Is Alcoholism a Disease?
Disease: 1. Morbus; illness; sickness; an interruption, cessation, or
disorder of body functions, systems, or organs, 2. A disease entity
characterized usually by at least two of these criteria: a recognized
etiologic agent (or agents), an identifiable group of signs and symptoms,
or consistent anatomical alterations.
From: Stedman’s Medical Dictionary, 24th Edition, p. 403.
The year was 1854; the place, New York City. "John," a homeless person,
was walking the streets when he had another episode of severe dizziness,
lethargy, and violent outcries, then collapsed on the walkway with
convulsions. John was well known in the community for these episodes, but
the citizens had finally become fed up with his antics and had him
committed to the insane asylum, where he spent the rest of his days
(which were few).
Since this is an article about "alcoholism," you probably have assumed
that John was an alcoholic having a withdrawal episode. Actually he was
suffering from hypoglycemia, a now well-recognized metabolic dysfunction
that has effective treatment protocols, though no specific cure.
Had the thought that John may be suffering a disease process even entered
the minds of those citizens? One mustn’t blame the people of the time for
their ignorance—they simply didn’t know better. However, with the
improved scientific tools at our disposal, we are in a position to be
more enlightened.
Today, there is an active debate about whether alcoholism is an actual
disease or simply a lack of will power on the part of the afflicted
person. In some religious circles, the alcoholic is demonized; much like
Galileo when he suggested that the Earth is not the center of the
universe.
Let us examine alcoholism in a purely logical fashion, not in the
judgmental way that society often does.
Major symptoms of alcoholism include an intolerable craving for alcohol.
The exact etiology of this is unclear. Why do some people have this
craving for alcohol, whereas others do not? There are theories which
claim that an underlying genetic process in the digestion of ethanol into
simple sugars means that the alcoholic requires it for normal functioning
of the body, but this is far from proven. However, just because we do not
know all of the mysteries of this process does not exclude it from being
a disease. If this were so, then since the scientists of the time did not
understand or recognize hypoglycemia, then John did not have a disease—he
was just evil. A patently ridiculous statement.
With continued use of alcohol, symptoms of withdrawal become apparent,
such as shaking, nausea, vomiting, seizures, delirium, as well as other
disorders.
Signs, which are what the physician finds on examination, include altered
mental status (even when not acutely intoxicated), tremors or shaking,
elevated blood pressure, and flushing of the face, as well as a large
number of other measurable physical symptoms.
It is important to note that diabetics who constantly neglect their
disease process have signs such as retinopathy (degeneration of the
retina of the eyes), kidney failure, and so on, similar to an alcoholic.
When collecting data from an alcohol for a family map known as a
genogram, there is almost always a family tree full of alcoholics.
However some claim that this is simply a case of "monkey see—monkey do;"
or in other words, it is simply a learned trait. The weakness of this
statement is demonstrated by numerous studies of identical twins of an
alcoholic heredity, separated at birth, one placed in an alcoholic home,
and the other in a sober household. In every study, in a high percentage
of cases, both children became alcoholic. So from these studies, as well
as studies performed on monkeys, it appears that there is a genetic link.
With all of the research being performed in genetic mapping, perhaps a
common gene, or more likely a group of genes, will be discovered in
alcoholics.
The drinking of spirits is not the only problem alcoholics have to deal
with; there is also the incredible apparent loss of rational thought,
even when sober. It is often the case that an alcoholic who has not had
had a drink in several months will still act the same as he did when
actively using. He is referred to as a "dry drunk." His thinking often
becomes "black or white," "all or nothing." Grandiosity is also a common
symptom—the thought, "I can do anything" runs rampant, as is impulsivity,
acting on thoughts without thinking. These patterns of thinking are very
reproducible from alcoholic to alcoholic.
Depression is now recognized as a clinical disease with effective
treatments. Clinical depression has a set of specific symptoms, such as
unexplainable sadness, insomnia, poor appetite, among others. The
scientific community is constantly finding new etiologies to explain this
complex problem, with new treatments being developed almost daily,
whereas only sixty years ago the only answer to the problem was to "pick
yourself up by the bootstraps and get on with life," or in other words,
exert more will power. The answer to alcoholism is far more complex than
simply to stop drinking. The answer lies in the biochemistry of the
brain, where much research is being performed.
Is alcoholism a disease? With a specific set of symptoms, most notably an
uncontrollable craving of alcohol whose exact etiology is unknown but is
reproducible from one afflicted person to another, as well as the other
symptoms and signs listed above; and with the definition of a disease
clearly spelled as having identifiable and consistent symptoms, it would
appear that alcoholism is indeed a disease and needs to be treated as
such. It is time to stop the prejudice that society directs at these
people, and treat it for what it is: a disease rather than a spiritual
deficiency.
By Dr. Dale, author of Faith Love, and Overcoming: My Battle With
Addiction, found at http://www.pdbookstore.com Copyright 2001 American
Book Publishing.
Contact:
The Legacy Group of Alcoholics Anonymous © 2005