There are a lot of stances that were taken in the 1950’s that years later have been proven incorrect: nuclear power is good, cigarettes are not harmful, sugar won’t hurt you and it tastes good so let’s put it in everything. Now big organizations stand on the podium and take it all back. Well, here’s an interesting question: Is alcoholism a disease or isn’t it? Can it be medically diagnosed or is it a weakness?
In 1958 The American Medical Association recognized alcoholism as a disease. The symptoms required before a diagnosis can be made are:
- Craving – A strong need or urge to drink
- Loss of control – Not being able to stop drinking once drinking has begun
- Dependence – Withdrawal symptoms, such as nausea, sweating, shakiness, and negative emotional states such as anxiety, after stopping drinking
- Tolerance – The need to drink greater amounts of alcohol to feel the same effect
Still, there is no medical test, no definitive proof, no lab result that claims irrefutably, “Here it is, the results are in, you are definitely an alcoholic!” And that’s where people get their panties all in a bunch.
Prior to its national recognition, alcoholism was thought of as a character flaw and not a disease. Lacking in moral fiber, ordinary discipline and self will, alcoholics and drug addicts were considered dirty old men, wearing trench coats and lurking in alleyways. They could stop if they wanted to, they just didn’t have enough backbone. Society failed to include women in their verdicts.
Bill W. and Dr. Bob, founders of Alcoholics Anonymous helped to change that perception and strengthen the disease concept. Here were two successful men, with families and jobs who struggled with drinking and had no idea why they couldn’t stop after just one. Introducing the concept of anonymity was a great help in removing the stigma of the worthless bum. It allowed men and women to seek help and not worry about having their reputations suffer. This in turn allowed more people to seek treatment and thus increased needed case studies for addiction.
Psychiatrist, Dr. Harry Tiebout, had many years of training and experience in the field of alcoholism prior to meeting Bill W. and Dr. Bob. He believed that accepting alcoholism as a disease was essential for recovery. The caveat was that, in his experience, “chronic alcoholics will not take the steps necessary to recover unless they become conscious of themselves as people with a disease.” A certain amount of mental clarity and acceptance are necessary to think in these terms, which some people whom are deteriorating from the effects of alcohol do not have. This presents one argument against the “disease concept.” People who have cancer definitely know they have cancer, and the same with every other disease. Denial is epidemic in the mind of an alcoholic, which is apropos as that is where the disease is centered.
Understanding the distinction between an addiction and a problem is vitally important and could be the reason there are still some who refuse to regard alcoholism as a disease. A problem drinker/drug user could be controlling their use and have undiagnosed medical issues, unhealthy behaviors and physical costs that have not surfaced yet. Outwardly, they appear completely different from the depraved, shaking alcoholic and drug addict who has lost everything. However, it is important to note that alcoholism is also known as a progressive disease, over time it will get worse.
Recently, there has been a return by some to the point that addiction is not a disease, but a choice. Many forms of treatment are trending that are in alignment with this theory. The opinion is that naming it a disease removes any responsibility from the alcoholic, and that addiction is a compulsive symptom. By discovering which thoughts lead to performing addictive acts, the addict will learn how to master their behavior. The school of thought here is that addiction has very little in common with diseases as it is characterized by a change in behavior, and that calling it such interferes with finding new interpretations for its character. Some people believe that if labeled a disease it can be used as a control mechanism, forcing people to conform to a social norm.
Doctor’s are discounting other doctor’s declaring alcoholism is a disorder, not a medical disease, and that emotions and behaviors are being repackaged in order to sell more drugs. Brilliant, but not science. I think there are just as many, if not more who could counter this by telling of numerous incidences where diagnosed medical diseases were avenues for the medical profession to order unnecessary tests, treatments and prescribed drugs.
In spite of trending opinions, battling egos and someone’s personal belief system, the fact is that alcoholism has been recognized nationally as a disease by the American Medical Association so it’s time to move forward. The result has been an increased sense of compassion and support for the addicted person, from their family, friends, the professional community, work associates and also from within. Increased compassion fuels positive energy and makes room for a more accepting view of alcoholism. This in turn has created more avenues for treatment and change with more still to come. So what are we really arguing about?