Disease theory of alcoholism Totally Explained

Everything about The Disease Theory Of Alcoholism totally explained

The Disease theory of alcoholism is a theory based on the concept that alcoholism is a disease process. The disease theory is generally accepted by the medical community, which argues that genetic, neurological and behavioral studies distinguish those with alcohol dependence from problem drinkers.

Theory

The term "disease" refers to a disorder of structure or function. The term can refer to a physical disorder, such as diabetes, or to a mental disorder, such as schizophrenia. Diseases can be short-lived, such as the common cold, or life-long, as in sickle cell anemia.
In the case of alcoholism, research has demonstrated both genetic and environmental contributors to the development of a condition that carries significant physical morbidity. Such factors as a typical course and well-described epidemiology (the incidence and prevalence of the condition) also contribute to the establishment of a disease entity.

History

The disease theory of alcoholism was first proposed in 1784 by Dr. Benjamin Rush of Philadelphia, and independently by Thomas Trotter. The modern theory of alcoholism as a disease was put forth by E. Morton Jellinek. Controversy over Jellinek's claim that he received a doctoral degree has contributed to criticisms of the disease theory. Jellinek himself admitted that his proposals lacked any demonstrated scientific foundation, and remarked that "for the time being this may suffice, but not indefinitely".
The first major empirical challenge to the disease model came in 1962 with the publication of Dr. D. L. Davies' follow-up of seven alcohol abusers which found that some of them were able to return to "controlled drinking". Other research also reported that some alcoholics could drink in moderation.
In 1978, what is commonly referred to as the RAND report published extensive evidence that alcoholics could learn to consume alcohol in moderation. The publication of the book caused strong controversy in its findings that people suffering a disease which reputedly leads to uncontrollable drinking could manage to drink controllably. Subsequent studies also found that many alcoholics can drink in moderation. Indeed, according to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), about one of every six (17.7%) of alcohol dependent adults in the U.S. whose dependence began over one year previously had become low-risk drinkers.
In 1980, the American Medical Association's Council on Scientific Affairs (now the Council on Science and Public Health) noted that "alcoholism is in and of itself a disabling and handicapping condition". Between 1980 and 1991, medical organizations, including the AMA, worked together to establish policies regarding their positions on the disease theory. These policies were developed in 1987 in part due to the fact that third-party reimbursement for treatment was difficult or impossible unless alcoholism were categorized as a disease. The policies of the AMA, formed through consensus of the federation of state and specialty medical societies within their House of Delegates, state, in part:

"The AMA endorses the proposition that drug dependencies, including alcoholism, are diseases and that their treatment is a legitimate part of medical practice."

In a 1988 US Supreme Court decision on whether alcohol dependence is a condition for which the US Veterans Administration should provide benefits, Justice Byron R. White's statement echoed the District of Columbia Circuit's finding that there exists "a substantial body of medical literature that even contests the proposition that alcoholism is a disease, much less that it's a disease for which the victim bears no responsibility". He also wrote:

"Indeed, even among many who consider alcoholism a "disease" to which its victims are genetically predisposed, the consumption of alcohol isn't regarded as wholly involuntary."

In 1991, The AMA further endorsed the dual classification of alcoholism by the International Classification of Diseases under both psychiatric and medical sections.

Current acceptance

Current scientific and medical opinions favour the concept that alcoholism is a disease, however, debate still remains on the subject.
The American Society of Addiction Medicine and the American Medical Association both maintain extensive policy regarding alcoholism. The American Psychiatric Association recognizes the existence of "alcoholism" as the equivalent of alcohol dependence. The American Hospital Association, the American Public Health Association, the National Association of Social Workers, and the American College of Physicians classify "alcoholism" as a disease.
Current evidence indicates that in both men and women, alcoholism is 50-60% genetically determined, leaving 40-50% for environmental influences.

Opponents

Critics such as psychotherapist Dr. Stanton Peele, psychologist Dr. Jeffrey A. Schaler and Dr. Thomas Szasz reject the disease model.

Miscellanea

Many doctors are "loath to prescribe drugs to treat alcoholism, sometimes because of the belief that alcoholism is a moral disorder rather than a disease", according to Dr. Bankole Johnson, Chairman of the Department of Psychiatry at the University of Virginia. Dr Johnson's own pioneering work has made important contributions to the understanding of alcoholism as a disease.
Frequency and quantity of alcohol use are not related to the presence of the condition that is, people can drink a great deal without necessarily being alcoholic and alcoholics may drink minimally or infrequently.
A greater belief in the disease theory of alcoholism and higher commitment to total abstinence were found to be factors correlated with increased likelihood that an alcoholic would have a full-blown relapse (substantial continued use) following an initial lapse (single use). However, the authors noted that "the direction of causality can't be determined from these data. It is possible that belief in alcoholism as a loss-of-control disease predisposes clients to relapse, or that repeated relapses reinforce clients' beliefs in the disease model."

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