Can Alcoholics Ever Drink Safely Again?

[Neeranam]

Can an alcoholic ever drink normally again? I'd be interested to hear if there are any here who have.

[imaneggspurt]

I think yes, circumstances change, and attitude,,but willpower is number one,,.alcoholics usually have a reason for getting inside the bottle,its a personality disorder as we know and usually brought about by circumstances,..im a binge drinker,but once home after a night out thats it for me from an indefinate period from 1 week to one year,.i have a built in siren that tells me if i did that every night id kill myself,.or go skint

[Wrong Turn]

Can an alcoholic ever drink normally again? I'd be interested to hear if there are any here who have.

Neeranam,

I think it depends on the classification of "alcoholism."

I think some of the daily drunks I've known, by definition, were probably not "alcoholics."

They cut down on drinking to say, one night per week, or less.

Other folks I've known and still know, can never take a drink again after quitting. I think these latter folks have a genetic predisposition. They are/were the kind of drinkers that could not stop until the passed out, and they often blacked out.

The label "alcoholic" can be over-used sometimes, I think.

[dumball]

Can an alcoholic ever drink normally again? I'd be interested to hear if there are any here who have.

It all depends on what you call normal , i am a recovering alcoholic , have been for many years , but i still drink even theres care-free days . I have no particular pressure or reason (as i had convinced myself) because i spent 5 weeks in hospital being taught (brainwashed) how to respect my inner self , i can take 1 drink or 4 , social or just for the heck of it , but my inner self tells me when i need to throw that last half-a-glass down the drain , a person just has to become ones own concience and safety monitor .

[imaneggspurt]

Can an alcoholic ever drink normally again? I'd be interested to hear if there are any here who have.

It all depends on what you call normal , i am a recovering alcoholic , have been for many years , but i still drink even theres care-free days . I have no particular pressure or reason (as i had convinced myself) because i spent 5 weeks in hospital being taught (brainwashed) how to respect my inner self , i can take 1 drink or 4 , social or just for the heck of it , but my inner self tells me when i need to throw that last half-a-glass down the drain , a person just has to become ones own concience and safety monitor .

Well said, and well done

[Groongthep]

Can an alcoholic ever drink normally again? I'd be interested to hear if there are any here who have.

I think that just about all the clinical evidence (of which there is a huge amount) shows that the answer to this question is NO. While there may be evidence of some extremely rare cases where chronic alcoholics have returned to moderate social drinking they are surely a miniscule minority. I have not taken a drink in over 11 years after having been habitually drunk during the 25 years before that. I wouldn't dream of risking going back to those dark days by taking a chance at trying to return to "social drinking". The first few years of abstinence are hard but you do eventually get to the point where the "Oh my God I'll never have fun again" delusion fades away and you learn to live a happy life without any alcohol. I suspect that anyone who tells you that they have gone back to moderate (one or two drinks or beers a day) drinking after having suffered from chronic alcoholism is either not being truly honest with you or himself or was never really an alcoholic in the first place. if you have an alcohol problem, quitting doesn't guarantee you a happy life but it will guarantee you a longer one with an immensely better chance at contentment.

[Chris Lawrence]

[quote name='Groongthep' I suspect that anyone who tells you that they have gone back to moderate (one or two drinks or beers a day) drinking after having suffered from chronic alcoholism is either not being truly honest with you or himself or was never really an alcoholic in the first place. if you have an alcohol problem, quitting doesn't guarantee you a happy life but it will guarantee you a longer one with an immensely better chance at contentment.

Suspision kills Groongthep. These decisions are best left to the individual as well as the decision to turn your will over to a higher power.

[sgunn65]

In response to Groonthep. This hardcore AA attitude does you and your philosophy no favours. If a former alcoholic decides, after a period of abstinence, to return to controlled drinking then who are you to say they were not an alcoholic in the first place.

As a former drug addict i have had several debates with fellowship members who tell me I am in denial when I refuse to categorize myself as a drug addict.

We are all individuals and therefore we will all see the world through our perspective. I choose my way and am not burdened with a label that only defined a part of my life. Others find the label keeps them safe. Don't judge others by your own standards.

I would be interested in a link to this massive weight of clinical evidence you refer to. Having been in the business 15 years I have yet to see any clinical evidence that is verifiable and impartial that proves addiction to be a disease, uncureable or genetic but I am always happy to be shown the error of my ways.

In answer to the OP Yes it is possible to return to controlled drinking after a decent period of abstinence and a good understanding of Relapse Awareness.

[Scott]

I think a true 'alcoholic' cannot safely drink. I think the big problem is in trying to figure out who/what an alcoholic is. I almost always drink to excess--but I have no desire to drink, per se. I can easily take it or leave it, but if I decide to drink, I usually get drunk. I do have a safety valve of sorts--if I eat food, then I quit drinking. For some strange reason, once I have food in my belly, I have no desire to consume alcohol. (That's probably the reason I get quite drunk, because I only drink if I haven't eaten).

I have several friends who I enjoy going out and they are what I would call truly alcoholic. They drink until they can't remember what happened the night before. Don't know how they got home (and sometimes don't get home) etc. etc. And they can repeat the process night after night.

Sadly, alcohol is a tricky drug and best left alone about those who have concerns about it and it's effect on them.

[jumnien]

It's a little like asking if a woman who has been raped once can be raped again and learn to enjoy it. Why would someone who has had the crap beat out of them by alcohol and drugs want to get reamed a second time? There are ways to enjoy life and ways to make it miserable; choose freely!

[Bengt]

Can an alcoholic ever drink normally again? I'd be interested to hear if there are any here who have.

Once an alcoholic addict you are an alcoholic for life and the only way to live a normal life is to stop forever.

Pls contact AA they have maybe the best know ledge about alcoholism.

Myself...I have been out of drinking now for 7 years and anyone that want to stop are able to whit right support from other people whit same problems.

[wade72]

Can an alcoholic ever drink normally again? I'd be interested to hear if there are any here who have.

Once an alcoholic addict you are an alcoholic for life and the only way to live a normal life is to stop forever.

Pls contact AA they have maybe the best know ledge about alcoholism.

Myself...I have been out of drinking now for 7 years and anyone that want to stop are able to whit right support from other people whit same problems.

AA does not have the best knowledge on addiction, some 'people' in AA however may have considerable a amount of knowledge. It's a crap shoot though and depends on which meeting you go to and who you meet.

Edited September 11, 2008 by wade72

[típ-yá-jàk-sòo yaan]

I have some real issues with AA and their way of doing things. Although I am not an alcoholic I do have intimate knowledge of some who are and have attended meetings with them. I cannot condone the "I have no power over my own decisions, and must subjugate to a higher power" philosophy. The higher power that most westerners believe in gave mankind the gift of SELF DETERMINATION - true strength comes from within. Why does AA believe it has to strip away an individual's inner strength to commence healing?

Statistically AA does not have a great record, "...people are about ten times as likely to change on their own as with the help of doctors, therapists, or self-help groups (read AA)." J. Gurion, American Health Magazine, March 1990. Parentheses mine.

...facts about present-day A.A. are these in their own studies: (a) A definite 75% fail to maintain sobriety. ( Probably no more than one to five percent maintain permanent sobriety. © As often as not, those who aligned with AA have a lower success rate than those who got sober without AA. (d) To date there has been no adequate survey of success or failure among those AAs who like the pioneers were born again Christians, reliant upon the Creator for help, and joined together in some Christian church or Bible fellowship, or prayer group.

[StreetCowboy]

I have some real issues with AA ... A definite 75% fail to maintain sobriety. ( Probably no more than one to five percent maintain permanent sobriety. ....,

AA provides real and effective support to people who genuinely do not want to drink again. And so long as people fall into that camp, then I think they (AA) are very effective. But AA can't stop a person who wants to drink from drinking, and they don't claim to be able to. What they do, and quite effectively, is reinforce the individual's commitment not to drink, if he wants to maintain abstinence.

I found AA to be 100% effective for the period when I did not want to drink.

But when I changed my mind, and stopped going, of course AA was powerless to stop me drinking; but I did understand a little better what I was doing, and the implications, and the need for control. Whenever I decide that I don't want to drink again, I'll go back, and I'm sure that AA will help me maintain my resolve for as long as I don't want to drink.

I don't think that the criterion for success should be whether one acheives permanent abstinence; for a start, because you can't measure that till you're dead... more relevant is whether people who participate in the programme have control of their own lives today; and I thought they did pretty well in that respect...

SC

[Wrong Turn]

I think a true 'alcoholic' cannot safely drink. I think the big problem is in trying to figure out who/what an alcoholic is. I almost always drink to excess--but I have no desire to drink, per se. I can easily take it or leave it, but if I decide to drink, I usually get drunk. I do have a safety valve of sorts--if I eat food, then I quit drinking. For some strange reason, once I have food in my belly, I have no desire to consume alcohol. (That's probably the reason I get quite drunk, because I only drink if I haven't eaten).

I drink about 6 big bottles of Tiger per day. Sometimes 7 or 8.

I drink about 4 liters of water per day to rehydrate.

I eat a medium to large size meal as a base. Then I sip on the Tiger beer. I eat small meals about every 3 hours.

I take multivitamin b-complex vitamins. I break them in half and take one about every 2.5 to 3 hours.

I usually take a multi-vitamin w/ mineral vitamin in the morning with breakfast.

Occaionally, I work in the mornings, and I eat a small meal at night, and take the multi-vitamin w/ minerals and 1/2 of a complex-b right before bed.

Sometimes I take a break from the beer for 2-4 days.

I like sipping and going on bar crawls and chatting with different folks around town.

Can I define myself as an alcoholic, or abuser? I don't know.

But more importantly - I don't care.

I got a DWI 18 years ago and had to attend 6 AA meetings. These meeting are very informative and helpful, and motivational - for people who want to attend, and want to quit.

but I could not relate to many of the harder stories that I heard. I never went into the deeper levels of drinking as many member have.

[wayfarer108]

I have some real issues with AA ... A definite 75% fail to maintain sobriety. ( Probably no more than one to five percent maintain permanent sobriety. ....,

AA provides real and effective support to people who genuinely do not want to drink again. And so long as people fall into that camp, then I think they (AA) are very effective. But AA can't stop a person who wants to drink from drinking, and they don't claim to be able to. What they do, and quite effectively, is reinforce the individual's commitment not to drink, if he wants to maintain abstinence.

I found AA to be 100% effective for the period when I did not want to drink.

But when I changed my mind, and stopped going, of course AA was powerless to stop me drinking; but I did understand a little better what I was doing, and the implications, and the need for control. Whenever I decide that I don't want to drink again, I'll go back, and I'm sure that AA will help me maintain my resolve for as long as I don't want to drink.

I don't think that the criterion for success should be whether one acheives permanent abstinence; for a start, because you can't measure that till you're dead... more relevant is whether people who participate in the programme have control of their own lives today; and I thought they did pretty well in that respect...

SC

So if you succeed in not abusing alcohol, AA gets the credit. If you fail, it's your fault. Applying that criterion to any treatment program would mean that they are all 100% successful. In fact it's all up to you either way.

I went from occasional drinking to alcohol abuse and finally to the point I became alcohol-dependent. I was treated, quit all alcohol for two years, and after that was gradually able to resume controlled drinking.

But the original question depends, of course, on how you define 'alcoholic'. Trouble is there is no single definition of 'alcoholic' that everyone agrees on, and most modern substance-abuse researchers don't use the term anymore.

For those who can't take one or two drinks without stopping, you'd have to find the root for the psychological problem behind their alcohol dependence. If that is treatable, as it was in my case, then that person could presumably go back to social drinking, if they want. If that psychological problem can't be successfully treated, then no.

The problem with the term 'alcoholic' is that many -- in particular the alcoholism movement - use it in a way that is circular logic. That is, if you're able to resume normal drinking after treatment, the alcoholism movement will be quick to say you're not a true alcoholic. In that sense the alcoholism movement tries to 'control' the meaning of the word in order to control the individual.

From my experience and from what I have seen in others, and read in substance-abuse literature , it depends on two thing: quality of the treatment and the will of the individual.

Those who are formerly alcohol-dependent and now abstinent should remain abstinent if their treatment isn't complete or they don't feel confident they can drink normally. But they shouldn't be brainwashed into thinking there's no possibility of successful treatment, in my opinion. If treated successfully, anyone can go back to controlled drinking.

Edited September 12, 2008 by wayfarer108

[dotcom]

If your drinking is out of control & you decide you don't like the status quo then AA is a great resource.

In general I would say the answer to your question is NO.

AA is a self help support group. It helped me.

The question is "Why would you want to"? I have been sober over 10 years & I can't think of one thing that a drink would make better.

On the contrary I can think of a lot of situations that a drink could make worse.

Yes AA's success rate is maybe 1% - so what? It has a lot to do with the nature of addiction.

Unlike chemicals such as heroin or nicotine - alcohol is not physically addictive. It's affects are more on the psyche - numbing it.

If AA's success rate is 1% in 10 years - then the number of people who drink excessively - then stop - then resume drinking normally is astronomically small. 1 in 10,000,000 or something.

My advice? Don't try & find out. Making the decision to stop is hard enough.

AA is free. If you are Brittney Spears or Lindsay Lohan you can attend some botique ranch for 10's of thousands of dollars - spend 2 weeks & come out "cured".

AA is a dam good resource for those that don't have a lot of money to splash out.

[sgunn65]

I agree with much of what the previous poster has said but, I would have to disagree with the statement that Alcohol is not physically addictive. It is! It is one of the few drugs (Barbituates and Benzodiazipines are the others) that can kill a heavy drinker if they try to go cold turkey. I know this as I have be doing detoxification for alcohol and drug users for 15 years.

[Groongthep]

Suspision kills Groongthep. These decisions are best left to the individual as well as the decision to turn your will over to a higher power.

I'm not trying to make any decisions for anyone, I was just making an observation based on my many years of experience with this and I certainly have no idea where you got the idea that I endorse turning one's will over to a higher power.

In response to Groonthep. This hardcore AA attitude does you and your philosophy no favours. If a former alcoholic decides, after a period of abstinence, to return to controlled drinking then who are you to say they were not an alcoholic in the first place.

Hardcore AA attitude? Where in my post did I say I was an AA member or that I endorse that organization? I'm speaking from experience not as a proponent of any program. As for the evidence ask the staff at any legitimate rehab clinic and I'm sure they will tell you that on a routine basis they see patients sobering up for a short time then attempting to return to social drinking which almost always results in failure. I used plenty of dope as well as booze in my lost years and I only speak for myself when I say that you won't get any better until you get honest with yourself and come to grips with the fact that alcoholics and addicts stand no real chance of ever going back to casual use. Nearly everyone I know who has been clean and sober for any length of time agrees with me. I understand that when people tell you that you are in denial or that you are fooling yourself it makes you angry. I felt the same way for years, but eventually I came to see the truth for what it is and now I'm living a life which is immensely more fulfilling and happy than when I was drunk and high. Good luck, I wish you all the best in your efforts to quit.

[IMA_FARANG]

Can an alcoholic ever drink normally again? I'd be interested to hear if there are any here who have.

The honest truth...I dont know. And probably neither do you.

AA would like to say that there sucess rate is high in "sobering up" alcholics. But they don't talk about the number of alchoholics would have "sobered up' but have relapsed again. I have one friend who was cured and relasped 3 or 4 times. The final time he managed to stop drinking only after losing more than 50% of his stomach (due to stomach ulcers caused by alchohol). The doctors told him he had one more chance at living, because there wasn't enough stomach left if they had to to operate again. He would have to be fed with IV's or a by being fed from a tube for the rest of his life. That finally shocked him into staying sober.

Honestly, genetics has something to do with the result. Was anyone in your family, especially a close relative, a heavy and constant drinker? If so, you could have a genetic need for alcohol. If that's the case you had better stop completely and forever.

Probably there are some heavy drinkers who can limit their drinking to "social situations". But there are also quite a few who find out they can't. There are many stories of cured alcoholics who relapsed.

You also need to understand that the amount of alchohol you can tolerate before getting 'drunK' can change with age. When you are young you can take more alchohol. You will think it isn't harming your body, but it really is. If you don't believe that at age 25, wait until you hit 50 years and the accumulated effects of the alchohol you've been drinking for 30 years or more starts to take effect. I know what I speak of on that point.

Anyway, why would any otherwise intelligent person, who begins to see that he/she is starting to have alchohol problems, continue to take the chance?

Drop it, like you would drop a hot match that was burning your hand.

[ding]

I couldn't and I tried everything!

Physical alergy coupled with a mental obsession for booze. I guess I'm a pickle and not turning back to a cuke.

[yanabill1]

I am a recovering person for the past 35years and know thousands of aa,s I know of not one case of anyone who has been able to happly return to drinking.So I think based on actual knowledge NO sincerely bill

[Bengt]

AA is a good choice if as alcoholic is alone and needs support.

Myself I was contact AA in 1999 and was able to stop for a few months then I fall back and took another try year 2000 but fall back again after a trip to Thailand and it was getting worse and year 2001 i become a very heavy drinker and consume somedays more than one litre of vodka or whiskey.

In beginning of september that year i took a last minit trip to Thailand and lots my memory for about 6 days until I was wake up in a hotelroom september 11 and couldnt remember much and how I got there from Phuket however i realized that i reach the bottom of a normal life and gave myself to choices..stop NOW or get back to Sweden and since september 11 I have become sober now for 7 years WHITHOUT AA.

The mainpoint for an alcoholic is that YOU want to stop because you cannot handle the alcohol in a proper way, if you think you can decrease the amount of drinking then you will just make a fool of yourself.

I am not any expert in alcoholism and cannot help others to stop drinking, the only advise i have is that they have to go inside themself and find out if they are dependent of alcohol or not and I use to say to others that its NOT my business to decide if others become alcoholic or not, they have to find out by them self.

BTW AA is a good beginning to get support and advices but they are not always right in their sentences,, it have to be the person himself that have to find out the right way in a life as an dryed alcoholic.

[Bengt]

Just forgot to say.........

IT IS NOT EASY........its a LONG period of abstinence's but by the time you will forget the feeling to be drunk.

I just whish all that want to live without alcohol a real GOOD LUCK and keep well and be strong.

Regards

[PeaceBlondie]

As usual, the debate turns to the effectiveness of AA. I think the question challenges a standard precept of AA. Most alcoholics cannot control their drinking, and therefore they should abstain completely.

[wayfarer108]

As usual, the debate turns to the effectiveness of AA

As no doubt intended by the OP, fishing for recruits perhaps

As soon as you introduce 'alcoholic' into the question, without unpacking the term and all its connotations (and I notice there have already been several threads trying to do just that), you've intentionally or unintentionally passed on a load of assumptions created by the alcoholism movement.

But I completely agree with those who suggest that if booze has brought family/social tragedy and major health problems into your life, why risk going back to it?

In the final analysis your prognosis depends on several factors, such as the degree of physical addiction, psychological factors, family history, and so on. Calling someone 'alcoholic' only begins to address the problem. For some: Detox, rehab, find the root cause for addiction, go back to controlled drinking. For others: Detox rehab, never again. Only you, with perhaps the help a substance-abuse specialist can decide for sure.

[Shotime]

Alcohol, drugs, bubble gum. Whatever the "substance" is, if you think you have a problem with using it, you usually do. Everybody has different "bottoms" where it becomes apparent that the "substance" is running your life. You have lost the ability to run it yourself. Generally, your life revolves around the "substance." Food is an addiction. Whether it's a physical addiction or not isn't really relative. The worst addictions (e.g., those difficult to stop) are not physical.

I agree that AA has it's pluses and minuses. However, the higher power doesn't necessarily have anything to do with religion or turning your life over to it. You are, in the final analysis, the higher power. If anything, at least AA can give you the opportunity to allow that part of your inner self to wake the fuc_k up. You are the only one that can control what you do. When you've reached the point where you realize you've got a problem, AA does offer you that opportunity.

Can you ever use the substance again after some period of sobriety? It's a question only you can answer. The only way to find out is to try. Once the inner struggle starts again, you've lost. Should I, shouldn't I. You've already lost that war before. Don't fool yourself.

[Groongthep]

As soon as you introduce 'alcoholic' into the question, without unpacking the term and all its connotations (and I notice there have already been several threads trying to do just that), you've intentionally or unintentionally passed on a load of assumptions created by the alcoholism movement.

I have never heard of the alcoholism movement or the load of assumptions that are created by it. Could you explain to me what they are. I hope it's not some sort of conspiracy theory; there seems to be enough of those out there already that are cooked up by people who are looking for easy answers or even worse by people looking to make money off those who are suffering. I agree with some other posters on this forum who say that the term "alcoholic" is not only hard (if not impossible) to define but is a word that elicits strong emotion from some. I myself openly admit that no matter what definition may be used I was definitely an alcoholic for a long time. Whether I am still to be considered one after 11 years of sobiety is a matter of contention for some, but quite frankly it doesn't bother me a bit if some people say I am an other say I'm not. I'm sober now and that's all that's important to me.

On my long road to sobriety, I was hospitalized in several rehab centers and also attended AA meetings for short periods of time but left them behind years ago once I knew I no longer needed them. I came away with serious reservations about AA especially the nonsense where if you don't follow the program you become labeled a "dry drunk" and are somehow considered not really sober by your AA peers even if you no longer drink. There is no denying the fact however, that AA has helped millions of people and for that reason alone I do not condemn it even though I don't follow it.

It was getting to know myself and accepting the fact that I was unable to control my drinking and drugging that has kept me clean, sober, healthy and usually happy for the last 11 years. This knowledge and acceptance is something that each person can only find for him or herself. Even though a councelor or a program may be helpful, the ultimate duty lies with each of us who believe we have a chemical dependency problem to take the necessary actions to heal ourselves. For me it was complete abstinence but for others it may be different even though I have never seen it happen and hence am skepical of those who tell me that returning to normal drinking is possible. (Besides, why would anyone want to risk trying, if booze and dope have already made your life a living hel_l in the past?) Completely giving it up has worked for me and I'm at peace with that. In fact it has worked so well that I highly recommend it to anyone wishing to rid themselves of all the problems associated with heavy drinking. I would also recommend that no one waste their time trying to simply "cut down" as these efforts nearly always result in failure and a return to problem drinking.

[Chris Lawrence]

A bit off topic; but the fear is actually finding a person that was an 'alcoholic' and returned to drinking. A number of replies appear to associate with AA, but when someone stops drinking and then returns to the drink, the AA person does not usually follow that person anymore.

Mentioned in other posts, only you will know if it is right for you. But can you chance it?

[wayfarer108]

As soon as you introduce 'alcoholic' into the question, without unpacking the term and all its connotations (and I notice there have already been several threads trying to do just that), you've intentionally or unintentionally passed on a load of assumptions created by the alcoholism movement.

I have never heard of the alcoholism movement or the load of assumptions that are created by it. Could you explain to me what they are. I hope it's not some sort of conspiracy theory; there seems to be enough of those out there already that are cooked up by people who are looking for easy answers or even worse by people looking to make money off those who are suffering. I agree with some other posters on this forum who say that the term "alcoholic" is not only hard (if not impossible) to define but is a word that elicits strong emotion from some. I myself openly admit that no matter what definition may be used I was definitely an alcoholic for a long time. Whether I am still to be considered one after 11 years of sobiety is a matter of contention for some, but quite frankly it doesn't bother me a bit if some people say I am an other say I'm not. I'm sober now and that's all that's important to me.

On my long road to sobriety, I was hospitalized in several rehab centers and also attended AA meetings for short periods of time but left them behind years ago once I knew I no longer needed them. I came away with serious reservations about AA especially the nonsense where if you don't follow the program you become labeled a "dry drunk" and are somehow considered not really sober by your AA peers even if you no longer drink. There is no denying the fact however, that AA has helped millions of people and for that reason alone I do not condemn it even though I don't follow it.

It was getting to know myself and accepting the fact that I was unable to control my drinking and drugging that has kept me clean, sober, healthy and usually happy for the last 11 years. This knowledge and acceptance is something that each person can only find for him or herself. Even though a councelor or a program may be helpful, the ultimate duty lies with each of us who believe we have a chemical dependency problem to take the necessary actions to heal ourselves. For me it was complete abstinence but for others it may be different even though I have never seen it happen and hence am skepical of those who tell me that returning to normal drinking is possible. (Besides, why would anyone want to risk trying, if booze and dope have already made your life a living hel_l in the past?) Completely giving it up has worked for me and I'm at peace with that. In fact it has worked so well that I highly recommend it to anyone wishing to rid themselves of all the problems associated with heavy drinking. I would also recommend that no one waste their time trying to simply "cut down" as these efforts nearly always result in failure and a return to problem drinking.

The alcoholism movement, aka alcoholism treatment movement, is the early to mid 20th century concept of alcohol addiction that spawned 12-step programs, based on the powerlessness of the individual, etc. It's a view that alcohol addiction is a progressive disease, and that "proceeding inexorably from stage to stage in fixed sequence ending inevitably in abstinence or death--has become part of the enduring mythology of alcoholism.” p. 133 Vaillant, G. (1983). The Natural History of Alcoholism: Causes, Patterns, and Paths to Recovery. Cambridge, Massachusetts: Harvard University Press.

The assumptions are many, beginning with the traditional “unitary disease” model that says “alcoholics are different from non-alcoholics" (more at bottom).

other refs:

A Farewell to Alcoholism? A Commentary on the WHO 1980

Expert Committee Report. British Journal of Addiction, 76:115-123.

On the “Jellinek Chart”: “Phases of Alcohol Addiction,” the source document

for the chart of symptoms of alcoholism--which (often with Glatt’s addition of the

symptoms of recovery) is perhaps the most widely distributed artifact of the

alcoholism movement...” p. 116

Notes the WHO Expert Committee’s substitution of ‘alcohol dependence

syndrome’ for alcoholism on the grounds that the latter term was “being

abandoned in scientific discourse.” p. 116

Rodin, M.B. (1981). Alcoholism as a Folk Disease: The Paradox of Beliefs and

Choice of Therapy in an Urban American Community. Journal of Studies on

Alcohol, 42:822-885.

“...the disease concept did not replace moral conceptions. Rather, the

attribution of sickness appeared to have been added to and combined with

attributions of moral failure and mental illness.” p. 822

“Illness then, as opposed to disease, is a cultural construct, and the particular

grouping of symptoms into named classes of illness is specific to cultural and

subcultural groups. Since such classes may not correspond to scientific disease

classes, treatment for folk illnesses is reasonably sought from folk healers.” p. 824

“That it often defies scientific medical treatment but frequently yields to lay

therapy, Alcoholics Anonymous, thus suggests that alcoholism fits the description

of a folk illness.” p. 824

“It appears, then, that promotion of the disease model has had the paradoxical

effect of increasing the heterogeneity of concepts of alcoholism and of

simultaneously promoting not professional but lay modes of therapy.” p. 832

“...the majority of community residents surveyed endorsed a disease designation

of alcoholism while rejecting medical and professional therapy in favor of AA.

That the disease of alcoholism is as much a cultural construct as a set of physical

and behavior pathologies is evident in this apparently paradoxical pattern of

beliefs. Designating alcoholism a folk disease resolves the paradox and in no way

trivializes the severity of the disorder.” p. 833

Orcutt, J.D. (1980). Professional and Public Conceptions of Alcoholism. Journal

of Studies on Alcohol, 41:652-661.

“Whatever its scientific merits, the disease conception of alcoholism has served

as an effective ideological tool in the efforts of these groups to expand their

influence on public policy and to replace punitive controls with more therapeutic

responses to deviant drinkers.” p. 653

“...greater endorsement of the medical view is accompanied by at least a partial

redefinition of alcoholics from ‘enemy deviants’ to ‘sick deviants.’” pp. 659-660

“...The alcoholism movement has not been particularly effective in removing

the stigma from the condition of alcoholism.” p. 660

Tuchfield, B. (1981). Spontaneous Remission in Alcoholics: Empirical

Observations and Theoretical Implications. Quarterly Journal of Studies on

Alcohol, 42(7):626-641.

Rohan, W.P. (1982). The Concept of Alcoholism: Assumptions and Issues. In:

Pattison, E.M. and Kaufman, E. Eds. Encyclopedic Handbook of Alcoholism.

New York: Gardner Press, pp. 31-39.

“...the attempt clearly to define the meaning of alcoholism has failed simply

because there is no specific entity to be defined. The term ‘alcoholism’ is merely

a convenient shorthand label for selected events involving alcohol use and

damage, not the name of an actual entity.” p. 31

“The destructiveness of some drinking schedules and their persistence, despite

horrendous consequences, makes it seem that some terrible power is operating

that victimizes the individual ...This has fostered the concept of ‘alcoholism’ as an

imputed ‘ghost’ accounting for observable events...the ghost in the machine

represents a projection and transformation of our words and ideas into a thing of

power disguised in the sophisticated and respectable language of medicine. This

assumes a solution and assurance that something is there soon to be discovered

and controlled.” p. 32

‘alcoholic’ and ‘social drinker’ are obfuscating terms that serve to differentiate

certain segments of the drinking population on dubious assumptions.” p. 36

“...alcoholism is simply a construct that may misconstrue reality.” p. 37

The American Society on Alcoholism and Other Drug Dependencies is founded to

oversee a board certification specialty in addiction medicine and improve

physician education on addiction; the group's name is later changed to the

American Society of Addiction Medicine (ASAM). (White, 1998, p. 272) (Acker)

Caddy, G. (1983). Alcohol Use and Abuse: Historical Trends and Current

Perspectives. In: Tabakoff, B., Sutker, P. and Randall, C. Medical and Social

Aspects of Alcohol Abuse. New York: Plenum Press. p. 1-30.

Glen Caddy describes the “traditional” “unitary disease” model of alcoholism in

terms of the following themes: “alcoholics are different from non-alcoholics; this

“difference” either leads to or induces psychological/sociological and/or

biochemical/physiological changes; these changes become part of a progressive

and irreversible disease process; the disease is characterized by “an inability to

abstain” and/or a “loss of control” over alcohol...treatment must emphasize the

permanent nature of the alcoholic’s “difference” and, in so doing, stresses the that

the disease can be arrested only by abstinence, which must be lifelong.” p. 15

In contrast, Caddy describes the emergence of a multivariate approach that

posits the following: (Quoted)

1. There are multiple patterns of use, misuse, and abuse that may be denoted as a

pattern of alcohol addiction.

2. There are multiple interactive etiological variables that may combine in

variable permutations to produce an alcohol-related problem.

3. All people are vulnerable to the development of different syndrome patterns

of alcohol problems.

4. Treatment interventions must be multi-modal to correspond to the particular

syndrome pattern and the particular person.

5. Treatment outcomes will vary in accordance with syndrome patterns, person,

and social contexts.

6. Preventative interventions must be multiple and diverse to accommodate

multiple etiologies. p. 17

“The concept of alcoholism cannot be defined adequately. It is an abstraction--

an ill-defined medical/social construct, sometimes a self-labeling process,

frequently an appellation based on a heterogenous array of medical, legal and

social consideration.” p. 22

“It is preferable, I believe, to view excessive drinking as the fundamental

individual and social problem rather than to wait until such drinking has brought

forth its own inevitable negative consequences and then to create a construct

“alcoholism” to describe the drinker and account for his of her lifestyle.” p. 22