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Allan Schwartz, Ph.D.Allan Schwartz, Ph.D.
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Is Alcohol Addiction a Disease?

Allan Schwartz, LCSW, Ph.D. Updated: May 23rd 2012

Is Alcohol Addiction a Disease?There is a paradox in the question, "Is alcoholism a disease? Alcoholics Anonymous asserts that alcohol abuse is an illness or disease, cannot be cured and can only be controlled through abstinence and with the help of AA and in belief in a higher authority. The medical establishment tends to view alcohol abuse as a disease that might be cured if the right set of medications can be found. Recently, there is evidence that drugs, such as Naltrexone, Acomprosate and Disulfiram help break the cycle of alcohol addiction. Yet, both AA and the Betty Ford Clinic are opposed to medication. That is part of the paradox. If alcoholism is a disease, why not use medication.

Where is the paradox in all of this? At least some people who are anti AA also reject the idea the alcoholism is a disease. Oddly, that puts them on the same side as AA in rejecting the use of medications.

All the evidence is that alcohol abuse is a disease. However, rather than being one disease, it is many. Just as there are more than one type of cancer, there are more than one type of alcohol addiction and that is why neither one medication nor one type of treatment will fit everyone. For some people, alcohol abuse results from their genetic background while for others it can result from PTSD as a result of either war or having been involved in some other catastropic event. For others, the problem lies elsewhere.

Therefore, the medications being used for alcohol addiction do not help everyone. In fact, there is a small but significant percentage of people who are cured by the combination of medication and psychotherapy while others are not. It is anticipated that, in the next ten years the percentages will increase and the scientific mental health community will be able to speak of a cure. That will mean the different medications or combinations of medications and therapy will be used to bring about a cure.

The fact is that, despite all of their efforts, including attendance at AA meetings or the Betty Ford Clinic, there are many people who relapse from addictions regardless of all their efforts to be abstinent. In my thinking, these people are not failures. Instead, they are suffering from a terrible disease.

What are your opinions about this issue?

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.

A Disease - Allan N. Schwartz, Phd - May 25th 2012

Michelle,

You are partially correct when you say that AA considers alcoholism a diseas. In fact, I have edited the article so that it's consistent with the concept that AA considers it a disease. In actuality, there is a long debate over whether AA truly accepts the disease concept or not. The word "illness" is used in the Big Book but, as I have read from others, it never states that it is a "disease." The major point is that they reject the use of any medication which they view as substituting one substance for another.

In any case, the article has been edited.

Thanks

Alcohol Addiction - Sarah Bell - May 24th 2012

Allan,

I agree with you that not all treatments will work for everyone.  I see patients who do really well w/ anti-craving rx, and some don't respond as well.  I am hopeful for future tools to manage this DISEASE more effectively.  Thanks for your blog

Sarah Bell, MA, LPC, CCDP-D

AA DOES consider alcoholism a disease - Michele Happe - May 23rd 2012

AA has long considered alcoholism a disease.  They say it is an allergy of the body coupled with an obsession of the mind.  AA believes in remission not cure...similar to some cancers...

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