Is Alcoholism a Disease?
At times, scientists, clinicians and others debate whether or not to call
alcoholism a “disease.” Usage of the term is usually acceptable if it is
properly defined. When one considers the wide scope of damage that
alcoholism does to the human body, mind and spirit, the condition can,
indeed, be legitimately described as having become a disease.
Over a period of time, alcohol abuse alters brain-cell function, induces
nerve damage, shrinks the cerebral cortex, imbalances the hormonal system
and damages vital organs. Scientists have found that repetitive alcohol
abuse wreaks a certain common havoc on the psyche that is perhaps even
more insidious than the damage sustained by the liver, the heart and
other vital organs.
During early and middle stages, alcoholics may be able to function, but
their productivity will be progressively hampered; their psychological
disequilibrium will magnify small problems and render them unable to cope
effectively with stress. This altered state of psyche will prevent them
from seeing the reality of a situation and thwart the normal process of
emotional maturing that enables people to assimilate and learn from
lessons of experience. The condition of alcoholics changes them into
people who think, act and feel differently than they should.
Because alcohol blurs effective insight into the way alcoholics look on
things, it is commonly impossible for others to reach them about what
their drinking is doing until they “hit the bottom” or are confronted
with a serious problem. Victims are so dependent upon alcohol to function
or feel well that they feel there is nothing abnormal about their
drinking. They delude themselves (perhaps one should say, lie to
themselves) that they don’t have a drinking problem. Many feel this way
because they aren’t derelicts or Skid Row types.
Some of the most serious diseases associated with chronic alcohol abuse
include cancer of the liver, larynx, esophagus, stomach, colon and
breast. Alcoholism may also lead to high blood pressure, stroke and heart
attack; damage to the brain, pancreas and kidney; produce stomach and
duodenal ulcers, colitis, birth defects and fetal alcohol syndrome,
impotence and infertility, premature aging, sleep disturbances, muscle
cramps, diminished immunity and other diseases. Alcohol abuse and
cigarettes are one of the worst possible combinations, greatly increasing
the risk of heart disease and cancer.
Calling the condition of alcoholism a disease is not a cop-out for
alcoholics. To the contrary, when alcoholics become aware of the
far-reaching damaging effects of their condition to their own minds,
lives, families and society, they have more responsibility, not less, for
seeking treatment.
Heredity Studies
The involvement of heredity in alcoholism has been suspected since
ancient times. The basis for this is the observation that alcoholism
tends to “run in families,” which in itself is not proof of genetic
involvement, since a shared environment could also explain the pattern.
However, the strongest evidence for genetic influence on alcohol-related
behaviors has come from a few adoption studies in which the effects of
biological parentage and rearing parentage are disentangled.
One of the best controlled-adoption studies was conducted by D.W. Goodwin
and his colleagues in Denmark in the early 1970s. This study compared the
drinking history of 55 adopted-out adult sons of alcoholics and 78
adopted-out adult sons of nonalcoholics. All of these sons were adopted
as infants, within the first six weeks of life. The researchers found
that biological sons of alcoholics who had been adopted by non-related
foster families were four times as likely to become alcoholics as the
adopted sons of nonalcoholics. (The researchers found the lifetime
prevalence of alcoholism as 18 percent in the biological sons of
alcoholics versus 5 percent in the nonalcoholic sons. The estimated
lifelong rate for alcoholism for males in the U.S. general population is
estimated to be about 3 percent to 5 percent. For females it is less.)
Goodwin and associates found high rates of alcoholism in sons who had a
biological parent who was alcoholic even if the adopted sons were raised
by nonalcoholic foster parents. These sons of alcoholics were also twice
as likely to become alcoholic by their late twenties or earlier and to
develop alcoholism serious enough to require professional treatment.
In 1978, a study of over 1,100 adopted sons of alcoholics in Sweden found
them three times more likely to become alcoholic than the adopted sons of
nonalcoholic fathers. Adopted sons whose mothers were alcoholic were
twice as likely to become alcoholic as those whose mothers were
nonalcoholic.
In 1979, Nancy S. Cotton, Ph.D, reviewed 39 studies on the heredity of
alcoholism that had been published over the preceding four decades. She
summarized the findings on the families of 6,251 alcoholics and 4,083
nonalcoholics involved in these studies: Without exception, every family
study of alcoholism showed significantly higher rates of alcoholism in
relatives of alcoholics (in father, mother, sibling or relative) than in
the general population. Cotton found that almost one-third of any sample
of alcoholics had at least one parent who was alcoholic. Two-thirds of
the studies of alcoholics found that at least 25 percent had fathers who
were alcoholics.
Dr. Marc Schuckit of the University of San Diego and chief of the
alcoholism research unit, remarked, “People do inherit things that make
them more or less vulnerable to the effects of alcohol. Certainly many
genes are involved, and there are many different ways to become
alcoholic.”
It is difficult to untangle the relative contribution of heredity and of
environment in alcohol response. It is important to point out that not
all alcoholics have alcoholic parents or siblings. Some have
tee-totalling parents. Humans are influenced both by genes that affect
their physiological or metabolic functioning, and by their social
environment. Modern alcohol research is finding that what is inherited is
not “alcoholism” but a susceptibility for it—a “genetic predisposition”
that renders a person more metabolically vulnerable to develop alcoholism
if that person drinks. Genetics alone is not the cause of alcoholism.
Alcoholism must still be created by improper drinking. In our world, this
is usually fostered by careless or socially encouraged abusive drinking
practices, or by trying to solve emotional problems with alcohol.
In summary, if one has alcoholism in his or her family, special concern
is warranted. If one does not have alcoholic relatives, concern is still
warranted because no one can safely assume he or she is immune.
Alcoholism can be created simply by unthinking, careless use or abuse of
alcohol.
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The Legacy Group of Alcoholics Anonymous © 2005