Is Alcoholism a Disease?
At times, scientists, clinicians and others debate whether or not to call alcoholism a “disease.” Usage of the term is usually acceptable if it is properly defined. When one considers the wide scope of damage that alcoholism does to the human body, mind and spirit, the condition can, indeed, be legitimately described as having become a disease.
Over a period of time, alcohol abuse alters brain-cell function, induces nerve damage, shrinks the cerebral cortex, imbalances the hormonal system and damages vital organs. Scientists have found that repetitive alcohol abuse wreaks a certain common havoc on the psyche that is perhaps even more insidious than the damage sustained by the liver, the heart and other vital organs.
During early and middle stages, alcoholics may be able to function, but their productivity will be progressively hampered; their psychological disequilibrium will magnify small problems and render them unable to cope effectively with stress. This altered state of psyche will prevent them from seeing the reality of a situation and thwart the normal process of emotional maturing that enables people to assimilate and learn from lessons of experience. The condition of alcoholics changes them into people who think, act and feel differently than they should.
Because alcohol blurs effective insight into the way alcoholics look on things, it is commonly impossible for others to reach them about what their drinking is doing until they “hit the bottom” or are confronted with a serious problem. Victims are so dependent upon alcohol to function or feel well that they feel there is nothing abnormal about their drinking. They delude themselves (perhaps one should say, lie to themselves) that they don’t have a drinking problem. Many feel this way because they aren’t derelicts or Skid Row types.
Some of the most serious diseases associated with chronic alcohol abuse include cancer of the liver, larynx, esophagus, stomach, colon and breast. Alcoholism may also lead to high blood pressure, stroke and heart attack; damage to the brain, pancreas and kidney; produce stomach and duodenal ulcers, colitis, birth defects and fetal alcohol syndrome, impotence and infertility, premature aging, sleep disturbances, muscle cramps, diminished immunity and other diseases. Alcohol abuse and cigarettes are one of the worst possible combinations, greatly increasing the risk of heart disease and cancer.
Calling the condition of alcoholism a disease is not a cop-out for alcoholics. To the contrary, when alcoholics become aware of the far-reaching damaging effects of their condition to their own minds, lives, families and society, they have more responsibility, not less, for seeking treatment.
The involvement of heredity in alcoholism has been suspected since ancient times. The basis for this is the observation that alcoholism tends to “run in families,” which in itself is not proof of genetic involvement, since a shared environment could also explain the pattern. However, the strongest evidence for genetic influence on alcohol-related behaviors has come from a few adoption studies in which the effects of biological parentage and rearing parentage are disentangled.
One of the best controlled-adoption studies was conducted by D.W. Goodwin and his colleagues in Denmark in the early 1970s. This study compared the drinking history of 55 adopted-out adult sons of alcoholics and 78 adopted-out adult sons of nonalcoholics. All of these sons were adopted as infants, within the first six weeks of life. The researchers found that biological sons of alcoholics who had been adopted by non-related foster families were four times as likely to become alcoholics as the adopted sons of nonalcoholics. (The researchers found the lifetime prevalence of alcoholism as 18 percent in the biological sons of alcoholics versus 5 percent in the nonalcoholic sons. The estimated lifelong rate for alcoholism for males in the U.S. general population is estimated to be about 3 percent to 5 percent. For females it is less.)
Goodwin and associates found high rates of alcoholism in sons who had a biological parent who was alcoholic even if the adopted sons were raised by nonalcoholic foster parents. These sons of alcoholics were also twice as likely to become alcoholic by their late twenties or earlier and to develop alcoholism serious enough to require professional treatment.
In 1978, a study of over 1,100 adopted sons of alcoholics in Sweden found them three times more likely to become alcoholic than the adopted sons of nonalcoholic fathers. Adopted sons whose mothers were alcoholic were twice as likely to become alcoholic as those whose mothers were nonalcoholic.
In 1979, Nancy S. Cotton, Ph.D, reviewed 39 studies on the heredity of alcoholism that had been published over the preceding four decades. She summarized the findings on the families of 6,251 alcoholics and 4,083 nonalcoholics involved in these studies: Without exception, every family study of alcoholism showed significantly higher rates of alcoholism in relatives of alcoholics (in father, mother, sibling or relative) than in the general population. Cotton found that almost one-third of any sample of alcoholics had at least one parent who was alcoholic. Two-thirds of the studies of alcoholics found that at least 25 percent had fathers who were alcoholics.
Dr. Marc Schuckit of the University of San Diego and chief of the alcoholism research unit, remarked, “People do inherit things that make them more or less vulnerable to the effects of alcohol. Certainly many genes are involved, and there are many different ways to become alcoholic.”
It is difficult to untangle the relative contribution of heredity and of environment in alcohol response. It is important to point out that not all alcoholics have alcoholic parents or siblings. Some have tee-totalling parents. Humans are influenced both by genes that affect their physiological or metabolic functioning, and by their social environment. Modern alcohol research is finding that what is inherited is not “alcoholism” but a susceptibility for it—a “genetic predisposition” that renders a person more metabolically vulnerable to develop alcoholism if that person drinks. Genetics alone is not the cause of alcoholism. Alcoholism must still be created by improper drinking. In our world, this is usually fostered by careless or socially encouraged abusive drinking practices, or by trying to solve emotional problems with alcohol.
In summary, if one has alcoholism in his or her family, special concern is warranted. If one does not have alcoholic relatives, concern is still warranted because no one can safely assume he or she is immune. Alcoholism can be created simply by unthinking, careless use or abuse of alcohol.
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