Is Alcoholism Really a "Disease"?

OK, so aparently we do limit 'diseases' to impairments traced back to solid biological causes, rather than poor thinking.

If they find a gene that prevents people from driving the speed limit or being able to file their taxes on time, look out...

 

http://www.ncbi.nlm.nih.gov/entrez/dispomim.cgi?id=103780
-a good overview, although rather scientific in nature, of genetic alcoholism research.

http://www.ncbi.nlm.nih.gov/entrez/query.f...term=alcoholism
-a list of genes found to be related to alcoholism.

 

I disagree that this "disprove"s the genetic theory. This is one example where the child of alcoholics is not an alcoholic. Maybe the gene wasn't passed on for some reason. Maybe there was another gene that was passed on that negated the alcoholism gene.

On the other hand, maybe there isn't an alcoholism gene.

My point is that one anecdote does not disprove a theory.

 

Did you mean to imply that MS=Mystery Squid is a disease?

 

I think that this discussion comes back to the "nature" vs. "nurture" argument. There have been several of these debates that I can recall recently (i.e. regarding homosexuality, skills of women at math/science, etc.) Different people have wildly different opinions. Personally, I believe that (as with most things), the truth is somewhere in the middle. I think that some people may have a genetic predisposition to alcoholism, but that this predisposition can be "fought" (with varying degrees of success depending on how strong the predisposition is).

Maybe this is why someone who has two parents who are alcoholics is able to not become an alcoholic. One might argue that this person "fights harder" than other people, since they see how damaging alcoholism is.

 

I think that if there are, say, combinations of genetic predispositions to
become "addicted" to this or that, they are more likely to present themselves on a scale, e.g., "guaranteed to become addicted------->impossible to become addicted, rather than on the yes/no (light-switch) model. There are all "degrees" of "social drinkers". There are people who smoke 3 cigarettes per day and those who smoke 3 packs; those who can quit easily, those who can quit but struggle, those who can repeatedly quit for long periods of time (but relapse)---and those who smoke even through the holes in their throats.

I think there are all gradients of "attention deficit disorder", depression, anxiety, drug addiction, "chronic fatigue syndrome" and obesity. Sexual identity itself certainly appears on a spectrum, including "asexual" and "totally unable to identify".

 

So far, no one's been able to prove that alcoholism is really a disease. Alcoholism is a substance abuse problem that causes diseases just as smoking does. But it isn't a disease unto itself.

 

What you'll see is a definition of 'disease', a startement that ______ (insert alcoholism this time) fits the definition, and very little room to argue that just because the definition is loose enough to fit doesn't mean a whole lot.

Stick something in the blank that 'fits' but pisses people off, and you'll be told what a disease REALLY is...

 

Thanks, Mike, I know what you're saying. But if it is a disease, it should be something that can be isolated objectively, scientifically. If it hinges on opinion or whether or not it offends someone, it's loses that objectivity and cannot be proven. I'd be glad to agree that it's a disease when someone can identify a pathology that is unique to alcoholism that is not caused by the alcohol itself.

 

ok... since clicking on the links was too hard...

and i quote, from online mendelian inheritance in man, a large database of human gene mutations and their manifested effects:

The tendency for drinking patterns of children to resemble those of their parents has been recognized since antiquity, e.g., in the observations of Plato and Aristotle (Warner and Rosett, 1975). Alcoholism is probably a multifactorial, genetically influenced disorder (Goodwin, 1976). The genetic influence is indicated by studies showing that (1) there is a 25 to 50% lifetime risk for alcoholism in sons and brothers of severely alcoholic men; (2) alcohol preference can be selectively bred for in experimental animals; (3) there is a 55% or higher concordance rate in monozygotic twins with only a 28% rate for like-sex dizygotic twins; and (4) half brothers with different fathers and adopted sons of alcoholic men show a rate of alcoholism more like that of the biologic father than that of the foster father. A possible biochemical basis is a metabolic difference such that those prone to alcoholism have higher levels of a metabolite giving pleasurable effects or those not prone to alcoholism have higher levels of a metabolite giving unpleasant effects. Schuckit and Rayses (1979) found that, after a moderate dose of alcohol, blood acetaldehyde levels were elevated more in young men with alcoholic parents or sibs than in controls. A certain degree of organ specificity in the pathologic effects of alcohol is observed. For example, patients have cardiomyopathy, cirrhosis, or pancreatitis but rarely more than one of these. A genetic basis of organ specificity is evident in Wernicke-Korsakoff syndrome (277730) and pancreatitis from type V hyperlipidemia (238400).

end quote.

they have proven genetic tendencies in human mixed families. they have bred alcohol-preferring animals.

but not all diseases are genetic only. cancer can be genetic, but it takes a mutation in the wrong place in the wrong cell line to cause disease. environmental factors are huge here.

maybe we can see exposure to alcohol to kick off alcoholism as we look at uv light as a mutagen that can cause cancer.

or does that make cancer something that's not a disease?

 

In my opinion no. No more than smoking is a disease. Both are addictions.

Now some people can become addicted more easily than others due either to something genetic, a mental condition or social conditioning. But I don't think any of those makes smoking, drinking or taking drugs a disease.

 

I'm "listening" galaxee but children who grow up in families where the father is abusive end up being abusive parents themselves. Much of what they point out involves probability studies. But can they remove the heredity factor and find something pathological in the person and determine that they're going to be alcoholic? I don't liken it to cancer, it seems more apt to see it as being in the same category with smoking. I can appreciate what alcoholism does to the families of alcoholics but isn't it more useful to blame the alcoholic instead of the alcohol? The bottle of alcohol doesn't force its contents down the alcoholic's throat against their will so it's difficult to see it as a disease. Peace.

 

This is exactly the type of thing that I was looking for to illustrate my point; thanks galaxee. This, in my reading, argues that nature is more important than nurture. This argues that there's some sort of hereditary connection and "choosing to put down the bottle" is significantly harder for some people than for others. Yes. No one is forcing alcohol down their throats, but you can also argue that no one is forcing the common cold germs down your throat; you could live in a hermetically sealed house and never contract the disease of the common cold.

Now, I understand the point that there is a virus that causes the common cold vs. no known virus that causes alcoholism, to my knowledge. But, the definition of "disease" (as I interpret it) is broader than simply some virus that's adversely affecting your health.

 

Well, most reasons for contracting the common cold are self-induced. Breathing through your mouth sends the germs right in to your body. Breathing through your nose reduces that infection route quite a bit. Not washing your hands enough, getting the germs on your hand and then touching your eye or some other point of contact through mucous will infect you. Allowing yourself to get run down, not eating right and eating too much can make you more susceptible. Whether you get a cold or not is more in your control than you might think.

 

i figured the whole "sons who lived with stepfathers had more likelihood to match their father's profile of alcoholism" thing to be a pretty solid proof that nature is taking precedence over nurture here. for example: bob grows up in a perfectly sober family with mom and a stepdad. bob's dad's a raging alcoholic. bob, despite growing up in a sober home, ends up to be an alcoholic himself. the tendency runs in the family- heredity. the opposite situation can also happen.

exposure to alcohol can be likened to an environmental factor. we don't blame melanoma victims for spending any time whatsoever outside because they may or may not have known that they harbored a mutation that was very sensitive to UV light...

i'm not saying that alcoholics are blameless. normally i'm one to place more than someone's fair share of blame on him/her for ruining his/her family's lives. trust me on this one. on a scale of 1 to 10 of people who hate alcoholism, i'm a 42. a forty freakin' two.

however, there are indeed some things that end up beyond our control. our genes are some of those things. and pretty much everyone experiments with alcohol, so who knows if you'll be hooked the first time or not? i had 2 hard drinks last night. that was the first time in 4 months that i had touched alcohol. but chances are that alcohol does not provide the "pleasure" to me as much as it does to someone else.

the way i see it, we all experience alcohol differently. this can be observed by going to a party- you have the goofy drunks, the drunks who laugh at everything, and the drunks who sit in the corner with their own bottle of booze and lash out at anyone who comes near them. to some it may be as addictive as heroin and they should never touch the stuff. but in many cases we're talking about teenagers experimenting here- and how many of them understand the complexities of inherited preference for alcohol? telling them no is just another way of telling them to go ahead and do it. most of us are fine with it, we can have a drink and walk away, but some can't do that.

there are addiction factors, there are genetic factors, there are environmental factors, there are emotional factors, there are psychological factors, and many many more. i personally think the psychological factor is what contributes most to the actual loss of self-control, but there seem to be genetics that can push you much faster down that path.

you see i mention self-control. i'm not saying your genes force you to go to the store and buy a bottle of Cuervo and drink the whole thing in one sitting. that, early on, is about self control. but genes may help egg on that craving. i think the interaction of psychological factors and predisposal can be enough of a common factor in society to bear the name "disease."

 

This reminds me of the occasions when somebody expects a quick answer to a complicated question in my field. It's even more fun when they don't have the background to understand the answer, and I don't have time to give it to them. Then they decide that I am being evasive...