Is alcoholism a disease?
If so, what causes it? What cures it?
AA says you can’t be cured… so what do you call alcoholics who have permanently stopped drinking?
(AA says you call them “dry drunks” which is one of the single most ridiculous concepts I’ve ever heard. I’m sure the hundreds of thousands or millions of people who have stopped drinking forever-- WITHOUT going through the pseudo-intellectual contortions of AA would probably agree with me.)
Well, there’s not much of a debate here. I’m sure an MD will be along at some point to back me up, but yes, alcoholism is a disease. It seems to be genetic, and there’s no known cure other than never drinking.
Not everyone who drinks too much is an alcoholic. Some people are psychologically addicted to alcohol–these are not alcoholics, just alcohol abusers. Other people have a chemical imbalance in their brain that causes them to be physiologically addicted to alcohol. These people, when they aren’t drinking, really are “dry drunks”.
A good resource is available at this site. In particular, look at this article.
Actually there is a pretty good debate here as I mentioned in the AA and religion thread.
The AA model of addiction is pretty much junk science. It really hasn’t moved much beyond the basic theory developed in the 30s that alcoholics reacted differently to alcohol than other people. This has never been demonstrated.
It is worth noting that the treatment industry and research community remain dominated by AAers. They have a vested interest in demonstrating a physiological/genetic link to addicive behavior. The disease model is extremely important to AA as it provides an medical excuse for what would otherwise be seen as irresponsible behavior. Thus the fascination with showing a genetic link for addiction, something that notwithstanding the rhetoric and claims to the contrary has not been meaningfully demonstrated, while far less interest is shown to sociological factors with clearer correlations.
AA professionals seem happy to integrate every new theory and bit of research on addiction into a twisted bit of nonsense. Like most things to do with AA, you can’t be too stupid but you sure can be too smart to make sense of it.
Having said that I have no problem labeling dependancies as disorders as long as the definition isn’t abused. I don’t think that people who fall into the trap of obsessive behaviors should be thought of as stupid or weak willed. It is one of many obsessive behaviors that people find extremely difficult to control.
Ned, what is it. Were you beaten up by an AA’er at some point? You kinda come off as having a prejudice against 12 step groups in general. The JAMA and the DSM4 and pretty much the whole(with a few execptions) medical community consider it a disease. And I think we can all agree that drinking oneself to death goes a little farther than ‘irresponsible behaviour’ and at least borders on the pathological. And BTW, there are no AA ‘professionals’.
Now, you could argue that it may be too trendy and ‘over-diagnosed’, and in some cases used as a cop-out, and I would have to agree. But that would be for another thread.
Now to the OP:
They are still called alcoholics, or recovering alcoholics, if you will. They don’t drink, one day at a time(and do other stuff as well). The disease is chronic. If the alcoholic drinks again…well, you know.
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*Originally posted by spooje *
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This is my problem with using a disease model for substance abuse.
I agree with Ned for the most part. However, I also understand that THINKING of your substance abuse problem as a disease can be a useful model for treating it. The problem for ME arises when we treat it like diabetes or Alzheimer’s disease, rather than the infection it is.
It might help some people to consider their substance abuse problem as an infection. If you have an infection, you know there are things YOU must do to rid yourself of it. You know that after you’ve taken your antibiotics and downed you fluids and gotten your extra rest, you will have to take steps to ensure that you don’t get infected again.
Substance abuse (defined by a person continually making a choice to engage in self-destructive behavior) is NOT a life sentence. It can be treated like disorders which are fixed so that the affected person can go about their business and live the rest of their lives without a label. And consequently, without the weekly (or more often) meetings, daily phone calls, and religious and other rituals of a 12-step program.
Giving you problem some kind of a name…referring to it as “the beast,” an illness, a monster, your evil side, or what have you, can be a good way to separate yourself from the problem and look at it from the outside. Thus it may give the abuser the means to see solutions to the problem and ways to think of killing that beast or curing that disease. But I remain firmly convinced that self-abuse is a perfectly killable beast or curable disease…NOT a chronic health problem that must color the rest of the (temporary) abuser’s life.
-L
Alcoholism is a genetic disease. You are born with it and it also goes under the term of ‘addictive personality’ because many alcoholics have dual addictions ranging from not just booze but to at it’s worst, illegal drugs and at the least, cigarettes and even coffee.
A true alcoholic is never able to drink booze again because the ‘taste’ is always there, lurking in the back ground, though a great many have tried. Almost every alcoholic has had a ‘slip,’ or two where he or she tried to drink normally and went back to being a drunk and had to sober up all over again. He can eventually not desire drinking booze, and a smart one will know that if he does try, he has a 99% chance of sliding back into active alcoholism.
Some alcoholics are not true alcoholics, but have a drinking problem called alcoholic dependency, where they drink to conceal a problem, usually mental. These people, once the problem is cured, often may drink socially again.
It took years for normal people and professionals to realize that alcoholism is a disease and not just some person being a spineless, coward of a slob who prefers to hide in the glow of the drink. Many alcoholics drink so much that they have gone beyond the ‘glow’ most people drink to achieve and have slipped mainly into the often unpleasant drunkenness or ‘drank themselves sober’ where they feel and act sober, but are far from it.
A prejudice against 12 steps? let me be a little more clear. The 12 steps have nothing to do with substance dependancy. They are a reversion to the days of shaman’s chants and blood letting. It is a fucking travesty that medical professionals and courts have been conned into thinking this is treatment. No, I wasn’t beaten but I watched enough young people in serious trouble pinning their hopes on this garbage, desperately trying to make sense of what they are told is their only option, to lose my normally tolerant attitude.
By AA professionals I mean the legions of AAers who utterly dominate the treatment profession and research fields. This, at least, is slowly beginning to change.
They found an alcoholic gene?
Marc
A lack of gene, actually.
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*Originally posted by MGibson *
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Consider that alcoholism was declared a disease LONG before the genome was partially mapped. Looking for something AFTER you’ve made the determination of where it MUST come from is generally a faulty research plan.
Also consider that human beings are “genetically predisposed” to countless numbers of things which are NOT diseases or considered chronic. A genetic predisposition to compulsive, self-destructive behavior does not mean that it’s necessarily an illness. Nor does it mean that once that behavior arises, the self-abuser cannot be completely rid of it of their own volition.
Help me out here. If alcoholism is not a disease, if these youngsters were just foolish and irresponsible and lacking in willpower, why did they go to AA? And how were they harmed?
Did you with them? Or did you listen to their version of what happened there, and maybe glanced at the Big Book?
QUOTE]It is a fucking travesty that medical professionals and courts have been conned into thinking this is treatment.
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So you have a rigorously “scientific” approach that has proven more effective ?
Or do you simply deny that AA has ever helped anyone ?
You may classify the 12 steps as the equivalent to rubbing blue mud in your belly to cure your ills, but until something demonstrably better comes along only a fool would would reject it because it fails to hold up to some high falootin set of scientific or moral principles. The twelve step program works for many people. If it doesn’t work for some, and they get more screwed up and maybe die, that’s just too damn bad. The programs inability to help 100% of the boozers out there is not sufficient reason to discard it as useless superstition.
It works, t has a good long term track record, NOTHING else does.
I am also extremely skeptical about alcoholism being a disease. And i think the concept probably cuts both ways as a treatment - on the one hand it makes people stop blaming themselves which may give them a more positive attitude which may be condusive to positive behavior. OTOH, by removing the blame from the person you may be giving them an out to some extent.
The fact that alcoholics are always at risk is no different, to my mind, then the fact that former smokers are always at risk of relapsing. Once you’ve come to enjoy something and to know a certain lifestyle you are more at risk of relapsing into that lifestyle.
People also claim, in the same manner, that drug abuse is a disease.
I think it is all part of the larger trend in psychology of identifying everything as a mental condition of some sort, and de-emphasizing personal responsibility.
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*Originally posted by Squink *
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The fact that people are unaware of a better method, does not make this method GOOD. And in fact, 12-step programs use their smug “you just don’t get it if you disagree with us” attitude along with other means to keep other solutions to the problem from being widely accepted.
Also, if you have stats that show that 1)12-step programs work well as treatment for self-destructive behavior and 2) nothing else works as well, PLEASE post them here. The problem with this theory is that only those who stay involved in 12-step programs are able to vouch for their effectiveness. How many people were failed by this system is not known. The insistence of 12-step followers that if you follow the program to the T and it doesn’t work for you, or if you seek alternative methods it’s YOUR flaw also clouds the issue.
-L
Personal responsibility is very important, but it’s not everything. According to this site, 50% of a person’s risk for alcoholism is genetic. If you got those genes, personal responsibility is one hell of a struggle.
AFAIK, some there are som polymorphisms that can be linked to certain effects of alcohol and to what is sometimes referred to a s Cloninger’s type II alcoholism (type II is a more severe variant, often running in families and is often associated with problems with aggression and impulse inhibition).
Also, some popymorhism and repeates of genes have been associated with a higer risk for alcohol abusive behaviour. Are you familiar with the concept “vulnerability”? Vulnerability means an individual, or a population, has a larger disposition, a larger risk, of developing for instance alcohol dependancy or abuse, schizophrenia, colon cancer or whatnot.
It’s far to early to draw the conclusion that alcoholism is a genetic disease.
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Usually, one does not make a distiction between “true” or “not true” alcoholists, but rather, the terms “alcohol dependancy” v “alcohol abuse” is classified according to degree of damage inflicted on the person’s life, and the degree of difficulty to quit, ie withdrawal symptoms and such. There might be national differeces, though.
I think it’s a bit of an oversimplification to believe that the reason why a person started drinking, is correlated to how severe the abuse will be. The genetic factors seem to affect things like how alcohol affects you and how severe withdrawal symptoms a person will have, and this is very important information regarding treatment and to increase the understanding why some people have more diffuculties to quit drinking and others. But so far, I haven’t seen any studies showing connections between drinking to flee from psychological/emotional problems, and genetics. ASAIK, most people start drinking as a strategy to handle difficulties in their lives, regardless of genetic background.
Viewing alcoholism as a person just having a “bad character” is deeply unfair and does not at all help the issue. But viewing alcoholism as a disease should not mean we can neglect the fact that socioeconomic and psychosocial factors have a great impact on the development of alcohol abuse. Just because something is caused by psychological factors, does not mean it’s less of a disease. If something awful happens to me, I go into a severe depression and the serotonin system in my brains goes whacko, does that mean I don’t have a disease and that I don’t have the right to treatment? No, of course not, but I know there are many people who believes psychiatric disorders or psychologicically induced disorders, are not proper “diseases” (whatever they mean with their definition of “disease”, but that’s another disussion).
??? Do you have a reference to this?
Have they really proved that alcoholism is an inherited trait? So far as I understand it alcoholism does run in families. But is that because people are raised observing certain behaviors in their parents or because of some genetic predisposition? Child abuse also runs in families but I don’t think many people claim to be genetically predisposed.
Marc
I may have overstated it by implying that there was no genetic component to it. Sorry. There is probably a genetic component to everything. I’ll bet most serial killers have something in their genetic makup which makes them more likely to become serial killers. But its only an increased subsceptability - it doesn’t mean that it is something that is out of their control. The question as I see it is if emphasizing the genetic aspects of it increase or decrease a person’s motivation to control it.