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The concept of alcoholism as a ‘disease’

According to a recent publication by the World Health Organization (WHO), there were 3.3 million deaths due to harmful use of alcohol in 2012. Alcohol consumption can not only lead to dependence, but also increases people’s risk of developing more than 200 diseases including cirrhosis of the liver and certain cancers (WHO 2014).

The validity of losing control to alcohol has been questioned for quite some time. The idea of alcoholism as a disease is still being debated; however, it is quite common for recovered alcoholics to succumb to triggers and continue to drink.

The “alcoholism as a disease” question

The disease concept holds that alcoholism is a brain disorder. It points out that alcohol abuse changes the structure and functioning of the brain to the point that the brain doesn’t function to the capacity that it did before the onset of heavy using or drinking.

In 1956, the American Medical Association (AMA) declared that alcoholism was an illness. In 1991, the AMA went even further and endorsed the dual classification of alcoholism by the International Classification of Disease under both its psychiatric and medical sections. According to one of the founders of the disease concept, Benjamin Rush, “Habitual drunkenness should be regarded not as a bad habit, but as a disease.” Rush has also been known to describe the loss of drinking control as a “palsy of the will”.

When a person stops heavy drinking, the brain is repaired in many facets and a chronic alcoholic stops behaving and thinking in the same way that he or she did during the time of the addiction though this return to a proper cognitive state can take weeks or years. In the same respect, there have been chronic alcoholics who recover and may start drinking again or stop altogether, proving that one could have control over the disease.

Some might wonder why it would be considered a disease, even after a person stops using or drinking and his or her brain begins to function normally prior to the addiction. According to an Oxford University press publication titled, “Manifestations of early brain recovery associated with abstinence from alcoholism”, if the chronic problem of alcoholism is managed properly, damage to the brain can be stopped and to some extent, reversed. Which begs the question, if a chronic alcoholic can regain control of his or her drinking or stop altogether and lead a productive life, does he or she still have the disease of alcoholism?

It is essentially the impaired control over alcohol cravings, compulsive thoughts about alcohol and distorted thinking caused by alcohol, that defines the ‘disease’ concept. The idea of an addiction being a disease is rooted in the neuropathology and the impairment of motivational circuitry of the brain that results in the continued drinking despite repeated attempts to quit drinking even while knowing about the negative consequences that may result from continued drinking. The changes in the neuropathology of the brain caused by alcohol or drug abuse prove that addiction to certain substances doesn’t halt when one substance is taken away and/or another is provided in its place. It is essentially the impaired control over thoughts, desires, obsessions and compulsions to take part in a certain act that brings one pleasure that sums up the concept of alcoholism and , in general, addiction, as a disease.

According to data from NIAAA’s 2001–2002 National Epidemiologic Survey on Alcohol and Related Conditions, only 14.6 percent of people with alcohol abuse or dependence receive treatment (NESARC). Another survey of people who experienced the onset of alcohol dependence a year before the study found that only 25 percent ever received treatment.

There are various ways to treat alcoholism. Depending on the individual’s situation, treatment can include medication and/or therapy after a period of detox. Along with a thorough treatment program, twelve-step groups and group therapy are also very useful in the effort to treating alcoholism and provide the individual with a full and long-lasting recovery. According to Dr. Jurgen Rehm, the most effective way to maintain sobriety is through cognitive behavioral therapies and motivational therapy.

If you or someone you love is battling an alcohol addiction, don’t hesitate to get help. Feel free to call the Drug and Alcohol Addiction Recovery Helpline at 855-441-4405 today for more information on how you can get started on your recovery today.

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