Alcoholism

[Kim25]

Alcoholism is a diseases that is recognized by the following:

Craving: A powerful need, or coercion, to consume.

Loss of control: The regular lack of ability to stop consuming once a person has started.

Physical dependence: The event of drawback symptoms, such as queasiness, perspiration, shakiness, and stress.

[StreetCowboy]

I think it would be better to highlight the sequence of development of alcoholism.

1) The alcoholic cannot control the amount that he drinks; when he drinks, stopping or not is due to external factors rather than his own decision (need to catch the last bus, run out of money, need to drive the car home...)

2) Reliance on alcohol in social situations makes the alcoholic unable to live life without alcohol, or to identify alternatives to drinking

3) Excessive drinking leads to addiction / dependency and physical cravings and withdrawal symptoms

Now, the important point, I believe, is that the alcoholism - the inability control the amount one drinks, manifests itself a long time before the physiological addiction (the shakes, the actual need for a drink). But, if one carries on drinking when one is bored, sad, happy, etc. one will get there in the end.

The other thing, for alcoholics who truly derive the most difficulty from their condition, is not only that they cannot stop once they start, but that they have a spiritual malady - a deep-seated dissatisfaction, that renders them prone to drowning their sorrows, drinking to escape, for courage, or whatever.

And, of course, we should remember that alcoholics are no less varied than anyone else - we are all individuals, with our won weaknesses, patterns and challenges

SC\

[jingjoe8]

alcholicism isn't a disease its an addiction,by calling it a disease you are not taking responsibility for drinking too much,the reason you want to keep drinking or drinking too excess is because you need to feed the addiction.

No different to smoking,shooting heroin,smack whatever your "poison" is.

And all this hogwash that A.A. spruicks about problems in your past have made you drink,it just gives you an excuse to keep drinking,deal with the addiction of the substance first then make peace with your demons.

When you finally are free from your addiction,don't live in fear and call yourself a recovering alcoholic,your'e not you are a non drinker,your body no longer needs its alcohol so there will be no more cravings

[jbrain]

Alcoholism is a character weakness.

[StreetCowboy]

alcholicism isn't a disease its an addiction,by calling it a disease you are not taking responsibility for drinking too much,the reason you want to keep drinking or drinking too excess is because you need to feed the addiction.

No different to smoking,shooting heroin,smack whatever your "poison" is.

And all this hogwash that A.A. spruicks about problems in your past have made you drink,it just gives you an excuse to keep drinking,deal with the addiction of the substance first then make peace with your demons.

When you finally are free from your addiction,don't live in fear and call yourself a recovering alcoholic,your'e not you are a non drinker,your body no longer needs its alcohol so there will be no more cravings

Do you think you could have made your post less helpful, less constructive? I get a feeling of spiteful fear from your post.

For sure, alcoholism is a character weakness. I'm colour blind, I know all anbout character weaknesses.

Let's suppose that this forum is intended to help people with drinking problems.

Now, let's suppose that you accept some people have drinking problems.

Now, was your post intended to be helpful? And do you think that it was?

SC

[smokie36]

Alcoholism is a character weakness.

Not necessarily. Many people overcome their battle with alcohol and live wonderful lives.

[jbrain]

Alcoholism is a character weakness.

Not necessarily. Many people overcome their battle with alcohol and live wonderful lives.

And how they overcome their addiction?

Not by taking medicines, but instead by building character.

[jingjoe8]

alcholicism isn't a disease its an addiction,by calling it a disease you are not taking responsibility for drinking too much,the reason you want to keep drinking or drinking too excess is because you need to feed the addiction.

No different to smoking,shooting heroin,smack whatever your "poison" is.

And all this hogwash that A.A. spruicks about problems in your past have made you drink,it just gives you an excuse to keep drinking,deal with the addiction of the substance first then make peace with your demons.

When you finally are free from your addiction,don't live in fear and call yourself a recovering alcoholic,your'e not you are a non drinker,your body no longer needs its alcohol so there will be no more cravings

Do you think you could have made your post less helpful, less constructive? I get a feeling of spiteful fear from your post.

For sure, alcoholism is a character weakness. I'm colour blind, I know all anbout character weaknesses.

Let's suppose that this forum is intended to help people with drinking problems.

Now, let's suppose that you accept some people have drinking problems.

Now, was your post intended to be helpful? And do you think that it was?

SC

I said alcohol isn't a disease its an addiction,you can't catch" alcoholism",its not contagious.

My point is for people to stop dancing around the reason they drink.

Don't look for a reason

,people drink when they are sad,drink when they are happy

,drink to celebrate a victory or at a wedding,

drink at a wake when someone as died.

Do you really believe a product can change all these emotions.

Its not so much a character flaw in some people its just they have consumed too much and now are addicted to the substance.

So now everytime you feel like a drink its not because you think it will make you happy when you are down,or happier when you are excited,its because the "itch" of the drug is asking to be scratched.

Give the body time to get it out of your system,and don't see it like you are losing something you aren't your defeating the addiction and gaining your life back.

[uptheos]

Makes you wonder why alcohol is legal and less addictive substances are not?

[GrahamF]

alcholicism isn't a disease its an addiction,by calling it a disease you are not taking responsibility for drinking too much,the reason you want to keep drinking or drinking too excess is because you need to feed the addiction.

No different to smoking,shooting heroin,smack whatever your "poison" is.

And all this hogwash that A.A. spruicks about problems in your past have made you drink,it just gives you an excuse to keep drinking,deal with the addiction of the substance first then make peace with your demons.

When you finally are free from your addiction,don't live in fear and call yourself a recovering alcoholic,your'e not you are a non drinker,your body no longer needs its alcohol so there will be no more cravings

In my case AA did help me get into a detox to get over the physical addiction and then taught me how to deal with my demons. FYI, many AA's who worked/work the AA program of recovery, call themselves recovered and do not refer to themselves as in recovery, although some do. Them term "in recovery" at least how it is used today is something that has seeped in from therapy. You may also want to do some checking as there is evidence that alcoholism or at least alcohol having a different effect than "normal" on certain people is genetic.

Your views regarding alcoholism are certainly not unique, I tend to regard them as poorly informed. Certainly, there are those who can get clean and never touch a drop of alcohol again, but in my experience without any further treatment/work most people tend to relapse if they don't get some sort of help. I've also found that in some cases there are some people who espouse your point of view that are themselves in the throes of some sort of addiction.

[StreetCowboy]

alcholicism isn't a disease its an addiction,by calling it a disease you are not taking responsibility for drinking too much,the reason you want to keep drinking or drinking too excess is because you need to feed the addiction.

No different to smoking,shooting heroin,smack whatever your "poison" is.

And all this hogwash that A.A. spruicks about problems in your past have made you drink,it just gives you an excuse to keep drinking,deal with the addiction of the substance first then make peace with your demons.

When you finally are free from your addiction,don't live in fear and call yourself a recovering alcoholic,your'e not you are a non drinker,your body no longer needs its alcohol so there will be no more cravings

In my case AA did help me get into a detox to get over the physical addiction and then taught me how to deal with my demons. FYI, many AA's who worked/work the AA program of recovery, call themselves recovered and do not refer to themselves as in recovery, although some do. Them term "in recovery" at least how it is used today is something that has seeped in from therapy. You may also want to do some checking as there is evidence that alcoholism or at least alcohol having a different effect than "normal" on certain people is genetic.

Your views regarding alcoholism are certainly not unique, I tend to regard them as poorly informed. Certainly, there are those who can get clean and never touch a drop of alcohol again, but in my experience without any further treatment/work most people tend to relapse if they don't get some sort of help. I've also found that in some cases there are some people who espouse your point of view that are themselves in the throes of some sort of addiction.

There are clearly (IMHO) aspects of addiction that go beyond the limits of sensible and competent willpower; physiological 'needs' that can be described as an illness, disease, sickness, disability whatever, depending on your vocabulary,

And then there are the reaons why we drink n the first pkace, and get ourselves into that situation. And the reasons why we relapse.

[473geo]

alcholicism isn't a disease its an addiction,by calling it a disease you are not taking responsibility for drinking too much,the reason you want to keep drinking or drinking too excess is because you need to feed the addiction.

No different to smoking,shooting heroin,smack whatever your "poison" is.

And all this hogwash that A.A. spruicks about problems in your past have made you drink,it just gives you an excuse to keep drinking,deal with the addiction of the substance first then make peace with your demons.

When you finally are free from your addiction,don't live in fear and call yourself a recovering alcoholic,your'e not you are a non drinker,your body no longer needs its alcohol so there will be no more cravings

In my case AA did help me get into a detox to get over the physical addiction and then taught me how to deal with my demons. FYI, many AA's who worked/work the AA program of recovery, call themselves recovered and do not refer to themselves as in recovery, although some do. Them term "in recovery" at least how it is used today is something that has seeped in from therapy. You may also want to do some checking as there is evidence that alcoholism or at least alcohol having a different effect than "normal" on certain people is genetic.

Your views regarding alcoholism are certainly not unique, I tend to regard them as poorly informed. Certainly, there are those who can get clean and never touch a drop of alcohol again, but in my experience without any further treatment/work most people tend to relapse if they don't get some sort of help. I've also found that in some cases there are some people who espouse your point of view that are themselves in the throes of some sort of addiction.

You were doing ok until the little digs at people who have pulled themselves back on track..........of which I am one

To me one of my achievements in life was stopping smoking over 15 years ago, this was followed by another achievement of virtually cutting alcohol out of my life for nearly 6 years, Now when somebody tells me I may relapse, well that is possible, I have not stopped drinking, I hate to be told what to do, I have cut down my drinking currently to less than 10 beers a year, I control it. How do I do this? Because I found something more important to me than drinking and socialising.....

My wife and children...

[GrahamF]

alcholicism isn't a disease its an addiction,by calling it a disease you are not taking responsibility for drinking too much,the reason you want to keep drinking or drinking too excess is because you need to feed the addiction.

No different to smoking,shooting heroin,smack whatever your "poison" is.

And all this hogwash that A.A. spruicks about problems in your past have made you drink,it just gives you an excuse to keep drinking,deal with the addiction of the substance first then make peace with your demons.

When you finally are free from your addiction,don't live in fear and call yourself a recovering alcoholic,your'e not you are a non drinker,your body no longer needs its alcohol so there will be no more cravings

In my case AA did help me get into a detox to get over the physical addiction and then taught me how to deal with my demons. FYI, many AA's who worked/work the AA program of recovery, call themselves recovered and do not refer to themselves as in recovery, although some do. Them term "in recovery" at least how it is used today is something that has seeped in from therapy. You may also want to do some checking as there is evidence that alcoholism or at least alcohol having a different effect than "normal" on certain people is genetic.

Your views regarding alcoholism are certainly not unique, I tend to regard them as poorly informed. Certainly, there are those who can get clean and never touch a drop of alcohol again, but in my experience without any further treatment/work most people tend to relapse if they don't get some sort of help. I've also found that in some cases there are some people who espouse your point of view that are themselves in the throes of some sort of addiction.

You were doing ok until the little digs at people who have pulled themselves back on track..........of which I am one

To me one of my achievements in life was stopping smoking over 15 years ago, this was followed by another achievement of virtually cutting alcohol out of my life for nearly 6 years, Now when somebody tells me I may relapse, well that is possible, I have not stopped drinking, I hate to be told what to do, I have cut down my drinking currently to less than 10 beers a year, I control it. How do I do this? Because I found something more important to me than drinking and socialising.....

My wife and children...

It certainly wasn't intended as a dig at anyone. From personal experience I have seen more people relapse who don't get some sort of help, after "getting clean" than those who do. I certainly believe that in my case if I hadn't gotten some help, in my case AA, that I would have relapsed as well. Case in point, a gentleman I was in detox with attended a 30 day rehab afterward and was of the mindset that after that he would be fine. Upon getting out of rehab he refused to go to counseling, AA, or anything, he was drinking again in 3 months. I found what I needed and it seems to me that you found what you needed to stop drinking. Different strokes for different folks, as they say.

Edit: BTW, congrats! I do know how hard it can be to stop or cut back on ones drinking!

[Neeranam]

alcholicism isn't a disease its an addiction,by calling it a disease you are not taking responsibility for drinking too much,the reason you want to keep drinking or drinking too excess is because you need to feed the addiction.

No different to smoking,shooting heroin,smack whatever your "poison" is.

And all this hogwash that A.A. spruicks about problems in your past have made you drink,it just gives you an excuse to keep drinking,deal with the addiction of the substance first then make peace with your demons.

When you finally are free from your addiction,don't live in fear and call yourself a recovering alcoholic,your'e not you are a non drinker,your body no longer needs its alcohol so there will be no more cravings

Are you a doctor? So you think you know better than lets see - The American Medical Association, The World Health Organization, American Psychiatric Association, the American Hospital Association, the American Public Health Association, the National Association of Social Workers, the American College of Physicians , Joint Committee of the National Council on Alcoholism and Drug Dependence and the American Society of Addiction Medicine

[Neeranam]

Managing Alcoholism as a Disease

By Thomas R. Hobbs, Ph.D., M.D.

Thomas R. Hobbs, Ph.D., M.D., is medical director of the Physicians’ Health Programs (PHP). The PHP, a program of The Educational and Scientific Trust of the Pennsylvania Medical Society, is a confidential advocacy service for physicians suffering from impairing conditions.

Published February 1998

The debate on whether alcoholism is a disease or a personal conduct problem has continued for over 200 years. In the United States, Benjamin Rush, MD, has been credited with first identifying alcoholism as a "disease" in 1784. He asserted that alcohol was the causal agent, loss of control over drinking behavior being the characteristic symptom, and total abstinence the only effective cure. His belief in this concept was so strong that he spearheaded a public education campaign in the United States to reduce public drunkenness.

The 1800s gave rise to the temperance movement in the United States. Alcohol was perceived as evil, the root cause of America’s problems. Accepting the disease concept of alcoholism, people believed that liquor could enslave a person against his or her will. Temperance proponents propagated the view that drinking was so dangerous that people should not even sample liquor or else they would likely embark on the path toward alcoholism. This ideology maintained that alcohol is inevitably dangerous and inexorably addictive for everyone. Today, we know that strong genetic influences exist, but not everyone becomes addicted to alcohol.

The temperance movement picked up steam in the late 1800s and evolved into a movement advocating the prohibition of alcohol nationally. Banning alcohol would preserve the family and eliminate sloth and moral dissolution in the United States, according to supporters. Backed by strong political forces, legislation was passed and prohibition went into effect in 1920. Paradoxically, the era of prohibition also marked the death of Victorian standards. According to A. Sinclair in his book, Prohibition: The Era of Excess, a code of liberated personal behavior grew and with it the idea that drinking should accompany a full life. Drunkenness represented personal freedom. Due to public outcry, prohibition was repealed in 1933.

Soon after prohibition ended, Alcoholics Anonymous (AA) was born. Formed in 1935 by stockbroker Bill Wilson and a physician, Robert Smith, AA supported the proposition that an alcoholic is unable to control his or her drinking and recovery is possible only with total abstinence and peer support. The chief innovation in the AA philosophy was that it proposed a biological explanation for alcoholism. Alcoholics constituted a special group who are unable to control their drinking from birth. Initially, AA described this as "an allergy to alcohol."

Although AA was instrumental in again emphasizing the "disease concept" of alcoholism, the defining work was done by Elvin Jellinek, M.D., of the Yale Center of Alcohol Studies. In his book, The Disease Concept of Alcoholism, published in 1960, Jellinek described alcoholics as individuals with tolerance, withdrawal symptoms, and either "loss of control" or "inability to abstain" from alcohol. He asserted that these individuals could not drink in moderation, and, with continued drinking, the disease was progressive and life-threatening. Jellinek also recognized that some features of the disease (e.g., inability to abstain and loss of control) were shaped by cultural factors.

During the past 35 years, numerous studies by behavioral and social scientists have supported Jellinek’s contentions about alcoholism as a disease. The American Medical Association endorsed the concept in 1957. The American Psychiatric Association, the American Hospital Association, the American Public Health Association, the National Association of Social Workers, the World Health Organization and the American College of Physicians have also classified alcoholism as a disease. In addition, the findings of investigators in the late 1970s led to explicit criteria for an "alcohol dependence syndrome" which are now listed in the DSM IIR, DSM IV, and the ICD manual. In a 1992 JAMA article, the Joint Committee of the National Council on Alcoholism and Drug Dependence and the American Society of Addiction Medicine published this definition for alcoholism:"Alcoholism is a primary chronic disease with genetic, psychosocial, and environmental factors influencing its development and manifestations. The disease is often progressive and fatal. It is characterized by impaired control over drinking, preoccupation with the drug alcohol, use of alcohol despite adverse consequences, and distortions in thinking, mostly denial. Each of these symptoms may be continuous or periodic."

Despite the numerous studies validating the disease model of alcoholism, controversy still exists. In his 1989 book, Diseasing of America, social psychologist Stanton Peele, Ph.D., argues that AA and for-profit alcohol treatment centers promote the "myth" of alcoholism as a lifelong disease. He contends that the disease concept "excuses alcoholics for their past, present, and future irresponsibility" and points out that most people can overcome addiction on their own. He concludes that the only effective response to alcoholism and other addictions is "to recreate living communities that nurture the human capacity to lead constructive lives."

Surprisingly, Dr. Peele’s view that alcoholism is a personal conduct problem, rather than a disease, seems to be more prevalent among medical practitioners than among the public. A recent Gallop poll found that almost90 percent of Americans believe that alcoholism is a disease. In contrast, physicians’ views of alcoholism were reviewed at an August 1997 conference held by the International Doctors of Alcoholics Anonymous (IDAA). A survey of physicians reported at that conference found that 80 percent of responding doctors perceived alcoholism as simply bad behavior.

Dr. Raoul Walsh in an article published in the November 1995 issue of Lancet supports the contention that physicians have negative views about alcoholics. He cites empirical data showing physicians continue to have stereotypical attitudes about alcoholics and that non-psychiatrists tend to view alcohol problems as principally the concern of psychiatrists. He also contends that many doctors have negative attitudes towards patients with alcohol problems because the bulk of their clinical exposure is with late-stage alcohol dependence.

Based on my experiences working in the addiction field for the past 10 years, I believe many, if not most, health professionals still view alcohol addiction as a willpower or conduct problem and are resistant to look at it as a disease. Part of the problem is that medical schools provide little time to study alcoholism or addiction and post-graduate training usually deals only with the end result of addiction or alcohol/drug-related diseases. Several studies conducted in the late 1980s give evidence that medical students and practitioners have inadequate knowledge about alcohol and alcohol problems. Also, recent studies published in the Journal of Studies on Alcoholism indicate that physicians perform poorly in the detection, prevention and treatment of alcohol abuse.

The single most important step to overcoming these obstacles is education. Education must begin at the undergraduate level and continue throughout the training of most if not all specialties. This is especially true for those in primary care where most problems of alcoholism will first be seen. In recent years, promotion of alcohol education programs in medical schools and at the post graduate level has improved. In Pennsylvania, for example, several medical schools now offer at least one curriculum block on substance abuse. Medical specialty organizations, such as the American Society of Addiction Medicine, are focusing on increasing addiction training programs for residents, practicing physicians and students.

Also, an increasing number of hospitals have an addiction medicine specialist on staff who is available for student and resident teaching, as well as being available for in-house consultations.

The American Medical Association estimates that 25-40 percent of patients occupying general hospital beds are there for treatment of ailments that result from alcoholism. In the United States, the economic costs of alcohol abuse exceed $115 billion a year. Physicians in general practice, hospitals and specialty medicine have considerable potential to reduce the large burden of illness associated with alcohol abuse. For example, several randomized, controlled trials conducted in recent years demonstrate that brief interventions by physicians can significantly reduce the proportion of patients drinking at hazardous levels. But first, we as physicians must adjust our attitudes.

Alcoholism should not be judged as a problem of willpower, misconduct, or any other unscientific diagnosis. The problem must be accepted for what it is—a biopsychosocial disease with a strong genetic influence, obvious signs and symptoms, a natural progression and a fatal outcome if not treated. In the past 10 years, the medical profession’s and the public’s acceptance of smoking as an addictive disease has resulted in reducing nicotine use in the United States. I feel that similar strides can be made with alcohol abuse. We must begin, as we did with nicotine, by educating and convincing our own colleagues that alcoholism is a disease. We must also emphasize that physicians have played a significant role in reducing the mortality and morbidity from nicotine use through patient education. Through strong physician intervention, I believe that we can achieve similar results with alcohol abuse.

[jingjoe8]

Managing Alcoholism as a Disease

By Thomas R. Hobbs, Ph.D., M.D.

Thomas R. Hobbs, Ph.D., M.D., is medical director of the Physicians’ Health Programs (PHP). The PHP, a program of The Educational and Scientific Trust of the Pennsylvania Medical Society, is a confidential advocacy service for physicians suffering from impairing conditions.

Published February 1998

The debate on whether alcoholism is a disease or a personal conduct problem has continued for over 200 years. In the United States, Benjamin Rush, MD, has been credited with first identifying alcoholism as a "disease" in 1784. He asserted that alcohol was the causal agent, loss of control over drinking behavior being the characteristic symptom, and total abstinence the only effective cure. His belief in this concept was so strong that he spearheaded a public education campaign in the United States to reduce public drunkenness.

The 1800s gave rise to the temperance movement in the United States. Alcohol was perceived as evil, the root cause of America’s problems. Accepting the disease concept of alcoholism, people believed that liquor could enslave a person against his or her will. Temperance proponents propagated the view that drinking was so dangerous that people should not even sample liquor or else they would likely embark on the path toward alcoholism. This ideology maintained that alcohol is inevitably dangerous and inexorably addictive for everyone. Today, we know that strong genetic influences exist, but not everyone becomes addicted to alcohol.

The temperance movement picked up steam in the late 1800s and evolved into a movement advocating the prohibition of alcohol nationally. Banning alcohol would preserve the family and eliminate sloth and moral dissolution in the United States, according to supporters. Backed by strong political forces, legislation was passed and prohibition went into effect in 1920. Paradoxically, the era of prohibition also marked the death of Victorian standards. According to A. Sinclair in his book, Prohibition: The Era of Excess, a code of liberated personal behavior grew and with it the idea that drinking should accompany a full life. Drunkenness represented personal freedom. Due to public outcry, prohibition was repealed in 1933.

Soon after prohibition ended, Alcoholics Anonymous (AA) was born. Formed in 1935 by stockbroker Bill Wilson and a physician, Robert Smith, AA supported the proposition that an alcoholic is unable to control his or her drinking and recovery is possible only with total abstinence and peer support. The chief innovation in the AA philosophy was that it proposed a biological explanation for alcoholism. Alcoholics constituted a special group who are unable to control their drinking from birth. Initially, AA described this as "an allergy to alcohol."

Although AA was instrumental in again emphasizing the "disease concept" of alcoholism, the defining work was done by Elvin Jellinek, M.D., of the Yale Center of Alcohol Studies. In his book, The Disease Concept of Alcoholism, published in 1960, Jellinek described alcoholics as individuals with tolerance, withdrawal symptoms, and either "loss of control" or "inability to abstain" from alcohol. He asserted that these individuals could not drink in moderation, and, with continued drinking, the disease was progressive and life-threatening. Jellinek also recognized that some features of the disease (e.g., inability to abstain and loss of control) were shaped by cultural factors.

During the past 35 years, numerous studies by behavioral and social scientists have supported Jellinek’s contentions about alcoholism as a disease. The American Medical Association endorsed the concept in 1957. The American Psychiatric Association, the American Hospital Association, the American Public Health Association, the National Association of Social Workers, the World Health Organization and the American College of Physicians have also classified alcoholism as a disease. In addition, the findings of investigators in the late 1970s led to explicit criteria for an "alcohol dependence syndrome" which are now listed in the DSM IIR, DSM IV, and the ICD manual. In a 1992 JAMA article, the Joint Committee of the National Council on Alcoholism and Drug Dependence and the American Society of Addiction Medicine published this definition for alcoholism:"Alcoholism is a primary chronic disease with genetic, psychosocial, and environmental factors influencing its development and manifestations. The disease is often progressive and fatal. It is characterized by impaired control over drinking, preoccupation with the drug alcohol, use of alcohol despite adverse consequences, and distortions in thinking, mostly denial. Each of these symptoms may be continuous or periodic."

Despite the numerous studies validating the disease model of alcoholism, controversy still exists. In his 1989 book, Diseasing of America, social psychologist Stanton Peele, Ph.D., argues that AA and for-profit alcohol treatment centers promote the "myth" of alcoholism as a lifelong disease. He contends that the disease concept "excuses alcoholics for their past, present, and future irresponsibility" and points out that most people can overcome addiction on their own. He concludes that the only effective response to alcoholism and other addictions is "to recreate living communities that nurture the human capacity to lead constructive lives."

Surprisingly, Dr. Peele’s view that alcoholism is a personal conduct problem, rather than a disease, seems to be more prevalent among medical practitioners than among the public. A recent Gallop poll found that almost90 percent of Americans believe that alcoholism is a disease. In contrast, physicians’ views of alcoholism were reviewed at an August 1997 conference held by the International Doctors of Alcoholics Anonymous (IDAA). A survey of physicians reported at that conference found that 80 percent of responding doctors perceived alcoholism as simply bad behavior.

Dr. Raoul Walsh in an article published in the November 1995 issue of Lancet supports the contention that physicians have negative views about alcoholics. He cites empirical data showing physicians continue to have stereotypical attitudes about alcoholics and that non-psychiatrists tend to view alcohol problems as principally the concern of psychiatrists. He also contends that many doctors have negative attitudes towards patients with alcohol problems because the bulk of their clinical exposure is with late-stage alcohol dependence.

Based on my experiences working in the addiction field for the past 10 years, I believe many, if not most, health professionals still view alcohol addiction as a willpower or conduct problem and are resistant to look at it as a disease. Part of the problem is that medical schools provide little time to study alcoholism or addiction and post-graduate training usually deals only with the end result of addiction or alcohol/drug-related diseases. Several studies conducted in the late 1980s give evidence that medical students and practitioners have inadequate knowledge about alcohol and alcohol problems. Also, recent studies published in the Journal of Studies on Alcoholism indicate that physicians perform poorly in the detection, prevention and treatment of alcohol abuse.

The single most important step to overcoming these obstacles is education. Education must begin at the undergraduate level and continue throughout the training of most if not all specialties. This is especially true for those in primary care where most problems of alcoholism will first be seen. In recent years, promotion of alcohol education programs in medical schools and at the post graduate level has improved. In Pennsylvania, for example, several medical schools now offer at least one curriculum block on substance abuse. Medical specialty organizations, such as the American Society of Addiction Medicine, are focusing on increasing addiction training programs for residents, practicing physicians and students.

Also, an increasing number of hospitals have an addiction medicine specialist on staff who is available for student and resident teaching, as well as being available for in-house consultations.

The American Medical Association estimates that 25-40 percent of patients occupying general hospital beds are there for treatment of ailments that result from alcoholism. In the United States, the economic costs of alcohol abuse exceed $115 billion a year. Physicians in general practice, hospitals and specialty medicine have considerable potential to reduce the large burden of illness associated with alcohol abuse. For example, several randomized, controlled trials conducted in recent years demonstrate that brief interventions by physicians can significantly reduce the proportion of patients drinking at hazardous levels. But first, we as physicians must adjust our attitudes.

Alcoholism should not be judged as a problem of willpower, misconduct, or any other unscientific diagnosis. The problem must be accepted for what it is—a biopsychosocial disease with a strong genetic influence, obvious signs and symptoms, a natural progression and a fatal outcome if not treated. In the past 10 years, the medical profession’s and the public’s acceptance of smoking as an addictive disease has resulted in reducing nicotine use in the United States. I feel that similar strides can be made with alcohol abuse. We must begin, as we did with nicotine, by educating and convincing our own colleagues that alcoholism is a disease. We must also emphasize that physicians have played a significant role in reducing the mortality and morbidity from nicotine use through patient education. Through strong physician intervention, I believe that we can achieve similar results with alcohol abuse.

..

All i am advocating is for people who maybe haven't had success with programs like AA which promote abstinence or cold turkey which is a negative approach it infers you are losing something or have to go without,which i personally found to be torturous when giving up an addiction,to approach it from another angle,do some research and soul searching of your own.

When you don't want to succeed its easy to find articles like the one above,find postive articles,look at the positive reasons to escape,

change the mindset from i can't have alcohol because i am a recovering alcoholic to

I don't want alcohol because i don't need it.

[Sheryl]

Posters are reminded to review the sub-forum specific rules. They purpose of thsi forum is to be supportiveo f and assist people who have a drinking problem. Theoretical debates about the pros and cons of different approaches to sobriety (and especially ones which attempt to denigrate a particular approach or aggressivekly convince so eone for or against one) are nto appropriate here.

Neither are semantic debates about the meaning of "alcoholism" or of disease, or whether or not addiction differs from disease, or whether or not aloholism is an addiction or som ething else etc etc. All useless and nonproductive.

the forum is intentionally titles "Drink Too Much" rather than "Älcoholic"in order to be inclusive and to avoid this sort of ideological trap and useless arguments.

This thread had no apparent purpose other than to push forward someone's personal views about alcoholism. It is therefore closed. Those who wish to post in this forum please confine yourselves to discussions iof your own specificv problems/experiences or to support for those described by others.