The debate continues......I "grew up" in a setting where the disease concept reigned supreme. It did not even occur to me to debate, and I accepted that the medical community was firm in the designation. It proved useful to me to think of my alcoholism as a disease: It was the springboard from which I could begin to forgive myself. Besides, I reasoned, if it was a disease then surely there was an antidote! So I immersed myself in the most ubiquitous mutual help program of the day: AA. I carried into 12-step meetings the language and philosophies I had learned in treatment, as others before me had done & more would do after us. It would be years before I questioned the notion of a disease concept, before I realized that AA had no opinion on the matter. I did not have to have a disease to be a member of AA: A desire to stop drinking was the only requisite.
There has been criticism of the disease concept and its use in treatment. For some, it is argued, it becomes an excuse to continue to drink; others may resign themselves out of hopelessness. I must have been one the lucky ones.
Today I am less convinced that my alcoholism is a disease. Oh, there are features of disease: It is progressive, left untreated it is fatal. But I begin to have trouble with that designation when I reflect that it was a 12-step program, a spiritual program, that arrested the progression. Cancer does not spontaneously remit when the patient grows sick and tired of being sick and tired.
I never wanted to grow up to be an alcoholic. I was genetically predisposed, and my environment made me vulnerable to all sorts of pathologies. I do not metabolize alcohol "normally," but does that make it a disease? I am also lactose intolerant! In the final analysis I believe that it was a useful concept to think of my alcoholism as a disease. There are other "explanations" that might be equally useful to other people. And really, I don't know that the explanation matters unless it facilitates the solution.