OnawaMiniya

What do you think?

Do you consider it a disease or not?

Why or why not?

LexieCat

Yes, I do, although it isn't a well-understood one. I've known many alcoholics whose bodies had an abnormal reaction to alcohol from the very first drink. I know many others (like me), who appeared to develop the alcoholism more slowly, over time. Maybe it is sort of like the difference between juvenile diabetes and the type that develops later in life (this is just an analogy).

It's not simply habit. I like the Big Book definition of alcoholism: a mental obsession that compels the alcoholic to drink even when he or she intends not to, plus a physical abnormality that causes craving once any alcohol is consumed. Obviously, not picking up the first drink is the answer to the "craving" part, but the mental obsession is what causes the repeated relapses and difficulty in staying sober. Willpower alone doesn't work for alcoholics. It isn't a conscious "choice" to drink--it is more giving in to scratch the world's most powerful itch. Not drinking, for an alcoholic, is a matter of extreme discomfort--something hard for non-alcoholics to imagine.

AA and other treatment programs seem to work to derail the obsession. Not all alcoholics need AA, but it does seem to work for many, many for whom nothing else seemed to work.

Tuffgirl

I recommend this book all the time here - Under the Influence - because it is by far the best read for understanding how the brain and body changes with alcoholism. I used to think it was a choice (stop drinking! duh!) but recognize now it is far deeper than just that. Does it make it a disease? I don't know.

OnawaMiniya

Can you elaborate on that?

Thanks

CarryOn

I consider it a disease.

My only first hand experience is with my RAH. After educating myself following his relapse, I see that his father was an A, his mother a codependent & possibly an A herself. His brother seems to be on his way to being an A.

RAH had 17 years dry - he white knuckled it at the age of 26. He was generally cautious not to eat anything made with alcohol (even though the actual alcohol was probably cooked off) or use medication. He had a hand surgery in August 2011 and asked them not to give him any meds, but they did, and three months later the relapse began. I've asked him if that was truly the trigger or if it may have been something else - the only other answer he can give me is that he let his guard down. His parents were deceased well before the relapse, and we have a pretty darn good life - there was no traumatic events/occurrences I could identify. It's a disease.

LexieCat

Most normal people, if they drink too much the first few times they drink (which isn't unusual when you don't know how it will affect you), will feel sick and dizzy and will not like the feeling. They sort of naturally adjust their drinking (at least on most occasions) to an amount where they are not out of control. They might drink too much to be safe to drive, but they aren't in a stupor or blacking out.

Some people are blackout drunks or drink insanely from the very beginning, and there is no "normal" level of drinking. I think that is indicative of something being physically abnormal--something about how the liver processes it or how the brain reacts, or both.

Just my theory based on educated observation.

mfanch

It doesn't matter to me. I still have to take responsibility either way. The victim-cape is nice and snuggly, but it doesn't look good on me.

BlueSkies1

Calling drinking too much too often a disease confuses my mind. It seems to get me right off course.
Because I don't think it's even the question about alcohol consumption.
I think the question is: If you drink too much or too often, are you willing to do anything about that?
Ok. Devil's advocate. Alcoholism is a "disease" for argument's sake.
If you get cancer, do you go to a doctor, do you seek help, do you try to get well?
Yes.
Well then, it's about the course of action, isn't it?

Sueski

I think it is a disease, especially after watching someone relapse first-hand. My thought is that there is some kind of inborn predisposition to addiction, exacerbated by life circumstances - being an ACOA, etc. It's like being a person who is genetically predisposed to type 2 diabetes, who is raised by a family of unhealthy eating, non-exercising people. Pretty likely that person will become diabetic if she doesn't consciously break the unhealthy cycle and remain vigilant about health. If she does develop it and doesn't change her ways, her health will deteriorate to the point of killing her. Sound familiar?

I could certainly be wrong but it makes sense to me.

LexieCat

Many people don't manage their medical conditions. Many, many diabetics lose limbs and die because they are unwilling to do the hard work of managing their disease. And some die despite their efforts to manage their disease.

I did a lot of research on diabetes when I had the gestational version (goes away completely after childbirth). You have to strictly control what you eat, when you eat, when you exercise, constantly monitor your blood sugar level, and constantly adjust your insulin dosage--which might have to be taken several times a day. It is a TREMENDOUS amount of work, and can change your whole life--not unlike alcoholism.

And family members can be affected, too, as they worry and watch helplessly as the diabetic with uncontrolled diabetes gets sicker and sicker--maybe losing limbs in the process.

So, yeah, denial and refusal to manage a disease is not limited to alcoholism. I don't think the fact that it is difficult to manage or that the sufferer often refuses to follow medical advice makes alcoholism not a disease.

fedupbeyondall

This is a conversatio Mr. Wonderful and I had recently. He pointed out that if it's a disease, then it isn't his fault that he drinks. I agreed that, that was a valid point, but if he had cancer and it was possible to treat it then he would immediately get to a dr and begin treatment. He walked out of the room in a huff and we haven't revisited the topic since.

I guess I'm torn on the idea that it's a disease. Yes, no one generally asks to be an alcoholic any more than they ask to have a terminal disease. On the other hand, if for example, someone has skin cancer, you wouldn't catch them out in the sun with out long sleeves and sun screen on them. I guess I'm making it too black and white, I know illness, espcially mental illness isn't so cut and dry.

Perhaps it's a menal illness type issue more than an disease?

Jazzman

After being classified a disease by the AMA insurance companies began covering medical treatment for it. My opinion matters not, but I call it a chemical dependency to alcohol.

fedupbeyondall

Good point Lexie. I hadn't considered that. It's tough for me as I don't suffer from alcohol addiction. I do smoke and that's very much an addiction, but I know it do it because I want to and my brain freaks out if I go too long without one. I also know Mr. Wonderful has a very physical reaction to going too long without alcohol. He becomes irritable and short tempered much like I will if I don't smoke for several hours. He will also shake uncontrollably if he goes a day without.

The definition is disease is-A disorder of structure or function in a human, animal, or plant, esp. one that produces specific signs or symptoms. So at it's base, yes alcoholism or addiction in general is a disease.

lillamy

Absolutely. Matter of fact, there's a lot of brain research going on right now that is fascinating, about how the brain creates feelings of pleasure in us, and how that is related to addictive behaviors.

I am convinced that in my lifetime, medical science will find physiological explanations to why some people become addicted and others (sometimes with the same consumption patterns) don't. I am also convinced the same will happen with other mental illnesses, as it has with depression.

jmartin

+1. At the family program at my AW's recent rehab, one of the doctors there presented a fantastic summary of recent brain electrochemistry/physiology research, showing how alcohol (and various other drugs) affect brain function, and how much progress has been made in understanding the mechanisms of addiction (beyond physical need/narcotic style addictions). Current models show how substance abuse hijacks low and midbrain fight/flight survival instincts that have nothing to do with rational thought or other upper brain intervention. The mechanisms create survival instinct like "cravings" for the pleasure responses that result directly and indirectly from ingesting various chemicals.

This is all very interesting, but things still come back to one's definition of disease. This is still a subject of some debate, but if you accept the findings of the brain research, classification as a disease or not seems like something of an academic and irrelevant argument. Here is a link to a slide presentation on this similar to the lecture I heard:

http://www.lahacienda.com/wp-content...ndtheBrain.pdf

The slides to not do justice to the presentation though, I wish anyone who has addiction issues, either themselves, or family, could get this, I wish a video was available. It changed forever my view of psychoactive drugs and alcohol and treatment. It gave me a much clearer picture of what we are up against, and why it is so difficult to understand and treat, and like I said, made me feel that the "disease or not" debate is a little silly.

lillamy

I think the reason I struggle(d) with the "disease" moniker is that I felt like if my husband was sick and not choosing to drink, I was a moral midget if I abandoned him in his disease. I didn't want alcoholism to be a disease because I (wrongly, I now believe) made the assumption that if it was, it put restraints on what I was and wasn't allowed to do.

I battled this for a long time. I finally decided that if my husband had had a brain tumor (or gotten bonked on the head, or whatever) and he behaved the way he did towards me and the children I would still have had the right to leave.

I finally got to the point in my own head where I could say "It doesn't really matter why he is being abusive -- he's being abusive and I don't want that in my life."

As much as I fear him, I am honestly utterly heartbroken that the man I married and loved has been reduced to a wreck of a human being. I think people are more understanding of you leaving an alcoholic than of you leaving someone with a brain tumor -- but the bottom line to me is behavior.

OnawaMiniya

As far as a debate being silly, I'm not sure I agree. I know it's definitely not simple. One thing that bothers me about calling it a disease is for some alcoholics it seems to give them an excuse they happily take, to hide behind, is all. I posted the question mainly with that thought in mind. I intend to do more research on the matter. It's interesting. A debate would be silly as far as the main point being you either do something about it and take control or you don't, regardless of whether it's a Disease or not. I guess maybe I should have also included:

Does the label of disease help or hurt an alcoholic?

Even then I suppose it varies from individual to individual.

I'll definitely check out that link.

Jazzman

This is great stuff and very similar to the presentations and lectures at a family weekend I attended back in 2004.

It reminds me of a great article in Time Magazine a few years back that explained in exact medical and scientific detail as to WHY teeangers not yet fully mature frontal lobe causes them to think like they do... or NOT think, actually.

But after you explain the WHYs you are still left with the HOWs?
How does an addict get clean/sober?
How does a loved one of an addict cope?

The debate is a circular argument and always comes back to the same conclusion. Not a worthless debate.. just frustrating.

FireSprite

Really interesting info and opinions here - I think I struggle a lot with the definition of "disease" so I end up on both sides of the argument depending on the day.

jmartin - that slideshow looks very informative.... I wish an audio or video was available to go along with it.

I find the physiology behind all of this somewhat fascinating & I'd love to find other resources like it if anyone has any more links.

LexieCat

I think it helps because (a) I happen to believe it is true--if it weren't true, then calling it a disease would not help anyone. As Abraham Lincoln said, "If you call a tail a leg, how many legs does a dog have? Four--calling it a leg does not make it one," and (b) there is no shame in being an alcoholic, even though alcoholics do thing that they rightfully ARE ashamed of (once they quit drinking and start thinking right). Some people are so stressed out by the thought of being an alcoholic that they don't seek treatment. Again, I don't think anyone CHOOSES to be an alcoholic. The diagnosis, or label, should not instill shame.

It also makes a big difference in how people are treated, post-recovery. If you have recovered, the fact that you are an alcoholic should not be a factor in employment, for example. But if you committed crimes while under the influence, those you are rightly held responsible for.