# Once an alcoholic, always an alcoholic? **URL:** \ **Category:** Great Debates\ **Created:** [August 11, 2011, 2:49am UTC](https://boards.straightdope.com/t/once-an-alcoholic-always-an-alcoholic/592291 "2011-08-11T02:49:12Z")\ **Posts on this page:** 12\ **Page:** 18
**Author:** ![gurujulp](https://avatars.discourse-cdn.com/v4/letter/g/ba9def/32.png) [@gurujulp](https://boards.straightdope.com/u/gurujulp)\ **Post date:** [August 18, 2011, 8:30pm UTC](https://boards.straightdope.com/t/once-an-alcoholic-always-an-alcoholic/592291/342 "2011-08-18T20:30:27Z")
> [@OneMissedPost](#): > > What ignorance? You said that all mental illnesses are self-diagnosed? Prove it. No, I’d rather you take the time to actually find a cite to backup your claims. > > No, I don’t want to hear what your wife has to say. I want to hear what you have to say. Spend time finding cites for a good debate. Do some research. > > You do not debate by saying your wife has a PhD. What does that have to do with our debate? I have. I am waiting for you to intelligibly respond, or I will stop feeding you. ---
**Author:** ![OneMissedPost](https://avatars.discourse-cdn.com/v4/letter/o/8e7dd6/32.png) [@OneMissedPost](https://boards.straightdope.com/u/OneMissedPost)\ **Post date:** [August 18, 2011, 8:42pm UTC](https://boards.straightdope.com/t/once-an-alcoholic-always-an-alcoholic/592291/343 "2011-08-18T20:42:24Z")
> [@gurujulp](#): > > The OP cares, and has raised the question as to whether he should be labeled an alcoholic. Most people believe that if you have to ask the question, you probably have a problem. The OP doesn’t wish to believe this, and so far, the common trend seems to be that if he can live his life and drink, then cool, if he can’t then he should stop drinking. I agree with this. ---
**Author:** ![sleestak](https://avatars.discourse-cdn.com/v4/letter/s/919ad9/32.png) [@sleestak](https://boards.straightdope.com/u/sleestak)\ **Post date:** [August 18, 2011, 9:38pm UTC](https://boards.straightdope.com/t/once-an-alcoholic-always-an-alcoholic/592291/344 "2011-08-18T21:38:45Z")
> [@Czarcasm](#): > > An untrained patient who has self-diagnosed her/himself as having an incurable disease goes to a support group of untrained amateurs who have done the same. Shouldn’t a trained professional of some sort or another be involved somewhere in this process? And what, exactly, will the doctor do that would add value other than say ‘Yep, you are an alkie’? (Side note, I am not an amateur when it comes to alcoholism. I am a full on professional. I know more than any _non_ alcoholic could ever know about the mental aspects of this disease. I also urge people who think they are alkies to talk to a doctor and psychologist/psychiatrist about their issues as well as finding a support group that works for them) Mental diseases are different than physical diseases\*. The symptoms of a heart attack (chest pain, shortness of breath, etc) do not necessarily mean that the patient had a heart attack. It requires a professional to check the persons actual heart to find out if the symptoms truly represent a heart attack. The doctor can see the actual physical damage or see the malfunction by testing. However, the symptoms of alcoholism are different than those of a heart attack. The most important symptom of alcoholism, the _need_ for the alcoholic to drink is not measurable without the patients involvement. You can make guesses based upon the persons behavior but there is no test a doc can run to prove someone is an alkie. Additionally, unlike the most of medical issues, the main actor in the recovery is the patient themselves. If someone has a heart attack, the doctors and nurses perform the actions required to fix the problem with little input from the patient. The patient plays a limited role, basically answering questions if they can. For alcoholics (and addicts or those suffering from depression and other mental illnesses) the main diagnosis _has_ to be self administered. The person with the problem has to see that they have a problem and, hopefully, talk to someone about how to solve the problem. Take depression for example. How can a doctor fix someone with depression without that persons assistance? And how can you treat a person who does not believe they have a problem? They can force feed medication but that is about it. It requires active participation on the patients behalf to treat depression. Same thing with many mental illnesses. It also requires the patient to honestly tell the doc what is going on. A heart attack or a broken leg, is easy to diagnose from the outside. How do you diagnose something from the outside when most of the symptoms are inside the patient and many are unreachable without the patients assistance? Slee \*Evidence points to the disease of alcoholism having a physical cause in the way the body processes alcohol. The issue is that the symptoms of alcoholism are not physical, they are behavioral and emotional. ---
**Author:** ![pinkyvee](https://avatars.discourse-cdn.com/v4/letter/p/6de8d8/32.png) [@pinkyvee](https://boards.straightdope.com/u/pinkyvee)\ **Post date:** [August 18, 2011, 10:45pm UTC](https://boards.straightdope.com/t/once-an-alcoholic-always-an-alcoholic/592291/345 "2011-08-18T22:45:56Z")
> [@OneMissedPost](#): > > Cite please? Are you going to keep providing anecdotal evidence or are you actually going to provide a cite? Have you BEEN to an AA meeting? No one ever says: “I am a diagnosed alcoholic.” They say their first name, and if they want to, they say “alcoholic”. As in: “George. Alcoholic”. Or: “George. Double winner.” Or: “George. Grateful to be here.” Or, simply: “George.” This is what I meant when I said people in an AA meeting self identify. Pretty much anyway they want to. I was wondering… Do you object to people making the self identification of a different problem requiring a different support group, such as Al-Anon? ---
**Author:** ![MsRobyn](https://avatars.discourse-cdn.com/v4/letter/m/90ced4/32.png) [@MsRobyn](https://boards.straightdope.com/u/MsRobyn)\ **Post date:** [August 19, 2011, 2:33am UTC](https://boards.straightdope.com/t/once-an-alcoholic-always-an-alcoholic/592291/346 "2011-08-19T02:33:12Z")
Al-Anons only identify by first name. ---
**Author:** ![Revenant\_Threshold](https://avatars.discourse-cdn.com/v4/letter/r/f1d935/32.png) [@Revenant\_Threshold](https://boards.straightdope.com/u/Revenant_Threshold)\ **Post date:** [August 19, 2011, 3:25am UTC](https://boards.straightdope.com/t/once-an-alcoholic-always-an-alcoholic/592291/347 "2011-08-19T03:25:42Z")
> [@OneMissedPost](#): > > WRONG. Mental illnesses are not self-diagnosed. If mental illnesses were all self-diagnosed, there would be no need for psychologists and psychiatrists. While you are at it, you might as well come up with an argument why we do not need psychologists and psychiatrists. I guarantee that if you start with the premise that all mental illnesses are self-diagnosed, you will be laughed at endlessly. Not self-diagnosed, I agree. But a diagnosis of a mental illness requires the subjective input of a patient more than does a physical one, by and large. It’s considerably more difficult (though not impossible, at least in all cases) to study the brain and the mind in the same way that we might take a blood test or ECG, and likewise to interpret the results. To a certain extent, you’re reliant on self-reporting, and of patients to accurately report their symptoms. Again, it’s not self-diagnosis, but by and large it’s more of a cooperative diagnosis than a physical illness might require. ---
**Author:** ![thatguyjeff](https://avatars.discourse-cdn.com/v4/letter/t/6de8d8/32.png) [@thatguyjeff](https://boards.straightdope.com/u/thatguyjeff)\ **Post date:** [August 19, 2011, 4:44pm UTC](https://boards.straightdope.com/t/once-an-alcoholic-always-an-alcoholic/592291/348 "2011-08-19T16:44:41Z")
> [@Czarcasm](#): > > It is perfectly fine for an untrained amateur to self-diagnose diseases: Yes or No? There is no black/white answer to this question. IMHO at least - that depends on the severity of the condition combined with the risk of treatment. Reasonable people self-diagnose themselves all the time, and prescribe treatment for themselves all the time. But this is generally only done when the self-prescribed treatment carries little or no health risk. In other words, I think it is “perfectly fine” for the untrained amateur to self-diagnose diseases AND prescribe their own treatment. AA doesn’t have any harmful side-affects. I’m not risking my health when I diagnose myself as an alcoholic and prescribe AA as a treatment for my disease - that is, I’m not creating additional risks above what alcoholism creates in and of itself. If I were to diagnose myself with a disease and attempt to prescribe myself a treatment which carries measurable health risks, that would be ill-advised. Additionally, I would be unlikely to obtain such treatment because such treatments usually require the use of drugs/procedures which can only be performed/prescribed legally by a licensed physician. One could ask - what about someone who is a text-book alcoholic, who self-prescribes AA as treatment and that treatment fails - are they not harming themselves for not seeking/prescribing themselves a more effective treatment. Yes - but that’s no different than how most people self-treat any disease. As in, I have all the classic symptoms of the common cold and I prescribe myself rest, fluids, and an OTC medication for my symptoms. My condition does not improve after several weeks. I can choose to seek a professional diagnosis/treatment or I can continue what I’m doing, or I can do nothing. A reasonable person would argue that not seeking professional assistance in that situation is not “perfectly fine,” though my initial self-diagnosis and treatment is justifiable and reasonable. ---
**Author:** ![thatguyjeff](https://avatars.discourse-cdn.com/v4/letter/t/6de8d8/32.png) [@thatguyjeff](https://boards.straightdope.com/u/thatguyjeff)\ **Post date:** [August 19, 2011, 5:03pm UTC](https://boards.straightdope.com/t/once-an-alcoholic-always-an-alcoholic/592291/349 "2011-08-19T17:03:18Z")
Quote: Originally Posted by pinkyvee View Post AA members self identify, they do not self diagnose. > [@OneMissedPost](#): > > Cite please? Are you going to keep providing anecdotal evidence or are you actually going to provide a cite? Book of AA - Forward to the First Edition: “The only requirement for membership is an honest desire to stop drinking.” Some members choose to self-identify/self-diagnose as alcoholics. Failure to do so does not exclude anyone from membership/attending AA. It is not a requirement to self-identify or self-diagnose themselves as alcoholics. ---
**Author:** ![I\_Love\_Me\_Vol.I](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/i_love_me_vol.i/32/521_2.png) [@I\_Love\_Me\_Vol.I](https://boards.straightdope.com/u/I_Love_Me_Vol.I)\ **Post date:** [August 20, 2011, 4:47am UTC](https://boards.straightdope.com/t/once-an-alcoholic-always-an-alcoholic/592291/350 "2011-08-20T04:47:09Z")
> [@freep5637](#): > > I’ve never ever seen anyone coerced into believing that they’re an alcoholic. You should go to an AA meeting sometime… it happens all the time there. ---
**Author:** ![I\_Love\_Me\_Vol.I](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/i_love_me_vol.i/32/521_2.png) [@I\_Love\_Me\_Vol.I](https://boards.straightdope.com/u/I_Love_Me_Vol.I)\ **Post date:** [August 20, 2011, 11:58am UTC](https://boards.straightdope.com/t/once-an-alcoholic-always-an-alcoholic/592291/351 "2011-08-20T11:58:20Z")
> [@pinkyvee](#): > > Well, let me say that there are certain symptoms of the disease of alcohol abuse that do need medical diagnosis as well as medical intervention. Most of these occur towards the end zone of the alcoholic spectrum. > > For instance, alcoholic cirrhosis. I’ve never met a lay person able to self diagnos this result of their drinking. Same with alcoholic dementia, Wernicke-Korsakoff syndrome. There are many other end stage sequela I have not mentioned. These diagnoses are not left to lay person speculation.\*\* Fuck. This is the same lame bullshit the True Believers always bring out-- “Only a doctor can diagnose cirrhosis or other clearly physical pathologies. BUT… when it comes to our special little ‘disease’, alcoholism, we laypeople are the sole arbiters of whether you have it or not. Doctors are not always able to diagnose it because it is a spiritual disease and only some of them have been indoctrinated.” Look. Work your program if you work it, but do not pretend it is an effective strategy for dealing with drinking problems amongst the general public. It has been shown that is it less useful than nothing at all, so please let people get some real help and not get sucked into your bullshit, OK? If it works for you, then work it. But PLEASE stop trying to attract (cuz we all know you don’t promote) real people into your web of crazy. OK? 'Kay. You can have it. Work it. Work those spiritual Steps! Just don’t EVER try to pass it off as useful to those who haven’t bought into the crazy, and STOP trying to pull them all in. ---
**Author:** ![freep5637](https://avatars.discourse-cdn.com/v4/letter/f/cdc98d/32.png) [@freep5637](https://boards.straightdope.com/u/freep5637)\ **Post date:** [August 20, 2011, 1:43pm UTC](https://boards.straightdope.com/t/once-an-alcoholic-always-an-alcoholic/592291/352 "2011-08-20T13:43:17Z")
> [@I\_Love\_Me\_Vol.I](#): > > You should go to an AA meeting sometime… it happens all the time there. Been to thousands, and never seen it. Couldn’t care less whether or not YOU think you’re an alcoholic. But if you do think so, I’m there to help. ---
**Author:** ![Bamboo\_Boy](https://avatars.discourse-cdn.com/v4/letter/b/839c29/32.png) [@Bamboo\_Boy](https://boards.straightdope.com/u/Bamboo_Boy)\ **Post date:** [September 25, 2011, 10:24am UTC](https://boards.straightdope.com/t/once-an-alcoholic-always-an-alcoholic/592291/353 "2011-09-25T10:24:34Z")
> [@Dr.Drake](#): > > (I can try, though: what can you do at a bar that you can’t do at a restaurant or café?) This seems exceedingly naive to me. As a one time single and trying-to-get-laid person, the answer is: SCORE. Patrons in a bar are much much much more likely to be up for being chatted up (or chatting you up!) than in a bar than a cafe or restaurant. Chatting people up in a bar is socially acceptable while the same action in a bar or restaurant would probably be considered tacky or a gaff. Also, I have heard many negative things about AA in terms of them forcing people to acknowledge and surrender to a ‘higher power’. I have also heard/read that they take the tack of convincing you you are weak and powerless otherwise (rather than an empowering approach). YMMV, of course, and I might add I’ve never been to AA. I have read this time and time again, though. Perhaps considering an alternative abstinence program might be a better idea. At least look out for this ‘surrender to a higher power’ stuff if it’s unwelcome. [Previous page](https://boards.straightdope.com/t/once-an-alcoholic-always-an-alcoholic/592291.md?page=17)