Is Alcoholism Really a Disease?

Great Debates
41

[QUOTE=Geobabe]
Not drinking “fixes” the problem of the physical addiction to alcohol, but does absolutely nothing for the mental illness. As I’ve said several times already, AA is therapy, it’s not a cure; it’s intended to address the mental and behavioral aspects of the addiction. There are those people who can simply stop drinking and never have any more problems, but for those for whom that isn’t the case, they need something more than just quitting cold turkey.

[/QUOTE]

I would agree with the above. My MIL is a dry drunk–she hasn’t touched a drop in over 10 years, but she still has all the mental health issues that she had prior to AA. Basically, she’s a controlling, narcissistic, manipulative bitch who never outgrew adolescence, but I digress.
I see value in AA (I’ve known a few people who really get their lives straightened out by it), but I wonder about the psychological aspects of addiction and alcoholism. It seems to me (and I’ve never been to AA or Alanon, so I may be completely wrong) that AA gets you sober and functional, but any other personal growth is up to you.
I also have an issue with the whole addiction “curve”. Where is the tipping point from bad habit to addiction? When does the physiological addiction kick in? How come many, many people prevent themselves from becoming addicted? Is it only brain chemistry or are there behavioral/learned respsonses at play as well? Those are questions I’m interested in.

42

[QUOTE=olivesmarch4th]
That argument concerns me, because it suggests that 5% is good enough. I’m really concerned that there might be a better treatment out there, that’s not AA, that doesn’t get as much mainstream acceptance…
[/QUOTE]

There are alternative treatments out there. In fact, a brief glance at the Treatments header of Wikipedia’s page on alcoholism shows a number of them, including the well-known detox and the lesser-known Antabuse. As with any treatment, patient compliance is valuable — no pill will cure an alcoholic if he refuses to take it, no therapy will help a patient if he is only there to have his chitty signed so he can leave, and no detox will make the patient stop drinking again once he’s out. You can spend all your efforts curing the patient of his physical withdrawal symptoms, but ultimately you have to find a way to convince them to want to stop drinking, otherwise detox is just a finger in the dike.

I think arguing over the success rate of one treatment is getting off the subject over whether alcoholism is, in fact, a disease.

43

I have no dog in this fight, but it seems to me that those who criticize AA for a poor success rate are not taking into consideration the obvious corollary, which is what is the success rate without AA, or for programs other than AA? IOW, if we posit some drug that is so perniciously addictive that only 5% of the people who fall down that rabbit hole will ever successfully climb back out, and we posit a program wherein 6% are shown to climb back out, then that program is a success.

I’m not advocating for AA, but you can hardly call the program an abysmal failure if people are able to do as well or better than they would have done on another program, or without a program.

It also seems obvious to me that people’s mechanisms for coping and recovering differ by the individual. Some people do well in groups, some people do better alone. Some people are helped by being able to talk it out, some people just find that reinforces the problem. I don’t see how something as subjective as that could ever be called bullshit by anyone. It may truly be bullshit for you – but a lot of other people may think it works for them.

I’m not an alcoholic, thank God, but I m a complete convert to Weight Watchers. Bear with me here, because I’m not trying to hijack the converation, to say WW is like AA, or losing weight like alcoholism – none are true. BUT there are reasons to go to weekly meetings that have nothing to do with outside emotional support or “therapy.”

I go to WW meetings every week. I am not a hold-handsy, talk-about-your-problems kind of person and not infrequently I find them very boring. But FOR ME:

  1. A weekly meeting psychologically breaks the program down into do-able chunks. I’m not trying to do great for the rest of my life; I’m just trying to do okay from week to week.

  2. If I know I have a meeting coming up, I am less likely to snarf down a sackful of craptastic goodies, because I know in a day or two, I’ll have to take ownership of that behavior when I step on the scale.

  3. Making time in my schedule to physically go to meetings reinforces my commitment to the program. It is much harder to sort of wander off, doing okay but not great, less great as time goes by, until BOOM! you’re face down in a chocolate pie (or a fifth of scotch), if you are literally ass-in-the-chair in attendance every week. Just going, without anything more, helps me stick with it.

None of these has anything to do with what happens at the meetings, or whether the content of the meetings are helpful or useless. So long as I do not find the meeting’s content actually counterproductive, there is enough value in the fact of the meeting itself to keep me attending.

YMMV, obviously, which is why I would never say anyone was wrong to take whatever steps they felt they needed to deal with their own issues.

44

From Rational Recovery Website

{{{{{ :Cringe: }}}}}}

Stay Away from Recovery Groups of all kinds? Stay Away from Shrinks??? Did they really say shrinks? Don’t go to your physician??

What a bunch of BS. I would probably say that even if I were not in a recovery program.

Yeah - tell the crack head to do it on his own… Good advice! :rolleyes:

45

[QUOTE=olivesmarch4th]
New OP:
**Hi guys! I hope you’re all having a fabulous day! So I’ve been thinking about the past lately, and my painful experience having been the child of an alcoholic father. I’ve often heard the expression that Alcoholism is a disease, and since I don’t know a lot about it I was wondering if anybody could point me toward information that supports this theory? I’m also wondering about the effectiveness of 12-Step Programs – can anybody provide evidence that they work, because all the investigating I have done has indicated they have an abysmal failure rate. Furthermore, how do people feel about the issue of personal responsibility when it comes to alcoholism? Are alcoholics completely responsible for their drinking behavior and the way it affects others, or to a certain degree are they at the mercy of this ailment?

Thanks so much for your helpfulness!**

[/QUOTE]

I spent a week with my sister in rehab last Spring. Not a great experiance. Though I did learn to be able to look at someone and tell if their addiction was opiates or alcohol.

Alcoholism is chronic and progressive - in that way it behaves like a disease. There appears to be a genetic predisposition to addiction - that also appears to be physological (my sister is a third generation alcoholic - though no direct alcoholics in the second generation - if she is even an alcoholic - that is still somewhat undetermined - she may have been self medicating through alcohol - she was in an abusive relationship - and never crossed whatever line is there between overuse and abuse).

I think treatment has an abysmal failure rate which is hard to track - but its making an effort and its getting support. Its sort of like diabetes if there were no insulin and everyone needed to be diet controlled - some people would diet control easily, others would be non-compliant and eventually die. (I’ve known my share of non-compliant diabetics). My own sister’s treatment was horrible - far too much “blame your childhood, look for repressed memories” bullshit, but subsequent treatment has done fairly well and recreating a functional person. (She still drinks, but at this point in time is functional and isn’t drinking to excess - a glass of wine and she stops - which she wasn’t before).

Are alcoholic responsible? Yes and no. Clinical suicidal depression also runs in my family - and sometimes you get to a point where you don’t get to choose what emotions you are going to have. I believe alcoholism is similar. You lose control of yourself. That doesn’t mean its OK, nor does it mean the people around the alcoholic should allow the alcoholic to hurt them, nor does it absolve them of responsibility - but it does mean its perhaps understandable.

46

I am convinced, based on information given here, that alcoholism is recognizable by a given set of symptoms and interferes with day to day functioning and physical health, therefore by at least the loosest standards it may be safety considered a disease, in the same way that psychological disorders may be considered a disease… i.e. something that theoretically could respond to systematic treatment methods.

Re: arguing over whether AA works, I specifically asked for information on that in my Post # 26, rephrasing the OP, which I openly admit came off as really snarky and vicious though I didn’t intend it that way.

47

I always question the motivation of one who says “alcoholism is a disease.” It does seem as thought the purpose is to take blame from the alcoholic.

The way I see it, alcoholism is no more a disease than anger. Hot-temperedness can be inherited, can manifest itself physically, and can lead to an early grave. But that’s not a disease, even though it can also be dealt with in group therapy. Whether or not something is a disease shouldn’t affect how we find a solution to it. Sometimes I wonder if the belief that it is a disease makes people think it is incurable. The notion being that it is hard-wired into a person, therefore one probably shouldn’t waste their time and effort trying to do anything about it.

48

So actually, a less imflammatory question might be – are there treatments out there that have been proven to be more effective long term than AA? And, correctly, you would want scientific studies, not merely testimonials or biased information, like a program’s own opinion that it is in fact The Cure, with no other evidence presented.

I will be highly surprised if you are able to find the sort of quantifiable evidence you are looking for, that any program is better than AA. AFAIK, recovery rates suck across the board. So should the addict just think, “fuck it” and go back to their DoC? Or might they be reasonable in trying to find a program that works for them?

49

[QUOTE=twickster]
For me, AA is all about accepting responsibility for my actions.

twicks, sober 21 years, 1 month, and 10 days by living by the steps.
[/QUOTE]

I have two brothers who are sober/straight after years of alcohol and drug abuse, and members of my family – myself included – are aware that we share characteristics that can lead to alcoholism. I do enjoy the occasional drink, and wine is common around our house. But over the years I have developed strategies to keep me from over-imbibing. One of my brothers says he probably could do the same thing without too much trouble, but simply chooses to not drink “to be on the safe side”; the other says he simply cannot touch alcohol.

My experience and the number of newspaper stories I’ve done on it lead me to believe that alcoholism isn’t a character flaw, and it’s something that probably results from the way individuals are “wired”. And I’d say **twickster ** hit the finger right on the nail. Congratulations, twicks, you accomplish more in a single day than I do in a month.

50

[QUOTE=olivesmarch4th]
That argument concerns me, because it suggests that 5% is good enough.
[/QUOTE]

It suggests that for 95% of people, it’s not good enough, but it also suggests that of all of the treatment programs available, there are people who are helped by it. I wasn’t helped by it, so I left.

It’s not like it’s a government program and we have to find something that’s more effective and doesn’t waste taxpayers’ money. So what’s the problem.

51

They would be completely reasonable in doing so. Twickster has my unwavering support and admiration for getting help to deal with his(?) addiction. I find it frustrating that alcoholics have so few options for treatment and I wonder, if certain programs like AA did not have such mainstream acceptance, would more people be out there trying to figure out what really does work? I’m not criticizing the addict–as with any other form of unsuccessful treatment, I’m criticizing whatever system is keeping that non-proven method firmly entrenched in universal consciousness, to the point that successful treatments are not tested and utilized on a widespread level. I think part of what keeps those systems going are the widespread belief that they work, despite evidence to the contrary. AA is in the unfortunate position of being very accepted by the mainstream but lacking evidence to back it up. How many people will try unsuccessfully to overcome their addiction because the treatment options are not there? Do you see why I feel this is important?

All this is of course, irrelevant to my father, who refuses even to go to an AA meeting… but it’s NOT irrelevant to people like Twickster, who took responsibility for their own behavior in seeking treatment–but, unlike Twickster in that they were unable to find the help they sought.

52

[QUOTE=Charger]
I always question the motivation of one who says “alcoholism is a disease.” It does seem as thought the purpose is to take blame from the alcoholic.

The way I see it, alcoholism is no more a disease than anger. Hot-temperedness can be inherited, can manifest itself physically, and can lead to an early grave. But that’s not a disease, even though it can also be dealt with in group therapy. Whether or not something is a disease shouldn’t affect how we find a solution to it. Sometimes I wonder if the belief that it is a disease makes people think it is incurable. The notion being that it is hard-wired into a person, therefore one probably shouldn’t waste their time and effort trying to do anything about it.
[/QUOTE]

Just like my Ulcerative Colitis (which is a disease), I don’t think it IS curable. It can be controlled, as my UC is. The colitis medication that works for me may not work for others (bringing us back to the argument about whether AA works).

If any addicts/alcoholics on this board think they are “cured”, then I’ll take that back, but I can have a “flare-up” of my addiction, just as I can with UC.

53

[QUOTE=Jodi]
I have no dog in this fight, but it seems to me that those who criticize AA for a poor success rate are not taking into consideration the obvious corollary, which is what is the success rate without AA, or for programs other than AA? IOW, if we posit some drug that is so perniciously addictive that only 5% of the people who fall down that rabbit hole will ever successfully climb back out, and we posit a program wherein 6% are shown to climb back out, then that program is a success.

I’m not advocating for AA, but you can hardly call the program an abysmal failure if people are able to do as well or better than they would have done on another program, or without a program.

It also seems obvious to me that people’s mechanisms for coping and recovering differ by the individual. Some people
[/QUOTE]

While the numbers are inherently tough to pin down, this gigantic article addresses self-quitters vs those who seek help.

There is a lot of statistical info in the article. Interesting stuff, though I admit I have trouble absorbing statistics with all the variables listed.

54

[QUOTE=olivesmarch4th]
They would be completely reasonable in doing so. Twickster has my unwavering support and admiration for getting help to deal with his(?) addiction.
[/quote]

Hers, unless I’m mistaken. One of many reasons she rocks. :slight_smile:

I’m not sure I buy the reasoning that the way to get more programs – and more effective programs – is to criticize existing programs. To me, in order for that to be reasonable, you would have to be able to make a reasonable argument that AA is an actual detriment to sobriety. It think that would be hard to do. And although this is not my field, AFAIK it’s not like people haven’t tried everything from exorcism to drug therapy to try to handle alcoholism, and nothing has been shown to be truly effective, by your standards of effectiveness. So before eliminating the programs you think don’t work, maybe we should try to find programs that do? Because I don’t think the problem is not enough people out there “trying to figure out what really does work.” A lot of people are looking for the magic pill for alcoholism. I don’t think we can dismiss the very real possibility that there just isn’t one.

Again, this assumes (a) AA is not only not-proven but in fact not effective; (B) another, more effective program either exists or can be constructed; and (C) the fact of (A) impedes the development of (B). I don’t think any of those theories are correct.

Sure, but I don’t see how removing one of the current treatment options improves the situation. Again, you are theorizing that in the absence of AA, another, better treatment option will move in to its place of primacy. What’s the evidence for that? There is no evidence that AA is any worse than any other option, and there’s no indication that some “magic bullet” could be found that is not being looked for because of AA. The recovery rate for alcohol and drug addiction is abysmal across the board. So for me, your argument would be more persuasive if AA was the go-to choice, BUT it wasn’t the best choice, and therefore it was actually IMPEDED effective recovery. I don’t think that’s the case.

55

[QUOTE=Nutty Bunny]
Just like my Ulcerative Colitis (which is a disease), I don’t think it IS curable. It can be controlled, as my UC is. The colitis medication that works for me may not work for others (bringing us back to the argument about whether AA works).

If any addicts/alcoholics on this board think they are “cured”, then I’ll take that back, but I can have a “flare-up” of my addiction, just as I can with UC.
[/QUOTE]

Yep - and whan I have a flare-up of my addiction, I hit a few more meetins and talk it over with another alcohlic…helps for me, and that’s all I need.

Last time I got in this discussion with people on this board I left feeling like I had been rode hard and put up wet, like a alpha hippo beaten after a long battle :slight_smile: I just say what means the most to me and let it go now…

56

Whoops. Sorry, Twickster :stuck_out_tongue:

This makes perfectly logical sense to me. I concede the point. It would be far more effective to find what does work and spread the word. Then people would not feel defensive about treatments that don’t work, and would naturally drift to the more logical choice. Good point.

Regarding A: Every single piece of scientific research I have seen on the matter indicates that AA is not proven to be effective. I asked for cites to the contrary, but got nothing.
Regarding B: I think it’s possible that something might exist, and extremely more possible that something better can be constructed.
Regarding C: As stated before, I now agree. I went about this backwards.

57

[QUOTE=Jodi]
I’m not sure I buy the reasoning that the way to get more programs – and more effective programs – is to criticize existing programs. To me, in order for that to be reasonable, you would have to be able to make a reasonable argument that AA is an actual detriment to sobriety. It think that would be hard to do. And although this is not my field, AFAIK it’s not like people haven’t tried everything from exorcism to drug therapy to try to handle alcoholism, and nothing has been shown to be truly effective, by your standards of effectiveness. So before eliminating the programs you think don’t work, maybe we should try to find programs that do? Because I don’t think the problem is not enough people out there “trying to figure out what really does work.” A lot of people are looking for the magic pill for alcoholism. I don’t think we can dismiss the very real possibility that there just isn’t one.
[/QUOTE]

Bingo.

twicks, who is, indeed, a she – and who isn’t attention-whoring here, despite all evidence to the contrary. :wink:

58

I’m of the belief that there is no “program” that fixes the problem. I’ve seen people walk away from it with barely an inkling to pick up another drink and I’ve seen others who were hopelessly caught in the downward spiral. And when I say hopeless, I mean that there was zero chance that I could see of them ever becoming sober without being physically removed from the possibility of obtaining a drink. Some people just can’t get sober no matter what. That’s the sad truth.

The upside is that most people can beat the problem and eventually do.

59

[QUOTE=Charger]
I always question the motivation of one who says “alcoholism is a disease.” It does seem as thought the purpose is to take blame from the alcoholic.
[/quote]

And I don’t want the doctors to question my motivation if I turn up at the emergency room with a fractured wrist. I don’t want them to base my treatment on whether they thought it was an accident or a choice.

“Look, dumbass, you were out riding your ATV in the woods and you got thrown off. No helmet, no elbow pads. Of course your arm’s broken, stupid! You did it to yourself. Now have you learned something? Nurse, get this idiot out of the ER and bring me a patient who’s a victim of something.”

Is that what you want?

Doctors can call alcoholism a disease, because I feel doctors shouldn’t care about placing blame on people. Doctors should instead be concerned with causation: how did this condition arise, what is its nature, how do we treat it? Once the patient is better, then somebody — probably not that doctor — can worry about how to prevent relapse.

60

I agree with this statement. Very good point.