Is alcoholism a dsease?

Great Debates
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::checks Forum name::

Yep, this is Great Debates, and that means that “it is reasonable to expect” is neither evidence nor proof. I’m still waiting to hear about those “many people” who find that the best way to cure their problem drinking is just to stop drinking for good. In fact, I’d like to hear about any of them. I’m aware of a number of anti-AA books which take the position either that (1) The steps of AA are inadequate in some way (too religious, don’t deal with psychological issues enough, etc.) and therefore a modified step program is necessary, or (2) It is possible for problem drinkers to learn to drink in moderation. I’m not aware of any book or research that shows that problem drinkers can simply stop drinking, much less that this is the best way. If people were having this astounding success, I’d certainly expect them to be sharing it with the world.

As for alcoholics prior to AA, I’d like to see some evidence that any of them were able just to quit – even anecdotal stories about individuals who had severe drinking problems and then just stopped would be interesting, although not probative. One of the symptoms of alcoholism is that in spite of “compelling reasons to quit”, alcoholics continue to drink.

Well I am not a 12-Stepper, and when I refer to “the medical community,” I mean people who have obtained medical degrees from reputable universities, the members of the American Medical Association, published peer review medical journals, and the like. That medical community, as represented by the AMA and the World Health Organization, defines alcoholism as “a chronic, progressive treatable disease in which a person has lost control over her or his drinking so that it is interfering with some vital area of her or his life such as family and friends or job and school or health.”

To reiterate, the medical community does not believe that AA is the one true path to recovery from alcoholism. There are alternative treatments, including medication and alternate forms of therapy, being researched and implemented all the time.

The one method that does not seem to work for those with the disease of alcoholism is the willpower or “just quit” method. Too many people are desperate to stop drinking and yet unable to quit to make this a viable treatment.

DoctorJ – Yes, sadly many people have a hard time grasping that psychological disorders exist, or that addicts are suffering from more than just a lack of character. As we learn more about the human brain (and researchers have already found specific differences in the brains of some alcoholics) the harder it will be to dismiss diseases of the mind as just bad behavior.

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Clearly, a person’s alcohol consumption has nothing to do with his/her character.

As for the willpower or “just quit” method. It’s the only game in town. There is no other way to quit than to take the plunge and just quit.

Can anyone tell me any way anyone anywhere can quit drinking other than screwing up their courage and simply stopping?

This is how SMART, Rational Recovery and other non-religious substance abuse programs work. When you go to their websites you will find testimonials from alcoholics who have quit drinking without any 12-step irrationalities.

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Hey, SexyWriter. how ya doin?

OK, it’s not just WedMD. I have no idea what the Pope calls it. The American Medical Association and the DSM4(an important diagnostic reference used by most of the profession) say it’s a disease. A Question: Do you really think they came to that conclusion with no research? That it wasn’t hotly debated? That medical doctors and research scientists just blindly accepted a PC version and changed their minds?

And Dr. Goo Fee

I’m assuming you do not see the irony here. If all it takes is the willpower and courage(that everyone has) to just quit, why are SMART and Rational Recovery and what not necessary? Are their clients being bilked?

I don’t know anything about Rational Recovery, but what are their clients recovering from?

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Sorry, I haven’t read the entire thread yet, but this, to me, is the single biggest problem: people are not allowed to have ‘bad character’ anymore. I’m not responsible for what happened, and I need ‘treatment’ to help me.

Bovine excrement. Obesity, gambling, smoking, alcoholism, just to name a few (and particularly the last three): any such vice taken to an extreme that is damaging/harmful either to the person involved or the persons around him/her, are 100% due to the lack of self-control on the part of the addict (with obesity perhaps being the one exception, but only a very minor part of the time).

Calling the end result of obesity, gambling, smoking, alcoholism, whatever, a disease is fine. The treatment may be like treating a disease. But the cause of alcoholism is not a disease. Alcohol gene my ass. Just like the obesity gene. I think the whole concept is bullshit: our entire gene structure has probably any number of genes that give us ‘inclinations’ to do/be this or that – but that does not excuse or remove the self-will/control and freedom of choice factor from the person involved.

Alcoholics are alcoholics because they chose to drink. Smokers smoke because they chose to smoke. The obese are obese because they chose to overeat and/or not exercise (in the vast majority of cases). Gamblers are addicted to gambling because they chose to gamble. No one is out there putting guns to heads and forcing down one more drink, lighting up one more cigarette, pulling one more quarter in the slot machine, shoving one more Twinkie down.

I have every respect and admiration for anyone who admits that they and they alone are responsible for their condition and seeks help (regardless where they look for help; I could really care less, be it AA or whatever).If they want to consider themselves alcoholics even if they aren’t drinking, fine.

But as I have mentioned before, alcoholics who simply pass off their condition as a disease are beyond pathetic: they are a slap in the face to people who did not chose to end up with some terrible blood disorder or some other real genetic related disease.

Sorry for the rant.

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**

Actually, it’s not inconsistent at all. Many members of AA will tell you that the obsession to drink is gone. That doeasn’t mean that they aren’t alcoholics anymore! Nor does it mean that the same old craving won’t kick in if we do have that drink, because it will, and we will be right back where we were before we stopped drinking. It just means that we don’t have to obsess over drinking every moment, as we may have in the past.

I thought about that the other day. Would some people also tell someone with OCD to “just quit washing your damn hands?” But I am coming from a “disease perspective” while others are not, so the twain shall never meet.

spooje, I wondered about Goofy’s assertion too. If we should just get our shit together and keep it together, why should we go to ANY program? Or does RR really offer something else, like their own philosophy? GASP! You mean like AA? Horrors! :smiley:

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Actually, maybe not. I am an alcoholic, yet I drank less than many people I know who aren’t alcoholics. Most people can drink any amount with impunity, except for maybe a hangover! Alcoholics process alcohol differently than those people. It has been described as both an allergy of the body, and an obsession of the mind.

But back to your point- lots of people choose to drink. No-one chooses to be an alcoholic. Can you imagine any of us wanting people to talk about us like you do? No thanks!

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I’d be careful about calling it an “allergy”; folks will come by wanting to know the exact immunological mechanism present in alcoholics. (I know what you meant.)

There are three components to addiction: psychologic dependence, physiologic dependence, and habit. Alcoholism offers a heavy dose of all three.

Oh, and a message from an Unofficial SDMB Public Health Officer: If anyone reading this thread drinks heavily, and is considering quitting, DO NOT simply quit cold turkey. The withdrawal can be life-threatening. If you drink significantly, do not attempt to stop drinking without medical guidance.

Dr. J

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Too true, Doc J. I should be more careful.

What you said about quitting cold turkey is dead on (so to speak). Isn’t the stat that about 5-10% of the people who go through delirium tremens (DT’s- think Ray Milland in Lost Weekend) die from them? Yuck. That’s besides the hallucinations, seizures, etc.

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Wiwaxia: http://www.ucsf.edu/pibs/faculty/gordon.html

[among others]

Finally, we have also found differences in the localization of the catalytic subunit of PKA in lymphocytes of alcoholics. The Ca catalytic subunit is localized to the nucleus in lymphocytes of alcoholics but appears only in the cytoplasm in control lymphocytes. These differences in localization of the catalytic subunit of PKA in freshly isolated lymphocytes from alcoholics suggest that the effect of EtOH on cAMP signal transduction may play an important role in the chronic effects of EtOH in humans. A biological marker for alcoholism and intervention based on the proposed mechanism of action of EtOH are currently being evaluated.

*btw; I don’t consider the lack of a gene an excuse.

As someone mentioned; nobody made me a drunk. I did that al by myself.

As I stopped drinking al by myself.

And perhaps some people have other lacking genes which make them insensitive bastards.

I hope they can stop that, al by themselves.

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There’s a lack of llll’s as well in my post. Excuses.

Read all instead of al

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I’m a friend of Bill W’s also. (Alcoholic) I’ve been sober since 95. Previously I was sober since 84. I joined AA, but did not follow the strict program they provide i.e., sponsor, 90 meetings in 90 days, joining a group and the 12 steps but AA gave me the ability to sober up and stay sober. Having had a medical and psychological background, I fully understand why I drank heavily, what happened and why I cannot drink again.

I miss the fun I had while boozing but I do not miss the misery and trouble I got into in the latter stages nor the helpless addiction to the stuff. Having sat in at many a meeting with numerous alcoholics of all ages and both sexes, it is easy for me to understand why various people drink, to grasp the fact that many people are predisposed to getting addicted to booze and to understand that the addiction is genetic. While there might not be a specific gene for alcoholism, there are genes that enable one to have an addictive personality, and alcoholics do not start out wanting to be alcoholics.

In my groups we had doctors, lawyers, businessmen and women, teens and old farts, so the disease does not strike just one or two levels of intelligence or have a racial predisposition.

I no longer go to AA, having been able to develop the fortitude to no longer need a support group, but it is nice to know that if I ever start to get the strong urge to drink again that I can walk back into any meeting and recharge my batteries if needed. Plus, I understand drunks a whole lot more because I’m one, even though sober.

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I wouldn’t call AA a useless superstition, but it certainly is a superstition. I’ve never heard of any well-documented evidence that its long-term track record is better than any alternative.

AA was there when I thought I needed it, and I’m glad it was. But I would be more glad if I had known then what I know now, which is that I didn’t really need it.

I was intimidated into believing things that I have since discovered aren’t true. I could have gotten sober and stayed sober without that, and I wish I had. I also wish more people knew that they can do it, as well. You don’t have to stop thinking to stop drinking, but you wouldn’t know that to hear most AA members tell it.

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From
http://boards.straightdope.com/sdmb/showthread.php?threadid=81533&pagenumber=3

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DSM4 does not have alcoholism as a separate impairment, but it is included in substance disorders. And substance disorders are divided into substance dependency and substance abuse.

If one abstains from substances, he is not cured but “in remission.” There are four different kinds of remissions. Less than 1 year (but more than 1 month) is known as early remission. Early remission and and remission are further divided into two kinds each, depending upon whether all the criteria for dependency and abuse are in remission or only part of them. It also lists the criteria for each.

I don’t have DSM4 here at home. I tried to post it at work where my book is, but the post was timed out. If any one is interested, I’ll post the details tomorrow.

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[QUOTE]
*Originally posted by DouglasOfCalifornia *
**

Really? I don’t know any AA’s who just lay there and drool, but maybe that’s just me.

It is upsetting to see so much misinformation spread about AA, but it has been brought to my attention that it is none of my business what other people think of AA, so I will confine my comments to this last post.

The concept of a higher power is part of the AA recovery process, but it isn’t the only part. Hell yes, I have a vote in what I do! It is my choice whether or not I drink today, not some God’s. If I choose to drink tomorrow, no higher power will “miracle” the drink out of my hand! And no higher power “miracles” me sober each day. I do that.

I have to make the conscious choice not to drink every day, and I have to do the work. Where I get the strength to do it, that could be a higher power at work, but that’s personal to me and to each person.

I am an expert in alcoholism. I am an alcoholic, and I understand how it feels to have your skin actually crawl when you need a drink. I know how it feels to swear every morning that I won’t drink today, then find myself drunk that night, having had every intention of staying away from it. I know the pitiful and incomprehensible demoralization that comes from an absolute loss of control and choice.

I am also an expert in recovery. I have been sober over 10 years. I have walked through hundreds of events and situations that would have had me running screaming for a drink before, without having to drink. I share my experiences with other people in case it might help them learn to face daily life without getting plastered. Some of us in AA have been doing this for 10, 20, even 30 years. We have a lot of practical experience in how to just not drink one day at a time.

And that’s the point, isn’t it?

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Then we’ve both been there and done that. Cool.

My remark was intended as hyperbole. Obviously, no AA member really stops thinking. In all the groups I was involved with, though, members assuredly were encouraged to suspend their critical thinking. Does this sound familiar: “Your best thinking got you here”? Or “Don’t analyze, utilize”? How about: “Nobody is too stupid to learn the the program, but some people are too smart”?

If the point is that AA does help many people stay sober, yes, that is demonstrably true.

If the point is that any organization that accomplishes this must be a good organization, I think that’s open for a bit more debate.

But I think the point could also be made that while AA does good things for some people, it also does bad things for some people.

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Now why did you have to go and bring ‘government’ into this, I thought it was about AA.

The most troubling thing to me about all this discussion is the few who believe that since it does not make sense to them, and they don’t even have the problem, yet they are going out and actually trying to get people to not even try AA or any other A because it is not ----- in their OPINION.

And all this talk of what AA leaders, not any, says so in the books they like to quote only the parts they want to, they have heard someone say, so what, they have seen someone die, well whoopie do, they will not try, have you Doc Goo, of taking the young man/woman aside and saying, I’ll help you, come with me, yeah, right, they stand on the corner yelling about the sky falling but when approached for shelter, they say no, not me, well, the A’s at least do try and not for profit, Doc Goo, you work for free? AA does not own nor profit from treatment centers, nor the court appointed people with little papers to sign, they are just willing to try, and NO ONE has to do anything, it is up to each individual. :: sheesh :: But these ‘people’ KNOW that it is -BAD- or not effective?

Arggggggg

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Let me try to explain to you why some people object to A.A.

  1. Some people object to the courts telling them to go to a religious program.

  2. Some people think that it is dishonest of A.A. to pretend not to be religious. God is mentioned throughout the teachings, and when the term “Higher Power” is substituted, the term is capitalized(allowing those in A.A. to pretend to the outside world that it isn’t “really” religious, wink-wink}.

  3. Some people object to the incredible claims made by A.A. that are unsupported by scientific studies.

  4. Some people object to the very idea that a supposed medical problem can be solved by getting the victims together to talk it out, without tested medical help or professional therapy. Can you imagine any other medical problem being treated this way?

  5. Some people object to the idea of getting a large group of people together and telling them that they should all follow the same type of “group therapy” without a professional first doing an individual session or two(or twenty) to see what therapy might be best for the patient.

Cat, these objections have been brought up by others in this thread and other related threads, so why do you continue to pretend not to see them? Object to them individually if you can, but blind dismissal of them is uncalled for, IMHO.

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Huh? Is there a point in this rant somewhere? Care to clarify your position and make some firm statements? I seriously can’t make any sense out of this.

-L

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