Alcoholism: disease or choice?

Published

Specializes in cardiac, ortho, med surg, oncology.

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

Up Vote Up Vote ×
Specializes in neurology.

Alcoholism is an addiction - but the choice eventually comes down to whether or not a person is going to take that first drink or not. People in recovery stay sober by choosing to NOT drink one day at a time - but the actual alcoholism gets set in motion the moment they pick up a drink.

And here's a question for you - why would anyone CHOOSE to be an alcoholic, when they could have chosen to be a normal drinker? I can't imagine anyone would voluntarily do that to themselves.

Personally, I've stayed sober with the help of AA for over 6.5 years, and I think it is a disease. :twocents:

Up Vote Up Vote ×
Specializes in LTC.

I think certain people are more predisposed than others, and hence it is an immediate problem for them. A class I once took explained it like this. A non alcoholic's brain will see a drink think about drinking it, examine the consequences (ex. will I be driving home tonight? Will my wife be angry?) and then drink or not drink. Its like a bridge process with the the thinking in the middle being the bridge. Alcoholics loose that bridge because they are addicts. It no longer becomes a thinking process, its simply I see the drink, I need the drink so I drink it. The two sides of the brain just fuse together with no bridge in between. Hallmarks of the disease are drinking to the excess of passing out ALL THE TIME. Alcoholics can not socially drink even if they TRY TO, or want to. They will have one which will lead to another and another and so on. Alcoholics will look back and realize that there are consequences to their drinking but still they will not stop because they can't without proper help. True alcoholics continue to call themselves alcoholics even 20 years after they have quit drinking, why? Because they know that even one drink will flip that switch in their brain again and they could be right back where they started. So basically if you took the time to read all this, I think it is initially a choice to drink or not to drink, but in those that are predisposed, it very quickly turns into disease.

Up Vote Up Vote ×
Specializes in ICU/Critical Care.

Disease.

Up Vote Up Vote ×
Specializes in ICU, Emergency Department.

I absolutely believe that alcoholism falls under the category of disease, just as I'd call addiction a disease. But I also agree with NYGirl that it does come to a point, especially when an addict is in recovery, where they can make the choice to pick up again or not. An addict/alcoholic is always an addict/alcoholic, but after getting clean, they do have the choice to stay that way or go back to old ways of thinking.

Up Vote Up Vote ×

Wow...you are gonna get alot on this one question, kinda like opening a can of worms.....lots of personal opinions on this one.

From what I know....both. You make the choice to drink. Some people are predisposed to addictions. I know I am. My dad, his bro and just about all the males and a few women in his family are all alcoholics. Maybe that is all he knew? If you are having a problem, stressed, happy, sad, etc...have a drink.

Don't know the answers to those questions....he died at the age of 58 from liver failure. Soooo...yes, I think it is a disease.

Up Vote Up Vote ×
Specializes in Hospice.

Disease ... combination of mental illness and physical predisposition.

I believe that a significant variation exists in the enzyme pathways that metabolize alcohol in alcoholics. The blurb I read also identified these same pathways in the children of alcoholics.

Don't remember where I read it or I'd give you the citation.

Similarly, it has been documented that opiate addicts have significantly lower production of endorphins than non-addicts ... whether that's cause or effect isn't clear.

'tis a tangled web, fer sure!

Up Vote Up Vote ×

Disease and choice. My son (10 months clean and sober, yea!!) is an addict. I know he chose to put those oxy's up his nose, but after that first time, he was hooked, always looking for a better high. Now, he's choosing to not use, but the underlying desire/disease is always there. Also, there's a study about THQ (I believe that's the term) that is present in higher levels in the brain of addicts. There's science to backup the argument of disease, and personal testimony to back up the argument of choice.

Up Vote Up Vote ×

I have always questioned the "disease" aspect-which got me into a lot of trouble in nursing school.

Example: Alcohol gives me terrible headaches. I cannot drink wine at all-it triggers a nasty migrane. Does that mean because that is the way my body chemistry is, that I have a disease too? Anti-alcoholism?

I just think giving it a disease label is too easy-it is definitely multifactoral.

Up Vote Up Vote ×
Specializes in Home Care, Hospice, OB.

let me duck for cover before i add my :twocents: that alcoholism is a choice.

i chose to drink because i liked the numbness, i quit and learned to deal with my life. no one ever made me drink, and no one else could have "made" me stop.

i know all about genetic links, metabolism difference, etc....and think they exist. you can also have a genetic tendency to diabetes and rotten eating habits, but make a choice to eat right, exercise, and never have type ii diabetes. diabetes, however, remains a disease, albeit an avoidable one for type ii. drinking, shooting, smoking or snorting whatever is a choice.

ok..beat me up, but i know what i have seen and experienced.:redbeathe:heartbeat:redbeathe

Up Vote Up Vote ×
let me duck for cover before i add my :twocents: that alcoholism is a choice.

i chose to drink because i liked the numbness, i quit and learned to deal with my life. no one ever made me drink, and no one else could have "made" me stop.

i know all about genetic links, metabolism difference, etc....and think they exist. you can also have a genetic tendency to diabetes and rotten eating habits, but make a choice to eat right, exercise, and never have type ii diabetes. diabetes, however, remains a disease, albeit an avoidable one for type ii. drinking, shooting, smoking or snorting whatever is a choice.

ok..beat me up, but i know what i have seen and experienced.:redbeathe:heartbeat:redbeathe

i don't think you should be beat up for that view.

you bring up some interesting points. i would like to add there is much anger toward alcoholism, especially by people who have been touched by it, either personally or by a loved one. i think that drives many people away from the disease model, as it would act as an excuse of behavior.

my experience is there are some alcoholics who make a choice to stop numerous times in their life, and simply can't. they die at an early age from complications (from the pathophysiology of the disease, just like those with diabetes mellitus). many, with both afflictions, make lifestyle changes and return to sustainable health; some do not.

the alcoholics that do not, or can't change their behavior eventually are diagnosed with end stage alcoholism; which sounds like a disease to me. it's fatal.

just my :twocents:

Up Vote Up Vote ×
Specializes in Home Care, Hospice, OB.

the alcoholics that do not, or can't change their behavior eventually are diagnosed with end stage alcoholism; which sounds like a disease to me. it's fatal.

just my :twocents:

good point....the damage done by the poisoning effects of alcohol is very real and fatal. but, as you point out, it's because of a behavior that can be changed. in the same vein, most lung and throat cancers are a disease that is brought on by the behavior of smoking...:smokin:

Up Vote Up Vote ×
+ Join the Discussion