’t it? As if it is somehow beyond comprehension that someone could have a disease that can be arrested and treat it. Why that would be crazy talk!
What defense do I need? I indicated Step 2. A power greater than yourself is a soft-pedaled synonym for God.
If you substitute “promote” for “believe” in that clause, then it’s true. Alcoholics who are very sick, i.e. insane, will often have a deep distrust in and aversion to God. Hence the God language is carefully qualified.
There is a strong denial of that amongst the followers. Even those who believe in god are convinced that god is not necessarily a component of the program. The vast majority of AAers I’ve spoken to think of it in terms of my description; not yours.
This may be a hijack, but I really think that I have to try to clear this up. God is not a necessary component to recovery in AA. Billy Baroo is wrong here.
This is a pretty common confusion, because people tend to assume that “higher power” is some sort of a double secret code for God, but it really isn’t. I assume that the thinking is that AA is somehow looking to recruit people and spring the god thing on them later but keep it understated or denied up front. At which point someone will trot out the stupid “doorknob” thing. For the record, we really aren’t on a membership drive.
This is not to say that AA is not a spiritual program. It is. But this is just not the same as “you have to believe in God to be sober”.
I think it’s pretty safe to say that Billy does not speak for AA as a whole, and that Agnostics and Atheists can and do get sober with the support of 12 step programs.
How does one get tetanus then? Is that a disease even thought you had to step on a nail to get it?
If an action leads to a disease, that doesn’t deny the disease of any validity. If you’re trying to argue that the ABUSE of alcohol is not a disease that’s fine and I’m not going to try to contend that issue with you.
But there comes a point when a negative behavior will lead to an actual medical issue, and that’s where we get into addiction and alcoholism, which CAN be considered pathological problems. If you’re trying to say well it’s a disease because you’re doing it to yourself- then again, just because you’ve induced a medical problem doesn’t make the disease any less of an issue. And there are genetic factors that do make one more susceptible to the disease as well. Sure, they will still have to indulge in a risky behavior to induce the disease, but they are still slightly different than the average person who may have a higher EtOH tolerance and/or less of an addiction pathway wired into his brain. Just as an immunocompromised person is more likely to get certain illnesses based on their physiological differences, the same could be said of a person predisposed to an addiction. If they indulge in certain behaviors, then due to their physiological makeup they’re more likely to have the illness than another person who does the equivalent behavior but has a more hardy physiological makeup.
Can you stop having tetanus after contracting it by stopping stepping on nails? All of these analogies fail because the only symptom of alcoholism as a disease is the continued use of alcohol. If you stop, practically there is no more disease.
You can’t stop having tetanus in your bloodstream by not stepping on any more nails.
You can’t stop having herpes by not having any more unprotected sex.
You can’t stop having stomach cancer by deciding not to have any more cancer.
Stop with the weak analogies. Yes, some behavior leads to a greater chance of having a particular disease. That doesn’t mean they’re analogous, because in most cases, once you have the disease, it takes its toll on you without any continuance of that behavior. The negative effects of the “disease” of alcoholism entirely come from the continuance of your behavior.
My best understanding, though, is that (in very broad strokes) what causes addiction to alcohol is that from the get go alcohol is metabolized differently in the bodies of the potential or actual alcoholic and that this leads to build ups of specific chemicals in the brain which causes dopamine issues and malfunctioning of the reward system. I.e. addiction.
In other words, the alcoholic is born with a metabolic disorder that makes him susceptible to physical dependence on alcohol in a way that the majority of the population is not. Granted, I am more than willing to believe that I am wrong about this. But that really seems a lot like something that we would call a disease.
I regret if my own subjective opinions on the meaning of the 12 steps came off as speaking for AA as a whole. In any event, AA principles are not germane to the disease debate.
But ceasing that behavior does not magically render one a non-alcoholic. Are you asserting that the only difference between an alcoholic and a normal drinker is that one chooses to abuse alcohol and the other does not? Is that choice identical for both? Do you contend that alcohol affects the alcoholic and the non-alcoholic in identical ways, and one chooses to abuse alcohol but the other does not?
I’m not trying to assign these beliefs to you if you don’t hold them, just trying to clarify. This seems to be the principal weakness in the argument of the “it’s not a disease” camp, IMO–i.e., the dismissal of the cited physiological differences that exist for the alcoholic. Or are you saying something like, “certainly there is a physical explanation for it, but it’s still not a disease”? I’ve known alcoholics, people in horrible pain, desperate to stop drinking–and they couldn’t (or couldn’t without a great deal of assistance). It just seems inarguable, based on scientific evidence and observation, that alcohol affects certain people differently. It’s NOT simply that some people choose to drink to horrifying excess and others don’t.
One analogy cited earlier seemed strong to me–it’s the equivalent of telling someone with clinical depression to stop being so sad. And, yes, the clinically depressed do play a role in their own recovery, one that requires commitment to a regimen of treatment (among other things). It is also analogous in that it seems difficult for non-sufferers to understand, and there is still a significant percentage of people who view it as just another “state of mind,” a choice one could shake off really, despite the scientific evidence to the contrary. Diseases associated with mental functions, even when there are specific physical attributes, just aren’t accepted by some as springing from any sort of physical source. Not sure why that’s so, or what comfort people get in that position(again, not saying you’re doing so).
I think that the inclusion of god in any substance abuse program negates some of the other trust being taught to these poor people.
The first step is admitting your addiction. Reportedly the hardest one. You are given the chance to talk about how it started, when you do it, why you do it, etc. You get to open up to a LOT of people with the same problems, counselors advise, you can call for help at any time, any day, and everyone I’ve met in AA stress the point that although this is a global problem for many, they KNOW it is their individual problem. They are the solution.
And then you end each session with a prayer??? To me, that would negate all the things I’ve heard from my counselor, doctor, fellow AA members, etc.
Some friends of mine that are in AA tell me, they don’t take the prayer seriously even though they are believers. They believe it’s up to them and no one else, supernatural or real. Hell, priests drink too.
That may be some people’s talking point, but other than the woman mentioned in the OP I haven’t noticed anyone in this thread mentioning that an alcohol abuser/dependent buys into the disease theory just so they can be “absolved of responsibility” for their actions.
I do not believe that alcohol dependence is a disease. However, that does not mean, IMO, that those with alcohol dependence/abuse do not have a very serious problem with the way that they use and handle (or rather ABuse and MIShandle) alcohol. These people need serious help to stop abusing the substance. This may or may not include total abstinence though for many (but certainly not all), simply abstaining seems to be a more manageable solution than trying to moderate their intake.
While one’s physician is usually a good person to approach initially if one is experiencing substance abuse/dependence, ultimately it will take behavior modification strategies to get past these problems. AA is one such non-medical strategy some people (though not very many, alas) benefit from. Others find help in family/friends, clergy or talk therapy. But there is no medical procedure (yet) that your doctor can provide that will cure your dependence/abuse. The best they can do is help you find a behavior modification strategy that will work for you.
But because everyone is different, the common treatment of funneling everyone into a “one-size-fits-all” program (almost always 12-Step) does not work for the vast majority of those afflicted, and because they may not realize that a 12-Step program is ineffective for them for months, years or even ever at all, can actually be counter-productive or even destructive.
A side note: it has always been odd to me that while 12-Steppers believe that alcoholism is a medical condition, their method of treatment specifically calls for untrained laypersons (Sponsors and the Groups in general), not medical personnel, to treat the substance abuser. In fact, AA goes out of its way to insist that no affiliation with any other organizations–profession/medical or otherwise shall be involved in their program.
12-Step programs are essentially spiritual or faith healing programs. But again, there are some people (only 5% of those who enter AA is the oft-cited number offered by AA itself) for whom this spiritual/religious (not medical) approach works.
I worry about the other 95% who are coerced into 12-step when the appropriate course of action would actually be something else.
The same is true of later more severe stages of alcohol as well. There are many symptoms and side effects caused by alcoholism and are associated with the disease, and yes, there are some that are permanent even with the cessation of alcohol (A good example would be Korsakoff’s Syndrome which is often associated/ a progression of Wernicke’s encephalopathy, which in turn is another syndrome associated most often with Alcoholism). While Wernicke’s is treatable if caught early, the signs of Korsakoff’s are much harder to remove, with recovery being quite slow, and there’s less likely chances of a person returning fully to normal functioning (especially if the alcoholism is not fixed). So yes, alcoholism does have negative effects which can continue even after cessation, but that’s in its most severe stages.*
The Joint Committee of the National Council on Alcoholism and Drug Dependence and the American Society of Addiction Medicine classified it as a disease in 1992 and they give it certain qualifiers as well :
Alcoholism has been classified as *“a primary, chronic disease with genetic, psychosocial, and environmental factors influencing its development and manifestations. The disease is often progressive and fatal.” *(cite) With another website where they try to simplify/ explain each of those terms here)
/extra
Also, interestingly enough the DSM used to classify alcoholism as it’s own disease, but in 1980 they changed it, and have been modifying it’s definitions between Alcohol abuse and Alcohol dependence. Just a fun history of the changes here if you want to read more about it.
(bolding mine)
Are there genetic factors that make one more susceptible to stepping on rusty nails? Is “rusty-nail-stepping-on-olism” a disease?
I, too, believe that ultimately it is up to the alcohol abuser to get a handle on his/her problem even though most benefit greatly from outside support (e.g. support group meetings). But this seems to me to run exactly counter to AA’s assertion that one is “powerless” and that the only way to salvation is to admit that one is powerless and can only get better through the intervention of “God” (whether that is Yahweh or a doorknob).
Long term alcohol abuse has health consequences. If someone that you wouldn’t diagnose with alcoholism yet drank chronically all their life suffered from these problems, what would those health problems be? Symptoms of alcoholism, or just the result of lifetime abuse of alcohol?
If I punch myself in the face really hard every day, I’m bound to eventually have health problems - broken nose, bruised skin, split lips - yet punching-self-in-face-ism isn’t a disease - it’s just the end result of constantly abusing your body.
Something I’m wondering - let’s assume there’s a strong genetic component to alcohol addiction. Are there people out there that don’t have this gene, who nonetheless decide to drink their problems away? Are they alcoholics? If not, what difference in treatment would you make for these two groups?