# 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:** 20\ **Page:** 6
**Author:** ![gonzomax](https://avatars.discourse-cdn.com/v4/letter/g/e8c25b/32.png) [@gonzomax](https://boards.straightdope.com/u/gonzomax)\ **Post date:** [August 12, 2011, 2:16am UTC](https://boards.straightdope.com/t/once-an-alcoholic-always-an-alcoholic/592291/102 "2011-08-12T02:16:56Z")
> [@guizot](#): > > I have several addict friends, who tell me that the “recovery” industry is mostly bogus. Some of them have gone to three or more rehabs with no success–all with prestigious medical staffs, etc.–and all obscenely expensive. But you shouldn’t conflate the rehabs with “12 steppers,” even if they use 12 steps in those bogus facilities. AA and NA themselves are not making a bunch of money. The actual meetings–outside of the rehabs–are free, usually in a church or hospital that donates the space. THe police do not want to admit that they can not change people. They must be convinced that burying people in legal costs and making their lives miserable will cure them. They quit pretending that jail rehabilitates long ago. People will quit drinking when they are ready. ---
**Author:** ![RedFury](https://avatars.discourse-cdn.com/v4/letter/r/ec9cab/32.png) [@RedFury](https://boards.straightdope.com/u/RedFury)\ **Post date:** [August 12, 2011, 2:42am UTC](https://boards.straightdope.com/t/once-an-alcoholic-always-an-alcoholic/592291/103 "2011-08-12T02:42:05Z")
> [@guizot](#): > > I have several addict friends, who tell me that the “recovery” industry is mostly bogus. Some of them have gone to three or more rehabs with no success–all with prestigious medical staffs, etc.–and all obscenely expensive. But you shouldn’t conflate the rehabs with “12 steppers,” even if they use 12 steps in those bogus facilities. AA and NA themselves are not making a bunch of money. The actual meetings–outside of the rehabs–are free, usually in a church or hospital that donates the space. [Questions about Resisting 12-Step Coercion](http://www.peele.net/bookstore/resisting.html) The model dominates… ---
**Author:** ![tomndebb](https://avatars.discourse-cdn.com/v4/letter/t/b9e5f3/32.png) [@tomndebb](https://boards.straightdope.com/u/tomndebb)\ **Post date:** [August 12, 2011, 6:20am UTC](https://boards.straightdope.com/t/once-an-alcoholic-always-an-alcoholic/592291/104 "2011-08-12T06:20:18Z")
> [@RedFury](#): > > [Questions about Resisting 12-Step Coercion](http://www.peele.net/bookstore/resisting.html) > > The model dominates… If you have nothing to contribute but repeating the same link with throw-away one-liners, then don’t post to this thread. [/Moderating] ---
**Author:** ![RedFury](https://avatars.discourse-cdn.com/v4/letter/r/ec9cab/32.png) [@RedFury](https://boards.straightdope.com/u/RedFury)\ **Post date:** [August 12, 2011, 12:36pm UTC](https://boards.straightdope.com/t/once-an-alcoholic-always-an-alcoholic/592291/105 "2011-08-12T12:36:26Z")
> [@tomndebb](#): > > If you have nothing to contribute but repeating the same link with throw-away one-liners, then don’t post to this thread. > > [/Moderating] From the link you apparently didn’t bother to read prior to scolding me: > [@](#): > > How big is the 12-step treatment industry? > > According to the Substance Abuse and Mental Health Services Administration, there are about 15,000 treatment facilities in the country, and well over 90% of them are 12-step facilities. Both the Department of Health and Human Services and the Institute of Medicine have estimated that treatment is a $10-billion-dollar-a-year industry. Reason it was posted twice is because it was ignored the first time. Of course, you’re more than welcome to rebut it yourself. More on the dominance, cost and ineffectiveness of 12 step treatment: [**We’re addicted to rehab. It doesn’t even work.**](http://www.washingtonpost.com/wp-dyn/content/article/2010/08/06/AR2010080602660.html?sub=AR) > [@](#): > > …For decades, Americans have clung to a near-religious conviction that rehab – and the 12-step model pioneered by Alcoholics Anonymous that almost all facilities rely upon – offers effective treatment for alcoholism and other addictions. > > Here’s the problem: We have little indication that this treatment is effective. When an alcoholic goes to rehab but does not recover, it is he who is said to have failed. But it is rehab that is failing alcoholics. The therapies offered in most U.S. alcohol treatment centers are so divorced from state-of-the-art of medical knowledge that we might dismiss them as merely quaint – if it weren’t for the fact that alcoholism is a deadly and devastating disease. > > And the way we attempt to treat alcoholism isn’t just ineffective, it’s ruinously expensive: Promises Treatment Centers’ Malibu facility, where Lohan reportedly went for her second round of rehab, in 2007, has stunning vistas, gourmet food, poolside lounging and acupuncture. It costs a reported $48,000 a month. > > Even nonprofit facilities that don’t cater to Hollywood types are too costly for most people. At the 61-year-old Hazelden center in Minnesota, which bills itself as “one of the world’s largest and most respected private not-for-profit alcohol and drug addiction treatment centers,” a typical 28-day stay costs $26,000… ---
**Author:** ![Bloodless\_Turnip](https://avatars.discourse-cdn.com/v4/letter/b/82dd89/32.png) [@Bloodless\_Turnip](https://boards.straightdope.com/u/Bloodless_Turnip)\ **Post date:** [August 12, 2011, 2:37pm UTC](https://boards.straightdope.com/t/once-an-alcoholic-always-an-alcoholic/592291/106 "2011-08-12T14:37:40Z")
AA meetings are free. AA has literally saved lives (this was told to me by a sober alcoholic). Rehab centers are a different animal entirely, and range from free (Salvation Army) to very expensive. ---
**Author:** ![Sitnam](https://avatars.discourse-cdn.com/v4/letter/s/6a8cbe/32.png) [@Sitnam](https://boards.straightdope.com/u/Sitnam)\ **Post date:** [August 12, 2011, 2:52pm UTC](https://boards.straightdope.com/t/once-an-alcoholic-always-an-alcoholic/592291/107 "2011-08-12T14:52:05Z")
> [@jamiemcgarry](#): > > The harmful effects of long-term football playing isn’t on par with the effects of long-term unchecked diabetes or alcoholism. :dubious: > > That’s like saying, I’m in denial about having big feet. Because of this denial, I am going to stuff my size 12 feet into a size 10.5 shoe. This is “shoe disease” because I will suffer harmful effects in the long run from the effects of doing this. I think a wide receiver playing in the NFL into his 60’s will surely suffer as much as any alcoholic. Degree of harm is irrelevant to your analogy though, which is a bad one anyway, hence my comparison. Do you think those addicted to smoking have a disease? Outside of probable lung cancer that is. ---
**Author:** ![Kearsen](https://avatars.discourse-cdn.com/v4/letter/k/82dd89/32.png) [@Kearsen](https://boards.straightdope.com/u/Kearsen)\ **Post date:** [August 12, 2011, 3:04pm UTC](https://boards.straightdope.com/t/once-an-alcoholic-always-an-alcoholic/592291/108 "2011-08-12T15:04:38Z")
I’d respond but it’s hard to type with one hand round my gal and the other wrapped around some single malt scotch (yes, the bottle) ---
**Author:** ![Truman\_Burbank](https://avatars.discourse-cdn.com/v4/letter/t/ecc23a/32.png) [@Truman\_Burbank](https://boards.straightdope.com/u/Truman_Burbank)\ **Post date:** [August 12, 2011, 3:18pm UTC](https://boards.straightdope.com/t/once-an-alcoholic-always-an-alcoholic/592291/109 "2011-08-12T15:18:16Z")
> [@Trom](#): > > What about someone like myself, a social drinking 27-year old guy, who has a hangover on Saturday and ends up sleeping late instead of going to the gym? That’s a negative, but plenty of times outweighed by the positive experiences I have out late with friends. I wouldn’t suggest that is a negative enough ‘consequence’ to warrant too much concern. Generally, I’d consider serious consequences to be legal, relational, medical, or occupational (off the top of my head, I’m sure we could think of others)… ---
**Author:** ![kushiel](https://avatars.discourse-cdn.com/v4/letter/k/bbce88/32.png) [@kushiel](https://boards.straightdope.com/u/kushiel)\ **Post date:** [August 12, 2011, 5:13pm UTC](https://boards.straightdope.com/t/once-an-alcoholic-always-an-alcoholic/592291/110 "2011-08-12T17:13:41Z")
To answer the subject line: yes. I look at alcoholism like most cancers: you can go into remission, but you’re never truly cured for life. It can always come back. I don’t say my dad is a former alcoholic, I say he is a recovering alcoholic. No alcoholic drinks alcohol for the sake of the beverage. An alcoholic drinks alcohol because of something it does to them. Whether or not it makes them happy, or makes problems go away, they drink for an effect. There is always the temptation to regain that effect, which is why you can’t cure alcoholism (at least, with current technology). ---
**Author:** ![thatguyjeff](https://avatars.discourse-cdn.com/v4/letter/t/6de8d8/32.png) [@thatguyjeff](https://boards.straightdope.com/u/thatguyjeff)\ **Post date:** [August 12, 2011, 5:56pm UTC](https://boards.straightdope.com/t/once-an-alcoholic-always-an-alcoholic/592291/111 "2011-08-12T17:56:23Z")
Consider these FACTS: 1. The American Medical Association (AMA) classifies alcoholism as a disease. 2. The World Health Organization (WHO) classifies alcoholism as a disease. 3. You have been diagnosed with the disease of alcoholism by a board certified health care professional specializing in the behavioral health field. Whether you choose to accept these FACTS is up to you. Sometimes when people are diagnosed with a serious disease, they like to get a second opinion. Anyone (who is not a board certified health care professional) replying in this thread who says alcoholism is anything but a disease is expressing an uneducated OPINION. My OPINION is that I agree with others who said that AA is like the hammer and all alcoholics are nails. And back when AA was started, it was the only game in town. Lots has happened since then and there are various effective treatment alternatives. Only you can decide whether or not to seek treatment for your disease and what sort of treatment is best for you. ---
**Author:** ![Czarcasm](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/czarcasm/32/4050_2.png) [@Czarcasm](https://boards.straightdope.com/u/Czarcasm)\ **Post date:** [August 12, 2011, 6:02pm UTC](https://boards.straightdope.com/t/once-an-alcoholic-always-an-alcoholic/592291/112 "2011-08-12T18:02:14Z")
Is there anything in the medical journals about it being incurable? ---
**Author:** ![gonzomax](https://avatars.discourse-cdn.com/v4/letter/g/e8c25b/32.png) [@gonzomax](https://boards.straightdope.com/u/gonzomax)\ **Post date:** [August 12, 2011, 6:11pm UTC](https://boards.straightdope.com/t/once-an-alcoholic-always-an-alcoholic/592291/113 "2011-08-12T18:11:43Z")
> [@thatguyjeff](#): > > Consider these FACTS: > > 1. The American Medical Association (AMA) classifies alcoholism as a disease. > 2. The World Health Organization (WHO) classifies alcoholism as a disease. > 3. You have been diagnosed with the disease of alcoholism by a board certified health care professional specializing in the behavioral health field. > > Whether you choose to accept these FACTS is up to you. > > Sometimes when people are diagnosed with a serious disease, they like to get a second opinion. > > Anyone (who is not a board certified health care professional) replying in this thread who says alcoholism is anything but a disease is expressing an uneducated OPINION. > > My OPINION is that I agree with others who said that AA is like the hammer and all alcoholics are nails. And back when AA was started, it was the only game in town. Lots has happened since then and there are various effective treatment alternatives. > > Only you can decide whether or not to seek treatment for your disease and what sort of treatment is best for you. So we are putting people in jail for a disease? That does not sound right.. ---
**Author:** ![Dr.Drake](https://avatars.discourse-cdn.com/v4/letter/d/ad7895/32.png) [@Dr.Drake](https://boards.straightdope.com/u/Dr.Drake)\ **Post date:** [August 12, 2011, 6:20pm UTC](https://boards.straightdope.com/t/once-an-alcoholic-always-an-alcoholic/592291/114 "2011-08-12T18:20:51Z")
> [@gonzomax](#): > > So we are putting people in jail for a disease? That does not sound right.. No, we are putting them in jail for the actions they perform while in the throes of their disease, the same as we do for violent schizophrenics or a modern Typhoid Mary. In all cases, the judicial system has the option of restricting the prisoner to a treatment facility rather than mainstreaming them in jail. Merely being an alcoholic isn’t an arrestable offence. ---
**Author:** ![Typo\_Negative](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/typo_negative/32/484_2.png) [@Typo\_Negative](https://boards.straightdope.com/u/Typo_Negative)\ **Post date:** [August 12, 2011, 6:27pm UTC](https://boards.straightdope.com/t/once-an-alcoholic-always-an-alcoholic/592291/115 "2011-08-12T18:27:29Z")
> [@thatguyjeff](#): > > And back when AA was started, it was the only game in town. Lots has happened since then and there are various effective treatment alternatives. > > Only you can decide whether or not to seek treatment for your disease and what sort of treatment is best for you. AA is not _treament_. Nor is NA. It is a fellowship. Its a way of life. People joining together, doing together what they could not do alone. AA is where you go _after_ treatment. Lot’s of folks skip the treatment part, go straight to AA. ---
**Author:** ![sleestak](https://avatars.discourse-cdn.com/v4/letter/s/919ad9/32.png) [@sleestak](https://boards.straightdope.com/u/sleestak)\ **Post date:** [August 12, 2011, 7:58pm UTC](https://boards.straightdope.com/t/once-an-alcoholic-always-an-alcoholic/592291/116 "2011-08-12T19:58:59Z")
> [@Czarcasm](#): > > Is there anything in the medical journals about it being incurable? The AMA calls alcoholism a ‘primary, chronic disease with genetic, psycosocial, and environmental factors’. I cannot find a cite that says uncurable but I also cannot find a cite that says it is curable. Slee ---
**Author:** ![Czarcasm](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/czarcasm/32/4050_2.png) [@Czarcasm](https://boards.straightdope.com/u/Czarcasm)\ **Post date:** [August 12, 2011, 8:05pm UTC](https://boards.straightdope.com/t/once-an-alcoholic-always-an-alcoholic/592291/117 "2011-08-12T20:05:48Z")
> [@sleestak](#): > > The AMA calls alcoholism a ‘primary, chronic disease with genetic, psycosocial, and environmental factors’. > > I cannot find a cite that says uncurable but I also cannot find a cite that says it is curable. > > Slee Do they say under what conditions they would consider somebody to be cured, at least? ---
**Author:** ![Bridget\_Burke](https://avatars.discourse-cdn.com/v4/letter/b/7cd45c/32.png) [@Bridget\_Burke](https://boards.straightdope.com/u/Bridget_Burke)\ **Post date:** [August 12, 2011, 8:19pm UTC](https://boards.straightdope.com/t/once-an-alcoholic-always-an-alcoholic/592291/118 "2011-08-12T20:19:02Z")
> [@Czarcasm](#): > > Do they say under what conditions they would consider somebody to be cured, at least? Rule of thumb for oncologists: The patients lives long enough to die from something else. ---
**Author:** ![Ambivalid](https://avatars.discourse-cdn.com/v4/letter/a/a5b964/32.png) [@Ambivalid](https://boards.straightdope.com/u/Ambivalid)\ **Post date:** [August 12, 2011, 8:30pm UTC](https://boards.straightdope.com/t/once-an-alcoholic-always-an-alcoholic/592291/119 "2011-08-12T20:30:21Z")
> [@Bridget\_Burke](#): > > Rule of thumb for oncologists: The patients lives long enough to die from something else. How far removed from alcohol abuse must that “something else” be in order to be considered a “cure”? ---
**Author:** ![SeldomSeen](https://avatars.discourse-cdn.com/v4/letter/s/7ba0ec/32.png) [@SeldomSeen](https://boards.straightdope.com/u/SeldomSeen)\ **Post date:** [August 12, 2011, 8:36pm UTC](https://boards.straightdope.com/t/once-an-alcoholic-always-an-alcoholic/592291/120 "2011-08-12T20:36:55Z")
> [@Czarcasm](#): > > Do they say under what conditions they would consider somebody to be cured, at least? I don’t know that the military establishment should be considered a good source of medical advice, but when I was enlisted (a good many years ago) they had their own treatment programs and means. The Navy, in its wisdom declared a person “cured” after two years of sobriety. At that point the restrictions were lifted, the slate was wiped clean, fliers who had been grounded due to drinking problems could return to flying, security clearances were re-established, etc. In the eyes of the military powers-that-be, if one could stay sober for two years, chances were good he could remain so for the rest of his enlistment. ---
**Author:** ![Bloodless\_Turnip](https://avatars.discourse-cdn.com/v4/letter/b/82dd89/32.png) [@Bloodless\_Turnip](https://boards.straightdope.com/u/Bloodless_Turnip)\ **Post date:** [August 12, 2011, 8:37pm UTC](https://boards.straightdope.com/t/once-an-alcoholic-always-an-alcoholic/592291/121 "2011-08-12T20:37:17Z")
> [@Czarcasm](#): > > Do they say under what conditions they would consider somebody to be cured, at least? AMA paper on it is [here](http://www.ama-assn.org/resources/doc/alcohol/alcoholism_treatable.pdf). > [@](#): > > 1. The AMA believes it is important for professionals and laymen alike to recognize that alcoholism is in and of itself a disabling and handicapping condition. > 2. The AMA encourages the availability of appropriate services to persons suffering from multiple disabilities or multiple handicaps, including alcoholism. > 3. The AMA endorses the position that printed and audiovisual materials pertaining to the subject of people suffering from both alcoholism and other disabilities include the terminology “alcoholic person with multiple disabilities or > alcoholic person with multiple handicaps.” Hopefully, this language clarification will reinforce the concept that alcoholism is in and of itself a disabling and handicapping condition. (CSA Rep. H, I-80; Reaffirmed: CLRPD Rep. > B, I-90; Reaffirmed by CSA Rep. 14, A-97) > [@](#): > > The AMA > > 1. endorses the proposition that drug dependencies, including alcoholism, are diseases and that their treatment is a legitimate part of medical practice, and > 2. encourages physicians, other health professionals, medical and other health related organizations, and government and other policymakers to become more well informed about drug dependencies, and to base their policies and activities on the recognition that drug dependencies are, in fact, diseases. (Res. 113, A-87) I 100% disagree with them that it is a disease btw. Not that it matters 🙂 [Previous page](https://boards.straightdope.com/t/once-an-alcoholic-always-an-alcoholic/592291.md?page=5) [Next page](https://boards.straightdope.com/t/once-an-alcoholic-always-an-alcoholic/592291.md?page=7)