Out, Damn Beer! Out, I say!

A friend of mine recently inquired whether I thought alcoholism was a disease.  She postulated that perhaps it is a disorder, instead.  She had heard an interview on NPR (which I cannot for the life of me find right now) with a man who argued for labeling alcoholism as a disorder.  Interesting.

Disease implies that the person had no control over becoming physically ill .  Something, physiologically, has happened to them to make their body function improperly.  Disorders, on the other hand, are often associated with mental health or mental function;  Autism Spectrum Disorder and Bipolar Disorder are two examples that come readily to mind.  In both of these cases, at one point the person functioned somewhat “normally.”  Now they do not.

Right then.

These distinctions seem like splitting hairs.  I guess that, in fact, alcoholism seems like a disease because people inherit a predisposition towards alcoholism, if they have alcoholics in their family.  But that argument quickly falls apart because people also inherit a tendency toward mental illness from their families (again, most of those are seen as disorders).

Confusing.

Alcoholics have the ability to control their disease, as do diabetics.  But the “medicine” for the disease isn’t tangible.  In fact, in AA they teach that the only treatment for alcoholism is a spiritual life.   Certainly not very scientific.  And, while cancer patients have absolutely no control over whether or not they come out of remission, alcoholics do control whether or not they relapse.  Don’t want to relapse?  Don’t pick up a drink.  Simple principle; difficult for some in practice.

I think the debate comes back to personal responsibility.  The people who are affected by the actions of an alcoholic justifiably resent the alcoholic’s claim that her “disease” caused all the havoc.  In fact, I think that is crap, too.  It can be very difficult to quit drinking.  But by the time a person decides to stop, they have most likely had countless indications (some subtle, some shockingly direct) that their drinking was destroying not only themselves but also those around them.  Since people choose to quit drinking, does that mean they are less diseased at the time they make the choice?  Or simply that they have a moment of clarity from their self-induced fog and realize that something must change?  If an alcoholic can make the choice to get better, can alcoholism really be a disease?

I am pleased to know that I am not ever going to get “struck drunk” (Good Lord, the AAs love that one).  It is also an awesome responsibility to know that I alone am responsible for staying sober.  And I am the only person that knows the right formula to keep myself from picking up a drink.  That is an incredible amount of responsibility–  the same kind of responsibility that others were facing day in and day out while I was boozing it up.

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