The disease theory of alcoholism, and why I disagree about the "lack of discipline" viewpoint

Lately, there has been quite a debate on whether alcoholism is a disease or not, and some people seem to insist quite confidently that it is not a disease, regardless of what its status is among doctors and medical staff - and I would like to point out my opinions on this, and see what you think about all this.

People who say that alcoholism is not a disease often use the argument that it is "all about discipline" - however, I will have to disagree about that.
I personally know two alcoholics myself, so I know how unreasonable they can be when it comes to trying to talk sense into them.
The big problem with them is that they simply don't even realize that they are alcoholics - they live in a huge illusion where they think they just "like to drink every now and then", and don't even notice that this ruins the rest of their lives.
I think that this kind of psychology is the reason why alcoholism is sometimes considered a disease and/or a mental illness - because it makes the person unable to realize the problem in the first place.
If alcoholism was just about having "enough discipline" then the problem would be much more about finding the motivation to quit drinking, not about realizing that the problem exists.

You can sort of compare this with depression, which as far as I am aware counts as a psychological disorder - depression makes a person feel completely apathic and hopeless, and a lot of depressed people even believe that their depression is how they are supposed to feel, and that happy people are fooling themselves.
You cannot just tell a depressed person to "lighten up", this will only infuriate them and make them feel even more hopeless.
I see many similarities among alcoholics - you cannot just tell them that they are alcoholics, because they won't understand what you are saying, and in my opinion that's the underlying problem with alcoholism.

What I am wondering is - why do some people think they have the right to argue against the opinions of educated doctors?
I was actually present at a seminar about alcoholism as recently as last year, which was presented by a doctor, and as far as I can remember, she called alcoholism a form of psychological illness.
And if doctors are in an agreement that alcoholism is some form of illness or disorder (which, at the moment, seems to be the case), then other people honestly have no right to argue against that, nor are in any position to do so.
Yes, you can have your personal opinions about it, but do not expect to get much support from doctors then.

Also, the reason why things like this are sometimes labeled "diseases" etc is because it make it easier for doctors to approach the problem - it doesn't mean that the patient should just "surrender" and stop caring, it means that the patient should realize the exact problem and approach it the best they can themselves.

I think the problem is that many people tend to think of "infectious disease" as the only form of a "valid disease," so that "addiction disorders shouldn't be called diseases." Addiction-based diseases/disorders do largely start out initially via voluntary behavior, at least that first time (ingesting substances that lead to addiction), so that's probably the foundation of the "willpower" argument, that then gets sort of extended to a "well they could quit at any time" mindset.

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Originally Posted by FryingMan

I think the problem is that many people tend to think of "infectious disease" as the only form of a "valid disease," so that "addiction disorders shouldn't be called diseases." Addiction-based diseases/disorders do largely start out initially via voluntary behavior, at least that first time (ingesting substances that lead to addiction), so that's probably the foundation of the "willpower" argument, that then gets sort of extended to a "well they could quit at any time" mindset.

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Yeah, that's pretty much how I think of it as well.
Clearly there is something different about alcoholics if they are unable to even have a drink during a dinner party without instantly getting out of control, whereas everyone else is completely fine the entire time.
Alcoholics aren't in a state of mind where they can "quit at any time", because like I said, they don't even realize that they are alcoholics - and that's one of the first barriers that they need to overcome.
I guess you can kind of think of this as them "becoming lucid", lol.

I am definitely not trying to imply that alcoholics are "doomed to be alcoholics" or anything - I am a strong believer in people's abilities to change themselves for the better - but what I am saying is that in almost all cases they need professional help from real doctors (and I am not talking about AA now, haha) and learn how to handle it.

I am not a doctor by any means, so I shouldn't state "facts" too confidently, however this is what I think of alcoholism in general.

Definitely. Its a pain killer. These ppl are in pain. https://www.youtube.com/watch?v=66cYcSak6nE

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Originally Posted by Laurelindo

You can sort of compare this with depression, which as far as I am aware counts as a psychological disorder.

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Depression is a physical disorder, caused by a chemical imbalance, which in turn affects the brain. There is a reason people whom stay indoors all the time tend to be grouchy; they're not getting enough sunlight.

In mine opinion, alcoholism isn't a disease, but rather a dependence. Much like any other addictive substance, once you dip in the river Styx, it's not easy to get out. That said, the discipline argument, in mine opinion, only applies to the very first swig--after which your body will inevitably become dependent on it. Even if you have the willpower to quit drinking, your body won't respond well to the change. That, monsieur, is called "withdrawl". You CAN die from alcohol withdrawl--it has happened before. Ergo, the best way to quit the bodily addiction is to steadily wean yourself off it.

Personally, I can't function without caffiene. I've been drinking Black Tea nearly all mine life. The amount I consume isn't large (Black Tea is roughly half as strong as coffee), but since I've been on it so long, mine body is highly dependent on it. If I don't drink mine tea the next day, I won't sleep well (if at all), I won't be able to think clearly, mine nasal cavities will swell up, mine head will hurt like hell, and every muscle in mine body will ache and stiffen--to the point to where I can barely move. Bluntly put, I'd be a lifeless, irritable zombie. [Smirks and Shrugs] That said, however, I'm not quitting mine tea, for the taste is great. As long as I keep drinking it in moderation, I won't have to worry about death by suffocation.

In a nutshell, though it's one thing to have the mindset to quit a dependence, attaining the bodyset requires much time and care.

Even with great discipline, something is nipping at their heels. That is where I would focus- what is nipping at their heels? Certainly not the drink itself (minus the slow weening that must occur, to avoid severe withdrawal symptoms). Alcoholics tend to use alcohol in order to numb themselves. An awakening needs to occur. They need to address the hounds on their tail, before they can move forward. I think that if they can do this and beat it, they will have passed a life test.

It's not just alcoholism, addiction in itself is mental illness, there's functioning forms of addiction and not so much.. You can be addicted to most anything too, it's just that some things are a lot worse for your health to be addicted to.. But anybody who says that a lack of discipline will always fix addiction doesn't even begin to comprehend what addiction is or how it works, these people are picturing habits and not addictions. I absolutely hate the term "drug habit" it's not a habit in the least bit when it gets to a certain point and anyone who has suffers from addiction will tell you this.

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Originally Posted by mooseantlers

It's not just alcoholism, addiction in itself is mental illness, there's functioning forms of addiction and not so much.. You can be addicted to most anything too, it's just that some things are a lot worse for your health to be addicted to.. But anybody who says that a lack of discipline will always fix addiction doesn't even begin to comprehend what addiction is or how it works, these people are picturing habits and not addictions. I absolutely hate the term "drug habit" it's not a habit in the least bit when it gets to a certain point and anyone who has suffers from addiction will tell you this.

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Yeah, that's exacly how I view things as well.
I actually think that it's a bit insulting towards for example alcoholics to claim that it is just a "lack of discipline" that turns them into alcoholics - that's actually like saying that all alcoholics in the entire world don't care that much about the rest of their lives, and are just like "oh yeah, I really enjoy drinking alcohol, in fact I enjoy it so much that I am ready to sacrifice all the other aspects of my life", and I find this pretty absurd.
This has also made me feel a lot less respect for the South Park creators - I know that show is supposed to be satire, but I can't stand the episode "Bloody Mary", because they always rant about how alcoholism isn't a disease etc, and both they themselves and lots of their fans seem to take that episode 100% seriously as well.
I mean, why should we listen to Trey and Matt regarding something like this?
They have no medical knowledge, they have no right to argue against doctors who actually know what they are talking about.
If doctors count alcoholism as a disease or disorder or whatever, then that's what it is, period.
If they define it as something like that then they have professional reasons to do that.

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Originally Posted by Laurelindo

Alcoholics aren't in a state of mind where they can "quit at any time", because like I said, they don't even realize that they are alcoholics - and that's one of the first barriers that they need to overcome.

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I beg to differ. I would say any alcoholic you come across at least has an idea that they are an alcoholic. Maybe they even joke about being one in some self-deprecating humor in way to make it seem like a less serious matter or something they aren't suffering from. I'm sure there are many alcoholics out there that aren't aware of what they are, but must surely be just as many that know it full well. A size-able portion of those who know may be in denial, but in order to be in denial you know that a problem exists in the first place whether you're willing to admit it or not. Unfortunately for many of those who know, they still aren't willing to even get comfortable with the idea of having to quit, majorly reduce consumption, or get some solid help. Some even use it as another failure of theirs to tally up on the chalkboard, and sink further into depression or at least apathy and social dysfunction (which not already being a symptom of the former, will probably cause the former).

I feel like the topic should be a bit broader though. Alcoholism isn't different than addiction to any other substance. I would even begin to go as far as to say that it comparable to other addictive behaviors given they post enough threat to your physical and mental well being. However, alcohol abuse and substance abuse are pretty much one in the same. Alcohol abuse is merely a more specific form of abuse/addiction.

I definitely agree that it isn't simply a matter of will power. There is literally so much that can cause someone to become addicted or even hopelessly addicted to drugs. Genetics, diseases, disorders, injuries, mental-social-physical health, and socioeconomic status all play very large roles. I may will empathize mostly because I've been addicted to drugs myself, and a lot of it has been my fault. At the same time, I've had two traumatic brain injuries, am a veteran, have two uncles on paternal side with bipolar, and my mother, sister, and all the women on my maternal side of the family suffer from fairly crippling anxiety and go through bouts of serious depression on and off throughout their lives. I'm chock full of hereditary mental illness and the brain injuries enough have caused enough to have a major impact on my life. My usage started out as recreational, and then I found my niche drug class, the dissociatives. It started being where I picked up usage and simply didn't care. Didn't matter if I lived or died anyway, especially when I was in the military. Then it turned into self-medication and just degraded into abhorrent compulsive abuse. If anything I think part of me was trying to disrupt enough of my ability to function as a person at all in society that I was recognized as having a problem by somebody else and coerced and practically forced into seeking help and actually facing my issues instead of running away.

It's a slippery slope, and the only reason I think alcohol deserves any kind of special distinction from the term "drug addiction" is because it is so widely accepted, found everywhere, drank by so many, and so cheap enough to get. I think labeling it as alcoholism rather than simply giving it the designation of drug addiction is unfortunately used by many to make what they suffer from sound less dirty and low. Alcohol is deeply ingrained in cultures world-wide and its ability to generate cash flow earns it a somewhat "softer" sounding designation. Well yeah, an alcoholic has problem, but a drug addict just sounds so much worse. Besides, given alcohol is something socially accepted, it would follow that it would be less likely to be viewed as negatively as "drug addiction" I don't know if I can explain it like I want to, but if other drug classes don't get their own names I don't see why alcohol should (besides my first sentence in this paragraph). If anything it is liable to reduce receiving the proper amount of help or being taken as seriously as it should be. I guess that's all I'm worried about.

Anyway, I definitely agree OP. Although it's definitely a bit foreign to me why we describe it as a disease. Obviously that has no bearing on whether or not someone should just be able to will themselves to quit, but it is misleading and creates dissonance in a situation where there doesn't need to be any. The idea that it's a disease sounds wrong to me, but that wrongness shouldn't affect whether I think people are in control or not. Unfortunately though, a lot of people do that though. It's entirely preventable too.