Alcoholism is not a Disease

​From an article by David J. Hanson, Ph.D.:

The proposition that drinking necessarily becomes uncontrollable once it has begun, had been disproved over a quarter century ago by more than 100 research studies reporting that a significant proportion of alcoholics return to moderate or controlled drinking without problems. Since then, the number of such studies has more than doubled.

The proposition has also been disproved by a nation-wide survey of alcoholics conducted by the United States government. It found that 17.7% of alcoholics are now drinking in moderation. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) has discovered that
twenty years after onset of alcohol dependence, about three-fourths of individuals are in full recovery; more than half of those who have fully recovered drink at low-risk levels without symptoms of alcohol dependence.

About 75 percent of persons who recover from alcohol dependence do so without seeking any kind of help, including specialty alcohol (rehab) programs and AA. Only 13 percent of people with alcohol dependence ever receive specialty alcohol treatment.

The director of NIAAA's Division of Treatment and Recovery Research stresses that "These and other recent findings turn on its head much of what we thought we knew about alcoholism." 

The third proposition, that medical help is necessary to deal with alcoholism, is clearly not the case. Indeed, most alcoholics control or modify their behavior without any help from anyone else other than themselves.

Those who use AA or other disease theory 12-step groups are using a non-medical approach. Dr. Stanton Peele observes that "Why supposed medical treatment consists mainly of going to group meetings and why people can't develop their own spiritual approaches to life if they choose are questions disease theory adherents ignore."

A survey of general practice physicians and nurses found that a majority believed that there are no medical or health care treatments that are effective in treating addiction.

The fourth proposition, that alcoholics aren't responsible for their behavior, is certainly not true. In 1988, the United States Supreme Court found that alcoholism is always the result of the alcoholics "own willful misconduct." It reaffirmed the lower court's finding that there exists "a substantial body of medical literature that even contests the proposition that alcoholism is a disease, much less that it is a disease for which the victim bears no responsibility. It also noted that "Indeed, even among many who consider alcoholism a 'disease' to which its victims are genetically predisposed, the consumption of alcohol is not regarded as wholly involuntary."

The Supreme Court also held the arguments presented in favor of the disease theory of alcoholism constitute a syllogism or deceptive argument and that "the inescapable fact is that there is no agreement among members of the medical profession about what it means to say that 'alcoholism' is a 'disease.'"

In 1990, the Alcoholics Anonymous General Services Office or AA GSO, the governing organization overseeing all "autonomous" meetings, published an internal memo for the employees of its offices. It was an analysis of a survey period between 1977 and 1989. The results were in absolute contrast to the public perception of AA. "After just one month in the Fellowship, 81 percent of the new members have already dropped out. After three months, 90 percent have left, and a full 95 percent have disappeared inside one year!" (Kolenda, 2003, Golden Text Publishing Company) That means that in under a year, 95 percent of the people seeking help from Alcoholics Anonymous leave the program. While this only speaks for attendance, it has further implications. For the most part, those who study the efficacy of Alcoholics Anonymous do not include dropouts in their sobriety failure statistics, which is deceptive, if not outright dishonest. When studies include AA GSO dropout statistics, "...the total averages of sobriety for the total AA membership become 3.7 percent for one year [of sobriety], and 2.5 percent over five years." (Kolenda, 2003, Golden Text Publishing Company) It's important to understand that 95 percent of all substance abuse treatment centers in the United States are 12-step based programs. Thus, the failures of Alcoholics Anonymous are also the failures of treatment.

Repeated studies have shown that the average person, who could be diagnosed with a substance abuse problem, will discontinue use on their own 20 to 30 percent of the time. But, those who are exposed to AA and treatment and who are taught the disease concept have a drastically decreased chance of achieving sobriety. While treatment professionals are aware of program failure, governing organizations support and promote the adoption of 12-step tenets into treatment programs for substance abusers. Families pay tens of thousands of dollars to help their loved ones only to place them in programs that follow guidelines of a documented failed program. Any program based on a program that fails will inevitably fail. For most, 12-step has become synonymous with failure. 
In contrast, programs that teach personal responsibility and choice are far more successful than programs that teach the disease theory. While conventional treatment methods result in a 3 percent success rate after five years, programs that do not teach the disease concept, and instead teach choice, have success rates of more than 60% percent after five and even 10 years (Baldwin Research Institute 2003). 

In conclusion, after reviewing the available research from both sides of the debate, the belief in the disease of alcoholism (addiction), causes the disease. Organizations and institutions that promote the disease theory are, in many cases, doing irreparable harm to the individual and performing a disservice to the population as a whole. Geneticists are aware that a predisposition does not dictate subsequent behavior, and treatment professionals are aware that the programs they offer, fail. It is an outright injustice when faced with the facts. Stripping human beings of their ability to choose is damaging, whereas giving them back the power of their own volition is essential for recovery. Alcoholism is a choice, not a disease.

Even if we jump to the secular world it is not a small minority that rejects the disease concept, The Rational Recovery Website has an ongoing challenge for anyone to demonstrate scientific evidence for the disease concept of addiction. 

http://www.rational.org/index.php?id=47