That's like saying if I never smoke and don't get lung cancer, therefore smoking does not cause lung cancer. 
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Posted on 06/22/2008 8:50:16 AM PDT by ventanax5
One of the most insidious things about the disease of alcoholism–and it is a disease, despite the best efforts of thundering moralists to deny the science and the plain medical and biochemical facts–is that it plays on your character defects (which all people have) and, worse, it progresses slowly. Biochemically, it’s known to generally progress faster in women, for a variety of reasons that are understood (women are generally smaller, with consequent lower blood volume on average, and may also be able to conceal drinking better if they’re stay-at-home moms) and some of which undoubtedly are not currently understood. But in any case, in most alcoholics the progression is slow;
(Excerpt) Read more at deanesmay.com ...
One of the most insidious things about the disease of alcoholism–and it is a disease, despite the best efforts of thundering moralists to deny the science and the plain medical and biochemical facts–is that it plays on your character defects (which all people have) and, worse, it progresses slowly. Biochemically, it’s known to generally progress faster in women, for a variety of reasons that are understood (women are generally smaller, with consequent lower blood volume on average, and may also be able to conceal drinking better if they’re stay-at-home moms) and some of which undoubtedly are not currently understood. But in any case, in most alcoholics the progression is slow; while a certain minority subset (with a strong genetic component most likely to effect males) progress at a frighteningly fast pace, most people will progress very slowly, moving from social drinkers who are basically functional members of society to having occasional overindulgence problems to drinking regularly to an unhealthy degree to finally reaching a pathological, out-of-control state. What’s also well-documented about the disease, even symptomatic, is that the alcoholic will occasionally under go “dry spells” where they “prove” to themselves and others that they’ve got the problem “under control” by just not drinking, or by moderating their intake. I myself had such a dry spell 3-4 years ago, where I went about 100 days without drinking, trying a few meetings and then giving up on them because I hated them–the ones I got to were mostly pity-parties, which is one of the negative things you see at some AA meetings. I also did a lot of reading on alternative approaches, and tried some of them with mixed levels of success. Those things I don’t regret, but what I do regret is that I did go back to drinking, with firm intention never to get out of control again.
But, as is yet another symptom of the disease, I soon was back pretty much where I’d left off. What is quite typical of the progression, which typically takes 3-10 years in women and 5-15 years in men (or so I was told in the hospital last fall), is that you go through periods where you don’t drink at all, or where you convince yourself that you’re moderating successfully. You have instances where you do indeed don’t-drink, or succeed in your goal to drink less. But you don’t notice that the times you fail are increasingly more frequent than the times you succeed. You see the success (”See! last night I said I’d have only two, and I had only two!”) but the failures are just things you kick yourself for in the morning, with much self-abuse, and then move on.
In my own case, I’m fairly well convinced I had no real “problem” per se until approximately 1999. I drank regularly, but only occasionally to the point where it made me irrational or affected my job or family life in a significant way. I had a lot of fun, and in fact a lot of people in my life said they preferred my company when I had a few in me, as I was a lot more jolly and funny and outgoing than my normally fairly quiet and reserved demeanor. Around 1999, after the failure of my business and I got into repossessing cars, I started working midnights and drinking more heavily, and was a hell of a lot grumpier. I got a better job I liked better, training computer classes, and accomplished a lot, but didn’t love that job either (although in retrospect I wish I’d never left it, I did well there and was well-liked). But by 2001, everything collapsed, none of it due to drinking. Financially and otherwise, disaster was more or less complete, and right around the time of the September 11 2001 attacks, too. I got a terrible job that was the only thing available then in Michigan’s economy for someone with my skillset, a crappy tech support job for a crappy company that treated its employees like dirt, making approximately a third of what I’d once made. Working the midnight shift was the only way to make the job bearable and pay enough, and but I also made the near-fatal mistake of deciding to get a college degree. The only thing that saved my sanity in those years, where I was so often isolated from my family, was blogging, and blogging also brought in money as a second job that was often helpful. But I was alone a lot, I was tired constantly (working midnights and going to school will do that to you) and so my family relationships suffered. Alcohol was the only thing that seemed to help.
Then around 2003 or so I had stomach surgery that is now known to tend to aggravate alcoholism in some people. I can see why. It caused alcohol to hit my system much faster than in normal people. Yet at the same time, strangely, my capacity went up. You can see why that was a disaster. From 2003 to about 2005, my progression went from slow to extremely rapid, aggravated both by physical factors and severe isolation and career/school stresses. It also made me a bear to live with, and my then-wife struggled to deal with it, usually valiantly. I quit for a while on my own, but the obsession wouldn’t leave, the factors making me miserable didn’t change, and so I went back, and took up almost exactly where I left off.
No matter what, the disease gets worse and worse, and no matter how much you convince yourself that you’re getting better, you’re not getting better at all. You convince yourself that the problems you’re having, most particularly in your personal life, are the fault of everything and everybody (including yourself) except for the one thing that’s really aggravating everything: the alcohol. No, not all your problems are caused by it, but as another friend in recovery wisely observed to me recently, “there is no problem in the world that can’t be made worse [for the alcoholic] by another drink.”
None of this applies to the person who occasionally drinks, or even occasionally ties one on after a period of stress. Heck, in some cases that may even be psychologically healthy–until it becomes a habit.
The truth of the matter is that if you think you have a problem, you probably do. On the other hand, there is spontaneous remission; something like 20% of people with severe alcohol problems just stop on their own and cease to have a problem.
About 80% don’t experience such remission. They continue to get slowly worse and worse. The result for them is usually the same, an increasing despair, despondency, and overwhelming depression, with irrational bouts of anger, joy, frustration, and even paranoia, and usually an aching loneliness even when around loved ones. For those around them, it’s often just as bad or worse. But as I say, it’s insidious: it usually doesn’t get worse over a period of weeks, but more often in a period of many months and multiple years. With one step forward, two steps back, but those little steps forward helping you convince yourself, to rationalize and lie to yourself, that you’re getting better and that whatever problems you’re having have nothing to do with that bottle. The bottle becomes your only real friend, especially when your social life is already gone due to things beyond your control (although the bottle makes that social life issue worse too).
No matter the journey, the end points are the same for most: unless you’re one of the lucky minority who has a spontaneous remission, the end is insanity, prison, or death. Usually death, because the number of alcoholics who spend years in jail only to get out and take up right where they left off is huge. So they either wind up drinking themselves to death, or, doing something else while intoxicated that lands them in jail for life.
Although I am a regular 12 step program participant, and active in 12th-step work, I’m actually sympathetic to many criticisms of AA and its approach. I firmly believe there are other approaches besides 12 step programs that work, and may in fact work much better for some people. I’ve written about that in the past, and you can search this site for articles on them, or just search the internet yourself. I chose it because it was the right fit for me at this time, and because I’ve seen how, properly applied, it can be tremendously helpful for some individuals, even if it is a poor fit for others and is sometimes rammed down people’s throats in an inappropriate manner.
Anyway, it was a fascinating chart given to me by a doctor (himself an alcoholic) that finally made me believe that this was a disease, that the science was rock solid, and that I had it; the way it described the progression was such a precise description of what the last 8 or so years had looked like in me, it was shocking, going from minor problem to full-blown out-of-control, with me quite rapidly approaching the chronic, often terminal stages.
Unfortunately, I can’t find that chart online and don’t have a scanner. The only one I’ve managed to find so far is the better-known Jellenek chart, which is much less detailed, although it is generally accurate and also hopeful (PDF here). On the other hand, it’s way too limited, too lacking in details, and elides the fact that some people enter recovery much sooner than it would indicate.
The chart I was given was much better, at least for my logic-and-detail-obsessed way of thinking. I’m wondering, does anyone out there know the one I’m talking about? It had three rows, showing a progression timeline through four basic stages, with various symptoms of each of the stages (like “water wagon” and “self-loathing” and “firm commitment to stop” among them). Anyone seen it?
Not trying to stir but can anyone else name a ‘disease’ that has been ‘cured’ thousands of times over often with no treatment beyond attending regular meetings with others similarly afflicted?
Nope, no one needs a doctor-just rigorous honesty, and thats hard enough..
RDWHAHB
It is not a disease. It’s self medication for depression.
This doctor has the answer:
A doctor and medical care, often a treatment center, is very appropriate for the majority of alcoholics. In about 90% of alcoholics an underlying biochemical depression is present and often has led the person to “self-medicate”. While there are psychological and behavioral issues that the 12 Step program addresses the best, it is most often not enough.
This is in keeping with the early 12 step formation as both founders, one a doctor, were very willing to address the need for medical or psychiatric care.
The number one cause for relapse in recovering alcoholics is an untreated biochemical depression.
While there are some alcoholics who do manage to “just stop” or use other programs, no other program has the longevity of success in dealing with the myriad other factors of a recovering person as does AA. this is most especially true for chronic drinkers or drug users.
Vetanax, keep up the good work. Thanks for sharing.
Sharing is a way to keep the obsessive compulsive urge at bay. God Bless.
The AMA defines a disease by two characteristics..1 a predictable path of progression and 2 a certain outcome.
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So if a significant portion of alcoholics (self-described or as described by others) become non-alcholics as denoted in the article does this violate the certain outcome proviso?
non-alcholics => non-alcoholics
something like a reverse bellcurve...i think it’s Jellinek’s curve...think I got his name wrong...but it’s something like that.
Calling it a ‘disease’ takes the accountability out of it.
As the child of an alchoholic, and the grandchild of an alchoholic, I rarely touch it because I see what it can do. There is nothing that reaches out of the shelf and grabs me, inflicting a disease on me. I don’t just wake up, go the doctor and get a diagnosis of ‘achoholism’. I’m not a moralist either. It’s just about accountability.
Same for drug abuse. And why all this pity for alchoholics as a disease, but none for the crackhead, methhead or herione junkie? Is there a medical journal that says that snorting, shooting or eating meth is a DISEASE? Um, I doubt it, but I could be wrong. I know I have been around idiots who have partied with drugs, and I have to admit to taking a few myself at times in my youth, but I did not ‘catch’ this disease.
I beleive some races have a certain chemistry that allows them to become more dependant on chemicals faster than others. But I am Irish and I am not an alchoholic. I am Scottish, but I am not an alchoholic and both of these groups of people are known for being drinkers. Some of my family members are, but that is by choice, not by blood.
And if a Native American NEVER DRINKS, they will NEVER become an alchoholic, therefore Alchoholism is not genetic. Behavior might be learned, but not genetic.
They use to categorize homosexuality as a disease. But they were PC'd into taking that back.
The medical establishment hasn't found a cure have they?
But Dr. Prasda has because he understands the true nature of alcoholism.
Which is self medication for depression gone awry.
Interesting read. Too bad he’s on the opposite coast from me! I’ve long observed that most alcoholics or other addicts had underlying psychological issues (depression, bipolar disorder, etc). My mom once told me that alcoholism ran in the family. In our two generations, only one uncle had a slight drinking problem, however many of us have suffered depression issues.
Raised by alcoholic parents, I’m something of an unwilling expert. IMO, the disease part is mental, exaccerbated by body chemistry that makes alcohol effect the person about 10x more than people who are NOT alcoholics.
I have the chemistry, get a very big bang from a sip of beer or the hard stuff. Fortunately, while I enjoy a beer or gin and tonic, I HATE the effect and have perhaps three drinks a year. (I often even hate alcoholics for their weakness.) For heaven’s sake, how demented would you have to be to put up with hangovers every morning? But they do.
I won’t even get into the well-known devastation alcoholics cause their loved ones. Selfish bleeps!
But I have the utmost admiration for those who get and stay sober.
And no 12 step for life requirements necessary.
If the AMA considers a “predictable outcome” to fall into three categories, then it’s a disease:
1. You die
2. You lose your mind
3. You quit drinking
No other choices.
Bingo.
Yes, it does have physiological aspects - the progression, for instance. But once free from the physical addiction, there is no physical reason to drink again. At that point it’s a matter of making a clear decision - acknowledging that you cannot drink again, and then DON’T.
I made that decision 23 years ago, and I’ve been truly free ever since then.
When I was rehab, they spent more time trying to find out tragedy occurred in my life that made me so "self destructive". There was none; raised in a happy, healthy, two parent household with all the advantages of a middle class catholic upbringing, and I still wound up in the gutter. Its called cunning and baffling for reason-it can affect anyone for any reason. I dont give a damn what causes it, I just know how to live with it..
If booze affected everyone they way it did me, everyone would be an alcoholic. It was magic for years and then it was hell...for years.
This is very helpful.Thank you.
Bullseye
All this demonstrates, however, is that alcohol is not universally addictive. If you doubt the power of addiction, however, try heroin, or morphine, or cocaine. Something out there almost certainly has your number on it. Part of the alcoholics' problem is that their drug of addiction, being non-problematic for the majority, is legal and socially promoted.
I’ve been slowly overcoming my fear of flying on my own, so I will see how I do on my next trip. It might be worth it to get my husband to stop smoking, though!
Smoking is an annoying habit but it gives comfort to the participant. There is no deep underlying need to smoke. It's a destructive pleasure so it's harder to rewire the brain to stop.
Judge Judy was a patient for smoking. I don't think she had relapsed.
Well hell, for that matter, EVERYTHING we do wrong is a mental illness.
Stealing? No need for jail, it’s a mental illness.
Rape a kid, it’s not that you are *bad*, you just have a mental illness.
Get SOOOOO angry at society that you join a gang and perform half a dozen drive by shootings in a week a half, it’s not your fault, you are mentally ill.
YES, there are mental illnesses in this world, but to claim every bad behavior as mental illness is not solving anything but making victims out of perps. Why have a justice system at all? Why not just set up one big mental institution instead?
And to call everything mental illness detracts from *real* mental illness, such as schizophrenia and bipolar (and even that disorder is overdiagnosed in my opinion).
“Nope, no one needs a doctor-just rigorous honesty, and thats hard enough..”
YOu speak the truth.
What is also a tragedy is people around you DON’T CARE. They don’t care enough to stop the downward slide that typically leads one to escape reality, whether it be through alcohol or drugs.
THNAK YOU!
It reminds me of the phony “gay gene” rgument that resurrects itself every now and then. Later it is quietly debunked but not highlighted.
I’m pretty sure you are correct about the correlation of mental problems and alcoholism. I think you will find this in almost all cases of alcoholics and it is a self-feeding disorder. I don’t know if i would call it a disease, but it is certainly a disorder. Having faced bouts of binge drinking myself, i do believe this. For me, drinking was a way of loosening the social side of me. I always felt much more relaxed, jovial and outgoing after a few drinks. It was a social lubricant. Unfortunately, i have a history of alcoholism in my family and by my early 30s i had began to experience blackouts and exhibited truly stupid and irrational behavior after drinking too much.
It is a horrible drug and it has inflicted so much damage on the alcoholics, their families, their friends and society as a whole. Its truly a devastating place to be for those that are alcoholics. I think it is a symptom of deeper lying causes, but not a disease in the traditional sense of the word.
I was fortunate; everyone cared..
I drink socially, and really really enjoy a cocktail with dinner, but I never have more than a few. I hate the effects of alcohol. I am a "puker" and even a few tend to make my bed spin, so I just stop before I get to that point.
On the other hand, I also hate being around people that are drunk. Since I am always sober (and my husband never has more than one beer) we are always the ones that leave the parties before the drinking becomes the only entertainment. I also have a sister that I really enjoy spending time with until she starts drinking. Although she does not drink everyday, or even every week, she is the type that just doesn't stop until she is drunk. She loses all sense of time and money (how much she is spending) so I just leave (making sure someone else is there to drive obviously).
My whole extended family seems to think that every single get together must revolve around drinking and I just don't get it. Although I am sure quite a few of them are "alcoholics" they all also lead productive lives and keep steady jobs, so until their "binges" actually affect their lives in other ways I don't see any of them changing.
You will read in many authoritative articles that depression is more common among women. Other experts suggest that alcohol is self-medication for depression, and if you include male alcoholics as depressed, the sex ratio for depression is nearly equal. You mention that alcohol was a social lubricant for you. Social anxiety and shyness are often correlated with depression in people, and can be mitigated with the same drugs (antidepressants).
That's like saying if I never smoke and don't get lung cancer, therefore smoking does not cause lung cancer. .
It’s well established that people of Mongoloid race (which includes Native Americans) are genetically different from Europeans regarding ability to metabolize alcohol. As for Irish, part of the problem could be the cloudy climate and long northern winters, which exacerbate seasonal affective disorder, which is a form of depression; another part would be the prevalence of distilled spirits (whiskey) which are much stronger than beer or wine, and hence accelerate the addictive process. Alcoholism is very common in Russia, because of terrible winters, vodka being the favored drink, and a quality of life which would depress almost anyone outside of Putin’s clique of cronies.
Amen. That's one reason for not legalizing other addictive drugs; legalization will increase use by 1) removing stigma 2) lowering cost and increasing supply. We have enough problem with alcohol already; it's not only a cause of accidents and physical disease, but a significant factor in violent crime and domestic abuse.
And if a Native American NEVER DRINKS, they will NEVER become an alchoholic, therefore Alchoholism is not genetic.
That’s like saying if I never smoke and don’t get lung cancer, therefore smoking does not cause lung cancer. .
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What the hell? It is no way the same. That is about the most ridiculous statement I have read yet.
Lung cancer is a tangible cause of death. Death by alchoholism WITHOUT THE ALCHOHOL is, um, nonexistent?
The ridiculous and insidious overuse in modern society of the words 'disease' and 'addiction' in one swoop allows you to say or think that it's not your fault, you're ill, you're whatever.
Alcoholics do not need to drink to be alcoholics. Alcoholism is indeed genetic, and we are born with our own propensity for compulsive drinking. You think you are immune? Work on it a little and maybe you’ll find out different. Just see how much drinking it takes before you can’t put the bottle down. For a native American, its not much. For an Irishman, maybe more. For another Irishman, maybe not so much. It just depends on what your ancestors’ genetics were.
Part of the alcoholics’ problem is that their drug of addiction, being non-problematic for the majority, is legal and socially promoted.
Amen. That’s one reason for not legalizing other addictive drugs; legalization will increase use by 1) removing stigma 2) lowering cost and increasing supply. We have enough problem with alcohol already; it’s not only a cause of accidents and physical disease, but a significant factor in violent crime and domestic abuse.
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That’s right! 10% of the population will screw it up, so let’s all suffer the consequences of those dumbies.
Right on!
Alcoholics do not need to drink to be alcoholics. Alcoholism is indeed genetic, and we are born with our own propensity for compulsive drinking. You think you are immune? Work on it a little and maybe you’ll find out different. Just see how much drinking it takes before you can’t put the bottle down. For a native American, its not much. For an Irishman, maybe more. For another Irishman, maybe not so much. It just depends on what your ancestors’ genetics were
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Aaahh, and herein lies your entire point. “Work on it”.
Work on it. If I ‘work on it’, I will BECOME chemically dependant on alchohol. If I have to “WORK ON IT”, it does not rely on my genetics, but on my forcing chemicals into my body, making my body wish to use these chemicals to function. Much the same as herione, cocaine, even caffiene.
Your statement of ‘work on it’ contradicts your ENTIRE argument.
I bet they would never dream of calling cigarette smoking and addiction a disease.
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