Alcoholism as a Disease
Does it make sense to view alcoholism as a disease? Does this model help us to diagnose and treat alcoholism, or does it get in the way or give people excuses?
This is a controversy that may never be transcended, because there are such strong opinions on both sides of the fence. Many people believe that the alcoholic drinks like they do simply because they are lazy, stupid, or ignorant. For the uninformed, this is the most plausible explanation given the crazy behavior of some alcoholics. The other idea is that they are mentally ill, because they are slowly self destructing and, in a way, very much suicidal.
And of course there are some people who claim that it is a disease and then use that as an excuse to justify outrageous behavior, or it becomes a bit of a self fulfilling prophecy in their life, and they basically use it as an excuse to stay stuck and to not do anything about their problem.
photo credit: Hairy.Jacques
One thing that is a bit interesting is to look at the program of Alcoholics Anonymous and how they view the disease concept and how they propose to treat the disease. The concepts get a bit tricky and there appears to be a subtle contradiction: the disease concept says that the alcoholic has a disease and it is similar to a physical allergy, in that their body reacts badly to alcohol and they cannot control their intake.
This is a disease and not a moral failing on the part of the alcoholic.
In other words, the disease model sort of absolves the alcoholic of being a drunk simply because they are a “bad person” or something. Instead, the disease model indicates that there is something more than a moral failing going on that causes the problems with drinking.
But the contradiction is this: AA is a program based on correcting the moral failings of the alcoholic!
So if the disease of alcoholism is not about the moral failings of the person, and is really more of a physical allergy, then why does our popular solution (the program of AA) basically seek to treat and change the moral character of the person in question? The two things don’t seem to be consistent with each other. One side must be fudging a bit in order for the 2 ideas to be compatible.
In the end, it probably does not matter, as any recovery program that pushes people to grow continuously and work with other alcoholics seems to produce good results. The key is in the follow through anyway. If you can ignore the contradictions and just do your best to stay sober and help other alcoholics, then you will probably do pretty well. Striving to take positive action every day cannot hurt your chances. And working with others really helps in terms of relapse prevention.
It may or may not be a true “disease” in the strictest sense of the word. But if we treat it like one and that works for us, then we should continue to do so.
The question is: does the disease label help us to treat alcoholism with greater success?
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