The discussion as to whether alcoholism is a disease or a personal behaviour problem is more than 200 years old. Dr Benjamin Rush, one of the ‘Founding Fathers’ of the USA first spoke of alcoholism as a “disease” in 1784.
The American Medical Association was first to formally approve of the disease concept in 1957 and in 1960 Jellinek’s definition was foundational to the development of the modern Disease Theory of Alcoholism.
During the past 50 years, professional studies conducted by health professionals and scientists have upheld Jellinek’s interpretation of alcoholism as a disease. The following organisations have defined alcoholism as a primary illness:
- The World Health Organization
- The American Psychiatric Association
- The American Medical Association
- The American College of Physicians
- The American Hospital Association
- The American Public Health Association
In 1992 the Joint Committee of the National Council on Alcoholism and Drug Dependence and The American Society of Addiction Medicine defined alcoholism as:
“Alcoholism is a primary chronic disease with genetic, psychosocial and environmental factors influencing its development and manifestations. The disease is often progressive and fatal. It is characterised by impaired control over drinking, preoccupation with the drug alcohol, use of alcohol despite adverse consequences and distortions in thinking, mostly denial.
Each of these symptoms may be continuous or periodic.” – The American Society of Addiction Medicine & The Joint Committee of the National Council on Alcoholism and Drug Dependence. There is still debate in professional circles as to whether alcoholism is in fact a disease and how best to treat it. The designation of “alcoholism as a primary illness” is a milestone for alcohol recovery treatment as it clearly established the illness as a medical disease rather than a condition resulting from a lack of will power or a lapse of moral judgement.
Today medical practitioners readily accept that therapeutic treatment for Alcohol Dependency (alcoholism) is best dealt with, in the hands of professionally trained counsellors and clinicians in registered rehab clinics and treatment centres.
The Disease Concept of Alcoholism
States that alcoholism can be caused by a brain disease, characterised by altered brain chemistry, structure and function. In addition to problem drinking, alcoholism as a primary illness is characterised by symptoms including an impaired control over alcohol, compulsive thoughts about alcohol and distorted thinking or Denial.
Furthermore it states that alcoholism as a primary illness is a life-long, incurable disease not dissimilar to diabetes. When managed properly, treatment can halt further damage to the brain and reverse the effects to some extent. Not to be confused with problem drinking or alcohol abuse (which also poses serious health risks and often a precursor to alcohol dependency) once established actual alcoholism, is irreversible and the alcoholic cannot return to safe or moderate drinking.
The Impact on the Alcoholic
The alcoholic doesn’t choose to suffer from a brain disease any more than a diabetic chooses to have a malfunctioning pancreas. The physiological and psychological effects of alcohol abuse and alcoholism are severe and with prolonged use may lead to further life threatening consequences such as; cirrhosis of the liver, increased risk of cancer, pancreatic failure, kidney disease, cardiovascular disease, central nervous system conditions, epilepsy and seizures.
Psychological implications can include; depression, anxiety, suicide, paranoia, psychosis and as the brain continues to deteriorate, loss of memory, Korsakoff’s syndrome and alcoholic dementia. Withdrawal symptoms from alcoholism as a primary illness can be severe and may give rise to life-threatening complications. Thus it’s important to admit the alcoholic into professional alcoholic treatment where a medically supervised alcohol detoxification (detox) program can be administered. If you’re family and friends of an alcoholic or if you suspect that you may be alcohol dependent and considering abruptly discontinuing the use of alcohol, we recommend that you discuss your options with a trained alcohol and addictions counsellor beforehand.
Alcoholism & Impaired Manageability
The life of the individual who suffers from the Primary illness of alcoholism is characterised by increasing loss of control over his drinking and manageability of his living processes. Which often result in marital disputes, divorce, domestic violence, job loss, crime, motor vehicle fatalities, suicide and mental illness. WHO (world health organisation) estimates that there are 140 million alcoholics in the global population today. The cost of alcoholism to the global economy for health care, insurance, accidents and mishaps, crime, divorce and to business, through lost profitability runs into the billions of dollars annually.
If Alcohol is a Primary Illness how would I know if I need help? Is a question that poses significant risks to the individual, friends, families, employers and society. The consequences of untreated alcoholism are serious and life-threatening. Anyone who feels they or others may be at risk, are advised to seek professionally trained help.
Recovering from Alcoholism as a Primary Illness
Alcoholism is often referred to as the disease of denial. Paradoxically the illness impairs the judgement or reasoning of the afflicted individual to the extent that they are unable to recognise the symptoms or acknowledge their condition. For this reason successful long term recovery and rehabilitation from alcoholism, a primary illness, requires the skills of the trained professional alcohol and addictions counsellor to break through the barrier of denial to enable the patient to confront his own illness.
Treatment for alcoholism a primary illness will include among others:
- Medically Supervised Detoxification (detox)
- Behavioural or Cognitive therapeutic counselling and programs
- Ongoing support such as 12-step meetings
Residential (in-patient) treatment is preferred and there is a correlation between the length of time spent in a quality alcohol rehabilitation facility and patient’s ability to remain sober afterwards. However in some cases out-patient therapy (after-hours rehab) may be considered appropriate.
Recovering from alcoholism is an arduous process, it takes great courage but to begin with the alcoholic may not be able to meet and overcome that challenge. Waiting for the alcoholic to be inspired or “ready” may be pointless…worse it may be enabling (allowing or helping the alcoholic to avoid the consequences of actions).
Many recovering alcoholics entered treatment reluctantly or under duress from outside pressures. Alcoholism is a primary illness and can be overcome once the alcoholic has broken through the denial and begins to understand that recovery is possible. To answer the question…is Alcoholism a primary Illness? Yes, we believe all the evidence points in that direction.
We Do Recover is an organisation committed to helping you find the professional help or information you need. To recover from alcoholism, our alcohol and addictions counsellors are professionally trained to discuss your options and advise you on the professional treatment solutions that fit your circumstances, your budget and your location.
Take a positive step forward; you’ll be glad you did. Our counsellors are available to answer all your questions now.
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Founded in 2008, WeDoRecover has evolved from an advisory service for addiction treatment into a comprehensive provider of care, following its 2019 merger with Changes Addiction Rehab in Johannesburg. Specialising in connecting patients to top-tier addiction treatment centers in the UK, South Africa and supporting individuals in recovery world wide.