When asked to define what alcoholism really is, the writers at Mayo Clinic put it clearly.
They say, “Alcoholism is a chronic and often progressive disease.” There’s one word in this sentence that seems to upset some people who think about alcoholism and recovery. That word is “disease.”
Merriam-Webster defines a disease as a “problem that a person, group, organization, or society has and cannot stop.” For many, that’s a perfect way to describe what alcoholism is and what it can do. That’s certainly what the writers working for Mayo Clinic believe.
Is this the right way to really think about alcoholism? Some don’t think so. In fact, some think that there’s another way to think about alcoholism, and they suggest that changing the way we think about drinking could help to change the way and the rate at which people recover.
Support for the Disease Model
The idea of alcoholism as a disease isn’t a new one. In fact, researchers with Potsdam University suggest that this definition of addiction comes from writing done in the 1940s. At that time, an influential article was published that suggested that people who develop alcoholism progress through a series of recognizable steps. These phases of alcoholism didn’t shift from person to person, researchers said, and that seemed to indicate that a disease was in play.
A progression to alcoholism might work like this:
- The person drinks
- The person finds drink more pleasurable than another person might
- The person drinks more than others do
- The person spirals into greater and greater drinking difficulties
This very old idea of alcoholism progression still resonates today. In fact, people who live with an alcoholic right now might find that these steps are intensely familiar. People who grew up in families with alcoholism might also read these notes about progression with a hint of familiarity. It’s the way we think about how alcoholism develops, and it’s a story recounted in movies, books and television shows. It’s instantly recognizable.
Most diseases come with a progression people can spot and understand. For example, most people know that Alzheimer’s disease begins with minor forgetfulness, which then grows more and more severe until the person no longer recognizes loved ones, familiar spaces, or common objects. It’s a process that can be tracked, and that typically moves in the same way in each person. If alcoholism really works like this, with measured and similar steps, the word “disease” seems apt.
There’s also some significant biological support for the disease model. For example, research done on mice in England suggests that there’s a specific gene that regulates how much alcohol a being ingests at one time. When researchers amended this gene, the mice drank significantly more than they would if they didn’t have that gene amendment.
That gene might, if it exists in humans, make otherwise healthy people drink much more than others would. It’s not a choice, and it’s not a decision people make. Their bodies make that decision for them, and that gene makes the people behave in ways that are detrimental to their health. This certainly sounds like a disease, and the more gene work done, the more researchers become convinced that there is some type of disease (not some type of choice) responsible for alcoholic behaviors.
Another study also supports the idea that genes have a role to play in alcoholism. In this Texas study, researchers found that people with a specific set of genes had alcohol disorders at a higher rate than people who didn’t have those genes. This is an observational study, meaning that researchers didn’t tinker with genes to see what changes came about. They just looked for traits and tried to match them to genes they could find, but it’s still an important discovery that strengthens the disease idea. If genes have a part to play, the idea of choice seems less valid.
Alternate Alcoholism Ideas
While some scientists seem convinced that alcoholism is properly defined as a disease, there are others that seem convinced that the drink choices people make have nothing to do with a disease process. To them, alcoholism stems from something altogether different, like choice or environment.
In one study of the issue, researchers found a link between alcoholism and peer drinking, and that link seemed to go in both directions. For some kids, pressure to drink came from spending time with others who drank. For others, the need to drink made them pressure others to drink. But, the researchers said, choice played a key role. The pressure was there, but kids had to make a decision to act upon that pressure.
It’s this idea of choice that often pops up for people who disagree with the disease model. If someone can choose to be impacted by the issue, or that same person could choose to do something else and avoid the illness altogether, that suggests that this isn’t really a disease. For people like this, calling the disorder a disease could lead to some negative consequences.
A researcher quoted by NBC News, for example, suggests that the alcoholism disease model implies some kind of deformity or defect. People who hear that they have a disease caused by genes or by something internal might come to believe that they’re incapable of getting better, simply because their bodies are defective. They might be less likely to get treatment, per this researcher, because they’re sure that the issue they have isn’t something that can be amended or treated.
There’s some merit to this thought. A big part of recovering from alcoholism involves feeling like decisions matter. People who know that the small things they do every day could have a big impact on their long-term health are less likely to do something destructive that might lead to a relapse. They’re more willing to really change. If the label of disease comes with a feeling of defeat or inevitability, those changes might be less likely.
A second researcher, quoted by an Arizona newspaper, suggests that alcoholism just can’t be a disease because some people recover without treatment. These people just decide to stop drinking, for reasons that are entirely personal, and they never set foot in any kind of treatment facility. They recover, too, even without getting help. If an addiction were a disease, per this researcher, spontaneous recovery wouldn’t be possible.
Again, this is an interesting idea. If people don’t always need treatment, doesn’t it mean that addiction isn’t really a disease? If not everyone who drinks alcohol gets alcoholism, does that mean troubled drinking isn’t a disease? These are the sorts of answers that will keep clinicians debating for decades. They’ll run studies, conduct surveys, and write books about their theories. Much of that might help to inform the public about how widespread and how serious alcoholism really is.
But for families that are dealing with these issues right now, the theories about how the issue started might not be as vital as the theories about what makes the problems end. They’re probably not concerned about whether alcoholism is a disease. They just want to make it stop, no matter what it is.
There’s good news for these families. No matter what label might be affixed to alcoholism, it’s clear that this is a problem many can overcome.
Illness or Choice? Recovery Is Possible Either Way
No matter whether you believe that alcoholism is a disease or something that develops through conscious choices made by individuals with the same genes as everyone else, research clearly demonstrates that people who have alcoholism can get better with time and help. In fact, a study in Germany suggests that the brain can start to recover from alcoholism with as little as 14 days of sobriety. In this study, researchers found that abstaining from alcohol for just a two-week timespan can help brain tissues to recover from the damage alcoholism can cause.
While changes inside the brain can’t be seen by people looking for signs of alcoholism recovery, there are many things people do on the outside when they’re recovering from alcoholism. For example, people can choose to stop drinking. When researchers measure that flat sobriety rate, they can prove that people get better. And many studies have done just that.
In one such study, published in Alcohol Research and Health, researchers found that of those diagnosed with alcohol dependence, 27.3 percent were in partial remission a year later, and 18.2 percent were in full remission. Statistics like this show that people diagnosed with an alcoholism issue can get better, but it can take time for them to make the changes associated with long-term sober recovery.
So how do people recover from alcoholism? Typically, people need help in order to make a real and lasting switch, and there are two ways to go about getting that help.
Some use a social model, like Alcoholics Anonymous, to overcome alcoholism. They attend meetings and learn more about how others have recovered from alcoholism, and they read publications about alcoholism published by the organization, so they can learn more about the theories that govern alcoholism. There are no professionals involved in treatment with programs like this, as it’s all about support from peers, but for some, that can be the right approach.
Others pair social support with professional support. In a professional alcoholism recovery program, people like this use medications in order to help address the brain changes alcohol can cause. They use therapeutic techniques to help build their resolve to stop drinking for good, no matter what new challenges might arise in time. Programs like this can take a long time to complete, as there are many lessons to learn. People who participate in programs like this often use social support models like Alcoholics Anonymous, both while they’re in treatment and when treatment is complete, so they can get the best of both professional and peer advice.
There’s no right way to handle an alcoholism problem. You’re an individual, with your individual reasons for drinking. The help you need should be similarly individualized, so it’ll handle your specific needs in a targeted way. That’s the kind of help we can offer you at The Oaks at La Paloma. We use comprehensive techniques to understand your motivations for drinking, and we help to boost your innate skills and tendencies that can help you to stop drinking. We’d like to help. Just call us, and we’ll get started.