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Allan Schwartz, Ph.D.Allan Schwartz, Ph.D.
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Is Alcoholism a Disease?

Allan Schwartz, LCSW, Ph.D. Updated: Oct 21st 2010

Is Alcoholism a Disease?There has been a long and continuing debate over the question of whether or not alcoholism is a disease. The AMA and the DSM IV classify alcoholism as a disease but that has not quieted the debate.

A recent piece of research points to alcohol abuse as being very much a disease with a real genetic basis to it.

It is a curious thing that, while some people become dependent on alcohol with the result that they crave the next drink, others do not. In fact, these other people can have their first drink and never want to take another one. Why this difference? Those who favor the disease model would answer the question by stating that the first drink set off the degenerative process of the disease. Those who oppose that model state that the alcohol dependent person makes a life style choice and are at fault for their continued drinking.

In the area of genetics as a causative factor for alcohol dependence, the evidence is conflicting. On the positive side of the debate there is strong evidence the this addiction runs in families, strongly suggesting that the tendency for alcoholism is inherited and, therefore, a disease, much like diabetes which is also inherited. On the opposite side of the argument is the fact that not everyone who becomes addicted to alcohol comes from a family with a history of drinking.

The latest piece of research is interesting because the findings reveal that there is a variant of a gene that seems to protect against alcoholism.

Researchers from the University of North Carolina at Chapel Hill School of Medicine discovered a gene variant that may protect against alcoholism.

The gene in which the variant protects against alcoholism is called CYP2E1. People with this variant have a particular response to their first drink. For the ten to twenty percent of people who have this gene variant, their first response to the first few drinks is to be more inebriated than the rest of the population. The remainder of the population have a different version of the gene. It important to understand that most of the findings prior to this indicate that those who react strongly to their first drinks are less likely to become alcoholic. In effect, this genetic variation makes the brain more sensitive to alcohol causing the individual to not want to drink again.

It seems to me that there is most likely a combination of causes of alcohol addiction. Among them are psycho social, genetic and biological factors that predispose a person to alcoholism. One new paper reporter from the past reported that despite his best efforts, when he was young, he could not become alcoholic. This is a paraphrase. 

Some of the population become alcoholic and others do not. Some can stop drinking and others cannot ever stop. In my opinion, these differences point to a disease model of this problem.

Why do I believe it is important to take the disease model seriously? Because, the disease model, if it turns out to be a fact, will allow the public to stop blaming people with this problem and help them be viewed and treated the same as people with cancer or any other disease.

Finally, science is now working on medications based on genetic research such as the one above to help treat or even prevent alcoholism

What is your opinion? Your comments and questions are strongly encouraged.

Allan N. Schwartz, PhD

Allan Schwartz, LCSW, Ph.D.

Readers who live in the Boulder, Colorado metro area, or in Southwest Florida may contact Dr. Schwartz for face-to-face consultation. He is also available for psychotherapy through Skype video for those who are not in Florida or Colorado. He can be reached via email at dransphd@aol.com for details.

Reader Comments
Discuss this issue below or in our forums.

Is alcoholism a disease? - Carol - Apr 30th 2011

One opinion never seems to be developed:  every alcoholic I know thinks it's perfectly allright to "get drunk" occasionally. I don't. I think it's disgusting. There's nothing funny or cute about it.

Alcoholics also seem to have been raised with the idea that drinking "correctly" is a SKILL! Hogwash! Drinking alcohol is a social crutch ...nothing more.

Alcoholics also seem to think that "partying" means drinking alcohol. Since when? Ever notice that non problem drinkers really don't care if alcohol is available or not? They never HAVE cared about it...it's NOT IMPORTANT!  Alcohol's the LAST thing they think about, if at all.

People who think occasionally getting drunk or frequently having 2 drinks with dinner...had better be careful:  eventually they'll become a problem drinker whom no one will want to be around.

Don't want to become or to raise an alcoholic? Then make sure your household places ZERO IMPORTANCE on alcohol!

Teach children that It's not BAD. It's not GOOD. It's simply unimportant!

 

What do we mean by "disease"? - Mona Lisa - Oct 24th 2010

In my opinion, the answer to this question depends totally on what we mean by the term "disease".

If by "disease" we mean that the predisposition to become addicted to alcohol can be inherited, then the answer appears to be "yes".

If by "disease" we mean that there are certain biochemical reactions in the addicted brain that do not occur in the non-addicted brain, then the answer appears to be "maybe".

If by "disease" we mean that addicted people have a spiritual malady that can only be arrested on a daily basis via a belief in God, then the answer is "hell no".

ML

HMM - Gabby - Oct 21st 2010

OK... all i KNOW how to do is talk about my experiances.... had my first Budweiser at 12..... fell in love at that moment ... with the way it made me feel and still like it.... although things MAY be changing...

MOM and DAD were both alcoholics... but they AGED out of it like so many drinkers do.... but yes, Mom drank and smoked with me...It was the 60's Free Love and LOTS of drugs....

BUT>>> I am NOT alcohol dependant.... I can quit anytime I WANT to and not have ill health effects.... no shakes no DTS.... but I know those that can't....

I can say that is is not enviroment... I was raised in a church going house... NO alcohol.... not even around it and went to Private CHRISTIAN schools... went to church 3 times a week and can qouote the BIBLE front to back.... I was raised right... but the were my foster parents and then eventually my adopted parents....

MAYBE some of it was my BIRTH Mom and Dad??? when I was in foster care they HAD to let me see them.... MAYBE I thought their lifestyle was neat????

But anyway... is alcoholism a disease??? In My Opion... I think it is ... it is Inherited.... or learned... jt

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