Peter

Opinion

I hear a lot of discussion going on again about the “disease” concept of alcoholism.

I know some people may have some pretty solid points about why alcoholism is not a disease and why it should not be labeled as such but AA’s all over the world have long subscribed to the disease concept of alcoholism and I personally have been very comfortable with it and I find that the idea works for me.

My dictionary defines “disease” as; Morbid condition of body.Illness.Sickness.Deranged state of mind or morals.

This definition pretty much defines my condition as an active alcoholic and quite accurately sums up what will re-occur if I was to have a relapse.

Alcoholism is a morbid state of mind,body and spirit and anyone who struggles with the disease concept of it need only look to the “mental” aspect of alcoholism to find some verification of this.

“Mental Illness is a pretty well researched and catalogued field and universally recognized as a very real condition,yet some will question the dementia ,delusion,paranoia and deranged state of morals which afflicts the alcoholic who goes untreated.

It is not my desire to change another’s views on what they choose to believe,all I know is that accepting that I have The disease of alcoholism carries with it a sense of urgency about my condition and strenghthens my conviction to recovery and if that is what is keeping this drunk off the streets then it would seem to me that this is a cause to celebrate rather than to discuss.

One of the greatest mistakes I know I can make is to assume I know what is best for someone else more than they might know what is best for themselves.

Sobriety is often such a fragile thing.All I ask of anyone is the freedom to work my programme in my own way and to enjoy my beliefs and my membership in Alcoholics Anonymous.

If after the debate is over and you still have trouble recognizing that alcoholism is a disease,try sticking a hyphen in there and call it….. DIS-EASE.

Either way you look at it the meaning is still the same….MISERY.

And if after that you are having trouble,try believing that only a mentally ill person would be writing this in the first place.

Peter.

The Jay Walker

Peter

I also believe that my alcoholism is a disease, I fought the desease theory for years, and would end up drunk, since accepting the disease theory, I have managed to stay sober, it's working for me,
I have heard some say that, the disease theory, can lead to giving a person an excuse to relapse.
in my case, knowing that I have the disease keeps me focused on my recovery, I hope I never get cured, I have seen droves of people get cured, and go back to the bottle.

justaround

Does it really matter??

We are addicts...time for recovery and sobriety...not why we dug the grave. Ahem....grave meaning the addiction

Jon

Actually, this is one of the places where the AA Big Book and I get along perfectly.

Allergy. I can really relate to that term. I drink, I want to drink more. I use, I want to use more.

There has not been a "social" side to my drinking or using in many, many years. I am allergic to any substance i use to alter my moods and or reality.

Allergic.

I ingest a substance and I "break out."

I break out in handcuffs, living under bridges or in psych wards.

I get cramps from dehydration and from standing or crouching on the floor of a ****** motel room for hours, not moving, too afraid of what's "out there."

I lose a lot of weight. And even more sleep. And still more relationships.

Allergic. An allergy.

I take something and it produces UN-desireable effects.

Loss of family, job, conciousness.

Loss of mental faculties.

Loss of self.

And let's not forget the obsession: Despite all that I've written above, my brain still says,

"maybe it will be different this time..."

Disease= n., Lack of ease; trouble

Yep. I've got that.

munchdaddy

Peter,
Let me start by saying to you, and anyone else with your view, that if believing that drinking to excess is a disease works to keep you from doing just that, keep believing it.

However, your belief is not based on fact. Webster’s defines a disease as “a condition of the living animal or plant body or of one of its parts that impairs normal functioning.” While alcohol certainly impairs normal functioning, its consumption is not a condition of the human body; rather its presence in the human body is a choice. Claiming that the irresponsible abuse of a substance places one in the company with people who have contracted a malady that is 1. Killing them and 2. Is in there system based not on their actions is irresponsible as well. Alcohol is addictive and creates a chemical dependency. Calling abuse of alcohol a disease is a convenient way for people to deny responsibility for their irresponsible actions under its influence. (i.e. recently head coach of Iowa State basketball). There is no part of a true disease that is caused by choice; save cancers and heart disease caused by an unhealthy lifestyle. So to answer your question justaround, it matters. It matters when the CEO of a company blames embezzlement on alcohol. It matters when the crown heights murderer says he was drunk when he did it. It matters when a university head coach goes to a frat party, asks for sexual favors, and then claims he was “out of control” and not responsible for what he did. Drinking too much is not a disease, it is a choice and for some of us, it was a really bad choice that we are now smart enough not to make.

Peter

So is pleading "Temporary insanity"
So is pleading "A voice in my head told me to do it"
So is "I have a rage management problem"

People will always find excuses to avoid blame for their actions but not all alcoholics hide behind their disease to avoid taking responsibility.

Webster’s defines a disease as “a condition of the living animal or plant body or of one of its parts that impairs normal functioning.

Although this description could be used to quite aptly describe the "Physical" aspects of alcoholism,it says nothing of the "mental" or "spiritual" aspect of the disease and this is where the true nature of the malady resides.

I may have willingly picked up my first drink but I did not "willingly" become addicted to alcohol.

QUOTE]your belief is not based on fact[/QUOTE]

Munchdaddy who said anything about "facts".

The heading at the top of my post quite clearly states "opinion" and for today I am sticking to it.

What are "facts" anyway but our own understanding of what we percieve to be the truth.

My own programme has taught me that "Everything we know is subject to revision, especially what we know about the truth".

Based on that I will try to keep an open mind.

At any rate the purpose of this post is to get a little discussion going about the "disease concept" of alcoholism and I appreciate all the input.

Peter.

munchdaddy

Peter,
My facts comment was not directed at you personally, rather the disease concept globaly. I do feel that classifying something, using an important medical term such as disease, should be required to be based in fact, my opinion.
Mental illness defined:
Mental Illness is a term used for a group of disorders causing severe disturbances in thinking, feeling and relating. The causes of mental illnesses are not well understood, although it is believed that the functioning of the brain's neurotransmitters is involved.
Granted, Alcohol in the system may cause “severe disturbances in thinking, feeling and relating”, one must chose for the alcohol to be in the system to do so.
As to the spiritual deficiency, I will leave that subject alone. I feel spirituality is a personal subject that is completely unrelated to the abuse of alcohol or any substance.

While you may not have chosen to become addicted to alcohol, that does not make a chemical dependency to it a disease. Smokers addicted to cigarettes do not have a disease. The way I can’t live with out that morning cup of coffee does not make me diseased either. The problem is, alcohol impairs judgment and those other substances do not. Therefore I find it irresponsible to call abuse of any substance a disease, because of the legal ramifications in doing so.

Again, all of this is my opinion

Jon

Allergy? Anybody?

Every study I've looked at shows that, for the most part, "alcoholics" break down ETOH differently than most. That there is in fact, a difference in our physical make-up.

So, if not a disease, and not an allergy, how do you define this "difference"?

munchdaddy

John,
I will absolutely concur that the biochemical makeup of certain individuals is different when it comes to breaking down alcohol. That is why my wife can have one Dewers on the rocks and not consider having another and gets sleepy. I, on the other hand, have one and get energy and choose to have more. I still do not see how that makes choosing to consume abundant amounts of alcohol a disease. Allergy, maybe, but most allergies have common symptoms, coughing, sneezing, shortness of breath, watery eyes etc. I do not see any of these symptoms coming from the over use of beverages that contain alcohol.

phoenix

It's all well and good to have opinions about alcoholism.But it remains a fact that the AMA classifies it as a disease because it meets the five criteria they have established for identifying diseases.Therefore the disease concept is based on fact...not merely opinion.You can hold any opinion about it you like.But you are mistaken if you believe that the disease concept is not fact based.

And as Jon mentioned,alcoholics react differently to alcohol.I know that's true for me.I never reacted normally to alcohol.I had my first blackout the very first time I got drunk.I was seventeen years old.Once I started drinking,it simply didn't occur to me to stop.But hitting the blackout stage didn't require a massive amount of alcohol either.I had an abnormal reaction...period.


"The Disease Concept of Alcoholism

by Sheila Leskinen


Denial is the biggest symptom of this illness,
and not just for the alcoholic.


In the '60s, '70s and '80s, alcoholism treatment was in its heyday. In 1956, the American Medical Association (AMA) stated alcoholism was a disease, as it met the five criteria needed in order to be considered a disease: pattern of symptoms, chronicity, progression, subject to relapse, and treatability. One could learn about the disease concept through community lectures, articles in the paper, alcoholism hotlines and, of course, Alcoholics Anonymous (AA) meetings.

I learned that alcoholism is an illness that crosses all social classes. Anyone could get it, regardless of age, sex, education, class, ethnicity or religion. Those with a family history of drinking are at a higher risk, even if they once swore they would never drink like their mother or father.

I also learned that alcoholism is a chronic, progressive disease that manifests itself with symptoms that affect one physically, mentally, emotionally, spiritually and socially. Denial is its number one symptom, and the alcoholic is usually the last one to believe he or she has it. Alcoholism has a ripple effect and affects at least four to five other people, including family, friends, co-workers, neighbors, etc.

There are four stages of alcoholism. Most people in the first or pre-alcoholic stage are usually amazed how much they can drink. In fact, many may joke about their "hollow leg" or being able to drink their friends "under the table." Other symptoms of this first phase include: drinking to provide relief from stress and mental fatigue, or to relax; seeking more opportunities when drinking will occur; and a gradual development of increase in tolerance (use of more and more alcohol to get the same desired effects).

In the second and early stage of the illness, the person may have alcohol-induced blackouts. These are amnesia-like periods that occur while drinking, when the person seems to be functioning normally but will later have no recall of some or all of what he or she said or did. The individual may not remember getting home or having said something hurtful or outlandish to another person. Other symptoms include: sneaking extra drinks before or during events; gulping the first drink or two; and feelings of guilt.

The third or middle stage of alcoholism is a crucial phase, for loss of control sets in. This is the inability to drink according to intention. Once the first drink is taken, the individual can no longer predict what will happen, even though the intention may have been to only have a few drinks. Other symptoms include: drinking bolstered with excuses; grandiose and aggressive behavior; persistent remorse; increase in amount and frequency of drinking; failure of repeated attempts to control drinking; failed promises and resolutions to self and others; loss of interests; avoidance of family and friends; trouble with money and work; unreasonable resentments; problems with the law; neglect of food and loss of willpower; tremors and early morning drinks; decrease in alcohol tolerance (needing less alcohol to feel the effect); and the beginning of physical deterioration.

The fourth, final and late state of alcoholism is chronic. Up until this point, the individual may have been successful in maintaining a job, but now drinking occurs earlier in the day and can go on all day. Symptoms in this stage include: onset of lengthy intoxications; moral deterioration; impaired thinking; indefinable fears; obsession with drinking; and vague spiritual desires. A person may not develop all of these symptoms or in this particular order, but there is a continual loss of control.

This disease is often described as cunning, baffling and powerful. The alcoholic is often just as puzzled as those around him or her, because no matter how he or she attempts to modify drinking, nothing seems to work. The individual just can't seem to get a "grip" on the problem. Denial is the biggest symptom of this illness, and not just for the alcoholic. Those around the alcoholic are also often in denial, believing the person just needs to stop drinking or cut down. It is only after treatment that this confusing problem begins to make sense. The alcoholic learns that he or she has a chemical reaction to alcohol and that it is the first drink that causes the trouble. That is, it's the first drink that sets the obsession to drink in motion.

Alcoholism does not have to continue through all four phases, but if help isn't sought, the fourth stage can end in death, insanity or incarceration. From recovery stories, we know that loving interventions planned by concerned others, with the aid of trained professionals, can help alcoholics avoid the pain and misery of all these stages."

That being said,feel free to believe whatever you like and treat your drinking problem in the way that works best for you.


phoenix

munchdaddy

From the CA journal of addiction
Most people have a confused idea of alcoholism as a disease that invades or attacks your good health. Use of such a strong word such as "disease" shapes the values and attitudes of society towards alcoholics. A major implication of the disease concept is that what is labeled a "disease" is held to be justifiable because it is involuntary. This is not so. Problem drinking is a habit in which the so-called "alcoholic" simply has decided that the benefits of drinking outweigh the liabilities; it is all a matter of personal choice. An alcoholic participates in or causes many of their own problems by their behavior and the decisions they make, so why should they be viewed as helpless victims of a "disease"(Skipper 1)? Alcoholism should not be viewed as a disease, but as an addiction brought about by the alcoholic's personal choices.
What is wrong with disease theories as science is that they are tautologies; they avoid the work of understanding why people drink. People seek specific, essential human experiences from their addictive involvement. They can come to depend on such an involvement for these experiences until -- in the extreme -- the involvement is totally consuming and potentially destructive (Peele 146). The idea that alcoholism is a "disease", which is only typified by the loss of control, was only sanctioned by the American Medical Association in 1956 (Wilbanks 39). The AMA gives the following definition for alcoholism: " Alcoholism is an illness characterized by preoccupation with alcohol and loss of control over its consumption, such as to lead usually to intoxication if drinking; by chronicity, by progression and by a tendency toward relapse. It is typically associated with physical disability and impaired emotional, occupational and/or social adjustments as a direct consequence of persistent excessive use (Langone 27)". This meant that an alcoholic could now get help in a hospital, just as a person with a real disease such as diabetes or leukemia would . Moreover, the use of the words "loss of control" make it seem as though the alcoholic's free will has just been ripped away from him. On the contrary, there is no evidence that the will of the drinker has been overpowered. Besides labeling alcoholism as a disease, the AMA has also done a huge error in stating that alcoholism causes people to lose control over the consumption of alcohol. This will only negate the fact that the amount of alcohol consumed and if it is consumed at all is completely up to the drinker, not an inevitable disease that overpowers your free will. The belief that alcohol controls us rather than we control alcohol is obscene. It rejects the very idea of humanity- that we are not simply animals controlled by our instincts and impulses (Wilbanks 40).
The notion that alcoholism is genetic or hereditary is also based partly on an article by Donald Goodwin. In the article it states that about 18% of the children of alcoholics become alcoholics themselves. This also indicates that 82% of the children of alcoholics do not become alcoholics, therefore indicating that it is very likely that alcoholism indeed is not hereditary (Claypool 23). And could it be possible that those children who did become alcoholics did not do so because they inherited it, but they actually learned it from their parents? I believe this is very probable. We learn everything form our parents; how to dress, how to act, how to express ourselves, why not how to drink? Researchers also investigate possible genetic components of alcoholism by studying populations and families as well as genetic, biochemical, and neurobehavioral markers and characteristics. But these studies have not yet proven that alcoholism is based solely on genetic factors. The acclaimed anti-disease model revolutionist, Herbert Fingarette, quotes:"There was no genetic or other biological explanation for why a person drinks too much either on a particular occasion or habitually, why a person decides or commits violent or criminal acts when drunk, why a person decides that he or she is an alcoholic and that drinking is an excuse for misbehavior ( Peele 2)." Fingarette views drinking as an all-purpose excuse, a special case of self-deception anointed by science but actually steeped in the lore of magical "loss of control"- "I couldn't help myself"- as though this description of irresponsibility was somehow an explanation and an excuse for it (Peele 2).
"Disease" is the powerful word that generates provision of health insurance payments, employment benefits such as paid leave and workmen's compensation, and other government benefits. The direct and indirect cost of alcoholism is rapidly increasing, already exceeding a billion dollars annually (Fingarette 51). According to government statistics, the largest single area of economic loss at $9.35 billion, is the lost production of goods and services that can be attributed to the reduced productivity of alcohol-troubled male workers (Claypool 39). In addition, cost to society on alcoholics' health care expenditures alone already total to $18,820 million dollars (Cost 1). Health insurance companies are paying for these treatments of alcoholics as if they actually had a disease. This means the United States actually has to pay more for their health insurance - health insurance that should not be provided at the cost of the American public. . This is an absurd amount of money to be spending on alcoholics, people who preferred to take the path of drinking to the extent that they became addicted.
Alcoholism is not only costly money-wise, but it also claims many lives each year. Nearly 200,000 people die each year from alcohol abuse, that includes deaths from accidents and diseases caused by alcohol (Claypool 17). Alcohol abuse plays a part in some 10,000 accidental deaths a year, at home and on the job (Langone 39). The U.S. Department of Justice Report on Alcohol and Crime found that alcohol abuse was a factor in 40 percent of violent crimes committed in the United States (Violence 1). In 1996 there were 17,126 alcohol related traffic fatalities accounting for the 40.9% of all traffic fatalities during the year. Alcohol is also involved in at least half of all homicides in the United States, with either the attacker, the victim, or both under the influence. This is probably a good explanation for the fact that more murders occur on Saturday nights than any other night- the fewest murders occur on Tuesdays (Goodwin 16). Besides all these traffic fatalities and violent crimes where alcohol is a factor, let us not forget the premature deaths and birth defects alcohol abusers are also responsible for. In 1992 there were 31,327 premature deaths due to alcohol abuse (Cost 1). Each year 5,000 babies are born with Fetal Alcohol Syndrome; this is a form of mental retardation caused by mothers who drink while pregnant (Claypool 17). Imagine a child growing up with mental retardation, having to face all the hate and discrimination in this world. These innocent lives would have otherwise been spared had their mother not chosen to continue to drink during her pregnancy.
It has also become a legal basis for arguing that alcoholics should be excused from moral and legal responsibilities for any misdeeds. In the earlier 1968 case of Powell, the court rejected the criminal defense that alcoholism is a disease and hence that it ought to excuse the alcoholic for crimes committed while intoxicated (Fingarette 104). I find this to be truly outrageous! Imagine if all the alcoholics who, one night without thinking of the consequences, got drunk and decided to get behind the wheel, only to kill an innocent family, would try to justify themselves by saying "I had no control over it! I have a disease, I'm an alcoholic!" Another ridiculous case, where the excuse of alcoholism as a disease was brought to the Supreme Court, is that of two alcoholic veterans. The Supreme Court denied the two alcoholic veterans VA educational benefits they were unable to use within the period established by VA regulations because, they claimed, they were alcoholics (Peele 2). In other words, they spent so much of this time drinking that they didn't feel like going to school, a situation they claimed was brought on by the disease of alcoholism from which they suffered. One irony in this case was that, although the VA's position was that these men engaged in willful misconduct rather than manifesting a disease, the VA treatment creed is very much one based on the disease model. However, the VA expressed a different, sensible position in this case because to do otherwise would simply overwhelm the federal government with unimaginable claims it owed people who were too drunk to demand them at some time in the past (Peele 1). Cases like these prove that the word "disease" will only be used by alcoholics to excuse themselves from the consequences of their actions.
In conclusion, society and alcoholics have both been misled by the erroneous classification of alcoholism as a disease. It is not right to let alcoholics believe they are helpless and dependent on others, that they have an inevitable disease. It is not right to excuse them legally and give them special government benefits at the cost of the American public. Moreover, it is not right to let society keep viewing them as helpless victims, to keep paying for their treatments, and to keep losing thousands of lives each year to a drunks behind a wheel or women who drink while pregnant. Alcoholics are not powerless; their choices led them to the life they live and they should take responsibility for their actions. It is time we stop viewing alcoholism for what its not, a disease, and start viewing it for what it is, an addiction brought about by personal choices.

munchdaddy

Phoenix,
Does the AMA's archaic decision to call alcoholism a disease, which has been contested by organizations such as the Veterans committee, and still has no bases in fact, make it right?

Peter

Good question Jon.

In what way do we define this "condition".

Peter.

phoenix

You stated that the disease concept has no basis in fact.I merely pointed out that it does.

You'd need to rephrase your question before I could attempt an answer.It's not clear to me what you are trying to ask.In any case,I am not going to be drawn into an argument.You are welcome to disagree with the AMA.

If what you are doing keeps you sober, that's what really matters.

phoenix

Peter

Very good munchdaddy,but what about the "facts" which you insist on.

I see no "facts" in your CA journal of addiction article.I see a lot of opinions and speculation but no "facts"

My views and beliefs about alcoholism and addiction are based on my own experiences with this disease and not based on articles of speculation.I am not merely echoing someone else's ideas

I know.I have been to those dark places and I have experienced the misery that Alcoholism brings.

Peter.

phoenix

Allergies can have a wide range of symptoms.I have an allergy to certain cleaning products that causes the skin on my hands to crack,blister, and peel.However,it doesn't happen on contact.It may be many hours after exposure.It's aggravated by cold,moisture and stress.

I have a friend with a daughter who is allergic to eggs.It causes a skin reaction all over her body.Again,it's not an instant reaction.Both allergies were very baffling indeed.

But now we know that if we avoid those things we won't have a problem.Likewise,if I don't drink I won't get sick,or have blackouts and hangovers...or any of the even more devastating effects.

phoenix

munchdaddy

Hi Phoenix,
If I came across argumentative, I apologize. The point of my question was that just because the AMA categorizes something, does not make it factual. In fact, they have been challenged on this categorization by many qualified scientists and MDs.
I do like the allergy “analogy” for alcohol. But this analogy is not factual in basis either. My point is, that I am of the opinion that illnesses, diseases, allergies, and maladies are unfortunate, medically and factually defined circumstances that afflict individuals without their consent. Drinking too much simply does not fit that description.

phoenix

Facts are frequently challenged.Sometimes they are even disproved and then we have new facts.At this point I'm not sure what your definition of a fact is,nor do I understand why you are so determined to discredit the disease concept.

For myself,I think it's best just to agree that we disagree.

Have a great day.

phoenix

Jon

Good discussion-let's keep it going...


I think that the disease "concept" has become archaic because of it's use/misuse. Mainly by those not wanting to take any responsibility for their plight, and/or by th treatment industry needing/wanting insurance money.

Those two instances do not, however, make the concept incorrect.

Knowing exactly what will happen to me if I take a drink (consequences) will not always stop me from taking one anyway. Why? Obsession and compulsion. The dictionary desrcibes obsession as:

"A thought which overrides all others; exclusion of any other thought."

Based on that definition, and the fact that obsessive thoughts are, by definition, a form of mental illness, the argument that I can always choose not to drink (on my own anyway), just doesnt wash with me.

And, since a thought that overrides all others can prevent me from making a rational decision, once I do take that drink the other part of the "disease" kicks in. The "allergy" that mekes me want more, more, more.

AA, from the beginning, only claimed to be effective for "certain types" of alcoholics. In fact, moderate or even "hard drinkers" are gernerally ruled out. AA was meant and written to address the alcoholic of the "hopeless variety."

I bring this up only because I believe the problem may lie in the definition of "alcoholic" rather than "disease."

I have met many problem drinkers who have been convinced, by society and otherwise, that they are alcoholic. They might not be.

As far as personal responsibilty, the statisics clearly show that it is not the method that determines results, but rather the individual. A person in treatment at Betty Ford at 30,000 a month is no more likely to remain sober for a year than a person at the Salvation Army program, the person who stays sober through the church, therapy, or alternative groups or treatments.

I'm rambling, but this is important to me. Disease or allergy, illness, choice, behavior-the fact for me is that if/when I pick up that first one, I cannot tell you with any surety how the story will end. Something kicks in that does not happen with most people.

And, when not working some type of program, I cannot help but think about that "one", even though experience tells me it may very well kill me.

The plain fact is this: If at any time I am thinking about or doing something which brings harm to me, then I cannot be considered rational or sane. The only terms then are Irrational and Insane.

Anybody else that trys to hurt themselves gets locked up.

We get called drunks...

munchdaddy

Jon,
I am truly happy for you that AA works for you and that you see yourself as an alcoholic who practices the disease concept of alcoholism and that this works for you. If something works, great, keep at it. I know plenty of people who never found what works for them. According to the definition you provided I am not an alcoholic. That is good, because I do not believe in that term. To me an alcoholic practices alcoholism the same way a catholic practices Catholicism. I drank too much, about a bottle of vodka every two days for 10 plus years. I was chemically dependent. Through taking responsibility for my actions, and learning AVRT, I haven’t had a drink in years. I have never been happier and am a better person for this. For my “case” I guess I am what you refer to as a problem drinker. If it is helpful for you and others to believe that drinking too much is a disease, so be it. I however have control over what goes into my mouth.