Alcoholism is a disease
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Alcoholism is a disease
Can anyone give me good reasons why it is? I mean scientifically. I struggle with this, and it has held me back from being sober. I feel in a way like Jesus against the Romans.
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Originally Posted by JamesfrmEngland 
Can anyone give me good reasons why it is? I mean scientifically. I struggle with this, and it has held me back from being sober. I feel in a way like Jesus against the Romans.
Theoretical Frameworks and Mechanistic Aspects of Alcohol Addiction: Alcohol Addiction as a Reward Deficit Disorder
George F. Koob
This is a good review article about the state of addiction research at the neuroscience level. Here is the abstract, to get a gist of what the article is discussing.
Abstract
Alcoholism can be defined by a compulsion to seek and take drug, loss of control in limiting intake, and the emergence of a negative emotional state when access to the drug is prevented. Alcoholism impacts multiple motivational mechanisms and can be conceptualized as a disorder that includes a progression from impulsivity (positive reinforcement) to compulsivity (negative reinforcement). The compulsive drug seeking associated with alcoholism can be derived from multiple neuroadaptations, but the thesis argued here is that a key component involves the construct of negative reinforcement. Negative reinforcement is defined as drug taking that alleviates a negative emotional state. The negative emotional state that drives such negative reinforcement is hypothesized to derive from dysregulation of specific neurochemical elements involved in reward and stress within the basal forebrain structures involving the ventral striatum and extended amygdala, respectively. Specific neurochemical elements in these structures include not only decreases in reward neurotransmission, such as decreased dopamine and γ-aminobutyric acid function in the ventral striatum, but also recruitment of brain stress systems, such as corticotropin-releasing factor (CRF), in the extended amygdala. Acute withdrawal from chronic alcohol, sufficient to produce dependence, increases reward thresholds, increases anxiety-like responses, decreases dopamine system function, and increases extracellular levels of CRF in the central nucleus of the amygdala. CRF receptor antagonists also block excessive drug intake produced by dependence. A brain stress response system is hypothesized to be activated by acute excessive drug intake, to be sensitized during repeated withdrawal, to persist into protracted abstinence, and to contribute to the compulsivity of alcoholism. Other components of brain stress systems in the extended amygdala that interact with CRF and that may contribute to the negative motivational state of withdrawal include norepinephrine, dynorphin, and neuropeptide Y. The combination of loss of reward function and recruitment of brain stress systems provides a powerful neurochemical basis for a negative emotional state that is responsible for the negative reinforcement driving, at least partially, the compulsivity of alcoholism.
Alcoholism can be defined by a compulsion to seek and take drug, loss of control in limiting intake, and the emergence of a negative emotional state when access to the drug is prevented. Alcoholism impacts multiple motivational mechanisms and can be conceptualized as a disorder that includes a progression from impulsivity (positive reinforcement) to compulsivity (negative reinforcement). The compulsive drug seeking associated with alcoholism can be derived from multiple neuroadaptations, but the thesis argued here is that a key component involves the construct of negative reinforcement. Negative reinforcement is defined as drug taking that alleviates a negative emotional state. The negative emotional state that drives such negative reinforcement is hypothesized to derive from dysregulation of specific neurochemical elements involved in reward and stress within the basal forebrain structures involving the ventral striatum and extended amygdala, respectively. Specific neurochemical elements in these structures include not only decreases in reward neurotransmission, such as decreased dopamine and γ-aminobutyric acid function in the ventral striatum, but also recruitment of brain stress systems, such as corticotropin-releasing factor (CRF), in the extended amygdala. Acute withdrawal from chronic alcohol, sufficient to produce dependence, increases reward thresholds, increases anxiety-like responses, decreases dopamine system function, and increases extracellular levels of CRF in the central nucleus of the amygdala. CRF receptor antagonists also block excessive drug intake produced by dependence. A brain stress response system is hypothesized to be activated by acute excessive drug intake, to be sensitized during repeated withdrawal, to persist into protracted abstinence, and to contribute to the compulsivity of alcoholism. Other components of brain stress systems in the extended amygdala that interact with CRF and that may contribute to the negative motivational state of withdrawal include norepinephrine, dynorphin, and neuropeptide Y. The combination of loss of reward function and recruitment of brain stress systems provides a powerful neurochemical basis for a negative emotional state that is responsible for the negative reinforcement driving, at least partially, the compulsivity of alcoholism.
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I spent years wondering and arguing about this - but still drinking.
In the end, I discovered you don't actually need to work it out to stop drinking
I found it was way better to stop drinking, then delve in the perennial questions.
No ones going to put you on trial, let alone put you to death here, James 
Are you sober right now or back to drinking?
D
In the end, I discovered you don't actually need to work it out to stop drinking
I found it was way better to stop drinking, then delve in the perennial questions.
I feel in a way like Jesus against the Romans.
Are you sober right now or back to drinking?
D
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Join Date: Mar 2016
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James, I struggle with weather or not it's a real disease. I know many in the medical community who do not believe it's a disease. Of course, it's very PC today to say it is. I suppose it doesn't really matter though if it's destroying your life?
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Originally Posted by Unluckyatlife
James, I struggle with weather or not it's a real disease. I know many in the medical community who do not believe it's a disease. Of course, it's very PC today to say it is. I suppose it doesn't really matter though if it's destroying your life?
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Originally Posted by SolidKarma
The problem with this, is that the "medical community" doesn't necessarily follow addiction research. Keep in mind, the "medical community" often times knows only what they learned in medical school. New evidence in addiction research is coming out every day and I highly doubt most doctors are keeping up with Pubmed articles, and thus just because some Doctors doesn't agree with it doesn't mean they're right.
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Originally Posted by JamesfrmEngland
Addiction research is usually brought out by medical or psychological doctors and it is usually of one those AA tricks to say the 'medical community doesn't follow addiction research,' of course they do. Which is why I often struggle to take Anonymous groups seriously, they often surmise that they have the answer based on this research that they have selectively picked.
The majority of addiction research is being done by PhD Neuroscientists. There are some MD/PhD's who do research AS WELL as practice medicine. But pure Doctors DON'T do research. They treat patients.
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Join Date: Sep 2012
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Whatever it is, I have it and it is up to me to do something about it. People go round and round pontificating their views pro and con.
Personally I think it is a huge waste of time that does not get me any closer to sobriety
Personally I think it is a huge waste of time that does not get me any closer to sobriety
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Join Date: Oct 2013
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James,
Maybe it's time for some soul-searching. Having an internal debate about whether you agree with how addiction as viewed, and then deciding *that* is what is holding you back from getting sober sounds like a rationalization to keep drinking. Top it off with a sense of persecution -- Jesus vs. the Romans -- and you've found a reason not to get sober, whether that's wholly a conscious decision or not.
Here's what we do know about alcoholism. It's progressive. It gets worse.
I say none of this to figuratively kick you. I say it because at the end of the day, agreeing with the characterization of addiction as a disease doesn't matter.
What does matters is you do something. And sobriety is very doable, whether you pursue it via AA, Rational Recovery, SMART or by working with a counselor certified in dealing with addiction.
There are a lot of great tools here on SR, too. There are a lot of us here who gained our sobriety and live in recovery by taking full advantage of all SR has to offer.
Maybe it's time for some soul-searching. Having an internal debate about whether you agree with how addiction as viewed, and then deciding *that* is what is holding you back from getting sober sounds like a rationalization to keep drinking. Top it off with a sense of persecution -- Jesus vs. the Romans -- and you've found a reason not to get sober, whether that's wholly a conscious decision or not.
Here's what we do know about alcoholism. It's progressive. It gets worse.
I say none of this to figuratively kick you. I say it because at the end of the day, agreeing with the characterization of addiction as a disease doesn't matter.
What does matters is you do something. And sobriety is very doable, whether you pursue it via AA, Rational Recovery, SMART or by working with a counselor certified in dealing with addiction.
There are a lot of great tools here on SR, too. There are a lot of us here who gained our sobriety and live in recovery by taking full advantage of all SR has to offer.
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Join Date: Mar 2016
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Originally Posted by MIRecovery
Whatever it is, I have it and it is up to me to do something about it. People go round and round pontificating their views pro and con. Personally I think it is a huge waste of time that does not get me any closer to sobriety
Because I think it's a pretty important question to address. If we understood more about the brain and how it works, we might have a better idea of what has gone awry for us alcoholics.
Knowledge is power!
You're not shackled to not drinking, you're free from drinking
Join Date: Oct 2015
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Originally Posted by SolidKarma
Do you think it's a huge waste of time for the scientific community to pontificate about this question? I'm honestly curious.
Because I think it's a pretty important question to address. If we understood more about the brain and how it works, we might have a better idea of what has gone awry for us alcoholics.
Knowledge is power!
Because I think it's a pretty important question to address. If we understood more about the brain and how it works, we might have a better idea of what has gone awry for us alcoholics.
Knowledge is power!
A Day at a Time
Join Date: Sep 2012
Location: Grand Rapids MI
Posts: 6,435
Originally Posted by SolidKarma
Do you think it's a huge waste of time for the scientific community to pontificate about this question? I'm honestly curious.
Because I think it's a pretty important question to address. If we understood more about the brain and how it works, we might have a better idea of what has gone awry for us alcoholics.
Knowledge is power!
Because I think it's a pretty important question to address. If we understood more about the brain and how it works, we might have a better idea of what has gone awry for us alcoholics.
Knowledge is power!
I have a whole bag of tricks that have been given to me by the people here and in AA. This is what I use on a daily basis not all of the things I learned in two high end rehabs and extensive reading.
I seek wisdom not knowledge
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Join Date: Dec 2015
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What does this thread achieve?
Personally, I don't believe that my problem with drinking is a disease. So what? I need to identify what I think is the problem and deal with it that way.
I'm not sure what the point of this thread is, or how it can help you with sobriety?
Personally, I don't believe that my problem with drinking is a disease. So what? I need to identify what I think is the problem and deal with it that way.
I'm not sure what the point of this thread is, or how it can help you with sobriety?
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Along with 'Can I Moderate My Drinking', and 'Am I Really Powerless', 'Is Alcoholism A Disease Or Not' is one of the perennial questions here, folks.
I've already recounted my experience but people have a right to ask the question, and people have a right to reply, assuming of course the discussion is within the rules of the forum.
If you find yourself getting frustrated or too heated, it's fine to push your chair back and go do something else for a while
Dee
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SR
I've already recounted my experience but people have a right to ask the question, and people have a right to reply, assuming of course the discussion is within the rules of the forum
.If you find yourself getting frustrated or too heated, it's fine to push your chair back and go do something else for a while
Dee
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SR
EndGame
Join Date: Jun 2013
Location: New York, NY
Posts: 4,677
Claiming that alcoholism is a disease does not unburden us from the consequences and the responsibility of what we do while we're drinking, even after we get sober. Nor is it an excuse for not getting sober. Try using the "I was drunk when I did it" defense in a court of law, which is the primary complaint in cases of DUI.
None of us chose to be alcoholics. But each time we pick up a drink, and knowing what we've done in the past, what has happened to us in the past, while drinking, we make a decision to again place ourselves and others in danger, sometimes fatally so.
Never attempting to achieve success in life due to fear, self-doubt or negative thinking may not be a disease, but it certainly keeps many people from achieving a sense of fulfillment.
None of us chose to be alcoholics. But each time we pick up a drink, and knowing what we've done in the past, what has happened to us in the past, while drinking, we make a decision to again place ourselves and others in danger, sometimes fatally so.
Never attempting to achieve success in life due to fear, self-doubt or negative thinking may not be a disease, but it certainly keeps many people from achieving a sense of fulfillment.
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