[SIZE="2"]I think it might be helpful to make a few distinctions.
1. It is important to see that, as you say, even if alcoholism is viewed as a "disease" this does not remove a patient's responsibility for bringing it under control. Diabetes is a fine example. If a patient, despite the knowledge that he/she has diabetes, continues to ingest large amounts of sugar, then that person lacks responsibility for bringing the condition under control.
2. When you say that an alcoholic's body may react differently to alcohol, this may be because that person has atypical genetic characteristics.I agree with you on that.
But also over the course of time, due to continued drinking, an alcoholic's body, metabolism, chemistry, neuron interceptors, etc. will no doubt change so as to accommodate themselves to the alcohol. This results in tolerance, dependence and addiction.
The end result is that, as the "disease" progresses, an alcoholic is doubly disadvantaged: he/she continues to have those troublesome genetic characteristics, and secondly he/she has developed additional physical and chemical alterations as a result of persistent drinking.
But the "disease" concept does not exhaust the list of causal factors in this very complex situation. No doubt there are others, such as personality characteristics (e.g. shyness, compulsiveness, perfectionism, self centeredness, proneness to risk taking), socio cultural ones, such as a family history of drinking, college drinking, peer pressures. And some alcoholics have suffered from child abuse, mental and physical or suffer from bipolar imbalances.
So maybe it might be more accurate to refer to alcoholism as a "disease plus", a condition which requires not only medical care but an especially strong amount of patient responsibility, determination and cooperation. My experience has been that I could not do it alone. I had to have help, often from doctors who weren't really that skilled in providing that, and finally from one who encouraged me to get help from a group of fellow alcoholics. I'm very thankful for that.
W.
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