Alcoholism: Disease or Moral Dilemma?

 Is alcoholism a disease or just a moral dilemma? That is a question that many people still ask today. There are doctors, lawyers, professional people and everyday citizens that      believe alcoholism is just a social or mental issue. That it is not a disease like cancer or heart disease or many of the major illnesses that can befall any individual in their life. It is of my opinion and that of many others, that alcoholism is a disease and not just a matter of “willpower,” and men and women that have the potential to become alcoholics can quit on their own.

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 There is a chapter in the book Alcoholics Anonymous, by Bill Wilson entitled “The Doctors Opinion,” in which Dr. James Silkworth, who was a well-known physician and who worked with alcoholics and addicts in a prominent hospital states, “an alcoholic has an allergic reaction to alcohol, when ingested into the body”(Wilson,1939). The allergic reaction then produces a mental obsession that makes the body crave more alcohol. Therefore making him or her alcoholic. Also in the book a psychologist named Dr. Jung, said” that nothing short of a spiritual experience could help an alcoholic overcome his disease of alcoholism”( AlcoholicsAnonymous ,1939). Alcoholism is a progressive disease, and if not treated could lead to other health problems and even death.

 In 1976, the National Council on Alcoholism and the American Medical Society on Alcoholism published a formal definition of alcoholism. In that report it states that, “alcoholism is a chronic, progressive, and potentially fatal disease” (Flavin & Morse, 1991, p.266). It is caused by tolerance and physical dependency by direct or indirect results of drinking alcohol. Also in this article by Flavin & Morse they go on to explain that “alcoholism is a primary chronic disease with genetic, psychosocial factors influencing its development and manifestations. Characterized by continuous impaired control of and preoccupation with alcohol no matter what the consequences being” (Flavin & Morse, 1991 p. 266). Jails, institutions, or death! This is a statement heard very often in meetings of Alcoholics Anonymous. This statement means that if nothing is done about the disease of alcoholism in a person’s life, they could end up in jail for their actions, due to their drinking, or be put into an institution for treatment of their disease or could end up dying from the consequences of alcohol.

 In the past 172 years clinicians and researchers have tried to categorize alcoholics by typologies to advance and improve our understanding of alcoholism. It can be divided into three periods. The first one being the Prescientific period which was clinical observation of an alcoholic, the Jellinek Era  and the Post-Jellinek Era. E. M. Jellinek was the first to develop the theory that alcoholism is a disease. The Post- Jellinek Era is based on his work and also on that of empirical research on typologies by others such as Thomas F. Babor in his article,“The Classification of Alcoholics” (Babor, 1996). Babor based his typology on the “assumption that alcoholism is or could be genetic, biological, psychological and sociocultural” (Babor, 1996). In 1870 there were a few physicians that specialized in the care of alcoholics. They organized a group called Association for the Study of Inebriety, in which they agreed with the concept that alcoholism is a disease. Over the last forty years or more there have been numerous articles published in the Quarterly Journal of Inebriety from noteworthy physicians in the United States, England and France. There were national and international meetings, books and journals by these same physicians that helped define the medical response that alcoholism is a disease.

 Let us now examine some of those who believe that alcoholism is a moral dilemma or social problem that can be stopped by just putting ‘the bottle down’. Jon Burras who is a wellness consultant states in his article “that alcoholism is a choice; it has nothing to do with a genetic dysfunction” (Watkins, 2012 p.67). Burras also goes on to say that treatment centers, programs such as Alcoholics Anonymous and even the American Medical Association are based on misinformation about alcoholism as a disease. “Alcoholism is not a disease.” (Watkins, 2012 p.70). He believes it is bad choices and emotional, not biological. He believes that there is a solution but not in Twelve-Step meetings or in a laboratory. Burras says that “healing happens when we begin to let our emotions out, and that alcoholism is not a disease, only a misguided bird flying in wrong direction” (Watkins, 2012 p.72). I have read his article and am in total disagreement to all he has to say. This writer is an alcoholic in recovery and has been through all the stages of alcoholism and can tell you that from experience, it is a disease.

 Charlie Gillis, a writer for Maclean’s, conducted an interview with Gene Heyman, a Harvard psychologist on alcohol addiction where he explained it is not a disease, but of personal choice (Gillis, 2009). When asked by Gillis, what led him to believe that addiction or alcoholism, which this author believes that alcoholism is an addiction; Heyman explained, “He looked at data from biographies, histories and ethnographies of addiction and believes that if people changed their behavior then they can stop using alcohol or drugs’ (Gillis, 2009). Heyman was, in my opinion, looking at all the outside influences, instead of getting his data from real people with the disease of alcoholism. Heyman thinks that if a person had family issues, or if it were a choice between children and or significant other, or putting food on the table or moving to a neighborhood that disapproves of such behavior, that an alcoholic or addict can stop, anytime.  Heyman also believes that all the research that has been done over the years on alcoholism is not accurate because, much of that data came from treatment centers and that most of the people in there, have additional disorders. Therefore interfering with their capacity to engage in activities that compete with alcohol. Some have even called alcoholism a risk behavior, not a disease.

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 It is this author’s belief that alcoholism is a disease and not a moral dilemma. Not only is this a primary disease, but it can lead to other illnesses. In an article from Alcohol Health & Research World, Arria, & Van Thiel explain that alcohol abuse can and will, eventually lead to other health problem (Arria & Van Theil, 1992). Some of them being cirrhosis of the liver, heart disease and ‘wet brain’.  From all the research that has been done over the years on alcohol and drugs it is evident to me that it is a disease. There have been many well-known physicians and researchers that have put in hundreds if not thousands of hours on this question, Is alcoholism a disease or moral dilemma? People like Bill Wilson and Dr. Bob Smith would not have written a book about alcoholism, if they did not believe that alcoholism is “a chronic, progressive and fatal disease” (Wilson, 1939). I have read the book, Alcoholics Anonymous and know first-hand about this disease. I am an alcoholic in recovery and this book has saved my life. If it were not for a few simple suggestions in this book I would not be here to write this article. I have went through all of the stages of alcoholism. I had to be hospitalized to detoxification from alcohol, and have had some delirium tremens. I have been at the turning point of my life, not knowing whether I wanted to live or die. I could not stop drinking on my own. I had to have alcohol to keep me alive, so I thought, so I could function like a human being.” Let the scoffers, scoff and be damned” (Wilson, 1939). Alcoholism is a disease and not a moral dilemma. Thank you to all of the people who have convinced this writer that there is hope for people like me. It is only through understanding of the disease that alcoholics can recover from this chronic, progressive and fatal illness.

REFERENCES

• Arria, A. M., & Van Thiel, D. H. (1992). The epidemiology of alcohol-related chronic disease.
• (Cover story). Alcohol Health & Research World, 16(3), 209. Retrieved from ebscohost.com
• Babor, T. F. (1996). The classification of alcoholics. Alcohol Health & Research World, 20(1), 6-14
• Flavin, D. K., & Morse, R. M. (1991). What is alcoholism? Alcohol Health & Research World, 15(4), 266-271
• Gillis, C. (2009). Harvard psychologist Gene Heyman on why drug or alcohol addiction is not a disease, but a matter of personal choice. Maclean’s, 122(20), 19-21. Retrieved from ebscohost.com
• Watkins, C. (Ed.). (2012). Alcohol abuse. Detroit: Greenhaven Press.
• Wilson, B. (1939). Alcoholics anonymous. New York City: Alcoholics Anonymous World Services, INC.