Is alcoholism a disease?

[sleestak]

@I_Love_Me_Vol.I

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.

Do you bother reading any cites that are provided?

LINK

Is alcoholism a disease?

Yes, alcoholism is a disease. The craving that an alcoholic feels for alcohol can be as strong as the need for food or water. An alcoholic will continue to drink despite serious family, health, or legal problems.

Like many other diseases, alcoholism is chronic, meaning that it lasts a person’s lifetime; it usually follows a predictable course; and it has symptoms. The risk for developing alcoholism is influenced both by a person’s genes and by his or her lifestyle. (See also “Publications,” Alcohol Alert No. 30: Diagnostic Criteria for Alcohol Abuse and Dependence.)

That cite, by the way, comes from NIH: “The National Institutes of Health (NIH), a part of the U.S. Department of Health and Human Services, is the primary Federal agency for conducting and supporting medical research.”

Slee

[Guinastasia]

@BrandonR

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.

Most of them DO seek help once they finally admit they have a problem. Those who haven’t usually DENY they have a problem in the first place. I’ve never known anyone who said, “I can’t help drinking-I’m an alcoholic!” It’s usually, “I don’t have a problem-I can stop any time I want!”

@BrandonR

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.

The key words being “to ME.”

Opinions do not equal facts. Do you have a cite for this? Most will say, “once an alcoholic, always an alcoholic.”

[BrandonR]

@Guinastasia

Opinions do not equal facts. Do you have a cite for this? Most will say, “once an alcoholic, always an alcoholic.”

Sorry, I don’t need a cite for common sense. I’m using alcoholic in the sense of *currently *drinking alcohol. Someone who no longer drinks isn’t an alcoholic. Sure they could revert back to being an alcoholic if they choose to start drinking again and don’t want to stop again, but once they quit drinking they quit being an alcoholic. Same way a drug addict who stops shooting up is no longer an addict. As pointed out, if alcoholism is truly a disease, why does the treatment consist of someone telling the patient to stop drinking versus a real medical procedure which is the norm for real diseases?

And just because a government website classifies alcoholism as a disease means absolutely nothing really. The government also says marijuana is a dangerous substance but anyone with any real scientific knowledge knows how false that is.

[BrandonR]

But if we’re going to toss cites around, watch this video starting at 5:00: http://stars.mobily.com.sa/westmediajunkie/shot/103445 and then look up the Supreme Court case Traynor v. Turnage in which the Supreme Court agreed it’s not a disease…

[MsWhatsit]

@BrandonR

As pointed out, if alcoholism is truly a disease, why does the treatment consist of someone telling the patient to stop drinking versus a real medical procedure which is the norm for real diseases?

This is a weird yardstick to use for what constitutes a “real disease” or not. Many diabetics control their disease via eating a proper diet and getting exercise. No medical procedures are involved. Does this mean that diabetes is not a disease?

[BrandonR]

@MsWhatsit

Many diabetics control their disease via eating a proper diet and getting exercise. No medical procedures are involved. Does this mean that diabetes is not a disease?

While some can, some can’t control their diabetes without medical intervention. If you’re going to compare alcoholism to diabetes, then why does insulin even exist when the diabetics could just admit their own fault and refrain from doing something just like alcoholics do?

The difference is 100% of alcoholics can control their addiction by refraining from drinking. Once again, an addiction is not a disease.

[Delayed_Reflex]

Personally I think “diseases” with solely a mental component (they seem to be most often called “disorders”) should be differentiated from diseases that have a persistent physical component. Things like STD’s clearly fit in the latter, as SenorBeef and others have mentioned. I think alcoholism really fits more in the disorder mold than as a disease - however, I think what makes it tricky is that since the negative physical effects correspond to the actual consumption of alcohol, the term alcoholism seems to be more tied to the habit of alcohol consumption rather than the possibly underlying mental disorder.

One thing weird about disorders is that conceivably, someone without the disorder could CHOOSE to do the act and suffer the same consequences. Ie. Someone with OCD may be compelled to wash his hands 50x a day, resulting in dry, chapped hands. Someone without OCD could choose to do the same thing and have the same result. A person with anorexia may only eat an apple a day and waste down to an unhealthy weight. With the appropriate willpower, a mentally sound person could do the same thing.

However, obesity and alcoholism are two cases where it might be harder to differentiate between those with a disorder, and those who are mentally sound and just CHOOSE to eat too much food or drink too much alcohol. Most people can’t see any good reason to wash their hands 50x a day, so it is fairly easy to identify that as a compulsion probably caused by some disorder. But many enjoy drinking alcohol - so who knows if that alcoholic has a disorder, or if he was just drinking because he likes it and just went a bit too far?

1. The act of habitual or excessive alcohol consumption - not a disorder in itself

2. The underlying mental compulsion that may cause the above - is a disorder

Whether alcoholism is a disease or not depends on which of the above you are attributing the word to.

[SenorBeef]

@Delayed_Reflex

However, obesity and alcoholism are two cases where it might be harder to differentiate between those with a disorder, and those who are mentally sound and just CHOOSE to eat too much food or drink too much alcohol. Most people can’t see any good reason to wash their hands 50x a day, so it is fairly easy to identify that as a compulsion probably caused by some disorder. But many enjoy drinking alcohol - so who knows if that alcoholic has a disorder, or if he was just drinking because he likes it and just went a bit too far?

1. The act of habitual or excessive alcohol consumption - not a disorder in itself

2. The underlying mental compulsion that may cause the above - is a disorder

Whether alcoholism is a disease or not depends on which of the above you are attributing the word to.

This something I tried to cover in an earlier post. The person who doesn’t have a biological aptitude for alcohol addiction, yet abuses alcohol because they succumb to an immediate need above their greater good, are they an alcoholic?

If not, what’s the difference in treatment or approach?

The treatment is the same either way - any support system that gets the person to stop drinking. Ultimately they have to stop themselves.

If someone who suffer problems from alcohol abuse and alcoholics have the same problems for the same reason, and both require the same treatment - what’s the meaningful difference?

[Stratocaster]

@SenorBeef

This something I tried to cover in an earlier post. The person who doesn’t have a biological aptitude for alcohol addiction, yet abuses alcohol because they succumb to an immediate need above their greater good, are they an alcoholic?

If not, what’s the difference in treatment or approach?

The treatment is the same either way - any support system that gets the person to stop drinking. Ultimately they have to stop themselves.

If someone who suffer problems from alcohol abuse and alcoholics have the same problems for the same reason, and both require the same treatment - what’s the meaningful difference?

But they don’t. Someone who abuses alcohol but is not addicted may have the same physical consequences. But the treatment is significantly different when someone can easily simply choose to stop. Here’s one cite of many out there:

Typically, those drinkers who are diagnosed as only alcohol abusers can be helped with a brief intervention, including education concerning the dangers of binge drinking and alcohol poisoning.

Those who have become alcohol dependent generally require outside help to stop drinking, which could include detoxification, medical treatment, counseling and/or self-help group support.

They may have the same problem, but not for the same reason, see the difference? The fact that your naked eye may not be able to detect it doesn’t mean the difference doesn’t exist. Read some of the prior cites if you’re looking for some of the physical differences already established or under ongoing research.

[Dangerosa]

@Icarus

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).

This is a very insightful post.

[Clothahump]

@BrandonR

…and then look up the Supreme Court case Traynor v. Turnage in which the Supreme Court agreed it’s not a disease…

Actually, I don’t think they did. The Supremes basically kicked it back to Congress.

This litigation does not require the Court to decide whether alcoholism is a disease whose course its victims cannot control. It is not our role to resolve this medical issue, on which the authorities remain sharply divided. Our task is to decide whether Congress intended, in enacting § 504 of the Rehabilitation Act, to reject the position taken on the issue by the Veterans’ Administration and by Congress itself only one year earlier. In our view, it is by no means clear that § 504 and the characterization of primary alcoholism as a willfully incurred disability are in irreconcilable conflict. If petitioners and their proponents continue to believe that this position is erroneous, their arguments are better presented to Congress than to the courts.

Traynor v. Turnage, 485 U.S. 535 (1988)

[Mr.Kobayashi]

S: (n) disease (an impairment of health or a condition of abnormal functioning)

Yes.

[sleestak]

@BrandonR

While some can, some can’t control their diabetes without medical intervention. If you’re going to compare alcoholism to diabetes, then why does insulin even exist when the diabetics could just admit their own fault and refrain from doing something just like alcoholics do?

The difference is 100% of alcoholics can control their addiction by refraining from drinking. Once again, an addiction is not a disease.

Have you read ***any ***of the cites that have been provided? If you do you will find that A) there are medicationsused to treat alcoholism B) there are genetic factors involved in alcoholism and C) the Federal Government (via the NIH) classifies alcoholism as a disease.

Slee

[Mr.Kobayashi]

@sleestak

Have you read ***any ***of the cites that have been provided? If you do you will find that A) there are medicationsused to treat alcoholism B) there are genetic factors involved in alcoholism and C) the Federal Government (via the NIH) classifies alcoholism as a disease.

Slee

Agreed. I’d also say the statement by BrandonR that “The difference is 100% of alcoholics can control their addiction by refraining from drinking. Once again, an addiction is not a disease.” shows tremendous ignorance and is (I find) quite offensive; alcoholics can’t just ‘refrain from drinking’ otherwise they wouldn’t be alcoholics. Addiction also fits various definitions of the word ‘disease’ as a harmful abnormality.

[BrandonR]

@Mr.Kobayashi

Agreed. I’d also say the statement by BrandonR that “The difference is 100% of alcoholics can control their addiction by refraining from drinking. Once again, an addiction is not a disease.” shows tremendous ignorance and is (I find) quite offensive; alcoholics can’t just ‘refrain from drinking’ otherwise they wouldn’t be alcoholics. Addiction also fits various definitions of the word ‘disease’ as a harmful abnormality.

What I find offensive is that people seem to think alcoholics suffer some strange ailment that prevents them from not drinking! Stop trying to pass the burden of an addiction to some imaginary disease when it’s ultimately up to the addict. Are you implying that all drug addicts are really just suffering from diseases so it’s not their responsibility to stop using?

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.

Regarding medications… All the medications in the world won’t help you if the user doesn’t stop drinking. The ultimate cure for alcoholism is to stop drinking. Just because there are medications to help you to stop drinking doesn’t make it a disease. And while there may be genetic factors involved in making one more likely to become an alcoholic, it most certainly doesn’t mean you have to become one. Drinking is a choice. Do I need to continue or is this elementary point clear enough? Nobody has to drink alcohol!

And like I previously said, the government defining something as something doesn’t mean it makes sense. Marijuana is classified as a dangerous drug with no medicinal benefits by the government but thousands of terminally ill patients who use medical marijuana would disagree with their definition.

But ultimately, like I said before, it all comes down to what you define as a disease. To me, disease means infectious disease, not just any health condition like some of the people here are saying it is. It’s an issue of semantics.

[MichaelQReilly]

@smiling_bandit

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.

Good post.

I’m really on the fence on this one. On one hand, it’s obvious that alcoholism is genetic and that some people are predisposed to becoming alcoholics. Hell, I drink much less than many of my peers, but half the time I feel like I really need a few beers after a long week of work.

But, this is what gives me pause: many alcoholics eventually stop. Whether it’s with the help of rehab or on their own, they stop. So when we classify it as a disease that a person has no control over, I think we are giving the alcoholic a bit too much of a pass.

My 2 cents:
I think it’s more correct to classify alcoholism as a really powerful “like.” Humans have this with all sorts of substances. Some people really love ice cream. That’s not my thing, but I drool if I even smell coconut. Alcoholics are just people who have had the misfortune to respond that way to alcohol. From there, there is a choice process involved; there has to be or alcoholics would never voluntarily stop.

[Binarydrone]

BrandonR;11010115, Question: Have you seen a single post in this thread, or hell have you even ever met an alcoholic who is attempting to dodge responsibility for their disease? Where are you even getting this?

I guess that I am not getting you and the way that you are so invested in this being some sort of a moral issue is pretty strange. Are you working through some family issues on the board? The way that you refuse to read any cites or even consider facts that fly in the face of your emotionally charged opinion seems almost like a pathology.

I think that what I like best is your AIDS analogy. It is almost perfect in that the overwhelming cause (transfusion surprises aside) is a behavior (i.e. bareback fucking or shooting dope with dirty needles) but that the end result is a disease. Really the only difference is that AIDS can not be arrested the way that addiction can. But that aside, what do you call a condition that causes a minority of people to have a deficiency in the number of dopamine receptors in their brain and to metabolize alcohol differently and in such a way so that every cell in their bodies come to depend on it as a primary energy source and to crave it and send “I am dying” signals to the brain when the supply is cut off? Seriously?

[sleestak]

@BrandonR

But ultimately, like I said before, it all comes down to what you define as a disease.

It must be neat to live in a world where *you *get to define what a word means. That must come in quite handy for you.

Slee

[Mr.Kobayashi]

@BrandonR

What I find offensive is that people seem to think alcoholics suffer some strange ailment that prevents them from not drinking! Stop trying to pass the burden of an addiction to some imaginary disease when it’s ultimately up to the addict. Are you implying that all drug addicts are really just suffering from diseases so it’s not their responsibility to stop using?

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.

Regarding medications… All the medications in the world won’t help you if the user doesn’t stop drinking. The ultimate cure for alcoholism is to stop drinking. Just because there are medications to help you to stop drinking doesn’t make it a disease. And while there may be genetic factors involved in making one more likely to become an alcoholic, it most certainly doesn’t mean you have to become one. Drinking is a choice. Do I need to continue or is this elementary point clear enough? Nobody has to drink alcohol!

And like I previously said, the government defining something as something doesn’t mean it makes sense. Marijuana is classified as a dangerous drug with no medicinal benefits by the government but thousands of terminally ill patients who use medical marijuana would disagree with their definition.

But ultimately, like I said before, it all comes down to what you define as a disease. To me, disease means infectious disease, not just any health condition like some of the people here are saying it is. It’s an issue of semantics.

There are a lot of people here who evidently have not seen someone stagger down that path and therefore are spouting a lot of ignorance on the subject of alcoholism. There were 75,766 alcohol-related deaths in the US in 2001 - to suggest that these could all have been prevented simply by telling the user to stop drinking is obviously way off the mark. If combating alcoholism is as simple as you suggest, why is the death count so high?
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;

According to the Institute of Alcohol Studies, a person is considered to be dependent on alcohol when they have experienced three or more of the following symptoms during a year.

* A strong urge to drink, difficulty controlling how much they drink, or difficulty stopping.
* Physical withdrawal symptoms, such as sweating, shaking, agitation and nausea when they try to reduce drinking.
* A growing tolerance to alcohol - needing larger quantities to get the same effect. 

http://hcd2.bupa.co.uk/fact_sheets/Mosby_factsheets/alcohol_abuse.html

Alcohol dependence (addiction)

This is a serious situation where drinking alcohol takes a high priority in your life. You drink every day, and often need to drink to prevent unpleasant withdrawal symptoms (see below). In the UK about 2 in 100 women and about 6 in 100 men are alcohol dependent.
What are the symptoms of alcohol dependence?

If you are alcohol dependent you have a strong desire for alcohol. Sometimes the desire is overwhelming. You have great difficulty in controlling your drinking. In addition, your body becomes used to lots of alcohol. Therefore, you may start to develop ‘withdrawal’ symptoms 3-8 hours after your last drink as the effect of the alcohol wears off. So, even if you want to stop drinking, it is often difficult because of the withdrawal symptoms.

Withdrawal symptoms include: feeling sick, trembling, sweating, craving for alcohol, and just feeling awful. Convulsions occur in a small number of cases.

As a result, you drink alcohol regularly and ‘depend’ on it to prevent withdrawal symptoms. If you do not have any more alcohol, withdrawal symptoms usually last 5-7 days, but a craving for alcohol may persist longer. The severity of dependence can vary. It can develop gradually and become more severe.

Health Information | Medical Conditions by Category

I wish it were as simple as telling people just to ‘stop drinking’. It isn’t a choice, it’s a need, a dependence, a chemical compulsion, there’s no getting away from these facts. One that can be overcome, but on that in a lot of cases isn’t.

I think a lot of people would take issue with your definition of disease, also. I don’t mean to sound snarky, but your definition of ‘disease’ meaning only infectious disease is just plain wrong;

Definition of Disease

Disease: Illness or sickness often characterized by typical patient problems (symptoms) and physical findings (signs). Disruption sequence: The events that occur when a fetus that is developing normally is subjected to a destructive agent such as the rubella (German measles) virus.

http://www.medterms.com/script/main/art.asp?articlekey=3011

Under your definition conditions such as Alzheimer’s disease are not disease because of the trivial fact that they are not infectious.

[BrandonR]

@sleestak

It must be neat to live in a world where *you *get to define what a word means. That must come in quite handy for you.

Slee

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?