# 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:** 9
**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 13, 2011, 4:05pm UTC](https://boards.straightdope.com/t/once-an-alcoholic-always-an-alcoholic/592291/162 "2011-08-13T16:05:34Z")
> [@Alessan](#): > > “Once an alcoholic, always an alcoholic” is like “a gun is always loaded”. It may not be true, but it’s a good safety tip. But without a working definition, it is next to useless. ---
**Author:** ![guizot](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/guizot/32/3636_2.png) [@guizot](https://boards.straightdope.com/u/guizot)\ **Post date:** [August 13, 2011, 4:46pm UTC](https://boards.straightdope.com/t/once-an-alcoholic-always-an-alcoholic/592291/163 "2011-08-13T16:46:47Z")
> [@levdrakon](#): > > Sounds to me if you’re cured - no matter what a sloppy pathetic out of control drunk you were - then you were never an alcoholic. I think there are lot of people who develop a drinking problem over time, and then stop because of family/work pressure, or some other external reason. By self-control, they don’t drink anymore, but they’re miserable, unhappy people–impossible to be around–because their brain has come to know only one way to be at ease: with alcohol. They can’t look forward to a drink anymore, and so their lives are sapped. Is that “cured”? I don’t know. ---
**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 13, 2011, 4:52pm UTC](https://boards.straightdope.com/t/once-an-alcoholic-always-an-alcoholic/592291/164 "2011-08-13T16:52:55Z")
If an alcoholic is not _really_ an alcoholic if they manage to control it later in their life, then a person cannot _really_ be called an alcoholic until they die without successfully controlling the problem. By this definition, nobody posting on this board is currently an alcoholic. ---
**Author:** ![guizot](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/guizot/32/3636_2.png) [@guizot](https://boards.straightdope.com/u/guizot)\ **Post date:** [August 13, 2011, 5:09pm UTC](https://boards.straightdope.com/t/once-an-alcoholic-always-an-alcoholic/592291/165 "2011-08-13T17:09:48Z")
> [@Czarcasm](#): > > If an alcoholic is not _really_ an alcoholic if they manage to control it later in their life, then a person cannot _really_ be called an alcoholic until they die without successfully controlling the problem. By this definition, nobody posting on this board is currently an alcoholic. I think that’s why a lot of AA people still call themselves alcoholic even when they stopped drinking a long time ago and are doing fine. In other words, alcoholism is not just the drinking. It’s the inability to drink at all without problems. When they say, “Once an alcoholic, always an alcoholic,” it doesn’t mean they’re doomed to die in the gutter. It just means that the predisposition which prevents them from drinking doesn’t go away. ---
**Author:** ![Ambivalid](https://avatars.discourse-cdn.com/v4/letter/a/a5b964/32.png) [@Ambivalid](https://boards.straightdope.com/u/Ambivalid)\ **Post date:** [August 13, 2011, 5:12pm UTC](https://boards.straightdope.com/t/once-an-alcoholic-always-an-alcoholic/592291/166 "2011-08-13T17:12:32Z")
> [@Czarcasm](#): > > If an alcoholic is not _really_ an alcoholic if they manage to control it later in their life, then a person cannot _really_ be called an alcoholic until they die without successfully controlling the problem. By this definition, nobody posting on this board is currently an alcoholic. Sure they can. If that _alcoholic_ who “has managed to control it” were to be unknowingly exposed to alcohol in the same way that a person with no history of alcoholism were to be; that alcohol would affect the _alcoholic_ in a very different way than the non-alcoholic. ---
**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 13, 2011, 5:20pm UTC](https://boards.straightdope.com/t/once-an-alcoholic-always-an-alcoholic/592291/167 "2011-08-13T17:20:16Z")
> [@jamiemcgarry](#): > > Sure they can. If that _alcoholic_ who “has managed to control it” were to be unknowingly exposed to alcohol in the same way that a person with no history of alcoholism were to be; that alcohol would affect the _alcoholic_ in a very different way than the non-alcoholic. That _still_ means that you cannot call someone an “alcoholic” until after they react differently. You aren’t currently drinking? I can’t call you an alcoholic until after you fall off the wagon. ---
**Author:** ![Ambivalid](https://avatars.discourse-cdn.com/v4/letter/a/a5b964/32.png) [@Ambivalid](https://boards.straightdope.com/u/Ambivalid)\ **Post date:** [August 13, 2011, 5:32pm UTC](https://boards.straightdope.com/t/once-an-alcoholic-always-an-alcoholic/592291/168 "2011-08-13T17:32:31Z")
> [@Czarcasm](#): > > That _still_ means that you cannot call someone an “alcoholic” until after they react differently. You aren’t currently drinking? I can’t call you an alcoholic until after you fall off the wagon. So that’s like saying a person in remission _doesn’t_ have cancer. ---
**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 13, 2011, 5:41pm UTC](https://boards.straightdope.com/t/once-an-alcoholic-always-an-alcoholic/592291/169 "2011-08-13T17:41:42Z")
> [@jamiemcgarry](#): > > So that’s like saying a person in remission _doesn’t_ have cancer. Can you put someone under the microscope and find the indicators that exist only in alcoholics? if so, we have both a working definition of “alcoholism” _and_ a definition of “cure”. ---
**Author:** ![Ambivalid](https://avatars.discourse-cdn.com/v4/letter/a/a5b964/32.png) [@Ambivalid](https://boards.straightdope.com/u/Ambivalid)\ **Post date:** [August 13, 2011, 6:09pm UTC](https://boards.straightdope.com/t/once-an-alcoholic-always-an-alcoholic/592291/170 "2011-08-13T18:09:03Z")
> [@Czarcasm](#): > > Can you put someone under the microscope and find the indicators that exist only in alcoholics? if so, we have both a working definition of “alcoholism” _and_ a definition of “cure”. > **[Influence of the endogenous opioid system on high alcohol consumption and...](https://pmc.ncbi.nlm.nih.gov/articles/PMC167184/)** > > There is increasing evidence supporting a link between the endogenous opioid system and excessive alcohol consumption. Acute or light alcohol consumption stimulates the release of opioid peptides in brain regions that are associated with reward and... ---
**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 13, 2011, 6:14pm UTC](https://boards.straightdope.com/t/once-an-alcoholic-always-an-alcoholic/592291/171 "2011-08-13T18:14:21Z")
> [@guizot](#): > > I think there are lot of people who develop a drinking problem over time, and then stop because of family/work pressure, or some other external reason. By self-control, they don’t drink anymore, but they’re miserable, unhappy people–impossible to be around–because their brain has come to know only one way to be at ease: with alcohol. They can’t look forward to a drink anymore, and so their lives are sapped. Is that “cured”? I don’t know. This x 1000. AA, and other support programs teach alcoholics how to live “normally” minus the alcohol. My experience with an alcoholic: It was glaringly obvious when he quit working the steps. He became miserable, nasty, vicious. ---
**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 13, 2011, 7:26pm UTC](https://boards.straightdope.com/t/once-an-alcoholic-always-an-alcoholic/592291/172 "2011-08-13T19:26:39Z")
> [@jamiemcgarry](#): > > [Influence of the endogenous opioid system on high alcohol consumption and genetic predisposition to alcoholism - PMC](http://www.ncbi.nlm.nih.gov/pmc/articles/PMC167184/) Not quite there yet, but definitely along the lines of what I’m looking for. ---
**Author:** ![raindog](https://avatars.discourse-cdn.com/v4/letter/r/2bfe46/32.png) [@raindog](https://boards.straightdope.com/u/raindog)\ **Post date:** [August 13, 2011, 7:34pm UTC](https://boards.straightdope.com/t/once-an-alcoholic-always-an-alcoholic/592291/173 "2011-08-13T19:34:32Z")
> [@Czarcasm](#): > > That would be great if it were a church, which relies of belief instead of hard evidence. And why would that matter? Is my life any more saved if science claims to be the savior? ---
**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 13, 2011, 8:30pm UTC](https://boards.straightdope.com/t/once-an-alcoholic-always-an-alcoholic/592291/174 "2011-08-13T20:30:58Z")
> [@Oakminster](#): > > Alcoholism is not a disease, it’s a character flaw. “Alcoholism” is not a disease _or_ a character flaw. It is a behavioral problem. I put “alcoholism” in quotes because the term only has meaning if you accept the disease theory of problem drinking (which I as a layman, and many others who have a lot of training and experience in the substance abuse field, do not). The proper terms for problem drinking are: **alcohol dependance** or **alcohol abuse**. These are two different things, and should be treated as such. **Alcohol dependence** would be most similar to alcoholism, but with at least one important difference. A person can be alcohol dependent for a period of time and then at some point learn to modify their behavior so that that is no longer the case. Whereas the popular (AA) idea of **alcoholism as a disease** maintains that no amount of behavior modification can eliminate the disease. This is something of a self-fulfilling prophesy because when someone who is alcohol dependent quits drinking and later is able to drink in moderation, 12-Steppers will simply say they never had the disease to begin with. (Which is true, in a sense, because no one has ever had the disease of alcoholism because it’s not a disease.) **Alcohol abuse** is an acute, harmful consumption of alcohol. One needn’t be chronically dependent on alcohol to abuse it. Unfortunately, too many psychologists, therapists, and doctors consider the two different problems to be the same thing–a single disease (called alcoholism). Even more unfortunate\*, this (very large) subset of care-givers send you to a “one-size-fits-all” system called Alcoholics Anonymous. Which could be just the thing for some problem drinkers, but for many others is the wrong place to be. For example, some college kid who got waaaaay too fucked up and got in fistfights every weekend for a whole semester. Now obviously this is a serious problem. But it doesn’t necessarily mean the guys absolutely must never drink a single drop of booze ever again. Yet, that is what is drilled into him at AA meeting. They only have one, single, answer to a multitude of very different situations. \*Unfortunate only in the sense that they are taking a large group of patients with different problems that call for different solutions and shoving them into one system with only one solution. I’m NOT saying it’s unfortunate because it’s AA, _per se_. It would be just as unfortunate if they sent all these different cases to SMART recovery or Rational Recovery. ---
**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 13, 2011, 8:45pm UTC](https://boards.straightdope.com/t/once-an-alcoholic-always-an-alcoholic/592291/175 "2011-08-13T20:45:50Z")
> [@HazelNutCoffee](#): > > Lots of people go out Saturday night and have a few drinks without getting off-their-tits drunk. If you get shitfaced every time you go out for drinks, that sounds like you have a problem. Definitely a problem, but not necessarily alcoholic. And that’s my gripe with the way substance abuse is treated today. When anyone has any problem with drinking they get sent to AA where they’re told “You must never drink again”. Which might be good advice for some, but not for others. Indeed, the very thought of “never drinking again!?!?!” is enough to keep some folks from seeking help with their problem drinking. That is not a good thing. AA is just right for some, I just wish the majority of the medical profession would stop recommending it to anyone and everyone who has any kind of drinking problem whatsoever. ---
**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 13, 2011, 9:54pm UTC](https://boards.straightdope.com/t/once-an-alcoholic-always-an-alcoholic/592291/176 "2011-08-13T21:54:49Z")
Part of the frustration in diagnosing this type thing though (I would guess) is that the alcoholic patients will LIE and LIE some more to their physicians. They’re lying to themselves, their families, co-workers - everyone. Many will lie right up until death. Sadly. When you can’t get the truth and you have to guess, I suppose the one size fits all approach is about all you can do. ---
**Author:** ![pinkyvee](https://avatars.discourse-cdn.com/v4/letter/p/6de8d8/32.png) [@pinkyvee](https://boards.straightdope.com/u/pinkyvee)\ **Post date:** [August 13, 2011, 10:54pm UTC](https://boards.straightdope.com/t/once-an-alcoholic-always-an-alcoholic/592291/177 "2011-08-13T22:54:48Z")
> [@Scotty Mo](#): > > So I’ve been seeing a psychologist lately who has told me that I am an alcoholic and there’s no way around it. She illustrated to me a line where social use is seperated from alcoholic use and because it’s a “disease”, there’s nothing I can do to help it. I don’t care one whit if it is labeled a “disease” or an “addiction” or a “compulsion”. What I do care about is the fact that it is hell to live with an alcoholic who still wants to negotiate social drinking when they lack the ability to be a social drinker. > [@](#): > > I’ve also been attending some AA meetings where most people are of the same opinion. So what? Are they sober? Are their circumstances improving? Are they learning how to navigate life feeling actual emotions as a sober man/woman? Why debate success? > [@](#): > > I’m having a difficult time coming to grips with this. I’m a strong-willed person, but, I do have a hard time handling my alcohol. And yes, I am going to see these people because I recently got into trouble, but thats besides the point. Trouble is EXACTLY the point. Once uncontrollable alcohol consumption has caused you, or yours, “trouble” you have just obligated yourself to stop drinking. Come to grips with that. > [@](#): > > AA works for a lot of people and has been around for a relatively long time. So, I’m sure there’s some truth to this. However, I’m skeptical that I am an alcoholic. I really don’t crave drinks daily, and usually only partake on the weekends. Binge drinkers who get into “trouble” are often highly functioning alcoholics. My husband, for example. > [@](#): > > I’d just like to hear some opinions for and against this relatively conventional view of alcoholism. You want to be convinced you can drink sometimes? Right? That is every alcoholic’s dream. My husband is sober 15.5 years. Yes, he’s in AA. He says his life has never been better. He is happy. He has more friends than he ever had before. He & I together attend huge non-alcoholic social gatherings where fun in abundance. He was a very high functioning alcoholic as well. Never got picked up by the law, only out of sheer dumb luck. But, his drinking was ruining my life and when I finally hit my “rock bottom”, I knew that if he made the decision to drink, he’d be doing his drinking not married to me. About this time he says to me: “OK. I will stop drinking.” My response was: “Not good enough. Either you go to AA and work it, or live somewhere else.” I was done, and I never make weak ultimatums. I do not consider this an ultimatum, in fact, I consider this a healthy self protective boundary of mine. I just want to say to you, life is good without alcohol. I am a “normie” married to a sober “alkie”. 30 years down the drain … 😉 You only think you need to feel a buzz to have fun. Best of luck to you either way. ---
**Author:** ![Ambivalid](https://avatars.discourse-cdn.com/v4/letter/a/a5b964/32.png) [@Ambivalid](https://boards.straightdope.com/u/Ambivalid)\ **Post date:** [August 13, 2011, 11:58pm UTC](https://boards.straightdope.com/t/once-an-alcoholic-always-an-alcoholic/592291/178 "2011-08-13T23:58:22Z")
> [@I\_Love\_Me\_Vol.I](#): > > Definitely a problem, but not necessarily alcoholic. > > And that’s my gripe with the way substance abuse is treated today. When anyone has any problem with drinking they get sent to AA where they’re told “You must never drink again”. Which might be good advice for some, but not for others. > > Indeed, the very thought of “never drinking again!?!?!” is enough to keep some folks from seeking help with their problem drinking. That is not a good thing. > > AA is just right for some, I just wish the majority of the medical profession would stop recommending it to anyone and everyone who has any kind of drinking problem whatsoever. “I put “alcoholism” in quotes because the term only has meaning if you accept the disease theory of problem drinking (which I as a layman, and many others who have a lot of training and experience in the substance abuse field, do not).” In your first post you claim the term “alcoholic” hold no meaning to you. But in your second post you contest someone else’s definiton of “alcoholic”. And you seem to imply a definition of what a alcoholic _IS_ if I’m reading you correctly, although you don’t refer to the person as such. Don’t you suggest that there _IS_ a certain segment of “alcohol dependent” and/or “alcohol abusers” who should never consume alcohol again? Wouldn’t you agree that a label “alcoholic” would suit this group? ---
**Author:** ![Guinastasia](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/guinastasia/32/5751_2.png) [@Guinastasia](https://boards.straightdope.com/u/Guinastasia)\ **Post date:** [August 14, 2011, 12:40am UTC](https://boards.straightdope.com/t/once-an-alcoholic-always-an-alcoholic/592291/179 "2011-08-14T00:40:10Z")
> [@Czarcasm](#): > > That’s all very well and good, but can you answer my question, which is directly tied to the OP: Is “Once an alcoholic, always an alcoholic” falsifiable? Honestly? That I don’t know. However, I think I CAN attest that it’s definitely a disease, as in a mental disorder. Telling someone, “well, just quit drinking!” is just about as useful as telling someone with depression to “just snap out of it!” or someone with OCD to “just stop washing your hands, there aren’t any germs!” It doesn’t work like that. The whole, “well, no one’s FORCING someone to go to the store and buy booze!” is stupid and sounds like purposely misunderstanding the issue. **pinkyvee** , I’m so sorry you had to go through that. I’m glad to hear your husband is well now. ---
**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 14, 2011, 1:16am UTC](https://boards.straightdope.com/t/once-an-alcoholic-always-an-alcoholic/592291/180 "2011-08-14T01:16:31Z")
I’ll agree with mental disorder. But are mental disorders diseases? ---
**Author:** ![OneMissedPost](https://avatars.discourse-cdn.com/v4/letter/o/8e7dd6/32.png) [@OneMissedPost](https://boards.straightdope.com/u/OneMissedPost)\ **Post date:** [August 14, 2011, 1:34am UTC](https://boards.straightdope.com/t/once-an-alcoholic-always-an-alcoholic/592291/181 "2011-08-14T01:34:16Z")
> [@Bloodless\_Turnip](#): > > I’ll agree with mental disorder. But are mental disorders diseases? Alcoholism is becoming dependent on alcohol. It’s like having a drug addiction. An alcoholic becomes dependent on alcohol to deal with problems in life or to function. An alcoholic becomes mentally and physically dependent on alcohol. There’s no such thing as a functional alcoholic. The whole point of alcoholism is that the person is no longer functioning. [Previous page](https://boards.straightdope.com/t/once-an-alcoholic-always-an-alcoholic/592291.md?page=8) [Next page](https://boards.straightdope.com/t/once-an-alcoholic-always-an-alcoholic/592291.md?page=10)