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.

Specializes in Adult Stem Cell/Oncology.

I would have to agree that alcoholism is not a disease like cancer, etc.....

I would classify it as a mental illness, I guess. So many alcoholics drink to numb mental health problems, such as depression, anxiety, and loneliness.

I have a close family member that has been an alcoholic for years....she was drinking due to depression and anxiety. She had tried two different antidepressants over the years and they didn't work, so she kept drinking. She eventually ended up in the ER held on a 5150 (long story....) and was then on the behavioral health unit of another hospital for a few days. The doctor put her on Zoloft, which was like a miracle drug for her! It's been a couple of months now, and she's been sober (and happy) ever since!

She said she's no longer depressed and anxious and no longer feels the desire to drink. So clearly, alcoholism is linked to mental health, or lack thereof......at least in this case!

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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:

I agree. I think the addictive behavior IS part of a disease. However, every addiction starts with a choice. Not just one either. Multiple choices that eventually end in addiction.

Drugs and alcohol run through my family like wildfire. My brother is a junkie (Cocaine), my aunt is a 16 year recovering heroin addict. My mother, father, grandfather, multiple aunts/uncles and brother are alcoholics.

I was on the path in my highschool days but I chose to stop. The alcohol never had any allure for me so I still drink occasionally with no ill effects but certain drugs (Uppers), cigarettes and gambling pull at me like a river current. Even after one time the urge is ridiculously strong so I stay clear of all of that. Minus the smokes of course :) Can't be perfect. Oh, let's not forget caffeine either. I have enough nicotine and caffeine in my body right now to kill an elephant. Literally...

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I firmly believe that alcoholism is a disease, and that alcoholics remain alcoholics for the remainder of their lives (the same way you can "beat" CA but it can always return). However, I also believe that our society labels many people "alcoholics" who are actually alcohol abusers by choice - that's what I used to be. For several years I regularly drank to excess, but it wasn't out of any illness or disease. I drank too much out of boredom and for the social interaction I thought I was getting (who knew? All those folks I drank with weren't true friends!). I abused alcohol without being addicted to it. I've since calmed down, gotten married, and enjoy drinking socially, and have no health or psychological problems (to my knowledge) related to my former abuse of that particular substance. True alcoholics can't have "just one."

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Specializes in ICU, Telemetry.

I've got a good friend at church who's been in recovery for 25 years, and when I became a nurse, I asked him what did I need to do to help the alcoholics I see at the hospital. He invited me to the AA meeting, and MAN, did I learn a lot more about alcoholism that night than I ever did in school. Those in recovery who'd been sober for years were the toughest -- don't mollycoddle, don't make excuses, make them see the cost of their addiction, being nice makes them WORSE. One guy said his "specialty" in the the hospital was picking a younger or more inexperienced nurse, and getting her sympathy and then wheedling extra narcotics, etc., out of her by telling her he never drank until the house burned down and killed his wife and kids, and he couldn't get them out. He was never married and has never had kids, but he said this story "served him well."

While I think it can cause a physical disease process (and having had a guy with dissecting esophageal varices puke the lining of his esophagus up, I can testify to that, plus all the liver failures I see), I think it's primarily a behavioral/psych issue that causes a constellation of physical diseases. I think at it's root it is a form of depression with a self destructive impulse; if these folks were somewhere where there was no alcohol, they'd find something else to "addict" to because it is fundamentally their nature, and that's what the folks at AA told me (in a cloud of cigarette smoke and drinking coffee like it was going to be outlawed -- I told them while I wouldn't see them with liver failure, I had a feeling I'd be seeing some of them for lung cancer and cardiac palpatations, and they laughed and agreed).

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Do you walk with your right foot or your left foot?

Alcoholism--the trait that predisposes a person to have an unhealthy craving for alcohol--is, for the purposes of this discussion, a disease. I much prefer the term "condition" because it is less emotionally charged.

People don't get a choice about whether or not they experience this compulsion, therefore, that aspect of this situation should never be used as evidence of moral failing.

Those who live with this condition (about which they have no choice), DO, however, have decisions to make about how they will manage their lives.

If you look at the condition of alcoholism like magnetic attraction, you can see that there is a force at work that no amount of willpower can countermand. You can will iron filings to stay on the table when a magnet passes by, but magnetic force will overrule you every time.

Unless.

There are measures that can weaken, block, or outperform the magnetic attraction. That force still exists (as does alcoholism), but distance, insulation, and stronger magnetism can change the outcome.

For an alcoholic, these measures can include avoiding drink and all its trappings, taking meds which make alcohol consumption unpleasant or at least non-productive, stripping away years of rationalization and truly counting the cost of their drinking, enlisting the help of trusted partners to keep them honest, and many other means to stay sober.

Alcoholics who hope to wake one day with no desire to drink usually fall off the wagon. Some get run over by it. A handful of folks do, by the grace of God, find themselves liberated from the craving, but most do not. The real point of grace for them is to accept both the condition and the choices that they will live with every single day on this earth.

Alcoholism--the compulsion--is a condition. No choice involved.

Alcoholic behavior--to drink or not to drink, to seek help or not to seek help, to lie to yourself or let the truth in--is choice in its purest form.

Right foot, left foot.

Recognizing one without including the other will only leave you hopping in circles.

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:yeahthat:

Nice. You got it exactly.

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Specializes in med/sug/onc/geri.

Choice. Nothing says they HAVE to keep drinking once they realize it's a problem. Totally their choice to continue.

I'm not an alcoholic. But I do know addiction. I was terribly addicted to cigarettes--physically and mentally. But when I made the decision to quit, I quit. Haven't touched one in 6 or 7 years. So am I 'diseased' ? I think not.

I chose to stop. Was it hard? Heck yeah. But it was obviously doable. Same thing for alcoholics. Just don't drink. Same way I just didn't smoke.

See why I could never work psych? I'd just tell everybody to stop being stupid and whiny and suck it up! :trout:

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What is your definition of disease? I believe like obesity it is a choice that in time will definitely become a deadly disease. We all make choices that will eventually be the death of all of us. Drinking alcohol, over eating, laying on the couch vs. exercise, driving to fast (especially in the rain), voting for a president who may decide to get you into a war where you are nucked, running your mouth to the wrong person resulting in being shot in the head, getting married to someone you love who beats you to death or sleeps around without your knowledge resulting in HIV.

I believe alcoholism is both a disease and a choice. It will kill you just like any other bad choice.

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Specializes in DOU.

As the daughter of an alcoholic, I say alcoholism is a choice that results in disease.

I can feel the flames already.

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No flames, this subject is much too important and has effected far too many of us for sharp tongued debate.

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Specializes in cardiac, ortho, med surg, oncology.

I really appreciate all the replies and interest in this thread.

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Specializes in Geriatrics, ICU, OR, PACU.

Disease. From a recovery alcoholic, who has alcoholic and bipolar grandparents, father, and brother. Fortunately, my brother and I have broke the chain, and become sober. Alcoholism is also a very common disease in those with bipolar disease, which is evident in all three generations of my family. I find choice has very little to do with it, it's the choice to get sober that's the REALLY the choice.

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