Talk:Alcoholism/Archive 1

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Can I suggest a book for inclusion under "Further Reading"? It is: How to be Free of Alcoholism, Cancer and Many Other Diseases; A First Hand Report and Discussion in Simple Layman's Terms. Northern Lights Enterprises, Norfolk, Nebraska, November 2006 ISBN 978-0-9789090-0-0

In a nut shell, it is about the use of Low Dose Naltrexone to stimulate endorphin production which then has a pronounced effect on alcohol craving. Also, there is an article about a unique use of Low dose Naltrexone (LDN) in Wikipedia that you would likely find very interesting and informative. LeroysLeroys

For quite some time, the Alcoholism entry has provided out of date or incorrect information. I'm in the process of rewriting it to meet contemporary scientific standards for the disease. I welcome external review and discussion. -- Stuart Gitlow MD (Chief, Annenberg Physician Training Program in Addictive Disease, Mount Sinai School of Medicine, NYC)

Thanks for your contributions so far. You may be interested in creating a user account. Some of the benefits are discussed at this page: Wikipedia:Why_create_an_account? Osmodiar 03:30, 14 January 2006 (UTC)

It greatly reduces the chances people will revert your changes, for one thing. :-) Ronabop 03:42, 14 January 2006 (UTC)

Good points, and I've created an account as you suggest. See my notes below as well. --sg

In response to the commentary at the very, very bottom of this page (dupe social impacts), I've rearranged the content of the page a bit. I believe that it now better reflects the chronology of how people are impacted by alcoholism, and therefore reflects the order in which this information becomes important to people: definition, effects, diagnoses, treatment, broader issues.

FYI, I renamed the first instance of Social Issues to read "Societal Issues" and moved it into the broader issues area. I moved the latter one up to become a subheading of the "Effects" category. After this edit I'm going to go remove the original note of this (because it's no longer germain), so you'll have to look at the next edit in order to read it. Mythobeast 23:14, 1 May 2006 (UTC)

In looking over the article and the discussion of Stanton Peele's perspective et al, I'm wondering whether some of the ongoing discussion held on this page is about a misconception that alcoholism is equal to "excessive drinking," whatever that is. Alcoholism doesn't refer to someone who drinks a lot. Many people drink a great deal but aren't alcoholic. Conversely, many alcoholics don't drink very much at all compared against the general population's intake. Drgitlow 21:36, 26 June 2006 (UTC)

The section on "terminology" that you removed was intended to address exactly this misunderstanding. Since you seem to think it's important, I'm putting it back in. Mythobeast 17:32, 27 June 2006 (UTC)

rightoDrgitlow 19:38, 28 June 2006 (UTC)

Despite the difficulties that we've had of late, the entry is coming together nicely. I'm looking over the EFFECTS section, which has a good deal of information on alcohol itself, and the impact of alcohol USE. It is difficult to tease out the effects of alcoholism versus the effects of alcohol. The effects of alcoholism when an alcoholic is in recovery, for example, would be different from the effects of alcoholism while an individual is drinking on a daily basis. (This is similar, of course, to the situation with other diseases - the effects of diabetes when an individual has well-controlled blood glucoses are different from the effects of untreated diabetes). Nevertheless, I wonder whether the entire section would be more appropriately found in the alcohol article rather than here in the alcoholism article. Can we build a consensus regarding this area? Drgitlow 05:29, 1 July 2006 (UTC)

Alcoholism vs. Alcohol abuse

The National Institute on Alcohol Abuse and Alcoholism make a difference between one and the other. What I found more confusing is that from "alcohol abuse" you're redirected to "alcoholism".

"Alcoholism, also known as 'alcohol dependence,' is a disease that includes four symptoms: craving, loss of control, physical dependence, and tolerance".

Moreover, "Alcohol abuse differs from alcoholism in that it does not include an extremely strong craving for alcohol, loss of control over drinking, or physical dependence", etc etc.

>> Getting the facts @ NIAAA

--Issa 02:32, 12 July 2005 (UTC)

Response: Good point. From one interested perspective, AA literature itself discusses this issue and draws a clear distinction between alcohol abuse and alcoholism.--Midnite Critic 02:52, 12 July 2005 (UTC)

I can't make the correction. I'm not that good informed and my english is quite lousy. Could you..? --Issa 04:27, 21 July 2005 (UTC)

How about mentioning something about alcoholism as a form of drug addiction? Correct me if I'm wrong, but alcohol is certainly a hard drug, characterized by intense (and possibly fatal) withdrawals... isn't that addiction?

This is mostly true. The root causes of both forms of addiction have been determined to be the over-rewarding of neurons that are involved in actions relating to the use of the drugs. I present the question to all qualified people out there: Is alcoholism the addiction or the uncontrolled drinking caused by the addiction? To highlight the difference, programs like AA can cure the person of the drinking, but the addiction remains. - Robert Rapplean UTC 17:56 Dec 15 2005

Of the experts I have read, a compelling argument is that the addiction is to the pleasure caused by alcohol. And your midbrain decides that alcohol is as necessary for life as is oxygen. This midbrain has access to your language centers, and can "talk" to you to convince you that you want to drink. There are several texts expousing this theory. Also, this addiction is defined by them as a concious choice to pursue the pleasure against ones own best judgement. In other words, they are of two minds about their use - "I should stop" nad "this really feels good." User:jc c

What you're talking about is referred to as the "Common Understanding of Behavior", or CUB. By the CUB, we perform all of our actions based on a rational comparison of cost vs. reward. The way alcoholism works is a little different because chemical reinforcement is involved. When this happens, logic goes out the window. A good example of this is "cutters" - people who like to cut themselves. This has been traced to the same chemical reinforcer as alcohol, which is endorphin. There is no "pleasure vs pain" evaluation that goes on, it's just a craving for whatever stimulus released endorphins in the first place. When the cutter cuts himself, he is temporarily released from that craving, but the reinforcement is strengthened. The exact same thing is going on with an alcoholic. Mythobeast 21:59, 26 April 2006 (UTC)

Sounds interesting, but could you provide the sources you're referring to? JFW | T@lk 14:19, 28 December 2005 (UTC)

The complicated questions being asked here are very relevant, but are problematic due to terminology difficulties. We're talking about different things. With the use of alcohol, physiologic addiction will develop in 100% of those imbibing a significant amount over a significant period of time. This addiction is notable because it leads to tolerance (you need more to achieve the same effect as time passes) and withdrawal (many people have noted anxiety or difficulty sleeping the day after drinking heavily -- those are signs of mild withdrawal). HOWEVER, this is not alcoholism. Alcoholism, also called alcohol dependence by the APA, is a disease state that is independent of alcohol use. One can be an alcoholic yet drink only once a year. Alcoholism is defined with respect to the way one drinks, that is, despite one's best interest, not by the quantity or frequency of alcohol intake, nor by the degree to which one might be physiologically addicted. I can make anyone addicted (or physically dependent) by asking them to drink a gradually increasing amount over a period of a week or two; but those people will not become alcoholic after any length of time unless they were one to begin with. The disease alcoholism doesn't have anything to do with over-rewarding of neurons or pleasure center activity. It has to do with a pre-existing state in the alcoholic that the individual "fixes" through the use of alcohol or other sedatives. Remember, the alcoholic feels BETTER in the hour or two after a drink. Non-alcoholics feel DIFFERENT, but don't usually state that they feel better. And yes, as one person above asked, alcoholism is one of the substance use disorders, which also include opioid dependence, nicotine dependence, cocaine dependence, etc. etc. Each of these disorders is a different biologic entity, and while there are many drug users who seem to use whatever is available, nearly all have a distinct drug of choice. -- Stuart Gitlow MD

I have reverted most of the changes from your(?) IP, as they were mostly editorial, and lacked any sort of serious scientific backing or citations. There is no single (there may be multiple, I've seen ~46 so far) alcoholic "gene", and while some genes once activated, are present for a lifetime, there is no single gene, or gene cluster, that has been positively identified as causitive for "Alcoholism". Correlation is not causation. If you are going to posit that there is a physiological activation, or dormant form of alcoholism, please do so in a reputable journal, so we can cite it. Ronabop 07:15, 12 January 2006 (UTC)

I have reverted it back. I suggest you refer either to one of my texts on the topic, to the Lowinson textbook on addiction medicine (both available on Amazon), or to ASAM's textbook on addiction medicine (www.asam.org has all the information required to obtain their text). I've written nothing about a single gene or gene cluster, as that basis for the disease has neither been clarified nor is it important. I've said nothing about a physiologic activation, since that hasn't been clarified either, and since it is rather unlikely. If you think I should place extensive citations in the text here, I can do so, but I generally don't put primary references in Wikipedia entries. I'm in the midst of adding appropriate citations starting with the first section. --SG

Okay, first of all, the reasons we have WP:CITE and WP:V is so that claims can be verified by other editors. This winds up being *especially important* when anybody can wander in, claim expert authority, and make outragous claims supporting their position (Valid or not.). We also avoid using our *own* work for reference, as that falls under WP:NOR. I don't know how many wikipedia articles you've worked on, but the more contentious ones can wind up absolutely filled with references, because we have to represent majority, and minority, views. This can be extra fun in areas where scholarship isn't totaly settled. :-) As far as the question of a genetic or other biological basis for alcoholism, I believe the claim was made (by you, above, and similarly in the article) that there was a "pre-existing state in the alcoholic", which I assumed you were basing on a genetic state. Feel free to clarify what evidence there is for this pre-existing state, as without it, the premise of the state being pre-existing doesn't hold up as something that can be stated in the article as a fact (though it certainly *is* a popular hypothesis in the literature, and can be cited as someone's *opinion*). Note that this controversy is also already part of the article, as there are both existing academic claims of a disease and non-disease model. (And I also note that it's not cited very well, which is another reason this isn't a very good article right now). :-( Ronabop 04:49, 14 January 2006 (UTC)

Understood. The harm reduction approach is one that hasn't shown significant long term value in terms of disease treatment, but is one that carries a good deal of weight in terms of public policy. Part of the problem with the research is that a good deal of the literature deals with substance use and the problems that derive from that (for example, drunk driving is a result of alcohol use, and while alcoholics are likely part of that picture, they are not necessarily responsible for even a majority of the problem). The disease concept, part of which is the demonstration that a measurable problem exists prior to the onset of substance use, is as you point out problematic so long as people believe that the use itself is the disease rather than a symptom of the disease. May I refer you to an excellent prospective study from 1990: (Am Psychologist 1990;45:612-630) by Shedler & Block. It is a fine demonstration that something exists prior to the onset of substance use itself in those who use drugs heavily later in life. Even heavy use, of course, isn't necessarily indicative of addictive illness, but it is certainly suggestive of a problem. Overall, the science here lags far behind anecdotal observations, and while strides are being made in terms of the neuroscience, I fear it will be many years before we truly clarify what is going on here. I will endeavor to make certain that the wikipedia entry remains neutral with respect to opinions in the field.

One other issue is the pre-existing state in the alcoholic, e.g. whatever it is they have prior to use of alcohol. Let's take a look at diabetes -- a diabetic is an individual with an inability to metabolize glucose properly, typically due to auto-immune pancreatic damage. One could say that someone becomes diabetic at the point that their disease is manifest physically (that is, blood glucose rises above the normal level). Or one could say that the individual is diabetic at the time of onset of the autoimmune process, long before any physical symptoms become apparent. Or one might even say that the person is diabetic at birth if one were able to identify the genetic properties that guarantee the disease will eventually manifest itself. For alcoholism, we have only markers. We don't have genetics (though we have some ideas), we don't have identifiable symptoms, but we do know that those with substance dependency use drugs differently than others from the time of their first use, far before they should if their disease were the result of the drug use itself. We also know that there is a significant family history relationship even when separated from environment via adoption studies. The literature is clear that there are two issues at work, one being genetic and the other being environmental. Both are necessary for the disease to be present. Anything beyond that is probably in the realm of semantics for now and it's important that the entry make that clear. What do you think?

On this point, the work with wisteria rats in Finland ( see many sites here ) has determined that, for them, alcoholism pre-exists in non alcohol drinkers in the form of a highly active endorphin release system. This has been demonstrated to be also true in clinical trials (again, sites above) on humans. Although no test has been performed, it is possible to test for this by having a person exercise (like on a running machine) and check the endorphin levels in their blood immediately afterwards. I do not believe that you can refer to a highly active endorphin system as a disease, though, because it also serves to provide the person with quicker learning mechanisms for many beneficial behaviors. I'm also unsure if you could classify the person as an alcoholic so much as a potential alcoholic. Mythobeast 21:59, 26 April 2006 (UTC)

Re: Harm reduction and public policy... I somewhat consider it Palliative care, at a social cost reduction, and not something that acts as a disease treatment, but then we're back to defining "disease" as well. I couldn't find the full piece by Schedler & Block on Pubmed (though the abstract was quite helpful), and I did find a great number of their other papers, which helped me to understand their particular field of research.. it looks quite interesting, even to a Foucault-level about the adjustment of an individual and society, and methods of escaping from that normalization (which leads into questions of whether a heavy user/abuser is sick, or if society is... but I digress.) wrt Neutrality, we have the whole WP:NPOV thing, and re-drafting and revising in WP is just part of life. *shrug*. As least we can re-publish and unpublish in seconds on wikipedia.

As far as addressing the diabetes metaphor, there's a big problem with the analogy, in that regardless of the type of diabetes, we can measure a blood draw over time, and determine if someone has Type I, or Type II, diabetes. We don't have the same tests for a disease of alcoholism. In a similar vein (pun intended), while we do have behavioral studies for individuals who use various drugs in a non-normal way, we don't really have a (single) way to determine who that individual will, and won't, be. Hence, the annoying reports of "alcoholic gene found" every few months for this liver enzyme, that dopamine receptor, this intestinal enzyme, etc. Without getting too deep into the technicals, I personally think (which is why this view isn't in the article) that "alcoholism" is just as reliable a diagnosis as "consumption" once was. If someone is told as a child that if they have 3 drinks a day, they might as well have 10, and they then do such a thing for the rest of their life based on that ingrained belief, that would be one kind of "alcoholic". If someone has felt socially maladjusted most of their life (due to brain chemistry or environment) and drinks heavily as a result, that would be another type of "alcoholic". If someone has a birth defect which caused a level of chronic pain, and alcohol reduced that pain, so the person drank the rest of their life, that would be another kind of "alcoholic". If someone has contracted a childhood disease which caused a level of chronic pain, and alcohol reduced that pain, so the person drank the rest of their life, that would be another kind of "alcoholic". Getting back to the question of diagnosis for "consumption", my personal conjecture is that "chronic alcohol dependency" (or "alcoholism") isn't just a multi-factoral disease, but a multi-factoral *class* of diseases. A person with environmental-only alcoholism is one case, a person with genetic alcoholism is another case, and a person with a combination of both is a third case... see the issue?

So, with respect to your question (before I started rambling), I (personally) don't think both genetics and environment have to be present for diagnosis of a "disease", and the challenge of this article is navigating contributing factors, and resulting factors, returning in an end-result of "Alcoholism", or at least explaining how fuzzy the diagnosis is. Ronabop 07:23, 14 January 2006 (UTC)

You've addressed the argument perfectly. I fully admit that if we went back a few centuries or so and looked at everyone who we NOW know to be diabetic through the eyes of our ancestors, we'd think the patients all suffered from psychiatric problems. We wouldn't have a blood test, we wouldn't have known about the sugar, and all we'd know is that the patients develop fatigue and incredible thirst. Then they die, and we'd suspect they died because they drank too much water. We wouldn't have a clue. All medical illness has been defined in syndromic and/or behavioral terms until such time as the biology is understood. And you're right to say that we don't understand the biology here. What we do know is that there is a classic and routine course of disease which is easily observed. I can easily tell a heavy drinker apart from an alcoholic after just brief examinations of the two patients because the course of life in a heavy drinker differs from that in an alcoholic. And you're also absolutely right that we're probably talking about a multi-factorial class of diseases, one of which is alcoholism. Drgitlow 21:53, 14 January 2006 (UTC)

And what are the differences in the courses of life between a heavy drinker and an alcoholic?--Light current 23:34, 6 March 2006 (UTC)

What you're really asking is whether there are differences in morbidity and mortality between a heavy drinker and an alcoholic. Let's say that you have a group of heavy drinkers who are not alcoholic versus a group of alcoholics (some of whom will drink heavily but some of whom will not). The heavy drinkers are probably more likely as a group to develop liver, brain, and cardiac abnormalities secondary to the toxic effects of alcohol. They will not, as a rule, have premorbid functional difficulties (e.g. they won't have difficulties with work, home life, or education) secondary to their alcohol intake because otherwise they would fall into the alcoholic group. One might therefore call the heavy drinkers "functional alcoholics" and that's an expression we hear from time to time. Some might look at the entire issue as a range in which you have nondrinkers at one end, heavy drinkers in the middle, and alcoholics at the other end, BUT that presumes that alcoholism requires people to drink heavily. It doesn't. Alcoholism is defined by the functional difficulties that are not present in other forms of drinking. That's why quantity and frequency aren't important issues to the disease definition. Alcohol intake is merely a marker for the disease presence. The real issues are that the individual doesn't respond to that which anyone else would: the severe loss of all that is important secondary to intake of something that an individual could typically decide not to take. These individuals can't/won't make that decision. And that's where the disease is.Drgitlow 03:07, 27 June 2006 (UTC)

I would like to add a significant piece of information to this particular discussion. The doctors in Finland managed to create a breed of rat that is more prone to alcoholism. Their studies indicate that the specific genetic changes to these rats involve an increase in activity of the rat's endorphin system. They have also identified these specific genetic markers in humans that are prone to alcoholism. Studies performed with these rats, and then with humans, have determined that the craving for alcohol is caused by a release of excessive endorphins when the person drinks alcohol.

Specifically, the endorphins release dopamine, and the dopamine convinces their neurological system that what they've just been doing is the "good" behavior. This process is similar to that which convinces humans that sex and exercise is good, but it's being hijacked by alcohol, and it results in cravings for alcohol that go far beyond the "good" feeling that they get when they drink.

This has been demonstrated many times by providing alcoholics in several studies with a supply of endorphin antagonists - chemicals that prevent endorphin from binding to its receptor sites. When the alcoholics take the antagonists and continue their usual drinking habits, the craving part of the addiction goes away and their use of alcohol diminishes over a roughly three month period.

The problem with this cure is that those who have been treating alcoholism most of their life have a very hard time accepting any treatment that involves continued drinking, so they've attempted to perform this treatment in conjunction with abstinence. If the alcoholic doesn't drink, then his neurological system doesn't receive any input at all about the behaviors not being performed, and it doesn't effect the neurochemical addiction. The craving isn't diminished. The researchers invariably blame the antagonists themselves instead of their methodology, insisting that whoever did the successful studies must have skewed their numbers to demonstrate success. Mythobeast 22:57, 24 March 2006 (UTC)

There is reason that healthcare professionals have a tough time accepting any treatment that involves continued drinking. The Pendery article in Science in 1982 (Science. 1982 Jul 9;217(4555):169-75.) essentially blew the moderation movement out of the water by demonstrating that over the long-term, patients who truly had alcoholism and who tried to drink in moderation either a) died of alcohol-related disease, b) ended up with significant morbidity due to alcohol-related disease, or c) had successfully entered abstinence. One method of diagnosing the disease is to simply see whether a patient tries to control their alcohol intake; if they do, they probably have alcoholism (noone tries to control their orange juice intake -- if they did, one would think there's something wrong). Drgitlow 16:53, 3 July 2006 (UTC)

You're mistaking pharmacological extinction with moderation. Moderation is an attempt to use personal habits and willpower to attempt to decrease one's drinking habits to a more healthy level. Pharmacological extinction is an attempt to reverse conditioning placed upon a person's neurochemistry by providing stimulus, but by blocking the reward mechanism. I agree and accept that moderation doesn't work, but there is a great deal of evidence indicating that PE does. Robert Rapplean 21:45, 3 July 2006 (UTC)

Requests for evidence of specific claims

Drugs possibly involving lithium used to prevent withdrawal symptoms? Cite?

Is there anything on Wikipedia on alohol poisoning? I can't find it if there is. Please see the deaths site I added at the bottom of this, thanks, The Fellowship of the Troll 06:42, 15 Jan 2004 (UTC)

Another Stereotype of an alcoholic are Russians. However, those who believe in racial profiling believe this is not racism, as statistically Russians drink more alcohol than most other races. - despite the disclaimer isn't this somewhat racist, or at least badly constructed? This implies that all Russians are stereotypical alcoholics. Kevo00 01:22, 28 Feb 2004 (UTC)

Biological Cause

This section seems rather vague to me, with no citings. And the relaionship to gambling - I can't find the words.

There is a lot of addition research. It just hasn't reached this article, and it's not exactly my specialty. The relationship with gambling is obvious. You yourself suggested above that the addiction is perpetuated by the rush of drunkenness (rather tentative in my view). The thrill from gambling, which becomes equally compulsory, may be the same maintaining stimulus. Addiction research frequently compares gambling and alcoholism, so your disbelief may be misplaced. JFW | T@lk 14:19, 28 December 2005 (UTC)

I didn't mean disbelief, just that it needed some more text. I agree that any behavior can become a problem, and that one can probably become dependant on substances produced by the body just as ones external to the body. I like to participate in "extreme sports" because I like the adreanline of fear (having reached my mid 40's, it takes a lot less to feel endangered) and the endorphines from exertion. I have read that some believe that those addicted to gambling are actually addicted to the low they feel later rather than the high they feel during. It is interesting to me to consider how "pleasure" is such a subjective concept.Jc c 14:46, 28 December 2005 (UTC)

Alcohol dependence article

The contents of the article Alcohol dependence should probably be merged in here (then it should be redirected here) Andrewferrier 00:23, 2004 Dec 15 (UTC)

I would think this needs a section about the term "dry drunk" in order to be complete. I would write it myself, but unfortunately I'm no good at writing. So it remains a suggestion. Input junkie 02:51, 22 Dec 2004 (UTC)

Dry Drunk is an Alcoholics Anonymous premise, which is not universally accepted. It is generally used by people who believe you can only be "recovering" if you actually follow the "steps", even though this has no higher a success rate than quitting on one's own. Any reference to it in the article should have clear caveats about this. Kaz 15:51, 13 Feb 2005 (UTC)

Just a clarification on AA principles. AA does not say that their's is the only way for a heavy drinker to control his/her drinking problem. AA makes a clear distinction between a "heavy drinker" and a true alcoholic. Acording to AA, the only one who can tell if one is an alcoholic is the person with the alcohol problem himself. AA literature does say that, for the true alcoholics the only way to be truly recovered from the ilness is by working the 12 steps.

I don't believe that that last sentence is true, either: AA literature does say that something drastic like a "spiritual awakening", or a "psychic change", is required, in order for the "true" alcoholic to recover. According to the literature, the Steps are a way to achieve that. AA, per se, isn't interested in claiming to be the ONLY solution, although you may meet individual AA people who have such zealotous attitudes. Such people are human, and don't represent AA as a whole. Beanluc 23:43, 27 October 2005 (UTC)

Suggestion to better describe the symptoms of Alcoholism

Could there be an actual description of the symptoms of alcoholism rather than just references elsewhere? Wikipedia should not be a medical encyclopedia, but this article discusses everything but the condition itself.

This would be useful for novelists (if anyone wishes to do Medicine for Fiction) and others. See The Pale Horse for a fictional work which has led to (occasonal) diagnosis of a certain type of poisoning.

Many descriptions of symptoms and how a person might be able to identify their alcoholism have been presented in this article. Does this satisfy the questioner's suggestion, or were you looking for something further? Mythobeast 18:08, 15 June 2006 (UTC)

Identifying the source of the $170B social cost of alcoholism

Today, alcohol abuse and alcoholism are a major public health problem in North America, costing that region's inhabitants $170 billion annually.

This quote has no citation, anyone know where it came from? When doing estimates of damage we need to know the source, and also the methodology used to arrive at such a number, and the costs that were taken to account and the costs that were not (e.g. did it include absenteeism, long term liver care, emotional damange and the cost of therapy to children of alcoholics, etc. etc. etc.) --ShaunMacPherson 22:49, 3 Jun 2005 (UTC)

How right you are! This statistic comes from the National Institute on Alcohol Abuse and Alcoholism. However, the methodology it uses for this and earlier estimates have been challenged for logical fallacies and other problems.[1] For more, see [2] David Justin 04:03, 8 December 2005 (UTC)

Well it should at least read "according to the blah blah" I think. Otherwise it appears Wikipedia is making that claim. And there was a mention of a 1995 Gallop poll that indicated 90% of the population believed alcoholism is a disease. That would not surprise me but there was no citation for this and I have seen that alleged poll all over the internet but I could not find anything on Gallop's web site to confirm/support it so I removed that line. If evidence for that poll can be found it should probably go back in the article. Mr Christopher 19:56, 7 March 2006 (UTC)

Alcoholism and the rest of the world

Why is there no global description of alcoholism? "I am of the understanding" that it is a major problem in Russia, and among certain groups of the population generally (owners of bars/pubs etc) but from this article it would only appear to be an issue in America.

There needs to be more description of what the disease is. 212.85.6.26 16:23, 8 August 2005 (UTC)

Removal of the Cleanup tag from this article

An anonymous listed this article for cleanup. It looks pretty clean to me, so I removed the tag. What the article needs is NPOV, CITE and some tightening, but cleanup is too harsh a judgement. JFW | T@lk 12:44, 5 December 2005 (UTC)

Alcohol tolerance between populations

I was recently asked (in my capacity as a lapsed biologist) about the alcohol tolerance of different populations over the world. I half-remembered something about genetic variation around the enzyme alcohol dehydrogenase, but can't find anything in the WP to support or refute this. I also half-remember something about humans being special anyway in their enhanced ability to deal with alcohol relative to other animals (which could be attributed to millenia of brewing alcohol, and accompanying evolutionary change). Could anyone add to this? Either way it might be worth amending the article. Thanks in advance. Cheers, --Plumbago 13:19, 6 December 2005 (UTC)

I thought this was due to polymorphisms in alcohol dehydrogenase. It is actually the absence of one of the isoforms, see Online Mendelian Inheritance in Man (OMIM): 100650. After my exams I'll have a look. JFW | T@lk 14:00, 6 December 2005 (UTC)

Costs of Alcohol Abuse & Dependence

The estimated cost of alcohol abuse and dependence reported in this article has been subjected to serious criticisms as inaccurate and inflated. See, for example, Gene Ford's "Alcohol Abuse: The Economic Costs" [3]. I think the estimate needs to be qualified to reflect this reality.David Justin 16:47, 12 December 2005 (UTC)

Anti-Alcohol bias in this article

The question of whether alcohol does more harm than good is truly a point of view issue, and should not be presented in this article. That said, this article isn't about alcohol, but is instead about alcoholism. While I can see someone putting forth an argument about alcohol being beneficial, I would challenge anyone to put forth an argument that the uncontrollable consumption of alcohol is beneficial. While I agree that any judgement on alcohol itself should be removed, you can't address the topic of alcoholism without mentioning why the uncontrolled drinking of alcohol is a problem.

Unless someone can present an argument about why alcoholism might be beneficial, I'm going to remove this chunk of commentary to clean up this page. Mythobeast 17:37, 15 June 2006 (UTC)

Alcohol and public health

A potentially useful resource (quite comprehensive) is Room R, Babor T, Rehm J. Alcohol and public health. Lancet 2005;365(9458):519-30. PMID 15705462. JFW | T@lk 12:45, 27 December 2005 (UTC)

Not an AA site

It's essential that this page reflect the fact that most researchers no longer use the term "alcoholism" because of its intellectual (ideological) baggage.

Whether or not alcohol dependence is a disease is an issue itself. It's completely unacceptable to define it (or alcoholism) as a disease without thoroughly discussing the pros and cons of that continuing debate.

Alcoholics anonymous has apparently been of help to thousands of people, but this is not an article about AA and it shouldn't be based on AA doctrine. 24.163.88.33 17:09, 14 January 2006

So it's WP:NPOV you want? Please provide dissenting views with adequate source support, and your wish is fulfilled. JFW | T@lk 21:38, 14 January 2006 (UTC)

Here's an example of the fact that the disease model of alcoholism is rejected by a large number of scientists. See the section titled "Conflict Between the Disease Theory and Social Science Research" in "The Cultural Context...," a scholarly article first published in The american Psychologist" and reprinted in the book, "Alcoholism: http://www.peele.net/lib/approach.html

• Supreme Court [4]
• World Health Organization (WHO) http://www.sciencemuseum.org.uk/on-line/genetics/glossary.asp
• From the medical journal, Lancet: Disease theory is controversial [5]
• Med Help International [6]
• American Heritage dictionary [7]
• Dictionary definition [8]
• Webster's Collegiate dictionary, 10th ed. [9]
• Depression Dictionary [10]
• Havard Medical [11]
• National GAINS Center [12]
• Health Science Center [13]
• Nature of Alcoholism [14]
• Biology Online [15]
• Presbyterian Health Plans [16]
• Online Learning Center [17]
• Black Women's Health [18]
• Datasync [19]
• What is Alcohol? [20]
• Johns Hopkins University [21]
• Genetics Topics Dictionary [22]
• Family Health Guide [23]
• Addiction Center [24]
• Rosemary Hennessey [25]
• e-Medicine [26]
• Dr. Ann Reyes [27]
• Dr. Jeffrey Schaler [28]
• Dr. Mark Lender [29]

24.163.88.33 23:51, 31 January 2006

"Alcoholics anonymous has apparently been of help to thousands of people" and they have failed thousands more. Most research (including AA's own informal numbers) indicates about 5-6% of the folks who join are able to put the AA program to use and stop drinking. That means 94-95% do not find AA helpful. Mr Christopher 21:26, 6 March 2006 (UTC)

Mr. C., I hear this stat all the time. Where does it come from? Marshall Poe 7 March 2006

Marshall, the AA GSO [30] (the governing board if you will) periodically publishes a book sized report. About 15 years ago they revisited the 80% (or so) success rate claimed in the Big Book and also did an informal survey of AA members and published the results. Basically they admitted the 80% is no longer true and their own number suggested something closer to the 5% range. This caused a bit of a stir within AA. On the same subject, any student of alcoholism would be well served by reading Heavy Drinking: The Myth Of Alcoholism As a Disease Herbert Fingarette, PhD and The Diseasing Of America by Stanton Peele, PhD. Both authors cite scientific studies that have been done regarding the effectiveness of AA and AA style treatments. And George Valliant's own Natural History of Alcoholism suggests the "success" rates for AA and AA style treatment are quite low. Finally, no one disputes the AA plan for recovery does not help anyone at all, clearly it does. But the research and AAs own informal survey suggest the percentage of people who are able to make good use of the AA plan is quite small and that AA meetings and AA styletreatment are no more effective than other known treatment models including no treatment at all. Mr Christopher 15:39, 7 March 2006 (UTC)

Marshall, on second thought it was not the GSO that published that report, it may have been something like the AA World Services Organization or something close to that. It is the ultimate governing authority of AA. As I said I no longer have the book and it's been years since I read it. Mr Christopher 18:24, 8 March 2006 (UTC)

In case you're still around, AA takes an survey every three years or so ("Triennial Survey"). Around 1990 they published "Comments on A.A.'s Triennial Surveys" published by Alcoholics Anonymous World Services, Inc. It has an ID number of 5M/12-90/TC. It was written for internal use. You can find info about it online btu I could not find an online copy of it. I wish I would have hung on to my own copy... Mr Christopher 15:04, 18 March 2006 (UTC)

Faradism??????

Advocate of do it yourself Faradism / Faradic Aversion Therapy.
http://health.groups.yahoo.com/group/FARADISM
http://health.groups.yahoo.com/group/MinusOneFaradicMentalSensingExtinction
[Links that appear to be inappropriate to this page moved by User:Sethmahoney]
-Faradism 09:53, 24 January 2006 (UTC)

Alcoholism labeling>BE CAREFUL

I am distrubed by the way in which the term 'alcoholism', and the label 'alcoholic', is used throughout the articles. Be careful. 'Alcoholism', as with any disease, must be fully and formally diagnosed by a chemical dependency professional. Be sure the person you are writing about has been so professionally diagnosed. A person may be psychologically dependent upon alcohol without having the formal diagnosis of 'alcoholism'. Michael David 16:08, 25 February 2006 (UTC)

A chemical dependency professional cannot diagnose anyone as having the so-called disease of alcoholism. There is no such diagnosis for any disease called "alcoholism". There are plenty of "alcohol dependent" or "alcohol withdrawl" type of diagnosis, but none for any actual "disease. You cannot be tested to see if you have this so-called disease or if you are a carrier. Even though several mdeical associations define heavy or problematic drinking as a disease, none have offered any diagnostic criteria for this theoretical disease nor has anyone proven a biological basis for this theory. Sure, everyone knows it is a disease but no one has proven this scientifically. No one has ever discovered any disease called "alcoholism". The term "alcoholism" is probably best viewed as a collection of popular American myths and beliefs about problematic drinking. Mr Christopher 21:11, 6 March 2006 (UTC)

Today, and for some time now, there are highly accurate tools and other instruments which can accurately diagnose the disease of alcoholism. This is but one of many: SUDDS-IV A condition such as alcoholism and other psychoactive chemical use can, more than most other human conditions, have a devastating effect on not only the person suffering from that condition, but with everyone else in their life. Too often, the pain, frustration and feeling of betrayal can cause these other effected persons to make judgments about the person, most commonly focusing on their behavior. The attitude is, too often, ‘if they changed their behavior, if they didn’t pick up the drink, or take the drug in the first place, this wouldn’t be happening’. That is why it is critical to take the condition of chemical dependency out of the realm of public opinion and keep it where it belongs: in the hands of competent, unbiased professionals. Chemical dependency is no myth – it is very real. Michael David 01:20, 7 March 2006 (UTC)

Hi Michael- Alcohol abuse has clearly led to a wide variety of personal and social ills. It's also true that a small percentage of people become physically addicted to alcohol. However, addiction is not synomonymous with alcoholism and the disease model of alcoholism's scientifically unsupported assumptions, ideology, spirituality, and "treatment."David Justin 02:50, 7 March 2006 (UTC)

Michael David, I looked at your SUDDS-IV and it talks about

The SUDDS-IV is an objective, event-oriented 30- to 45-minute structured diagnostic interview that yields information for the lifetime and current diagnosis of alcohol and other drug dependencies according to DSM-IV

Note it is describing alcohol and drug dependencies and not talking about a disease. Yes chemical dependency is real, but so far no one has proven it is a disease. That is my point Did you not read my comments prior to responding to them? And I'll give you a dollar for every unbiased chemical dependency professional you can find. They all have an agenda. Mr Christopher 13:56, 7 March 2006 (UTC)

It is worth mentioning the SUDDS-IV that Michael David used to prove alcoholism is a disease that can be tested does not even mention the word disease. Mr Christopher 16:16, 7 March 2006 (UTC)

As with any disease, a person can have the disease without having been diagnosed. Diagnosis of alcoholism is a straight-forward process which takes but a few minutes when the patient is interviewed by a board-certified addiction medicine physician Drgitlow 02:15, 26 June 2006 (UTC)

There is no diagnosis called alcoholism in the DSM. How about we treat this article factually? Mr Christopher 16:03, 26 June 2006 (UTC)

DSM actually refers to alcoholism as alcohol dependence, a term not used by non-psychiatrists due to the terminology issues. There is such a thing as physiologic dependence (a pharmacologic term that indicates the presence of tolerance and withdrawal phenomena) which doesn't have to be present (but can be) for alcoholism to be present. DSM-V is likely to replace the alcohol dependence term with alcohol addiction. Again, though, the fundamental part is that the disease to which we're referring within this article is alcoholism (which the psychiatry folks term alcohol dependence in DSM-IV). The medical community understands this but we really don't need to get into the inner mechanisms of the terminology within the article. Drgitlow 21:33, 26 June 2006 (UTC)

Alcoholism and hypertension

Has this link been proven? If so please supply references. If not , please delete this statement--Light current 02:54, 3 March 2006 (UTC)

Just found a reference to the link between ^BP and alcohol.

In the British Hypertension Society Patient Information Factsheet it says:

There is a strong link between a high alcohol intake and raised blood pressure. However, drinking a moderate amount is harmless....

British Hypertension Society, 27 High Street, Teddington , Middlesex, TW 11 8HH Tel: 0181 977 0012

--Light current 10:58, 24 March 2006 (UTC)

Effects

This discussion is interesting but somewhat misguided. The disease "alcoholism" or "alcohol dependence" is not equivalent to alcohol intake or use. As Mr. Christopher points out, many people who drink problematically quit doing so without treatment. That may be true, but MOST people with alcoholism cannot. That, in fact, is one of the differentiating features between problematic use and the disease. We're not talking about alcohol use in this article, nor are we talking about problematic use; we're talking about the disease of alcoholism as defined by the medical community. That's an entirely different thing. Drgitlow 02:18, 26 June 2006 (UTC)

Defining "alcoholism" as a disease and actually proving such a disease exists are two completely different things, now aren't they? The medical community has yet to provide conclusive evidence such a "disease" exists, yet all the so-called "experts" (whose livelyhoods depend on this myth) insist such a disease exists yet have so far failed to prove it. Let's treat the Wiki readers with a bit more respect. Mr Christopher 16:09, 26 June 2006 (UTC)

The article states "The condition can be lifelong but can be sometimes treated through ongoing therapy accompanied by attendance at self-help meetings."

This sounds like pure AA inspired POV. Research (Valliants own work for example) shows MOST people who drink problematically quit doing so with no meetings, no therapy, and no treatment (and No AA for that matter). Does anyone want to try and clean that section up or shall I make an attempt? Mr Christopher 21:40, 6 March 2006 (UTC)

I notice that the long term effects section makes no mention of the widely used "wet brain" term. I'm not sure which of the effects listed (e.g. Korsakoff's) is actually "wet brain", or if the term is used to described a combination of several of the long term effects of alcoholism. Does anyone who knows for sure care to put a mention of it somewhere in the article? fonetikli 01:32, 31 May 2006 (UTC)

Diagnosis section

There is no diagnosis for "alcoholism" and the AMA defines it as a disease but that does not mean it can be diagnosed. The alcohol related diagnosis are for things like "alcohol dependence" etc, but not for "alcoholism". This should be clarified otherwise we are perpetuating the myth that the so called disease of alcoholism is a proven fact. It is not. Currently the disease of alcoholism is a popular belief for which there is no compelling medical or scientific evidence. Mr Christopher 21:46, 6 March 2006 (UTC)

When a physician diagnoses a patient with juvenile diabetes, that's the same as insulin-dependent diabetes, which is the same as Type I Diabetes. All are names of the same disease, despite the names being used by people more or less depending upon what year we're talking about. Alcoholism = Alcohol Dependence = Alcohol Addiction. All are referring to the same disease. Drgitlow 21:00, 27 June 2006 (UTC)

Alcoholism As a Disease

I have put the fact that there is no test to determine if one has the so-called disease of alcoholism in this article twice and both times it was removed. Unless you can show me a test for determining if one has the disease of alcoholism please stop removing my comment. Alcohol dependence and alcohol abuse are not diseases. No such biological/genetic/organic disease has ever been discovered and no test for this theoretical disease exists. Removing my comment on this is an obvious POV/bias. Please stop doing so and on the subhject of such a test not existing, you are free to prove otherwise. Until then stop removing my comment. Mr Christopher 15:46, 7 March 2006 (UTC)

I just added my comments back and tried to clarify them. If you have any objections let's discuss them here. This is what I added:

Although many people and medical organizations define alcoholism as a disease (with organic, biological and even genetic roots), there is currently no test or procedure to test or diagnose it. In view of this medical professionals diagnose proveable alcohol related conditions such as alcohol dependence' and alcohol withdrawl.

Mr Christopher 15:55, 7 March 2006 (UTC)

I think you have improved this article has a lot, in fact I implied as much here. I have no view as to whether alcoholism or alcohol dependence are "conditions" or "diseases", but perhaps this paragraph could go into a new Medical section which would subsume the screening and treatment subsections? Furthermore I'm sure you and Michael will be able to resolve any issues remaining, but if I can help, please ask me. Rich Farmbrough 16:42 7 March 2006 (UTC).

Thanks for your input, Rich. There is some overlap here in the Diagnosis and as a Disease categories. We should probably look at cleaning that up and perhaps more clearly indicating the disease theory is one that although is quite popular and widely accepted, it is nonetheless an idea that is disputed and controversial. Mr Christopher 16:48, 7 March 2006 (UTC)

Yes I think that's the way to go. Also I have just checked a dozen definitions of disease, and WP throws the sharpest relief with the phrase "Sometimes the term is used broadly" which may be at the root of the controversy. Rich Farmbrough 16:53 7 March 2006 (UTC).

user:Sadhaka rewrote the initial paragraphs to read:

...and the second is biological, which has been demonstrated as a variation in the temporal lobe, and/or temporal lobe processing, in the brain.[citation needed]

This demonstrable biological component is what separates alcoholism out from other, more psychosocially grounded compulsions (e.g., compulsive gambling, or compulsive eating). It is also the tipping point for the on-going controversy as to whether alcoholism can be defined as a disease, or if it is simply a compulsive condition that contains a biological component

user:Sadhaka if you are going to imply alcoholism is a biological disease you need to cite evidence to this prior to making these changes or those changes need to be reverted. If a Wiki author is going to claim alcoholism is in fact a biological disease they need to support that assertion. So far no one on Earth has been able to prove this so your cites need to be pretty good. Mr Christopher 19:47, 13 March 2006 (UTC)

Christopher,

What 'proof' would you be content with?

Michael David 20:04, 13 March 2006 (UTC)

Citations to the above claim would be a good place to start. Who discovered this biological disease? What kind of tests are available to test whether or not you have this disease. Whether one drinks or not if it is in fact a biological disease one should be able to take a test and find out if they have the disease. I'd like to have my two year old daughter tested for it if such a disease/test actually exists.

Not all diseases require formal testing. For example, a physician can diagnose tendonitis with an examination. Similarly, alcoholism can be diagnosed with ease with an examination. As to who discovered it, that's like asking who discovered the common cold. There was no single person who discovered it any more than one person discovered that grass grows. Biologic diseases are not defined by the way one determines their existence (e.g. testing). They are defined by the lack of normal function combined with a sense of discomfort or dis-ease. Chronic pain is another example of a symptom that sometimes has no objectively measurable origin, yet is clearly subjectively uncomfortable. Sometimes perhaps the patient is exaggerating, but sometimes not. As to testing your two year old daughter, we could see if she's a stimulus-augmenter (Hennecke) and we could observe her with her parents and peers (see the Shedler and Block studies, easily found on PubMed). While these test results wouldn't prove that she's alcoholic, we'd certainly have some good idea as to predisposition. Drgitlow 23:45, 26 June 2006 (UTC)

And I recognize the majority of people and medical organizations (and alcohol dependency counselors) claim alcoholism is a disease but until this claim is proven we need to avoid popularizing that unfounded claim here and stick to supportable facts. The disease theory is controversial and its controversial because no such disease has ever been proven. Unless something has changed in the last few days, no one has ever discovered a biological disease known as alcoholism nor is there a diagnosis for any disease called alcoholism. What is diagnosed and treated is alcohol dependence, alcohol abuse, alocohol withdrawal, etc. Those are not diseases. And I recognize many studies have attempted to prove this disease exists, I am also well aware of the fact that none of those studies has ever conclusively proven their claims. Mr Christopher 20:23, 13 March 2006 (UTC)

Christopher,

Your User Page reveals as much about you as does the substance of your response. I encourage User:Sadhaka to continue her fine work on the Article.

Michael David 20:47, 13 March 2006 (UTC)

You are very correct, my user page has nothing to do with this Alcoholism article. You asked me a question and I gave you an answer and you complain about my user page? And Sadkhaka is welcome to coninue his/her work, but making unsubstantiated claims about unproven diseases has no place in a Wiki article. I plan to rewrite that beginning if Sadhaka is unable to provide some supporting evidence. Wiki is not here to advance an agenda, Michael David, and you know very well the disease theory is debated and unproven. You know very well that alcoholism as a diease is unproven and hotly debated. This article should reflect that fact and not make wild, unsupported claims of unproven diseases. This is not the place for you to advance your personal agenda. Mr Christopher 21:00, 13 March 2006 (UTC)

Hey how about you point me to the Diagnosis in the DSM IV for a disease called "alcoholism". That can shorten this conversation greatly. The only diagnosis I see are :

291.0 Alcohol Intoxication Delirium Substance

291.0 Alcohol Withdrawal Delirium Substance

291.1 Alcohol-Induced Persisting Amnestic Disorder Substance

291.2 Alcohol-Induced Persisting Dementia Substance

291.3 Alcohol-Induced Psychotic Disorder With Hallucinations Substance

291.5 Alcohol-Induced Psychotic Disorder With Delusions Substance

291.8 Alcohol Withdrawal Substance

291.8 Alcohol-Induced Mood Disorder Substance

291.8 Alcohol-Induced Anxiety Disorder Substance

291.8 Alcohol-Induced Sleep Disorder Substance

291.8 Alcohol-Induced Sexual Dysfunction Substance

Do you see a diagnosis called "alcoholism" I sure don't. Do you know of a blood or DNA/genetic test for "alcoholism"? Me neither...Mainly because those tests don't exist. That's because alcoholism as a disease is an unproven theory. As I said, this is not the place to advance ones personal agenda. Put up some the evidence that alcoholism is a known and proven disease or remove the POV please. Mr Christopher 21:16, 13 March 2006 (UTC)

Christopher,

Your use of the phrase 'personal agenda' (twice) says it all.

Michael David 21:32, 13 March 2006 (UTC)

Actually I have mentioned "agenda" four times. You continue to imply alcoholism is a disease, I keep asking for proof. You nor anyone else answers that request yet you continue to want alcoholism charcterized as a disease. That constitutes an agenda. I could care less whether it is a disease or not but until it is a proven disease Wiki should avoid making any disease positive claims. More importantly, can you please offer some conclusive proof that alcoholism is a biological disease? Yes or no? And what is the diagnosis for it? Thank you. Mr Christopher 21:43, 13 March 2006 (UTC)

The first two paragraphs do a major disservice to readers by suggeting that alcoholism is a physical disease. Any existence of variations in the temporal lobe would not demonstrate that alcoholism is a disease. Alcoholics often have cirrhosis of the liver but that doesn't prove that alcohollism is a disease. It's time for science and logic to rule, rther than ideology.David Justin 22:30, 13 March 2006 (UTC)

David Justin, I commented on user:Sadhaka's talk page and asked him/her to please come back and offer citations to support their claims or rework what they added to remove the bias/POV. I was planning to give them a couple of days to respond before I make an attempt to clean it up. I was going to wait until Wednesday. This whole article could use soem rework. There is an awful lot of AA inspired folklore in it. Mr Christopher 22:40, 13 March 2006 (UTC)

Speaking of agendas...my goodness, kids. Firstly, Mr Christopher, to echo criticisms of the history of your interactions with others, and various Wiki-contributions, kindly watch the civility of your tone, and (re: my User Talk), play nice, do not presume to lecture.

Secondly, and in no way "defending a position" or myself, did I ever make a statement that alcholism is a disease. I made a statement to the effect that there is a biological component. And that statemtnt is a documented fact -- not POV. That component is a demonstrated (as in research evidenced...so I didn't have the cite at my fingertips, sue me...the tag is a reminder for myself, and a note to those who may have said cite(s) immediately available...that's Wiki-protocol (not policy, mind you), just like red links -- look it up) distortion in temporal and frontal lobe development/processing that shows a statistically significant relationship between said and the pre-disposition to compulsion and addiction, specifically in relationship to alcohol. Cirrhosis is a consequence, not a predisposition, David Justin. Apples and oranges. Disservice, indeed. Would you listen to yourself?...POV!

Dear Sadhaka- The temporal sequence was not addresses in the presentation on the Alcoholism page. In order for brain morphology to be considered a possible biological basis for alcoholism, we need (1) to show causal sequence, (2) to find significant correlations, (3) to rule out alternative explanations, and (4) to explicate the biological mechanisms involved.David Justin 16:00, 14 March 2006 (UTC)

English, please. I know you're smart, you don't need to impress me with polysyllabism. Just say it plainly, as, while I understand what you are talking about, I am not certain for it is that you are asking. Cheers! --Sadhaka 11:33, 15 March 2006 (UTC)

Oh, and that article, as well as the 10 pages of references supporting it, was co-authored by a colleague of mine who is the poster child for evidence-based psychiatry, and it is currently under peer review for inclusion in the next edition of the Harvard Guide to Psychiatry. I'll find the reference, promise...it's just that Wiki is a hobby, and some of us have day jobs.

Look, the article is poor...frankly, in my opinion, very poor. As I mentioned to one of the other editor/contributors, I started to work on it, and got overwhelmed because there is so much to be done. Mr C, you made a statement that the article needs "fine tuning" somewhere in here...it needs a major re-write. I suspect we would do well to collaborate, rather than continuing to bicker.

Finally, I don't know who any of you are, but know that I am a psychologist with a handful of degrees, and pushing 30 years of experience in research and clinical practice with the addicted and dually diagnosed. I'm not a fly-by-nighter, or someone with a positional axe to grind. I'm a serious professional who knows what he's talking about, and one who will not make a statement that doesn't have some evidentiary backing in the literature. We call that unethical, where I come from. So, before you start revising to accomodate what you perceive to be POV, keep that in mind. Cheers! --Sadhaka 12:30, 14 March 2006

(UTC)

I am looking forward to your citations. And yes I'd be happy to work with you to clean this article up. Obvbiously my primary concern is that we not portray alcoholism as a disease that has never been proven and thus cannot be tested. I am looking forward to your citations. Mr Christopher 14:44, 14 March 2006 (UTC)

Agreed. I look forward to collaborating. --Sadhaka 11:33, 15 March 2006 (UTC)

I came to Wikipedia as a diversion from my work, to research and contribute to Articles which pertain to the variety of other interests in my life. When I came upon the Alcoholism Article in its existing form, I imagined an adolescent trying to make sense of their family life; knowing Dad or Mom is drunk all of the time; has heard the word ‘alcoholism’ used in school, and reaching for an encyclopedia to find out what it’s all about.

I am in no way suggesting the encyclopedia should be geared to adolescents, but the average reader should be able to readily understand and to follow it. Anything beyond that and you have a textbook.

Frankly, I found the Article a mess. It was (and still is) a hodgepodge of science, pseudo-science, but mostly uninformed personal opinion. The fact of the matter is the entire Article needs a major reworking. It is trying to do and be too many things. The result: it merely creates confusion about a very important subject. The proposal to ‘fine-tune’ it would be merely like trying to rearrange the passengers on the Titanic hoping this would keep it from sinking

This is a highly complex and volatile issue to work on. It can evoke many highly personal responses. Most especially from persons still struggling with their own problems with chemical use and, sometimes even more passionately, from friends and family members trying to make sense of the chemical dependent’s seeming betrayal.

Christopher, you seem to have a particular passion for this Article, most especially as regards the ‘disease’ issue. You presume to act as editor-in-chief, you state many very personal opinions about the subject, yet you offer no indications of your credentials regarding the subject. In fact the only information (which in itself is rather revealing) is a rather glib statement, which you seem to believe suffices as your User Page. Please, this is an extremely important Article. If you have personal issues regarding the subject of Alcoholism or other-drug dependency, please see a professional. Wikipedia is not a place for you to act out. This merely serves to hinder any real progress towards a responsible, articulate and informed Article. This Wikipedia and everyone who refers to it deserve.

I have been a practicing psychotherapist for 40+ years, with a subspecialty in the Dependencies. I have seen tremendous progress in that time with professionals researching and finally solving some very touchy issues regarding the use and misuse of psychoactive chemicals and their effects on a person. A critical part of the ‘disease concept’ is that it removes this disorder from the hands of those who would paint it as simply a problem with the person’s behavior. Categorizing it that way has proven not only problematic with the self-concepts of the patient; frankly it has given ammunition to those who have tried to stand in the way of adequate funding for the research. If that represents an ‘agenda’ I can live with it. I am not going to quibble with anyone over whether it’s a disease or not. The only person who needs to understand is the patient. All else is bullshit.

Michael David 15:23, 14 March 2006 (UTC)

Alcoholism is primarily a disease

To clarify some of the points raised in this discussion I would like to argue in favour of the proposition that Alcoholism is a nutritional disease. The nutritional aspects need to be treated before any psychotherapy.

Quote:

"Alcohol addiction occurs in all types of hypoglycemic diseases. Most interestingly, when zinc deficiency is present (type 6 Disease), the individual's response to alcohol may in fact be quite different to normal individuals, in as much as an 'energy burst' may be experienced soon after alcohol consumption. This is because in zinc deficient people, alcohol metabolism bypasses Pyruvate to form Acetaldehyde with rapid energy output. In the conversion of Glucose via Pyruvate to Acetyl-CoA, zinc is a necessary coenzyme. In people with zinc deficiency, Alcohol metabolises to Acetaldehyde and subsequently to AcetylCoA and does not require zinc as a coenzyme. This is an energy-releasing step and accounts for an energy burst experienced by zinc deficient individuals. The addition to alcohol may be explained not necessarily in terms of enjoying being in a drunken stupor, but more in terms of enjoying the rapid energy burst that alcohol affords them."

• Samra, George(2004), THE HYPOGLYCEMIC CONNECTION II, One Step Allergies, Sydney Page 100.

Alcoholism is one of the symptoms of hypoglycemia. Conquering Anxiety, Depression and Fatigue Without Drugs - the Role of Hypoglycemia by Professor Joel H. Levitt

The hypoglycemic condition can be tested with the four hour Medical Test for Hypoglycemia as designed by Dr George Samra. We found that most alcoholics were found to be hypoglycemic, as well as people with other forms of mental illness.

Other sources:

Hypoglycemia and Alcoholism

Sugar can lead to Alcoholism (Abrahamson, E. and Peget, A.. Body, Mind and Sugar. (New York: Avon,1977.)

Here are some studies associating alcoholism with disturbed sugar metabolism.

References:

• Jones,K.L.,Shainberg,L.W.,&Byer,C.O.(1969), DRUGS AND ALCOHOL, Harper & Row, Pubs,N.Y.
• Poulos,C.J.,Stoddard,D. & Carron,K.(1976), ALCOHOLISM, STRESS AND HYPOGLYCEMIA, Davis Publishing;Davis Cal.
• Smith R.F.(1978), "Status rep. conc. the use of megadose nicotinic acid in alcoholics", J.OF ORTHOMOLECULAR PSYCHIATRY,7.1.,52-55

• Werbach,M.R.(1991), NUTRITIONAL INFLUENCES ON MENTAL ILLNESS, A Sourcebook of Clinical Research, Third Line Pres, Inc.Tarzana. Cal. Chapter on Alcoholism pages 18 - 47

• Murray, MT & Pizzorno KJ.(1990), ENCYCLOPAEDIA OF NATURAL MEDICINE, Optima Macdonald & Co (pub) Ltd Chapter on Alcoholism pages 118-127

• Pearson,D. & Shaw,S.(1982), LIFE EXTENSION; A Practical Approach, Warner Books,NY pages 267-283

Alcohol Withdrawal

My own article:

• Alcoholism is a Treatable Disease

And my book:

• Getting off the Hook

This information can be used in any way you like. Jurplesman 10:09, 14 March 2006 (UTC)

This seems to indicate that alcoholism can be brought on by nutritional diseases and sugar imbalance diseases. It doesn't specifically identify alcoholism itself as a disease. Also, alcoholism can cause diseases, like cirrhosis of the liver, but again that doesn't make alcoholism itself a disease any more than grabbing a hot iron makes muscular contraction a disease. Mythobeast 22:11, 11 May 2006 (UTC)

Diagnosing illnesses isn't something that requires "a test." If you have a wart, for example, a dermatologist will make a diagnosis in about a second without conducting anything other than an examination. If you have major depression, a psychiatrist will make a diagnosis within 20 minutes (and probably far less) without a "test" but with a mental status examination. Glaucoma requires a test, but cataracts don't. And so on. Whether a disease requires an objective test or not is not germane to the discussion of a disease state. It neither proves nor disproves the existence of the disease. Drgitlow 02:21, 26 June 2006 (UTC)

So, if you have this disease of alcoholism you should not want or expect any proof of it, just trust your local board certified MD whose livelyhood depends on the popular acceptance of this myth/unproven theory? In view of the fact that not a single person on planet earth has ever proven such a disease exists your comments are frightening to say the least. Mr Christopher 16:13, 26 June 2006 (UTC)

You make an excellent point regarding the "proof." Here would be the typical proof given to an alcoholic: "You've lost your spouse, your finances, and your health. You are now living on the street despite your educational background, you've been fired from your last five jobs due to coming in drunk, and now you're here because your remaining family has dragged you here." Is there anyone who would disagree that something is wrong with this patient? If you're found to have Major Depression, or Attention-Deficit Disorder, or Generalized Anxiety Disorder, there is also no formal "proof," but the presence of the disease is fairly obvious within a few minutes of the initial examination. Similarly, when there is formal proof, how do you know what's wrong? For example, your doctor tells you that your blood pressure is high - he measured it, so he has to be right - and yet, what does that mean. You STILL don't know what's wrong. WHY is your blood pressure high? We don't know. Genetics, environment, stress, substance use...all play a role, but whether proof is there or not, here's the bottom line: Absolutely I trust my local board certified MD. Just as I trust a roofer to tell me when shingles need to be replaced (I don't know squat about roofing) or a plumber to tell me when my pipes need to be repaired (all I know is that there's water on the floor), that's what experts are for! I could tell you in a few thousand words why alcoholism is a disease, but I'm curious as to why you think it isn't. You haven't said.Drgitlow 21:28, 26 June 2006 (UTC)

Proposed Clean Up Strategy

I think one thing we can all agree on is this article needs some serious fine tuning. There are numerous instances of POV/bias/folklore. I propose we handle it one section at a time starting from the top and moving our way down. I have already voiced concerns about this Wiki article portraying alcoholism as a disease. Unless someone is going to step up to the plate and show conclusive scientific proof that this is a biological disease then we should remove that claim from the definition and avoid describing it as a disease. We are supposed to portray a NPOV and assertions should be supported with verifiable evidence. As I mentioned above I am giving the last editor of that section a chance to substantiate their claims. Otherwise I'll post some of my ideas for cleaning up that section. After we get that one cleaned up we should move on to the next. I'm open to ideas. We might also consider setting up an archive page top move some of the Talk discussions that are no longer pressing to free up some space here and make the discussion of improving the article as little more organized Mr Christopher 02:11, 14 March 2006 (UTC)

Amusingly enough, much of the content on this very Talk page has about the "disease" discussion. Since there isn't a clear consensus on the disease question, we have to follow wikipedia guidelines, and rather than state 'X is Y', we need to phrase such matters as 'Z states that X is Y'. So, for Peele et. al., we can state their perspective(s) and definition(s), for NIAAA et. al., [31][32] we can state their perspective(s) and definition(s), but as soon as we claim that alcoholism either is, or isn't, a disease, we are not longer writing from a NPOV on the debate... we would be taking sides. Ronabop 06:42, 14 March 2006 (UTC)

Exactly. Mr Christopher 14:46, 14 March 2006 (UTC)

Evidentiary support for biological component

I've found 5 articles, with a total of something like 1,000 secondary references, documenting and supporting the biological component -- notice, I did not say disease -- perspective. Each article makes note that the biological component is not the only factor. I need to read these, and digest. In the meantime, leave the tag where it is, and I will stick something reasonable (i.e., a reference that is written at a popular level -- some of those psycho-genetics journals are a real mind bender...sheesh...) in there tonight. Cheers! --Sadhaka 13:13, 14 March 2006 (UTC)

OK, long day...I'll enter that citation after I leave the clinic this afternoon. --Sadhaka 11:27, 15 March 2006 (UTC)

Possible resolution?

As all of the above discussion indicates, there is a controversy about whether or not alcoholism is a disease. Until there is consensus among scientific researchers on the subject, that is a fact of life.

This suggests (1) that the existence of controversy needs to be addressed and (2) that we must operate on the assumption that alcoholism is not a disease until such time that there is scientific consensus that it is a disease.

NOTE: The scientiic stance requires us to treat the disease model as an hypothesis until the evidence indicates otherwise. The burden of proof rests on those who advance the disease hypothesis.David Justin 16:18, 14 March 2006 (UTC)

My thought is that we treat the topic from all perspectives on this page...that is, psychosocial, heredity, bio-heredity, biological component, diease, process, disease, etc...if you can advance it, you need to suport, though. We do all this with a healthy nod to the controversy, and then we develop a page that deals specifically with the controversy. We did this with dissociation and it's working rather nicely.

The editorial hypothesis is this: alcoholism (read:dissociation) exists; persona (read: components exist); alcoholism as a disease (multiple personalities) are in question. The acknowledgment and evidence of the condition live in on place, with a nod to the controversy. The controversy lives somewhere else, with a nod to the condition. Very tidy and yet cross-referential.

I plan to move forward operating in good faith that we all regard alcoholism as a condition that has several components -- psycho-social, biological, hereditary, etc., all of which are documentable and documented -- and that the medical community, just as it is struggling with the definition of MPD as a disorder, is struggling with the idea of whether or not alcoholism is a disease...and, just as we acknowledge the model as a hypothesis, that struggle is documented and documentable.

Nothing should be written in an article of this importance without a citation, or portent of a citation. Revision and edits should be welcomed, but reversion of anything that is evidenced for the sake of flounting a POV should be considered vandalism of the highest order.

C'mon, you guys...let's write a featured article! Cheers! --Sadhaka 11:26, 15 March 2006 (UTC)

I just rewrote the initial definition with what I believe is NPOV and removed the previous clinical assertions. Mr Christopher 16:34, 15 March 2006 (UTC)

Clever, but incomplete. --Sadhaka 17:33, 16 March 2006 (UTC)

Can someone point me to a functional definition of a disease? One that defines what characteristics an ailment should have for us to apply the term "disease". I've been reading this page up and down, and I don't think that the core problem is whether or not alcoholism is a disease so much as what we mean when we use that word. Mythobeast 23:05, 24 March 2006 (UTC)

Sure...the standard definition of alcoholism in the medical community is: "Alcoholism is a primary, chronic disease..." Drgitlow 02:26, 26 June 2006 (UTC)

Drgitlow, this is called "begging the question" The question was "what is a disease". A proper answer to that question would start "A disease is..." preferably followed up by some form of authoritative citation. Elsewhere you talk about diseases being a disfuction that causes discomfort, or dis-ease, and that argument would be better placed here in answer to my question. Thus... Mythobeast 17:33, 27 June 2006 (UTC)

I think the good doctor is basically saying a disease is anything the treatment community says is a disease and that lay people should simply accept this. They claim it is so, therefore it is so. "alcoholism" is one such example. A genetic link has never been proven, that idea is nutty in itself when you consider genes do not cause behaviour yet the treatment community insists such a link has been proven. A biological cause has never been found either, and those who reap some of the billions of dollars annually have yet to produce any scientific evidence that proves this "fact" and they tend to ridicule anyone who questions their unsubstantiated claims. The notion that alcoholism is an allergy is comical as well. As another editor here pointed out, no one who suffers from pollen allergies goes in a field of wildflowers and starts snorting pollen. Anyhow, pretty much anything the treatment community says is a disease is a disease and they prefer you not question their claims or point out contradictory evidence/research.

When discussing the merits of this unproven "disease" the use of reason is considered in poor taste and/or a sign you are an alcoholic. Treatment folks are not accustomed to anyone questioning their authority so they tend to short circuit somewhat at the suggestion their claims have never been proven. They will say things like "suggesting alcoholism is not a disease is like argueing the world is flat" or some other nonsense while implying no one but a trained addiction/alcoholism professional can really understand this mysterious disease. Mr Christopher 18:50, 27 June 2006 (UTC)

I have to draw the line at saying that a genetic link has never been discovered. One of the findings of the Finland team's work was in identifying a stronger endorphin reaction in the drinker's system to be indictative of succeptability to alcoholism. (Nature 249: 590-592, 1974) While this can't be identified through spotting a single genetic change, it is indicative of a genetic basis for a vulnerability to alcoholism, even if it doesn't indicate that the person is actively an alcoholic.

Stating that alcoholism is a disease is based upon the disorder of function present in those so afflicted (definition of disease is disorder of function). A broken bone is a disease, as is a cold; cancer, diabetes, hypertension -- all diseases -- obesity is a disease. Low IQ is a disease. High IQ is not (no functional disorder). Those with alcoholism are unable to drink alcohol the way the other 85% of the community can. They lose control, become manipulative, and lose their jobs, families, and finances as a result of this inability. That impacts function. It is therefore a disease. Read the 1992 JAMA article (I'll send it to you if you'd like) and I think you'll see where the scientists are coming from with this. Alcoholism's defining symptoms are like those of any other illness. So it's a disease. Obviously there are some diseases that are on the edge: receding hairline, graying hair, and other typical events that take place as men age aren't diseases but can still be treated...no functional loss with those. So even absent a disease, treatment is possible. I'm happy to cite the literature where you feel it is necessary. Drgitlow 21:20, 26 June 2006 (UTC)

How about muscle atropy, willful ignorance, or bigotry? These are all things which cause disfuction, and are caused by something that is uncomfortable to you, makes you uneasy. Would they be classified as a disease? I believe that there's a perception that something has to have a physical cause in order to be a disease, and medical science still has yet to point to a specific physical reason why alcoholics can't keep their hands off of alcohol. I have no problem with the disease classification, btw. Medically, it makes no difference one way or another, I just want a solid enough explaination to end the bickering on this page. Mythobeast 17:33, 27 June 2006 (UTC)

drgitlow, on the edge of becoming a disease? a broken bone is on the dge of a disease? Greying hair? Male pattern baldness? As a doctor can you tell me how effective the 12 steps are when treating male pattern baldness or using them to treat the disease of low IQ? Mr Christopher 17:42, 27 June 2006 (UTC)

Sorry, Mr Christopher, but the effectiveness of a 12 step program is not a valid test for determining whether something is a disease or not. I realize that you intended something else, but it doesn't make sense in the context of this argument. Could you remove that and this comment? Mythobeast 18:22, 27 June 2006 (UTC)

Muscle atrophy is a disease (or more likely a symptom of a disease). Willful ignorance and bigotry would not be (those are conscious choices that are within one's grasp to change until proven otherwise). And that is at the heart of why alcoholism is a disease. While it seems superficially to be a conscious choice within one's ability to change, observing one or many alcoholics proves that they cannot simply change on their own. They need help to change. There seems to be extensive discussion above regarding the genetic nature of alcoholism not being proven. On the contrary. Alcoholism has been shown to be based in part on genetics time and time again. Numerous studies have demonstrated that identical twins, separated at birth and adopted by non-alcoholic families, have high correlations with respect to incidence of alcoholism. That essentially proves the genetic origin. However, the correlation is not 100%: that suggests a number of possible explanations. The fact that there is an environmental contribution has also been proven through epidemiologic study, replicated on numerous occasions. Again, we seem to be arguing about something that has already been proven...it's not even close to controversial. The definition of disease is another issue entirely, is predominantly semantic, and doesn't change the actual facts as to what alcoholism is or is not. The fact that the medical community and the AMA recognize alcoholism as being a disease should be enough to allow us to simply state in the opening of the article that alcoholism is a disease, much as we would for diabetes or any similar chronic lifelong illness.Drgitlow 19:47, 28 June 2006 (UTC)

Curiously, nobody has posted this: Disease

 diseaseAddison's diseaseAlzheimer's diseaseamyotrophic lateral sclerosisBang's diseasebend[2,noun]bovine spongiform encephalopathyBright's diseasecaisson diseasecat scratch disease   

Main Entry: dis·ease
Pronunciation: di-'zEz
Function: noun
Etymology: Middle English disese, from Middle French desaise, from des- dis- + aise ease
1 obsolete : TROUBLE
2 : a condition of the living animal or plant body

or of one of its parts that impairs normal functioning : SICKNESS, MALADY

3 : a harmful development (as in a social institution)
- dis·eased /-'zEzd/ adjective

That sounds like an accurate classification of Alcoholism to me!
But hey, I'm an alcoholic, what do I know???
paull 30/6/06

Definition

Michael David you removed

The nature and cause of alcoholism is debated within the medical and scientific communities and even the definition of alcoholism varies from one organization to another. In view of this alcoholism is often a controversial subject and the disease hypothesis represents the flashpoint of the debate.

And I added it back. The nature and cause of alcoholism is in fact debated, the definition(s) do in fact vary, and as a result acloholism is in fact a controversial subject and the diseasee theory is in fact a flashpoint for that debate. Everything I wrote is neutral and verifiable. So please explain why you feel that paragraph is POV and justify your removal. Maybe I am missing something. Thanks Mr Christopher 17:35, 15 March 2006 (UTC)

Here is the existing and your addition:

Existing:

Alcoholism is a term that describes the excessive, and often times chronic, consumption of alcohol. Among the characteristics of alcoholism are compulsion and addiction. It can also be characterized as an illness or allergy, and many believe it to be a biological disease. The etiology of alcoholism is currently being debated within the medical and scientific communities and the very definition of alcoholism is a part of that debate.

Your edit:

In fact The nature and cause* of alcoholism is debated within the medical and scientific communities and even the definition of alcoholism varies from one organization to another**. In view of this*** alcoholism is often a controversial**** subject and the disease hypothesis represents the flashpoint***** of the debate.

• 'nature & cause' is etiology.
  • This is already said.
    • 'In view of this' is a POV conclusion.
      • This is unnecessary. The existence of a debate already infers that.
        • 'part of that dabate is NPOV; 'flashpoint is not.

By the way, this is the only time I am going to take the time to explain to you very basic encyclopedic issues such as these. I have no idea who you are; although it is quite clear where you are coming from. From now on I will let the Wikipedia community at large decide.

Be healthy,

Michael David 18:44, 15 March 2006 (UTC)

Well I will start going through the process to have this article peer reviewed and in the meantime I am putting back my previous comments and I'll clarify the "in view of piece". Mr Christopher 18:50, 15 March 2006 (UTC)

The back and forth between Michael David and myself has produced

Alcoholism is a term that describes the excessive, and often times chronic, consumption of alcohol. Among the characteristics of alcoholism are compulsion and addiction. It can also be characterized as an illness or allergy, and many believe it to be a biological disease. The etiology of alcoholism is currently being debated within the medical and scientific communities and the very definition of alcoholism is a part of that debate. Alcoholism is often a controversial subject and the disease hypothesis represents a focus of the debate.

I think we're making progress. I think this entry lets the reader know that a singular definition of alcoholism does not exists and that a controversy and debate concerning what constitutes alcoholism does in fact exist. I think this is a good definition/beginning. I don't see any POV nor is this part of the article making clinical assertions. And "focus" is probably a better encyclopedia description than "flashpoint". Mr Christopher 19:40, 15 March 2006 (UTC)

Actually a singular definition does exist - at least in the medical community - as published in JAMA over a decade ago. The research-oriented definition that is fully accepted is the one in the DSM-IV. You're correct, of course, that there are folks who believe there is a controversy here, but there is no controversy in the scientific or medical communities on the point: Is alcoholism a disease? The current issues, controversies, if you will, revolve around the underlying psychology, neurochemistry, and other constructs that lead to onset of the disease. But that's true for many diseases, including cancer, diabetes, and hypertension. Heck, we don't even know why some people get a cold and others don't when all were exposed. You have every right to argue with a point, but saying that this is a controversy is like my going to the entry for "Sky" and stating that whether the sky is blue is controversial. I may think it is, but the physicists who measure such things would chuckle. (And yes, I realize there are all kinds of theories about why the sky is blue, and that's my point...it's very easy to make much more out of something which on its face is obvious -- the sky IS blue; how it gets to be that way is open to discussion. Alcoholism is a disease; why and how are other matters). Drgitlow 21:10, 26 June 2006 (UTC)

Dr. Gitlow, you and the AMA are not the final authority on the cause of alcoholism. You can't even effectively explain it. Insisting that your classification has the factual strength of reproducible evidence is not supportable. Robert Rapplean 18:28, 27 June 2006 (UTC)

I and the AMA have said very little about the cause of alcoholism. I have my thoughts, and there are certainly many research studies proving both genetic and environmental causes, but if you tried to pin them down to a specific gene or a specific event in the environment, we'd all be hard pressed to name them. That's true for most illnesses. I'm sorry but that's just the state-of-the-art at the moment. And to effectively explain the disease in full takes textbooks. Textbooks in the field of addiction medicine are thousands of pages long for a reason. This is a simple encyclopedia entry covering the high points on alcoholism, a subset of addictive disease. But I'm not sure what it is about what I've said that you specifically are disagreeing with. 68.9.164.90 20:00, 28 June 2006 (UTC)Drgitlow 20:19, 28 June 2006 (UTC)

What seems to be confusing you, doctor, is that this Wiki article is not an extension of the AMA/APA or AA for that matter and promoting the AMA's view of alcoholism is called POV. And of course the AMA has said very little on the cause of alcoholism, they have yet to discover that this "disease" even exists.

Did you know there is a huge difference between a definition and a discovery? Just because the AMA claims, defines, or asserts alcoholism is a disease is not proof of that disease. You and I both know there is NO biological based test for alcoholism, there are only questions about use and such to determine alcohol dependence and alcohol abuse (or the level of alcohol currently in one's blood stream). You can claim alcohol dependence and alcohol abuse are diseases but that doesn't prove they are disease. Nor has any single gene ever been discovered to cause alcoholism (the unproven disease) yet your AMA/APA pro AA organizations claim this genetic link exists when that has never been scientifically proven. You are an AA member trying to push the AA/AMA POV here and it's totally innapropriate. Mr Christopher 20:34, 28 June 2006 (UTC)

Alcoholism exists despite your protesting it, and I remain puzzled as to why you would protest it. It's like saying the moon isn't there. There are no biologically based tests for many illnesses, so the absence of such a test is meaningless in terms of whether alcoholism exists as a disease state. No single gene has been discovered as causing it since the cause of alcoholism is multifactorial. But several genes have been identified as being related. This isn't like sickle cell anemia where one gene mutation causes the disease. I'm even more puzzled as to your accusatory tone in stating, wrongly, that I'm an AA member. Whether I am or not is hardly your business nor is it relevant to the discussion here.Drgitlow 20:40, 28 June 2006 (UTC)

Allergy?

Dear Colleagues- Am I missing something? If alcoholism is an allergy, then isn't it the only known allergy that leads to a compulsion to injest the supposed allergen and that finds relief in that substance. Do those with hay fever seek out pollen, inhale it, and gain relief or pleasure from doing so?David Justin 20:01, 15 March 2006 (UTC)

Good point, so how should that sentence read where it avoids this? Mr Christopher 20:15, 15 March 2006 (UTC)

Here's a possibility:

Alcoholism is the compulsive consumption of alcohol. Some believe it to be a biological disease. The etiology and nature of alcoholism are both currently being debated within the medical and scientific communities and the very definition of alcoholism is a part of that debate. Alcoholism is often a controversial subject and the disease hypothesis represents a focus of the debate.

An alternative to the first sentence is "Alcoholism is commonly viewed as the compulsive consumption of alcohol." Defining it as the excessive consumption of alcohol doesn't distinguish it from occasional excessive consumption on News Years Eve, St. Patrick's Day, or other times.

Hope this is helpful.David Justin 02:08, 16 March 2006 (UTC)

Bias

Although this article still has a clear AA ideological oriention or bias, it doesn't seem sufficiently strong as to warrant tagging it with an NPOV tag.David Justin 03:06, 17 March 2006 (UTC)

Trying to reason with A.A. counselors

By “A.A. counselors” I mean those who are licensed or certified professionals who work at A.A. inspired treatments centers.

Alcoholism/chemical dependency and chemical dependency research is a multi-billion dollar industry whose existence is predicated on the publics acceptance of the so-called “disease model”. There is a huge financial stake in convincing the public that alcoholism is a proven disease.

Since the 1950’s hundreds of millions of dollars have been spent on trying to discover or prove alcoholism is a biological disease. Thousands of articles and research papers have been written (some good and some border on idiotic) on the subject yet the discovery of any biological disease (including an “alcoholic gene”) has yet to be made.

On the other hand, Diabetes is a testable disease for which there is a medical diagnosis. One can have diabetes, one does not have alcoholism. As I have repeatedly said, there is no test to determine if one has alcoholism nor is there a medical diagnosis called alcoholism.

One of the A.A. counselors said they were going to have their colleagues review the article. I think that is a great idea. But you could stack every A.A. counselor and all their degrees upon one another and that will still not prove alcoholism is a disease. Better yet, why not contact the AMA and get their opinion?

I have written the AMA more than once on the subject and asked them to direct me to the article or research where alcoholism was discovered. I have asked for the research that proves alcoholism is genetic, or that alcoholism is hereditary or anything that proves alcoholism is a biological disease. What I got was laced with terms such as “promising”, “soon”, “suggestive.” But when cornered the AMA will admit no smoking gun exists.

I encourage the resident A.A. counselors here to have a similar discussion with the AMA. And see for themselves how unsupportable the idea that alcoholism is a biological disease. And the attempt to split hairs or confuse matters with “biological component” is noted. Excessive drinking can cause cirrhosis of the liver, this does not mean alcoholism is a biological component, it means excessive drinking can cause cirrhosis of the liver. And keep in mind alcohol is a mood altering substance and take in large quantities is a toxin. The fact that a mood altering agent affects some people differently than others does not suggest a disease is present.

Because I recognize these verifiable facts and continue to object to this article being treated as a treatment pamphlet for an A.A. treatment center and, I continue to point out the verifiable fact that this so-called “disease” has yet to be discovered or proven, two A.A. counselors here have said or implied I am a “sociopath”, “child”, and “stalker”. This is not surprising to me, I have experienced this hundreds of times in both professional and social circles so it is to be expected. If I had a dollar for every A.A. counselor who has made similar personal attacks for pointing out the lack of conclusive scientific evidence of a biological disease called alcoholism I’d have retired a long time ago. The real tragedy occurs when the person with an alcohol problem seeks help yet refuses to go along with the disease myth.

In A.A. treatment centers, anyone who does not accept the “disease” of alcoholism is seen as being unscientific or in denial or resistant to treatment. I have witnessed this hundreds of times. A person with a real alcohol problem seeks counseling or treatment and there mere presence indicates they recognize a problem exists and want help but this is not enough for the typical A.A. counselor/treatment center. No, the client/patient must adopt the disease myth. A treatment plan is put together and a part of that plan is for the alcohol abusing person to “accept” they have a “disease”. If /when the patient/client rejects or questions the unproven assertion he or she has a disease they are deemed “in denial” or “resistant to treatment” or some other such nonsense and their refusal to accept this “disease” becomes a point of contention in their treatment plan. The family “education” component usually includes teaching them that “daddy drinks because he has a disease” so the whole family is expected to buy into this unproven disease.

I have witnessed A.A. counselors call the patient/client’s employer, spouse, EAP, probation officer, and even their own insurance company, and tell them that the patient/client is being non-compliant simply because they refuse to accept this disease on blind faith. A Kafka like horror show materializes for the patient/client as an ideological black mail scheme unfolds. Sadly the A.A. counselor fails to recognize that people have been overcoming alcohol problems for thousands of years prior to A.A. and the disease theory yet they would have you believe that unless you accept you have this disease you are flirting with relapse.

This obviously brings up uncomfortable ethical concerns and the best thing the thinking patient/client can do is simply go along with their handlers and pretend they believe they have this unproven disease, or better yet find help that does not include disease indoctrination..

So the fact that I am being characterized as a sociopath, child and stalker by two A.A. counselors comes as no surprise. And it is not offensive to me in the least. It’s kind of comical actually.

Alcoholism is not a proven disease nor is there a diagnosis for it so this is a not a medical or clinical article. And of course the article would be incomplete without the disease theory and its use in clinical settings, but disease theories and the fact that many chemical dependency professionals call/define it an illness, disease, etc. belongs in the disease section and not the opening definitional paragraph. That paragraph still needs some of the POV removed.

The “we need experts to help with this article” is probably incorrect. Both A.A. counselors have already stated they have lots of degrees and decades working in the chemical dependency field. I refuse to get in a “who has the most degrees” or “who has worked in the field longer” game. I think we need less self-described "experts" and more people with common encyclopedia editorial sense. And I am all in favor of getting admins, peer reviewers, whatever to help improve this article and avoid POV. But keep in mind I do not plan on being “cowed” or going away anytime soon. As long as A.A. counselors try and use this Wiki article as a means of furthering their ideology and promoting unproven diseases I will be here to object to it. This could be a great article but until we can put a lid on evangelizing the disease theory any attempts to imrpove it are likely to remain contentious. Cheers! Mr Christopher 17:25, 17 March 2006 (UTC)