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.
March 18th, 2008 at 10:05 pm
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
March 21st, 2008 at 12:48 pm
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…………
April 7th, 2008 at 9:20 pm
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?
April 30th, 2008 at 4:59 pm
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.
June 25th, 2008 at 3:03 pm
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
June 26th, 2008 at 8:54 am
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
July 6th, 2008 at 11:33 pm
I GO TO AA being sober 10 months it realy works tried everything else
July 27th, 2008 at 10:09 pm
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
July 29th, 2008 at 11:16 pm
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.
July 29th, 2008 at 11:33 pm
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.
August 10th, 2008 at 2:44 pm
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
September 4th, 2008 at 4:03 am
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?
September 7th, 2008 at 2:44 pm
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.