Should Alcohol Abuse the Categorised as a Disease

¶ … Alcoholism a Disease?

There is little doubt that alcoholism is a chronic condition, which in 1956 was classified by the American medical Association as an illness, elevating the status to disease in 1966 (Baldwin Research Institute, 2015). However, despite this announcement, there still appears to be a significant level of dispute within the medical community, where the concept of alcoholism as a disease has remained unproven (Hanson, 2013), however many of the characteristics of the condition appear to be aligned with a disease diagnosis (Borelli, 1989). The aim of this paper is to consider the concept of alcoholism as a disease, considering the evidence for and against this hypothesis.

The Association of alcohol disease began during the 1800s, proposed by Dr. Benjamin Rush, who argues those who drank too much alcohol were diseased, and utilised this argument to promote his revisionist ideas (Baldwin Research Institute, 2015). However, simply calling it a disease does not make it so; indeed a number of commentators have argued that giving alcoholism slave is made more socially acceptable, and created the ability for drinkers to externalise the drunkenness, moving for behavioural decisions from the realm of unsociable social activity, to the sphere of illness (Hill, 1985). This perception has been furthered by the presence of alcoholism, described as alcohol abuse and alcohol dependence included in the Diagnostic and Statistical Manual DSM 1-5, the most recent classifying the two conditions as a single category (National Institute on Alcohol Abuse and Alcoholism, 2013; Hill, 1985).

The idea that alcoholism is a disease is based on four propositions which align the condition with disease (Hanson, 2013; Fingarette, 1990). Each of these propositions will be considered individually.

The first proposition is that heavy drinkers display a singular and distinctive behavioural pattern of ever increasing alcohol use, which leads to increased physical, mental, and psychological deterioration (Hanson, 2013; Fingarette, 1990). Some credibility may be gained by this argument when examining the work of Jellinek (1946), who published a study examining the faces of alcoholism, with research undertaken using self-reporting questionnaires distributed through Alcoholics Anonymous (AA). The research indicated a specific pattern in alcohol abuse, which led to the hypothesis that alcoholism, if untreated, would lead to an inevitable sequence of increased drinking, and the associated symptoms including blackouts, withdrawal distress, and eventually death (Hanson, 2013; Jellinek, 1946). However, while this progression appears to indicate characteristics associated with disease, even Jellinek admitted that the scientific basis for his research, utilising only 100 handpicked questionnaires, or from male members of AA (Hanson, 2013). Subsequent research has undermined these results, indicating the drinking patterns may fluctuate, and following the later research even Jellinek distanced himself from his original hypothesis (Hanson, 2013).

The second proposition supporting alcoholism is a disease is the way that once the condition appears, it will persist in an involuntary nature, with a craving that is irresistible to the alcoholic (Hanson, 2013; Fingarette, 1990). This is a misconception associated with alcoholism, and numerous studies have been undertaken by many researchers, demonstrating the assertion is not correct (Baldwin Research Institute, 2015; Hanson, 2013). Notably, the assertion that alcoholics cannot drink alcohol without returning to alcoholism is also been demonstrated as false, as research in the U.S. has found that twenty years after alcohol dependence 17.7% of former alcoholics were able to drink in moderation, and three quarters were a full recovery (Baldwin Research Institute, 2015; Hanson, 2013).

The third proposition is that medical expertise is required for the condition to be understood and alleviated or relieved, or at a minimum ameliorate the symptoms ((Hanson, 2013; Fingarette, 1990). This has also been demonstrated as incorrect, as researcher by the National Institute on alcohol abuse and alcoholism has found that 75% of individuals undergo a recovery from alcoholism do so without seeking any type of speciality help, including rehab programs or the AA ((Baldwin Research Institute, 2015; Hanson, 2013). Only 13% of people suffering from alcohol dependence recover through the use specific alcohol treatment (Hanson, 2013). Importantly, even those that you support services, such as AA, although gaining help, not gaining medical help (Hanson, 2013; Hill, 1985).