mackat

I often identify myself as an addict and an alcoholic or a junkie and a drunk.
Without that admission, i find it tempting to break out my selective rememberer. Think i'm just the lost misunderstood sensitive artist type trapped in this awful wrong world who 'deserves' to be high all the time..... or that it wasn't really THAT bad....

Worse yet, to imagine that i will stop at just one or two.

Maybe i do 'use' that stigma on myself as a fear mechanism - i readily admit i don't maintain a constant conversation with my spirituality. sometimes i just need to scare hell out of myself by knowing who i am and what that looked like.... at that moment i have not used, so i've given myself a chance...

equus

Thanks Mackat - that would sort of make sense that it got awkward when I said it about someone else. I think maybe he does that too - he's never exactly held back on descriptions of what happened.

Chy

I won't elaborate except to say for me I understand hubby's pov. I am one of those closet alcoholics. I was raised to believe "alcoholic" was a deragotory remark despite the fact we had a few in our family. I don't believe that to be the case today, but for me it's personal, private, and though I'm begining to come out of my shell more on it, I prefer not to make it public knowledge... yet anyway.

bartender129

You always have been a very wise one Chy.


Some people believe that the label “Alcoholic” makes others more tolerant (it is not your fault) and fosters an environment in which a person will be more likely to seek help.

I truly believe the opposite to be true.

Labeling can be dangerous both externally, and more importantly, internally.

lulu70

I am finding this conversation to be very interesting and thought-provoking. I DO believe that alcholism is a disease, but I don't by in to the fact that calling it a disease will render someone powerless. I may not have any control over the fact that I am an alcoholic (or that I am allergic or whatever), but I DO have control over what I do about it. I have always had that choice. Even when I was in active addiction, I had the choice to stop. As to whether calling it a disease is harmful or helpful--I believe it depends on the person. IMHO--if a person REALLY wants sobriety, it won't matter what you call the condition, they are going to do whatever it takes to recover. However, if they waiver at all on the decision to get sober, they will be looking for any excuse what-so-ever that will excuse them from really having to do the work.

Thanks for the thought-provoking thread!

BaBa OReiley

for me words are only words until i give them meaning.

by that i mean....... i'll never know what someone truly means when they say something, i can only interpet what is said in MY mind by what i've been taught.

i remember being in ireland when i was growing up and hearing the word *fag*, right away my mind went to homosexual because here in the states that's a term for homosexuals, but in the uk it means a cigarette!

for this alkie, i try to let words just be words, if you say something to me i take it at the words value and try not to add any meaning to what you've said, it ain't easy, but for me it keeps it simple.

CarolD

I ran this lable discussion by my home group at todays meeting....14 members of AA with sobriety ranges from 9 months to 16 years.

"Yep...We must be alcoholics cause
we are in a meeting. The drunks are in a bar"

equus

You wouldn't be here discussing it without any label, how would you find the site? You wouldn't be able to compare and talk with others about what's happening - unless of course you re-labelled it so that you could find each other. Maybe 'alcohol over use' 'alcohol withdrawal' 'acohol problems'. Or perhaps 'alcohol dependency' and alcohol abuse'. As in my other two examples (Down's syndrome and cerebal palsy) a double barrelled label can be harder to use in an insult.

It's the way the label is used that can be damaging both internally and externally. I think the variety of responses to this thread show that individuals can give it a positive meaning for themselves.

I also think that all of us as human beings should be aware of how language gets used. In retrospect I shouldn't have been surprised by D's reaction, the negatives of it being used purely to hurt have been there but as he doesn't yet want to stop drinking (he's aiming to become one of the 17.5% that manage to control alcohol after physical dependency) he isn't a candidate for many groups which would support the use of the word in a positive light.

My views are that by the dictionary definition of disease and by the diagnostic criteria of DSM I see Alcohol Dependency as a disease but I have become far less sure of the meanings given to alcoholism.

I think perhaps it is time for 'alcoholism' to die in our language, along with alkie.

My husband no longer has the symptoms of dependency, nor abuse and yet for all the power over it he's managed to achieve, it's by no means control. He drinks more than he wants to, it scares him, he drinks less but it creeps up, then it scares him, and round and round it goes. I wonder what this middle thing is?

Andy F

Although I use the term alcoholic, it is a label attached to the person, not the behaviour of the person. It is a reflection of an attitude similar to applying the 'primary' cancerous disease model to the individual. The individual is different to others not in the actions/behaviour they have taken, but are inherently, genetically different to the non-alcoholic. Thus making assumptions that the afflicted person(s) are organically different to their fellow so-called non-alcoholics and possibly allowing 'alcoholics' to believe at their most vulnerable, that they are victims.

If I were to label myself as someone who has found it desirable or necessary to be abstinent from alcohol, I have not necessarily bought into the genetic, disease model of alcoholism.

All the best

Music

When I think of the word "lawyer", I get a certain mental image. When I think of the word "baseball player", I get a certain mental image. When I was young and people talked about the "alcoholic", the way they talked about him gave me a certain mental image....not a pretty one, I might add. There are different types of lawyers, and different types of baseball players. Some good, some not so good. But the first impression I get when I think of those to professions is what's important.

The way I feel about my alcoholism, and me being an alcoholic, can affect the way people around me feel. If I perpetuate the sterotype by being secretive and ashamed, I'm doing myself no favors. I'm not talking about blabbing it around that I'm in AA. I'm just talking about being "free" enough to talk about being an alcoholic. I tend to speak freely about my drinking and I tend to share what it was like, what happened and what it's like now. People are going to think whatever they think, but I can certainly have an impact on what they think through my own actions by either being embarrassed and ashamed of who I am, or finding the humor and the education I've gained and sharing that. My attitude is what counts.

Don S

http://www.peele.net/lib/approach.html

Heavily footnoted, as are most articles by Stanton Peele.

Vince Fox, in researching his book Addiction, Change, And Choice, found 41 definitions of alcoholism/alcoholic, 18 of which I've posted elsewhere on these forums.

Don S

equus

^^^ Thank you. But it is dated 1985.

I know bang up to date is hard to find but if there is any debate left 2000+ shouldn't be that hard.

Don S

I'm not sure exactly what you're after. Proof that substance abuse researchers debate whether or not alcohol abuse is a disease? There's not much point in them debating that, since (see Fox reference earlier) it's largely a matter of definition. Journal articles would be about treating and managing symptoms and behavior, the neuroscience, and so forth.

Peele and others do get into this subject, but it is really more philosophical or semantical than research-related. It's almost as though the research community has just moved past that issue and is dealing instead with the brain science, the behavioral aspects, and so on.

Unfortunately, that leaves the justice system dealing with a possibly archaic disease concept as they try to formulate the most effective social policies. For example, there is some evidence that referring drug/alcohol offenders to treatment may be less effective than just having them face the legal consequences of their actions.

There's certainly no science to suggest that it is helpful to society to have them shunted off into programs of any type. Incidentally, most of those programs may be called 12-step, but they're not necessarily AA, and they're not necessarily run effectively--nor is any program likely to be effective when it's made up primarily of people ordered to attend it. Yet this kind of 'treatment' is the social policy prescription for something which may not even be a disease in any meaningful sense of the word.

It doesn't really matter whether researchers or the public call it a disease, a condition, a syndrome, etc. The AMA has officially called it a disease; the psychiatric association has (I believe) since changed their terminology. It does have important treatment implications for insurance coverage, and it's convenient for us all to use the same terms. But even on these forums I don't think you'd get broad agreement about what it exactly means to call any kind of addiction a disease.

To illustrate the problem with the definition: nobody I know calls cigarette smoking a disease, even though any definition of the one substance use/abuse would logically apply to the other. Cigarette smoking is a habit -- a behavior -- that causes known diseases. So is drinking. Smoking is a choice, but a hard choice to break. A good friend of mine told me that she found it far harder to quit smoking than heroin. Some people find it easier than others do. It has huge societal costs, and is a habit which adversely affects those around the addict. But nobody tells a smoker they have a disease until they get a disease from having smoked for a long time. Nor do we have a pejorative term for heavy smokers equivalent to that for heavy drinkers.

Your topic illustrates our lingering belief that alcohol or drug abuse is a moral failure. The fact that some people believe it stems from character defects, and use terms like 'weakness' to describe the inability to quit, perpetuates this moralistic view of substance abuse. I believe people who continue to drink or use drugs in the face of its obvious costs just haven't learned the tools to change behavior. Obviously, there is a physiological component which makes that change more difficult--just as there is with smoking.

Peele has published in numerous journals:
http://www.peele.net/cv.html
Somewhere in there I think you'll find an article that he's published in a reputable journal, footnoted with other references from reputable journals--some probably arguing with him.

Don S

equus

I would agree with this, but I also feel strongly about our access to science. Yes research has moved on and we can access it but to do so means a certain level of understanding which isn't fostered by continuing to 'go along with' the suggestion that science hasn't yet moved on, that it isn't in the physical realm. Our knowledge as a society has deepened and will deepen further we can either chose to remain ignorant of it or to look in more detail ourselves. (By ignorant I do NOT mean stupid, I mean only uninformed).

The 'big hitters' of the diagnostic world are the DSM and WHO they have consistantly been the most internationally used in research and respected - the first reflecting the latter. As for whether it matters or not it most certainly does, the amount of funding for research goes up considerably for recognised conditions. The validity and reliability of it's description come under higher scrutiny, often leading to subdivisions and more accurately applied treatments. As for whether it matters to the public - this thread did not begin by discussing the disease status - but apparently it did matter. I was shocked beyondf belief at the number of hits the thread stating alcoholism is a disease got, I think to those who are dealing with it - yep - it matters.

I would agree, what is interesting to me is that 40-50 years ago the same would have been true about autism, and still on occasion can be within the general public. (I'm not saying alcohol use/abuse is anything like autism - just using the history of autism as a diagnostic example because I know about it).

My point is that people are interested, the hits and debate reflects that, I don't talk to myself. Personally it took me forever to sift through terrifying and outdated definitions, knowing there was something missing, knowing we don't talk like that anymore, knowing there would be more info. I think this is understandable - hell I'd do the same if it was cancer but probably have faced far less definitions/prognosis dating back to the 1940's. It's not a matter of expecting the whole world to agree, it's about discussing and changinng ideas. I found alcoholism to be a world of mythmakers and soothsayers, and as people are interested I've brought the suggestion that science might be worth a look as well. I've brought that suggestion along with sources, along with the means for anyone to read, quote, debate, discuss, and see for themselves what's there.

I agree also the justice system can be an ass!! But it is worth bearing in mind these things couldn't even be studied or compared in the first place without a label. I would also agree the archaic concepts are damaging but the only way to challenge that is with precision, and a clear understanding of words like disease that we all take for granted. Everyone would say they know what it means - but how many could define it? And how many would realise they couldn't and then look it up as a word? It matters to have more than just our own definitions of words - we need to understand each other and your very good example about archaic concepts clearly shows WHY it matters.

I certainly do not call all drinkers alcohol abusers or alcohol dependent, no more than I would say all smokers have cancer. One can lead to another, cancer is a disease. I don't like crossing boundaries into other addictions simply because I haven't read enough. I don't want to comment whether other addictions are a disease in themselves because I don't know. Please don't read this as me saying they aren't, it's just a comment on my own ignorance.

Since writing this thread I wouldn't any longer have titled the other thread as 'Alcoholism is a disease'. I would have narrowed it to Alcohol Dependency purely because most of the info that went with it refered to that.

But please bear in mind my reference is to the DICTIONARY definition of disease, not my own or any group's redefinition, and the criteria in DSM IV Tr for alcohol dependency.

All in all - I think this has sparked interest, I hope I haven't acted in an offensive way, I hope I haven't created any offense. I'm sorry this thread got taken away from it's initial question but that has been 50% my fault. On the other hand it re-affirms to me that this matters very much to many people - something I find understandable, after all it matters to me too.

Don S

Well, we didn't stray toooooo far from your original topic, did we?!

In the US the history of attitudes about alcohol abuse is very intertwined with religion and morality--more so, I've read, than in other countries. Our Temperance movement, Prohibition, the Salvation Army, the religious origins of AA--all were based on the premise that alcohol abuse was a sign of moral weakness and poor character, and that redemption was to be found in the church basement and only through abstinence.

Although AA didn't invent the disease concept, it was a real breakthrough in attitudes when it was promoted so heavily. Peele and others have shown that public opinion about the nature of alcoholism changed dramatically in less than a generation, from the moral basis to the disease concept. That is one of the big achievements of early AA, really, as it reduced the stigma. So the term alcoholic really could be seen as an improvement--it gave a more clinical sound to the condition. But it also seems to some to remove the element of choice from the behavior.

The early leadership of some of the government and private alcohol organizations was very dedicated to promoting this concept through research funding and public relations. The strong 12-step bias in those organizations is a matter of record; hence the widespread institutional acceptance of the term alcoholism, even without a clear meaning.

So I don't really know what the 'wrong way' is to use the term. To me, it would be using it wrong to imply that someone is helpless in their condition, powerless over their choices, and some kind of victim of a disease. But others might ask me how I dare to suggest that they are responsible for their condition--who, after all, would choose to be an alcoholic?

BTW, SMART Recovery discourages the use of labels for the very reasons you are describing. Describe the behavior, not the individual. I don't call myself an alcoholic; never have, and certainly don't now that I don't drink.

Don S

equus

Yep - it does NOT define a person, I've Pm'ed you thanks - you've let me see what I did, I sort of knew I was a part of what was wrong. I defined the old couple as 'Alkies'. I don't know if you would believe me or not but I can promise that will be the last time I ever do that.

As for disease meaning loss of all control, well that isn't in it's definition. My personal view is that we physically deal with substances differently, I leave judgements of the precise level of responsibility to others - I wouldn't even want to comment on one individual let alone a massive group of people.