Friday, April 07, 2006
Alcoholism
The idea that Alcoholism is a disease was first introduced by a gentleman named Benjamin Rush. It was later adopted by Alcoholcis Anonymous around the time of the Prohibition. An interesting history can be found by reading Harry Levine's "The Discovery of Addiction: Changing Conceptions of Habitual Drunkenness in America", Journal of Studies on Alcohol, 1978: (15) pp. 493-506.
Anyway, I came across an interesting approach to understanding alcohol policy in Jacob Sullum's "Saying Yes: In Defense of Drug Use". According to him and other historians, alcoholism was only adopted as a disease when drinking was beginning to become socially unacceptable. The idea that alcohol was "bad" and should be banned from everyday usage became commonplace in 19th century America and is continued into much of contemporary America (State wide bans began in the 1850's with Maine)
So, Sullum gives us a few things to think about:
The meaning of this new disease model, which today is widely accepted, has always been murky. What sort of disease is alcoholism? A metabolic defect? A brain disorder? Is it inherited, acquired, or both? How can the permanent disability known as alcoholism be distinguished, before the fact, from a passing phase of heavy drinking? How can a disease be treated through programs that aim primarily to change people's beliefs (in particular, by getting them to accept the disease model itself)?
He goes on to state the empirical evidence against the model, individual's response to incentives in experimental situations, and how moderate drinking can be a better "cure" for this disease than abstaining.
I think the model hinges on the idea that individuals are not fully capable of controlling their own behavior and that abstinence is the only solution.
Now, these statements do not take away the negative aspects of alcoholism and alcohol abuse or deter from its serious addictive and harmful effects. Instead, it puts into question the notion of seeing alcoholism as a "disease".
You can actually see parallels in the sex education, drug use, and smoking policy realms.
Anyway, I came across an interesting approach to understanding alcohol policy in Jacob Sullum's "Saying Yes: In Defense of Drug Use". According to him and other historians, alcoholism was only adopted as a disease when drinking was beginning to become socially unacceptable. The idea that alcohol was "bad" and should be banned from everyday usage became commonplace in 19th century America and is continued into much of contemporary America (State wide bans began in the 1850's with Maine)
So, Sullum gives us a few things to think about:
The meaning of this new disease model, which today is widely accepted, has always been murky. What sort of disease is alcoholism? A metabolic defect? A brain disorder? Is it inherited, acquired, or both? How can the permanent disability known as alcoholism be distinguished, before the fact, from a passing phase of heavy drinking? How can a disease be treated through programs that aim primarily to change people's beliefs (in particular, by getting them to accept the disease model itself)?
He goes on to state the empirical evidence against the model, individual's response to incentives in experimental situations, and how moderate drinking can be a better "cure" for this disease than abstaining.
I think the model hinges on the idea that individuals are not fully capable of controlling their own behavior and that abstinence is the only solution.
Now, these statements do not take away the negative aspects of alcoholism and alcohol abuse or deter from its serious addictive and harmful effects. Instead, it puts into question the notion of seeing alcoholism as a "disease".
You can actually see parallels in the sex education, drug use, and smoking policy realms.
