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Thursday, August 20, 2009

T3 - Alcoholism...Disease or No?

Recently, I was reading over at a post about alcoholism at the Philosophy of KLo. The gist of it was asking whether alcoholism is really a disease or not. Well, I had to jump in on the discussion!

There are definitely people who drink moderately. Let's call them the Mods. Many of them can look at an alcoholic and think, "Have a little control. Be more responsible," or "STEP AWAY FROM THE BEER." Why? Because the Mods are able to drink moderately, having made the decision--conscientiously--not to drink to excess. I'd venture a guess that most of the people in the "Alcoholism is NOT a disease" camp are probably Mods or Complete Abstainers. And you can see their point, right? The camp motto might be, "You control your actions."

And there is something to be said for this idea...especially for beginning alcoholics. Certainly, the initial use of alcohol is voluntary, but once addiction takes hold, those in the camp that alcholism IS a disease (therapists, doctors) believe this initial control is disrupted.

We adhere to the medical model of addiction. There is a biological predisposition some people have that influence them in whatever environment they grow up in. Studies of twins, separated at birth, show them to have higher likelihood for both having an addiction than would be expected if there weren't some genetic component.

The official National Institute on Alcohol Abuse and Alcoholism position is that "alcoholism is a disease. The craving that an alcoholic feels for alcohol can be as strong as the need for food or water. An alcoholic will continue to drink despite serious family, health, or legal problems. Like many other diseases, alcoholism is chronic, meaning that it lasts a person's lifetime; it usually follows a predictable course; and it has symptoms. The risk for developing alcoholism is influenced both by a person's genes and by his or her lifestyle." Go here for a complete, word-by-word breakdown of the NIAAA's definition of alcoholism.

A person who is dependent on alcohol can't process rational cues that Mods might try to tell them about responsibility and control. They don't even process cues from their own bodies, as evidenced by people who drink knowing they are killing themselves with cirrhosis of the liver. Alcoholism is progressive, which is another mark of a disease (think cancer). It gets worse and worse. This level of drinking, despite all the negative consequences, indicates that something is distinctly different in their brain...AND THIS NEVER SHUTS OFF.

People who go to AA meetings will tell you that they are alcoholics. They introduce themselves that way at meetings even when they've been sober for twenty years. The desire is still there to drink! It's a constant struggle they fight every day to win. They will say they are never "cured," but are "recovering." If they relapse, they blame it on their disease, and the fact that relapse is a part of recovery (which it is). But at this point, as a therapist, I tell the client that the disease model is NOT a crutch to further their addiction or an excuse for irresponsibility. (So there is a fine line!)

As a Christian, I recognize the power of Christ in someone's life. I've known people who can literally put down a cigarette or beer after being saved and never pick it up again. This would lend some credence to the "Not a Disease" camp. But studies have been shown that people who reach the stage of "alcoholism" can never go back to being a Mod. So I'm betting even these miraculous "healings" come at the price of never again drinking the tiniest sip, for fear of the disease taking over once again.

I could go on...and I might in a later post...but for now, I'm curious what your thoughts are after reading some of the above stuff. Do you think its a disease or not?

Wordle: signature

25 comments:

Eileen Astels Watson said...

Personally, I think it can come to the point of being a disease. If you've abused it so much that your body reacts by chemically craving more once a touch of it is in the system, then yes, I'd call it a disease. I want to say learned disease, because really, there is enough knowledge out there that everyone should know the hazard of misuse by now. Sadly, many just don't listen!

Wendy @ All in a Day's Thought said...

Jeannie, I think you nailed it. You did a nice job explaining the disease, while also mentioning the MODS. I've loved someone who deals with this for a very long time. Where it gets tricky for me is when someone has this disease but remains "functional" in society.
Thanks for the informative post.
~ Wendy

MeganRebekah said...

It's an addiction for sure. So I guess the greater question is whether addiction can be considered disease. And personally I think it can be.

A person can get a skin disease, like psorasis. It's usually genetic and not something they contract. They can control it with medicine and a doctor's help, but it's always viable for a flare up. It's with them for life, even if they don't often show the symptoms.

Isn't alcholism the same way? People are often genetically predisposed to addiction. It's not something that's contracted. And it's something that they can come to have control over with a doctor (or therapist, or AAs) help. You may not see the signs often once the disease is under control, but it's always right there, under the surface.

Jeannie Campbell, LMFT said...

great comments so far! sounds like KLo and I aren't the only ones with thoughts about this issue!

Jessica said...

This is an interesting post. I just don't know. Disease to me implies something that is not wilfully started. I've always had trouble believing alcoholism or anorexia were diseases. It's just hard for me because to me a disease is cancer (even though I realize that can be "caused" too), lupus, things like that.
But I'm not a doctor, counselor or anything, so these are just my thoughts. :-)
I liked Eileen's comment alot. Also, I know people who might be alcoholics but are still functional in society too. It's really a tricky thing and like you said, there's a fine line. I'm also not sure there's a clear cut answer here, as each person's motivations and desires for drinking are probably more than just the physical craving. I'd think there'd be emotional reasons too, just as there are for drug use.

Stephanie Faris said...

I'm not arguing about it as a disease but what about compulsive overeaters? Or smokers? The addiction to smoking can be VERY strong...is that a disease? Where does it end?

Iapetus999 said...

I don't see how it's any different than OCD or PTSD or other mental illness.
One thing missing in your analysis is that you assume people keep drinking "despite the cost". No, they keep drinking because the cost of stopping is far higher than anything else. This is what feeds addiction. Once they stop, here come the demons, the horrible thoughts and feelings of withdrawal. They'd rather lose their family than deal with that. Drinking is what lets them function on a somewhat normal level, to keep their families and lives intact.

Jennifer Shirk said...

Well, speaking from someone who has an alcoholic in my family, it's definitely a very frustrating disease.
Speaking as a MOD, I can't understand it, but I do think it's a disease.

Jeannie Campbell, LMFT said...

excellent comment, Iapetus999. thanks for stopping by to share your thoughts.

stephanie - i think addictions of all kinds fall into a disease of sorts. you alter your body's response and reaction by chemicals....it's fascinating to read. of course, addictions also are mental disorders. tough road, for sure.

Amy Tate said...

Great post. I think alcohol is like any other substance. You can take one too many pills, you can eat one too many cookies, you can buy one too many pairs of shoes. I think anything satan can use to exercise control over our minds, he'll take full advantage of. We all have a weakness, and he is a master at finding it. I have a real heart for substance abuse, and I've seen it destroy members of my family. Is that a disease? I don't know. I suppose it depends on how one defines disease. Is it evil? Absolutely. One of the most powerful and life-changing Bible studies I've ever had the privilege of being involved with, is Beth Moore's Breaking Free. I thank God for that woman every day.

T. Anne said...

Definitely not. Addiction, yes. I am stunned to discover how many people willingly accept it as a serious illness. I file this under 'You will only die from this is you want to' category. Fine post.

Jeannie Campbell, LMFT said...

Breaking Free is a great Bible study...excellent. and you're right, amy, satan can take anything in our lives, propel it forward to center stage, and cause havoc. moderation is key, right?

t.anne - thanks for the dissenting opinion. i don't think alcoholics want to die...but the addiction/disease has them so under control that they keep drinking, unable to stop. no matter of rationalizing can help them.

Sarah Dawn said...

What a beautiful way to minister on line! Such a delight to meet you today.

Blessings from Costa RIca,
Sarah Dawn

Terri Tiffany said...

I'm married to a recovere alcoholic-- he can never touch a drink again. Also he just quit smoking four years ago-and he was addicted to his work--I would say he has an addictive personality and yes alcoholism is a disease.If it hurts someone you love and affects your job--you are an alcoholic.

Jeannie Campbell, LMFT said...

wow terri....congrats to your husband! thanks for sharing.

Katie Ganshert said...

This is super helpful, because one of my character's back stories for Wishing on Willows is an alcoholic father. Thanks, Jeannie girl!

Tabitha Bird said...

Great post and you raise some great questions. I guess the problem I have with calling it a disease is that I think of diseases as something a person has no choice over having and has no control (or little control passed medication etc) over the outcome i.e. getting cured. I am not a counselor or a professional, so really I don't know if something like alcoholism is genetic etc. But I do know that you don't just go out there and catch it. Somewhere along the line there are choices. And i don't know if genetics take away choices...
Anyway, just my thoughts. I enjoyed hearing yours and other's comments :)

Jeannie Campbell, LMFT said...

katie - glad it was timely. :)

tabitha - it does seem counterintuitive, but alcoholics really don't have any control once it gets to the addiction stage, crazy as that sounds.

Jenna Alexander said...

Oh – interesting topics. I’d love to see you do one on agoraphobia.

Jenna

Jeannie Campbell, LMFT said...

jenna - you got it. :) thanks for stopping by!

ComfortWriter said...

Hmmmm. I consider myself an addict and my fiance is a recoving addict. My drugs of choice - cocain followed closely by food; his drugs of choice - alcohol and heroin. He could give up one but never both and other drugs were mixed over the years. I don't believe that alcohol is the disease - addiction is the disease. There have been studies that show that a similar chemical reaction occurs in the brains of a person 'addicted' to carbohydrates and a heroin addict. When you consider this chemical componant - we don't have control once that balance is lost.

A question I have always pondered - how does this idea of disease or not disease fit with the biblical teaching that He (God) is "visiting the iniquity of the fathers on the children, on the third and the fourth generations of those who hate Me" Exodus 20:5

Great Post and interesting comments.

Elizabeth Byler Younts said...

HEY Thanks for the follow! I just added your 2 blogs to my blogroll. :-)

Tara said...

My great uncle craved alcohol to the point where he would drink perfume. (This was when most perfumes had alcohol as a base) So for him, I want to say it was a disease--beyond his control. But as bad as that was, he died sober, so...

One thing that I do think about is whether or not people are predisposed to become addicted. I've listened to a medical expert who has done studies and believes that you can be predisposed to an addiction up to three generations later. (Makes me think of Exodus 20:5 and Deut. 23:8, among other verses.) So, if my grandfather struggled with an addiction, it could be possible that I might have some predisposition to it as well.

K.M. Weiland said...

Very helpful post. As someone who falls on the "Mod" side of the line, I'm aware that in writing about alcoholic characters I'm writing about something I've never experienced and therefore can't fully understand. But posts like these are good starting point in the research!

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Both comments and questions are welcome. I hope you enjoyed your time on the couch today.