Is Alcoholism a Disease?

by pgh

There are certainly arguments on both sides of the coin.  Alcoholism is officially classified as a disease by:

  • The American Medical Association (AMA)
  • The American Psychiatric Association’s (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
  • The World Health Organization (WHO).
  • The American Society of Addiction Medicine (ASAM)
  • The American Hospital Association (AHA)
  • The American Public Health Association (APHA)
  • The American College of Physicians (ACP)
  • The National Association of Social Workers (NASW)

Is Alcoholism Genetic?

The “alcoholism as a disease” theory makes sense in some ways.  Current research indicates that alcoholism might be 50-60% determined by genetics.  Of course that means that the likelihood of alcoholism is still 40-50% determined by environmental factors.

Genetic Predisposition

Studies on twins and adopted children have demonstrated that genetics can predispose a person to becoming alcoholics.  In labs, scientists have even been able to breed rats that had a preference for alcohol – analysis showed that these specially bred “alcoholic” rats had a different chemical brain structure than the non-alcoholic rats.

There seems to be strong evidence to suggest that your risk of becoming an alcoholic is at least partially determined by genetics.  Furthermore, alcoholism shares many properties of other treatable chronic mental disorders.  Like other chronic diseases, Alcoholism tends to follow a predictable course, has common symptoms, and will last a person’s lifetime.

Why Alcoholism Shouldn’t Be Viewed As A Disease

And yet, there are still many scientists and doctors who argue that alcoholism is not a disease, and that classifying alcoholism as a disease reduces the personal responsibility of the alcoholic.  Studies have shown that only 20-25% of American physicians believe that alcoholism is a disease.

These critics argue that the disease theory is promoted by government agencies who have a vested interest in providing recovery services – the overwhelming majority of which are 12 step programs modeled on the disease theory.

Removal Of Personal Reponsibility

Critics also point out that removing personality responsibility from the equation might actually increase the risk of alcoholism/addiction.  Unlike other diseases, an alcoholic can take actions to “cure” themselves – as hard as those actions may be.  In fact, the only way an alcoholic can be “cured” is by changing their behavior.

No Treatment of Biological Causes

Critics point out that – even if the disease model were correct – it currently serves no practical use, since doctors and hospitals don’t actually treat any of the biological causes of alcoholism.  They argue that adherence to the “disease” theory might stop people from taking actions that could have a positive effect on their recovery.

No Biological Identification

Unlike most other diseases, there is also no way of biologically identifying someone as an alcoholic, other than how much they drink and how their drinking affects their lives.  The definition of “alcoholism as a disease” could be just as easily applied to people who:

  • Shop too much
  • Gamble excessively
  • Smoke
  • Play too many video games
  • Constantly get into dysfunctional relationships
  • Eat too much chocolate
  • Procrastinate
  • etc.

So does everyone who engages in detrimental compulsive behavior have a disease?

Does It Really Matter?

For researchers and professionals looking for better forms of treatment, its certainly an important debate.  Who knows, perhaps in the distant future, the disease model might actually provide a biological cure for alcoholism.

But for you or your loved one – the person caught in the chains of alcoholism right now – does it really matter if you view alcoholism as a disease?  All that matters is that you can only overcome alcoholism if you take massive action to change your life – whether or not you think its a disease.

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