If their drinking impairs them to where they can fall under the medical classifications of suffering from Alcohol addiction, I would treat them the same way as I would treat the genetically impaired ones as well who comes in with the same ailments.
An alcoholic is an alcoholic; if they need help, why should I turn them away? If they have an health problems resulting from the alcoholism, I will do my best to see that they get the proper medical care. If they come seeking counseling or advice, I would point them towards the proper resources for that as well.
But I would make no distinction between one predisposed to drinking or one who simply drinks heavily until his liver is shot, or he’s suffering from alcohol poisoning, or if he’s got the syndromes mentioned above. If someone is injured, I should provide care for them- the only pertinent history is if it helps me in diagnosing a problem or if it affects their medical care/treatment plans. It’s idealistic, but I’m young and naive currently. :dubious:
Now if you’re just saying there’s someone out there abusing alcohol, but has no impairment and doesn’t suffer any of the negative consequences from his drinking as stated by the criteria for abuse/addiction, all I can do is when he comes into the clinic is try to make him think about the long term consequences of his actions, and try to see if he fits the criteria for someone at risk for alcoholism. Then I can just see where he is on the wheel of addiction or whatever that thing is called (the motivation wheel? I can’t recall it- but judge at what stage of quitting he’s at, and I can only try to move him one step forwards at best). So i’d
just educate him about the consequences that could occur, and see if i could get him to think about it further. But that’s all I can realistically do within my scope.
My great-aunt did that. For my grandparents’ 40th anniversary, we had a huge party, and she knew my grandmother would be pissed if she showed up drunk, or saw Auntie drinking. So Auntie went cold turkey and wound up going into an alcoholic seizure at the party, and wound up in the hospital. (I remember for the rest of the day, my cousins and then made a ton of get-well cards and ran around getting everyone to sign them.
Since then, she’s been sober and a counselor for AA.
(She later counseled my other Aunt and godmother-unfortunately, Godmother died about two months after obtaining sobriety, after she got a bacterial infection, because her liver still hadn’t recovered enough after so many years of abuse)
I’m sorry, I seem to have been unclear. I knew that it was in the DSM-IV. I was expressing skeptism that it GOT into the DSM-IV so somebody could bill insurance for it. I was asking if anybody bought the insurance line and wanted to defend it.
… One of my friends said that she thought it was classed as a disease simply because they wanted insurance to pay for it.
QUOTE]
I think that if you ask insurance companies’ claims adjusters and their lawyers to define ‘disease’ then you will get a different answer than if you ask medical professionals.
I think it is reasonable to treat some aspects of alcoholism as a medical condition. And that the treatment of medical conditions is best done in the absence of claims adjusters and lawyers. I accept that others’ opinions may vary.
I don’t see how anyone could afford that. If you’re in an alcohol-related condition that requires medical attention, you probably can’t afford to do it without claims adjustors. By the time you need a doctor, you’re into some serious shit.
Alcoholism is most certainly not a disease. You don’t catch it and live with it uncontrollably. People don’t ridicule AIDS victims and tell them to stop living with it because it’s an actual disease. To stop drinking alcohol is, on the other hand, relatively quite simple and doable. A disease is something you don’t have control over. Drinking alcohol is something you do have control over. It being difficult to stop has no bearing on the matter whatsoever. Just because it’s hard for fat people to avoid fast food doesn’t mean we should label obesity a disease either. It’s a condition brought upon that person’s own bad eating habits. That’s not a disease to me.
Alcoholism is no more a disease than smoking cigarettes or drinking soda or any other controllable (regardless of how addictive) activities. People who say it is a disease are simply passing the blame to the alcohol since they lack the self control and willpower to simply stop doing it.
Bullshit! had a fun discussion on alcoholism being a disease in their episode about 12-step programs and I must say I agree with their take on the issue.
To no one in particular: Why do some people have such a stake in believing that alcoholism is simply a character defect, do you suppose? I can’t quite figure out what comfort people take in ignoring any evidence that contradicts this perspective. I don’t think it’s simply the semantical debate over what the word “disease” means; it’s more than that. It’s an assertion that the only difference between the alcoholic and the non-alcoholic is that one exercises willpower and the other does not, that to categorize this as a physical defect to any extent is simply a means of deflecting responsibility. Which is utter bullshit.
Because ultimately, it’s up to that person to decide to drink alcohol or not. Unless that person suffers some strange condition that completely prevents them from having any control over their arm and mouth, drinking alcohol must be willingly performed by said individual. Even if evidence exists that certain people are more apt to become alcoholics than others, it’s a moot point really because it’s still up to that person to decide to drink or not.
Hell, I could be more susceptible to becoming addicted to cocaine than most people but ultimately I have control over doing cocaine in the first place. The fact that if I do it I may become more addicted than most is a secondary point at best.
Is it your belief that alcoholics, upon their first sip of beer, sense that they have a problem, know that they shouldn’t drink since it’s a progressive condition, and simply ignore this knowledge? Cause it doesn’t work that way.
No but once they discover they have a problem, they should seek methods to stop it. That and they shouldn’t say they’re an innocent victim of alcoholism since it’s a disease. They should take responsibility for their own actions (which is quite respectable on its own) and seek ways to stop their own addiction. To me, an addiction is not a disease.
So, you believe that alcoholics think they have no responsibility in their recovery? There are alcoholics who believe they have a disease, take responsibility for the way they can influence this condition (which may include seeking assistance), and through hard work remain sober. They’re not mutually exclusive categories, the “fuck it” alcoholics who say they have a disease and therefore need do nothing about it, and the “good guy” alcoholics who reject the term “disease” and take charge, to the extent within their power, of their recovery.
I think ultimately it boils down to semantics and what your definition of a “disease” is. To some, a disease is any kind of health-related issue or ailment which could easily include addiction. To me, however, a disease is a more narrow, medical definition of specific illnesses that people contract.
More often than not though, I think a lot of people use the word “disease” as a scapegoat to take some of the responsibility of an addiction off them. After all, to cure a disease you often take prescription drugs or have medical procedures. To cure alcoholism, you stop yourself from drinking. Quite a difference.
There are medications that assist in alcohol addiction. Additionally, there are real physical issues that can occur when someone stops drinking–which can include vomiting, palpitations, hallucinations, convulsions and seizures. It is NOT as simple as “just stop drinking.” Sorry, it’s not. It is a predictable progression of measurable physical conditions.
I’m aware real physical conditions can occur due to the withdrawal process and perhaps I should have elaborated that the “stop drinking” part I said may necessitate a specific process to stop, but ultimately to stop suffering from the “disease” you have to stop drinking. Whether that takes a day or a month is irrelevant since what’s necessary to stop being an alcoholic is the same (to not drink anymore). That’s not a disease to me. And really, to get to the point of having such terrible withdrawal symptoms, that person had to progress their alcoholism a LOT on their own. Casual drinkers have no problem with quitting.
Once contracted, can one get rid of type 2 diabetes by simply avoiding a certain food or drink? I’m not a doctor but regardless of how one contracts a disease doesn’t negate the fact that if alcoholism were a real disease, it wouldn’t be as simple to get rid of it by simply not drinking any more alcohol.
You can’t “get rid of” alcoholism. Someone who is in recovery is still an alcoholic, still possesses the physical propensities for alcohol addiction previously noted in this thread. One can, however, change one’s lifestyle to remove or minimize the negative effects of the condition. Much like someone with type 2 diabetes.
But the disease *doesn’t go away just by the alcoholic not drinking. If a recovering alkie drinks the disease picks up right where it left off. The disease is in remission while the alkie isn’t drinking. I’ve seen guys and gals with 10 years+ sobriety go out and drink again. They all, without exception, ended up right back where they started within a few months.
Oh, by the way, the National Institutes of Health (NIH) classifies alcoholism as a disease. Linky.
Slee
*I have not seen an alcoholic successfully drink again after getting sober. The last guy I knew who went out and drank, after 10 or 11 years clean and sober, died within 6 months of drinking again. He lost his job, his house, his wife then died due to alcohol poisoning.
As a society, we classify alcoholism as a disease but interestingly we treat its consequences as if they were an elective choice.
Some of our harshest laws are for driving under the influence of alcohol, for example, and yet there is no “insanity” equivalent defense.
An hallucinating schizophrenic would be institutionalized for killing her child where a drunkard is just carted off to jail for killing the same child.
Then perhaps we should classify alcoholism as an elective choice too (albeit an extremely damaging elective choice for some people). Then we would be consistent.
I would ask again why, if alcoholism is a medical problem, is the only effective course of treatment (according to 12-Steppers) a distinctly non-medical treatment? That treatment being AA; which is performed by laypersons with no medical or even psychological training. Isn’t it risky and irresponsible to send people with a medical problem to laypersons for their treatment? When doctors refer anyone complaining of alcoholism to a non-professional self-help group for their treatment, isn’t that a breach of ethics? Might it not be grounds for a malpractice suit?
One might be temped to say that those last few questions are exaggerated hyperbole and I might agree. Perhaps it IS appropriate for laypersons to be the sole “caregivers” for alcoholism–but that’s only because it is NOT a medical condition. It is not a disease.
The fact that alcoholism is a behavior that can lead to severe medical problems is a moot point when consider the question posed by the OP. Obviously once someone suffers from cirrhosis or serious physical withdrawal symptoms then they need to be under the care of a physician. But cirrhosis and toxic withdrawal symptoms are not alcoholism. Just like black-eyes, broken noses and brain concussions are not boxing. They can result from that behavior, but they clearly are not the same thing.