AA doesn't call it a disease. We use words like illness and malady.
A couple of years back our lead researcher in this field, psychiatrist professor Doug Selman told us in a public meeting that it is primarily a brain disease and can be seen on the MRI. He also talked about a genetic component.
In one sense, as a disease, it certainly has a very specific set of symptoms and consequences and is highly predictable in how it will progress. A confusing element is the fact that it appears the sufferer inflicts it on himslef. Yet that is far from the case. Who in their right mind would choose alcoholic hell as a way of life?
However, heart problems and diabetes are diseases that can be self inflicted (lifestyle disease), yet they are still called diseases, even though the sufferer may have considerably more choice in their development.
Loss of choice, for the alcoholic /addict is a crucial element, though it is often disputed by those who have never lost the power of choice. It can be approached in two ways.
Firstly we could tell the sufferer that it is just a matter of choice, that he needs to toughen up, that his relapses are a sign of weakness, lack of committment, gutlessness, bad choices, that he is consistantly choosing to drink, and should just stop like everybody else does.
Or we might consider there is more to it, that the alcoholic is suffering from an illness or disease that is progressive and has a very definite pathology. We could recognise as, in almost any other disease, it is not a matter of choice. We can explain that there is a solution, a specific treatment for the illness which is known to be successful, and we could also empathise in that many of us (alcoholics) have struggled with this disease and been unable to beat it on our own. It is not a matter of weakness or strength, intelligence or lack thereof, it is simply a disease progressing in a specific way. And we know for even the hopeless cases like myself, it can be arrested if we choose/are willing to take the medicine.