Alcoholism (a.k.a. alcohol addiction or alcohol use disorder) is a complex condition that is thought to be a product of many contributing factors, including genetic disposition, developmental issues, and environmental stress.
For decades, even centuries, many experts have argued that alcoholism is a choice – a moral dilemma, so to speak – and that alcoholics could be cured of their affliction if they were just willing to seek out spiritual guidance and really, really try.
But if we are to consider alcoholism an incurable disease and not merely a choice, are we not taking control out of the hands of the individual? And what if alcohol addiction is not a disease? Does that mean that sufferers should not have intense, evidence-based treatment available to them that approaches it as such?
The Cambridge Dictionary defines disease as “a condition of a person, animal, or plant in which its body or structure is harmed because an organ or part is unable to work as it usually does; an illness.”
A copious amount of research has shown that chronic alcohol use leads to alterations in the brain in both structure and function – and indeed, some of these changes may be irreversible. According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), people who drink excessively for extended periods of time risk “developing serious and persistent changes in the brain” and that “damage may be a result of the direct effects of alcohol on the brain or may result indirectly, from a poor general health status or…severe liver disease.”
One such condition is known as Wernicke’s encephalopathy (WE), which results from a thiamine deficiency caused by excessive alcohol consumption.
So how do we address the issue of “choice” and control? Well, think of alcoholism as being similar to Type II diabetes regarding how personal choices affect disease – both conditions can be managed through diet and lifestyle changes. The person experiencing these problems must make these choices, however, and stick to them.
Suffering from a chronic condition is not the same as making the conscious decision to suffer – but rather, the disease is ultimately going to be affected in many ways by the choices one makes, and whether they are healthy or destructive.
Moreover, this is how people with diseases of the brain and body are able to exert some control over their condition – through prevention, treatment, and symptom management. Using this approach, being an alcoholic is not a choice, per se – however, many of the choices one makes in light of this condition are ultimately going to affect the severity, duration, and outcome of the disease.
Finally, research has shown that people who are treated for alcohol addiction using a disease model exhibit better outcomes than those who are not. The takeaway is this – even if alcoholism is not a disease, it is most effectively treated when addressed as one. This approach should include treatment that involves intensive mental and physical healthcare, as well as long-term support and lifestyle changes.
The Disease Theory of Alcoholism, Simply Put
The disease theory of alcoholism contends that alcohol addiction is a disease of the brain that changes the way a person thinks, feels, and behaves. Thus, qualified healthcare providers should be able to diagnose and treat both the causes and effects of alcoholism, just like any other medical condition.
What is Alcohol Dependence?
In 1956, the American Medical Association classified alcohol dependency as an illness, and in the early 1990s, it was also officially classified as both a medical and psychiatric condition.
Alcohol dependence is diagnosable based on the following four criteria:
- The development of tolerance to alcohol that requires that the person drink more and more to experience the desired effects (intoxication)
- Upon cessation of use, unpleasant mental, physical, and emotional withdrawal symptoms manifest
- A lack of self-control and inability to limit alcohol consumption despite the intention
- Adverse mental, physical, and social consequences that result from excessive alcohol use, such as mental illness, disease, and family conflict
Alcoholism Operating as a Disease
When approached as an illness, alcohol dependence appears as a remission/relapse disease based in the brain’s neurological pathways. Alcohol rapidly spreads through the body and also wreaks damage on the heart, liver, and over time, on other internal organs. When left untreated, alcohol addiction usually continues to worsen due to increasing tolerance and the associated neurological effects.
And alcoholism, like any disease, powerfully impacts the person’s life as well as the lives of those surrounding him or her. Failure to receive treatment leads to ever-worsening conditions, impulsive, dangerous behavior, and ultimately, an increased risk of life-threatening illness or injury and death.
Alcoholism, not unlike diseases such as diabetes and cancer, is not curable, but it is treatable. Alcohol addiction treatment can be extremely effective when approached medically and comprehensively, such as through services offered by our addiction treatment center. These include inpatient and outpatient treatment formats, behavioral therapy, individual group therapy, counseling, and aftercare support. So Is Alcoholism a Disease? While some scientists seem convinced that alcoholism is properly defined as a disease, there are others that seem convinced otherwise.