Alcoholism: disease or choice?

Specialties Addictions

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What is your opinion; is alcoholism a disease or a choice? Please provide your rationale or empirical support of your belief.

This one especially, but similar things like in the mental health area are questionable to me.

I would suggest you learn more about neurology and neuro chemicals.

To think that there is a choice about having mental illness is confusing to me. The research is overwhelming. Evidence based practice tells us a great deal about mental illness. Chemicals, not your opinion, are the reason for mental illness. Providing assistance for the brain to get the right chemicals or adjust the rest to the new normal comprises much of the treatment.

To drink methyl alcohol knowing that blindness is the consequence but the compulsion to use is overwhelming is not the enjoyment of overindulgence.

Addiction is as real as diarrhea. When you have a real case of the runs I suggest you decide you will not expell any feces and will not cave into the desire to run to the bathroom. Perhaps instead of this use of self will and failing self control you might try a medication to stop the symptoms. That is similar to dealing with addiction. One needs to allow the receptor sites to heal over so the compulsion to use is lessened, same as Imodium decreases the desire to run to the BR.

We are learning more about the brain everyday. it will be a challenge for you to get caught up with current knowledge let alone grasp the new stuff coming out. In the mean time it is not helpful to those who suffer with these illnesses to have to deal with the attitudes you are projecting, even if that is not exactly how you feel.

Well please explain your expert knowledge of these "diseases" to the victims of violence and their families. Like the shooting that took place in the CO movie theater recentl. I'm sure their families would be happy to hear this guy who shot 70 people is not at fault. He didn't have a choice right? No, it's a mental disease that made him do that I'm sure. Interesting that he was studying neuroscience..... Meh, I'm sure he will plead insanity and people will fall for it.

Specializes in Peds/outpatient FP,derm,allergy/private duty.

Lael, how often do you think people are not charged or tried for a crime because of a pre-existing mental illness? I'm pretty sure most people would say Charles Manson, Ted Bundy, and Dennis Rader are/were mentally ill. Are they sitting in their living rooms right now enjoying life?

A physiological basis for behavior tendencies isn't negated by the concept of responsibility for a crime.

Having a disease (or a condition, if you prefer) doesn't mean you don't have any choices. It means you have lots of choices!

Please, understand that the attraction to drink (or drugs or food or whatever) is the only part you don't get a choice about. All the other matters of daily living are loaded with decisions, and there is no free pass to indulge and blow holes in people's lives. There are no excuses for bad actions. None. There are reasons, because there are reasons for everything, but explanations are not excuses.

Alcoholics need consequences, not condemnation and they need them for actual behavior, not because they have a craving for drink. "If you are acting drunk when you come to visit, I will not let you in the door because I don't want your nieces and nephews to see you this way," is much more effective than, "You disgust me."

Alcoholism isn't a choice, but sobriety is.

Specializes in ortho, hospice volunteer, psych,.

for my alcoholic grandfather, there were indeed consequences to be faced when (and if) he drank.

1. he didn't get to sleep in his own bed because grandma would banish him to his parent's house until he was

sober again.

2. he didn't get to see his two beloved boys again until he "was himself" again.

3. his dental office would close up and remain tightly locked until all signs of his impairment were gone. that

was grandpa's rule and he was bound by the decisions of grandma's and his assistant's opinions and judgement.

4. he didn't get to see his grandchildren, whom he adored, in later years, unless he remained sober.

5. he had a gastric ulcer caused by years and years of heavy binge drinking.

6. he died of oral cancer along with stomach cancer, which are not good ways to die.

he would go for years -- sometimes for decades -- without any alcohol, then the alcohol in some of the products

in his office would begin to call out to him. then he'd be off and running again! he'd go back into rehab and come

back his "sober and aa going" self, but unfortunately, despite his best intentions, it never lasted forever.

was he a bad man? no. a weak man? no. derelict? nope. a sick man? yes. no different than if he had been

diabetic and sneaked to the soda shop for lots of hot fudge sundaes.

another analogy would be the defective neurological gene i inherited that caused an aneurysm that was hidden

from the mri to rupture and cause a cva. the very same gene that killed my triplet brothers born at the same time as i was, in infancy. to

me, the gene that predisposes one to alcoholism, is a similar sneaky gene, because you can only know whether it

is carried in your family line but not know which specific babies will have the disease until it appears.

my dad didn't drink at all after his frat boy days but his brother is a very unpleasant, obnoxious, loud,

alcoholic. did my dad carry the gene? i don't know. i don't even use the "made-for-adults" dental rinses

because many contain almost as much alcohol as a standard drink. i use the pedi formulas -- and not because

i love the taste of bubble gum. once in a great while, i'll cook with alcohol.

a disease. usually controllable, but not always, and, yes, sometimes there are relapses... as with any disease.

Specializes in ortho, hospice volunteer, psych,.
well please explain your expert knowledge of these "diseases" to the victims of violence and their families. like the shooting that took place in the co movie theater recentl. i'm sure their families would be happy to hear this guy who shot 70 people is not at fault. he didn't have a choice right? no, it's a mental disease that made him do that i'm sure. interesting that he was studying neuroscience..... meh, i'm sure he will plead insanity and people will fall for it.

i was a psych nurse and worked on the addictions unit, the forensic unit, and a

couple of other units in a state psych hospital for nearly two decades.

none of the patients wanted to be there or to have the diseases and/or addictions they had. no one ever says as a nine year old, "when i grow up, i want to be a fairy princess or a schizophrenic or a meth addict or an alcoholic or an astronaut..."

lael, are you a nurse? i'm not trying to be difficult. you just seem to have forgotten what you learned about psych and addictions nursing. very very few

people are inherently evil and malevolent.

This debate , and others like this one, can be whittled into the age old debate: will vs predetermination. Predetermination of course makes those exempt from taking responsibility for actions, but in the case of "diseases," frees individuals from taking ownership for changes in health and the latent functions and dysfunctions of these changes.

Did I, or McDonald's make myself fat?

Did I, or my socioeconomic climate make me a drug addict?

Did I, or my addictive biostructure make me an alcoholic?

I think we can all be intelligent enough to agree on the fact that not one or two but multidimensional factors in human life are contributing players on how or why we develop the way they do. Completely eradicating the notion of predetermination for its annihilation of the debate itself is another item we can agree on. Thus, I feel most of us can agree on the fact that yes, we are all born differently, and yes, we are to some degree influenced by factors that in some way can be classified as forces that exist beyond our control. For example, I was born Mexican American--this automatically predisposes me to a myriad of life paths that correlate with statistical observations that seem to trend uniformly across the board. We see trends for a reason. Raw statistics, whether they be medical, academic, political, social, or historical are objective reflections of how and why things occur the way they do. This phenomenon ALONE serves as a negating response to nay-sayers that believe "I and I alone am solely responsible for everything and anything that amounts to being me."

I see lots of emotionally charged posts from individuals refusing to accept alcoholism as a disease. I also tend to agree with those who compare diabetes and alcoholism, because to me they manifest themselves similarly in our society. I however find it tragic that there are so many societal infractions regarding the diabetic epidemic like the blame on food control but there are very little for alcoholism--I believe this may be due to a discrepancies between the aforementioned populations. It also doesn't help that alcoholism tends to lead to altered behaviors that exist as violent, self destructive, and in many cases illegal--I see how easy it is to enforce the idea that those who suffer from alcoholism should not only take responsibility for their condition but also make progress towards rectifying it.

At a young age I saw what alcohol does to a person, now that I am 26 I see even more how much this habit/condition deteriorates not only the individual but those around them. I do however believe that alcoholism is a disease that comes about from a combination of predisposed factors like personality/disposition, but more so from socioeconomical influences. I think in order to truly disect and understand alcoholism, diabetes, and many other disease we need to stop obsessing over the physical "proofs" that help but avoid the obvious "greyness" of the issue.

Saying alcoholism is a disease is not a "free pass" that excuses the individual for whatever caustic behavior they exhibit. I find ignorance in that mentality the same way I find ignorance in the mentality that the overweight are to blame for their condition.

For every person suffering from a preventable disease that is linked to correlative/causitive habits, whether it be consumption or something or riskiness in behavior there was a point in their life when it was, to a degree [some more than others] an event of free will or responsibility (do I order the big mac and fries or not, do I try beer for the first time or not, do I have unprotected sex or not)--and even then that breaks down to an even more complex division in culminating factors like: how much does one know about nutritional livelihood, how much does one know about the addictiveness of alcohol, how much does one know about STD protection)--and even that breaks down to an even more: (how much was I taught about or exposed to regarding diet, drugs, sex)--and that breaks down even more to (what baseline does my cultural exposure or immediate sphere of influence have regarding diet, drugs, sex) etc.....etc....etc...This can go on forever.

I'm all for debate, but I feel anyone who points the finger and says "you, and you alone, are solely responsible for who and what you are" needs to think a little more about the human condition.

There is a great deal of good research about the genetics of addiction. Does not matter if you are raised in it or not, if you have a genetic predisposition chances are much higher. As we learn more about genetics and brain chemistry I am sure more people will be less likely to argue as forcefully.

Anyone can be a drunk. It takes a great deal for a person to admit to the disease of alcoholism and stop proving him/herself to be a drunk. It is like the person who has DM and takes care of themselves versus the one who ignores the disease and then is a poster child for the losses DM creates.

Specializes in ortho, hospice volunteer, psych,.
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how wonderfully over simplistic!

when my husband comes home, the very first thing i'll tell him is that he

could have avoided being diagnosed with type-1 diabetes at age eight if he'd

only rationed those evil chocolate bars...

same ol' fallacious logic!

Specializes in Psych ICU, addictions.
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If it were only that easy and simple :) But we all know it's not.

I can see that going over wonderfully with my patients..."just don't drink anymore and you'll be fine." Problem is for them, thanks to the disease of addiction, the choice not to drink isn't one that they can readily stick to.

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