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?