Is alcoholism a disease, or is it just a drink problem?
Sometimes the terminology used when talking about alcohol problems can be quite unhelpful.
In fact, when using the terms ‘alcoholism’ or ‘alcoholic’ (which everyone does, including this site), the emphasis can be that the problem is with the alcohol itself.
But the problem actually stems from the state of mind that the alcohol gives you, not from the chemical as such. The importance that this state of mind takes on for you, the preferability of it despite the huge costs to other parts of your life, that is actually where the problem lies.
Similarly, people often refer to alcoholism as a disease. But what actually is a disease? Well, it is
“an abnormal condition that causes discomfort, dysfunction, distress, social problems, and/or death to the person afflicted, which is associated with specific symptoms and signs”.
The symptoms of the condition ‘alcoholism’ are generally agreed on as:
- tolerance – the need to consume more in order to achieve the same effect,
- withdrawal – the experience of unpleasant physical effects upon stopping drinking,
- craving – a preoccupation or prolonged urge to have a drink,
- loss of control – the inability to stop drinking at a sensible level once you have started.
You may have periods when you experience all four of these symptoms, and therefore you could be classified as an alcoholic. There may be other times when you’re not experiencing all of them, so you merely have ‘problems with alcohol’. But do you have a disease?
A disease is something over which you would have very little choice – “I don’t want this disease any more, I’m going to make some changes” would seem slightly ridiculous. So the way you view your alcohol problems, what terminology you use – will determine what you feel you can do about them.
If you view it as a set of problems, you will be motivated to solve those problems, but if you say to yourself “I’m an alcoholic, its a disease, it can’t be cured” then what are you likely to do about it? Not that much, I would suggest. Some people seem to have more control over their alcohol problems than others, so perhaps it is not a black or white condition, but one with varying shades of grey in between.
There are many different factors involved in an alcohol dependency, from genetic predispositions, or inherited behaviour from parents, perhaps learnt behaviour from society, to our beliefs about ourselves, our coping strategies, our self worth, our levels of anxiety and the stability or instability of our moods.
Different people will have different causes for their alcohol problems. The way to solve them is therefore to make yourself more aware of what factors are involved in your personal problem. Then you can go about making some changes to those underlying issues.
When i first clicked on the link, Is alcoholism a disease or a drinking problem, i assumed that it was another AA thought that it is a disease. I was very pleasantly surprised to read your views. In this day and age when soooo many celebrities ( after their stint in rehab- namely The Priory ) are telling the world that it is a disease and even doctors write out sick notes for years telling patient’s that they are sick rather than dealing with the underlying issues. So it was very refreshing that someone has the same views as me !!!
Keep up the good work !!
Best wishes Julia kaya
You have my vote as I have known a disease can’t be stopped but our drinking can be. I even think some folks can be moderate again while they may have let themselves lose control for abit for various reasons emotional ,finanicial, or other many reasons. I feel AA may be a helpful outlet but I also am opposed to the idea it is the only way and for many of us can be the wrong way causing opposition to helpful solutions. I have felt by various article read by others that are far more intelligent than myself that AA has become a problem in that it is the socially accepted method to fixing drunk people and if you are opposed to that institutional method then you are viewed as being in denial to your problem. My problem is wrong thinking and wrong solutions. Just like a gambler who thinks one more go at the table can be the salvation…………
I would definitely go with the ‘problem’ rather than ‘disease’ theory. To cite an example, people who have been abused as children tend to be much more prone to ‘alcoholism’ than others. They also tend to self-harm, abuse prescription and non-prescription drugs, have bulimia etc. etc.
Unless someone can show that there is a genetic predisposition to being maltreated which correlates with a genetic predisposition to self-harm, drug and alcohol abuse etc. the numbers don’t make sense.
Alcohol is an accepted way of dealing with ‘shocking’ experiences. Nobody judges someone who has just lost a loved one, his job etc. having one too many. The problem for some of us might be that all of our life seems like that – a state of emergency.
Sadly alcohol ends up creating its own state of emergency, so we end up having two – the original one and the alcohol one.
I think there was a lot of sense in regarding alcohol abuse as a disease when it was ‘morally reprehensible’. Better sick than evil. Perhaps now’s the time to move it into the ‘symptom of problem’ category?
I can understand how some people would say alcoholism is not a disease.That the person who picks up the drink has a choice to say no,and part of the problem lies with the person having problems at home,work,financial problems.I myself am an alcoholic,and had all the problems described.I have since resolved the problems that contributed to my problem drinking.However I still have a drinking problem that i have been seeking help for over the last 8 years.I have been to AA and am currently working with various agencies to combat my drinking problem.I have been through several detoxes and unfortunately relapsed several times.I do believe that alcoholism is a disease but it is not incurable.I hope that in the very near future that I will be able to abstain from drinking and live sober,but i will always be an alcoholic as someone with HIV will always have HIV but with help and understanding they will be able to control the disease and live a happy contented life.
You are absolutely spot on.
I had problems with alcohol spanning nearly 20 years. In the early years while I was single it was just that I went out too much and got drunk too often. Later in life when I had responsibilities it was more serious – ok for 3 months then suddenly be in a bender I couldn’t get out of for a week.
I tried various things and have a wide and varied experience to draw on and where I am now, I can see so many things that actually hindered me ‘getting better’.
One of the most fundamental is that most people you tend to see for help seem to be of the opinion it’s a disease, once an alcoholic always an alcoholic, the only way is to stop completely and if you do you must never touch another drink, even one, or you’ll lose control and it’ll start all over again.
That included two doctors.
I would say most everyone I saw over the years told me “it’s ok, you can’t help it, don’t beat yourself up, it’s not your fault”. With AA of course being the worst culprit for that. It was not what I needed to hear because it didn’t make sense to me.
In my opinion, very few people are powerless over alcohol but they love to be told they’re not responsible. And if that helps them quit and be HAPPY for the rest of their lives – that’s great. But from what I’ve seen, it lets them slip time after time because they were powerless. It’s so easy to say ‘I couldn’t help it’ when someone has virtually given you permission to do exactly that.
I was more demanding in finding a solution. It had to make sense to me and I had to be happy for the rest of my life otherwise it wasn’t a good enough solution.
There is no magic to alcohol. Just being told to accept it’s a disease or just to accept that you’ll never have control over it is quite frankly ridiculous.
I took full responsibility for my actions, past present and future. I accepted that I’d often made bad choices in choosing to drink too much and figured there was something I was trying to escape. I worked hard to understand that and I found a great counsellor who would work within the confines of what I wanted as an ideal outcome – and that was to be a normal person with a normal level of control over alcohol – no more, no less.
It’s a mind altering drug and it’s possible to become chemically dependent on it but for most otherwise healthy people, that tends to be a short term thing. Once alcohol has been out of your system for 3-7 days there is no trace of it.
IMO Craving can only be physical when you are still suffering withdrawal and that means after 7 days max there is no physical craving for alcohol.
But it takes either prolonged moderate drinking or short term heavy drinking to get INTO that vicious circle of not being able to stop because of the PHYSICAL craving.
By the way no-one underestimate how strong real physical craving is
But outside that, I believe it to be psychological. And that is good and bad. Good because it means it’s feasible to be what I call properly cured.
I decided my desired outcome still included being able to have a drink.
Imagine going through the rest of your life being scared of temptation and avoiding situations because of it.
One of my absolute worst phases over the last 20 years was when I, still high, promised never to drink again. It was the wrong time to make a promise but my family held me to it and I couldn’t lose face. The fact that it was forbidden made it occupy this huge space in my thoughts and it feels now inevitable that I just said “**** to being controlled” and went on a bigger bender than ever after drinking secretly for some weeks. That was ultimate in it being psychological and no other reason to blame.
Now I drink much more like normal people and it occupies only a small part of my thoughts. Many days go by and I haven’t even thought about it. That is exactly how I wanted to be, what I thought was feasible and I feel empowered and pretty pleased with myself – such that I can now focus on enjoying the rest of my life.
And if I ‘stumble’ again – it will be my fault. I will pick myself up and take a long hard look and decide what I think is right from there. But I will never use an excuse for my behaviour again – it’s so disempowering.
Sorry for the ramble
Wow, all sounds really positive TW.
I only wish i could think the way you do and have the strength of control.
Good luck and keep strong
I GO TO AA being sober 10 months it realy works tried everything else
TW: thanks for the great rebuttal to the “Alcoholism is a Disease” question. I am someone with a serious drinking problem and would in fact call myself an alcoholic but your respsone is in line with what I am thinking. I am going to paste your response all over the house!
Thanks
Emily
I think disease may not be the right way of putting it, however I think there could be a genetic predisposition to alcoholism. Look at this article here:
http://alcoholism.about.com/od/genetics/a/blacer040818.htm
Do a search on the net for genes and alcoholism and a lot comes up. Interestingly, they’re talking about different types of “alcoholic genes”, that can do different things. Perhaps different genes can make you a type 1 or a type 2, which is what some of the articles suggest. I find that interesting as I’ve never identified with being a “typical” type 1 drinker, I can go several days without drinking (well 5 anyway, I hope to up that), I can count on one hand the number of times when I’ve had blackouts, but I know I’ve got a problem as there are times when I start drinking I cannot keep to 1 or 2, I just get this craving to continue, which is happening more and more.
However, it could be that even though someone has a genetic tendency to drink, doesn’t necessarily mean you’ll be an alcoholic, but things such as problems, difficult childhoods could encourage someone to drink more. There are also studies that point towards genetic links for depression, anti-social behaviour, but you may not end up being depressed, it can depend on your upbringing/environmental factors. But how you react and choices you make are also factors, but I think that in this society alcohol is way too acceptable, or at least binge-drinking is, which can easily cause issues for certain people.
I was also reading something today about addiction, cravings that people get are not just psychological, alcohol and the consumption of it alters the chemistry in your brain, and even when not drinking certain things can trigger these changes and make you want a drink. You have been conditioned to associate certain things with a drink (pubs etc) which then trigger the chemical changes, which then trigger the craving. Some studies point towards alcohol altering the neurons to make you want higher and higher levels of booze, this definitely made me want to stop.. will see.
The stuff I was reading did make it clear that people do stop, cigarettes and other drugs (cocaine and caffeine) also cause chemical changes that can lead to addiction… and people manage to cut these out. I’m living in hope anyway.
TW, I do find it interesting what you say about changing how you think, and still being able to drink, I may think about that.
Actually, I did mean to say that I managed to stop smoking after being a smoker since the age of 11 for 20 years… while it’s not drinking what made a difference was completely changing the way I thought about it (and reading Allen Carr’s books). It was hard sometimes but also easy as I thought about it as something I was going to do, I would manage to quit. This may not make sense but I did kind of say to myself “look, there may be times when this gets tough but you’ve been through other things which are a lot worse, you can do this, it’s not impossible”. It did work. I may apply that to drinking as well.
I think it is a bit of a family thing… Research shows genetic pre disposition to drink(alco) if you have family history.. this is a tolerance to alcohol… Habit is another factor
FOr me it is a thing I think when I am lonely and I want to have a bottle of wine and then think who can I call and connect with? Drink more, try harder to connect…different conversations…then I wonder do they know I am drunk? I think they must because they rarely call me back…then I wait for weeks to do it again…does that mean I have a drinking problem?
I have been reading this site with interest as I have wrestled with my alcoholism for many years, approximately 25. For many years I was unwilling to give up alcohol completely as it was the primary source of my pleasure and my social life revolved around bars and clubs. This was in spite of debt problems, sustained periods of unemployment, failed relationships, family problems etc etc the list is endless really.
Over time my drinking problem ALWAYS got worse never better. I tried AA ten years ago and when I attended I stopped drinking, the reason I left AA was I had lost the desire to stop drinking. Once I started to drink again, albeit with the best intentions of “controlling” alcohol, my problems with alcohol immediately returned and I have just spent the most miserable ten years of my life. I went back to AA three months ago and haven’t had a drink since!!
My life is getting better all the time as a result of finally being honest with myself around alcohol, I am optimistic about my future, AA does work, through reading these comments it seems to me a lot of people are just not prepared to get honest with themselves.
Yes AA is not perfect but it works a lot better than anything else I have tried, as for sleeping tablets, drugs it’s all just substituting one drug for another. AA works, trust me I really do know what I am talking about.
I dont think not wanting to try AA is a question of not being honest with ourselves. I think its just that it may work for one and not for others.
For me alcoholism is not a disease and I loved TW’s post. I do believe I have power over alcohol.
what I decided – for me – is that I needed to understand why I was drinking. Get to the bottom of the unhealthy behaviour and what it was feeding. I needed to find other ways of dealing with my stresses or painful feelings.
I did this through counselling. That was what helped me to stop drinking. I still have stress and painful emotions and life is not a bed of roses. But I dont need alcohol anymore to deal with it.
I dont crave alcohol and I feel generaly calm most of the time. I dont envy those that do drink and i dont miss it.
LOOK, AN OLD SAYING GOES LIKE THIS:
“FIRST THE MAN DRINKS THE WINE -
THEN THE WINE DRINKS THE WINE-
THEN THE WINE DRINKS THE MAN”
AIN’T THIS LIKE A CANCER CELL – FIRST THE CANCER CELL EMRGES IN THE MAN – THEN THE CANCER CELL RELICATES – THEN THE CANCER CELLS DESTROYS THE MAN – WHY THEN ISN’T ALCOHOLISM A DISEASE?
I would like to say that after many years of heavy drinking , i came to think that this was gonna be the way i was going to be the rest of my life , but one day i found a switch inside me somehow i turned that switch off . I can tell you now i have never touched booze in over 4 years now ,if you look hard you will find the switch as i did . Rob
i was very interested in the disease theory and researched it as much as i could but there just wasnt enough concrete evidence for me, maybe i wanted to be able to blame a disease rather than myself, my reason for drinking was my own discontentment with life, always wanting something else. now ive stopped chasing things are easier, AA saved my life when i needed help and although i dont go to mettings now i have the greatest respect for all who do, as for the disease theory, it cant be proved either way, but for me being content and happy with my lot was my answer.
I read your (TW’s) post with interest, but my own experiences and those of many other’s I have spoken to lead me to believe that your conclusions are brought about by the drink defending itself in your condition. There’s loads of people like us crave this ‘happy solution’ but until we accept that we are stuffed with this illness and we need help outside ourselves, the downward spiral of self-deciept only ever leads BACK TO THE BOTTLE. Sad but true.
Just hooked up to the site,I cant believe it its marvellous! I dont know if I’m ready to quit yet. But I really like wot i,m reading your all just normal folk like me its great. I like the tone of the discussions I know AA works for lots of folk but I got the impression from speaking to one particular freind who bored me for ages with his chat that it was like joining one of those mad sects.He seemed to have gained sobriety but in the process he seemed to have donated part of his personality and become a kind of clone. Thats two scary things giving up the drink is one thing but I think I”l hang on to me while i,m gettin sober.
I don’t usually drink but just lately in the last few months have been experiencing cravings for alcohol and I’m not sure why. Normally I’ll have a glass or two of wine when we entertain, usually on holidays or special occasions so it works out to maybe 4, 5 times a year at most. I don’t go out to clubs, etc. There is a history of alcoholism in my family on both sides. I am aware and very conscious of this and have made a point of not going out of my way to have a drink. I do enjoy it on the few occasions that I do but I found out years ago that I have a higher tolerance than most people so I keep it to a fairly strict limit since it makes no difference to me whether I drink the glass or the bottle. I don’t enjoy being drunk and have never understood it’s attraction for most of the drinkers I know. So it’s perplexing to me why I should be experiencing these cravings at this time. I wonder to myself, should I resist them, or should I take a drink and get it out of my system? What do you think?
Marie–I would say resist if you can–it may not be that easy to get it out of your system once it gets ahold of you. You sound like you have it under control so I would not take the chance on it getting out of control–that happens too often.
Nelly
Thanks, Nelly I appreciate the good advice.
I had cause to reflect on this whilst in rehab last year. I remember the subject coming up in Psychotherapy one day, and I put it to the group that perhaps it may not be a disease in the common term, but an ‘Illness’…which I believe to be a more acceptable definition of what is, essentially, an addiction (physical and mental) or partly a ‘Mental Illness’ (different strokes, folks!)
When I first went to an AA meeting, it took me less than an hour to be convinced that I was an alcoholic. The diagnosis is based on how you drink or drank and what has happened to you as a direct result of drinking alcohol. Although I agreed with the fact that I might have this condition called alcoholism-I had my own reservations about how to find the solutions to my problems. At that time I was unemployed and not properly housed-two problems which were not caused by alcohol in the first place. Drinking alcohol was the only way I could face the reality in which I found myself. I was not particularly happy with the notion that I had an illness which I was ‘powerless’ to deal with or control. I became sceptical and started seeking other solutions. My starting point was to try and identify the reasons that cause me to drink such as the two that I have mentioned above. I am working now and looking for my own flat. I still drink to this day to forget about my past misfortunes and cope with anxiety but not as heavily as before. However, I must admit that for people with symptoms of alcoholism, the best way forward is to eventually kick off the habit. TW’s story is fantastic but there are dangres of relapsing when storms come back. For example there seems to be somthing in my system which becomes triggered ‘on’ when I take my first drink, and that thing is very difficult to trigger ‘off’. I can drink and be very remoresful afterwards and promise myself never to touch the beer bottle only to start all over again. I am currently seeking counselling, medical and other treatments to stop. It worked for smoking after 20 years so I hope the same trick can happen with the booze.
Thank you all for your contributions and good luck!
Like yourself tj.I had to dig deeper
iam coming 4 yrs sober,smoked from
the age of 14 smoke weed from about
16 and nearly all drugs u can think of
no needles,thank god.In all I would
say 18 yrs of my life,I was in my own
bubble.until I ended up in a nut house
for six wks.It was in there I with help
began to wake up.simply because
for the first time in my life I felt at
home.ha that woke me up.
But when I came out I had to be gently
pushed that way.aa changed my life
or should I say the programme….
The first words that stuck with me
was take the gd out of the bad.
I didn’t enjoy my home group meetings
being from n.Ireland there was still
those same old issues….
After six wks of that I decided go
bck to work.big decision drink and drugs
heaven.that’s were I met my sponsor
and 5mnths later I had done the pro
not greatly with my sponsor but
take the gd out of the bad ect.
Any hoo,that’s when I leant more on
the weed and now and then coke.
Now the program works for all these
jst replace the one word alcholic to
drugs,overeating,sex,gambling ect
ect.that’s wot started to eat me how
was it a disease when all these other
disorders can rule even destroy and
kill.wot was the differnce????
NONE.I have stopped puffing the last
six months.
Yea grt.how???
By Cing shrinks drug rehab and a
shit load of prescribed drugs.
Which made me no shit like a
fckin zombie.
So I dug deeper,cancer runs in my
family and we have lost love ones.
Now it is a illness.which is a gene
that most people unfortunitly are
born with.without knowing and it’s
nomally smoking obvly,trauma ect
can awaken it.
I beleive therefore to my insane in
the membrain thinking,beleive
that this is a gene that some of us
r born with,and wither drink,drugs
over eatin anoreixic ect ect.
Again brought on by childhood
afflictions or trauma ect.
Srry for going on there.but liked
wot u were saying.
I have uncles who hold on to the
old principles but sober 17yrs
don’t forget this was formed in the
can’t think but b w and dr bobs
age.It’s old.when all these problems
there is now,it was the one that
was the worst then and now.
But as they say if it’s not broke
don’t fix it.gd outta bad…
It is as simple as….
One day at a time