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Is alcoholism a disease?

A critical review of a controversy

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Abstract

Commentators have repeatedly attacked the traditional view that alcoholism is a disease. Their arguments that alcoholism is a central aspect of life, a deviant life style, or a form of learned behavior are examined in the light of the history and philosophy of medicine as well as current bio-behavioral research. Our conclusion is that alcoholism, as a lawful pattern of observable signs and symptoms that deviate significantly from a norm of health, is a bio-psychosocial disease.

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References

  • Ader, R. (Ed.). (1981)Psychoneuroimmunology. New York: Academic Press.

    Google Scholar 

  • Armor, D.J., Polich, J.M., & Stambul, H.B. (1976).Alcoholism and treatment. Report R-1739-NIAAA. Santa Monica, CA: Rand Corporation.

    Google Scholar 

  • Berg, G., Laberg, J.C., Skutle, A., & Ohman, A. (1981). Instructed versus pharmacological effects of alcohol in alcoholics and social drinkers.Behaviour Research & Therapy, 19, 55–66.

    Article  Google Scholar 

  • Berman, K.F., Illowsky, B.P., & Weinberger, D.R. (1988). Physiological dysfunction of dorsolateral prefrontal cortex in schizophrenia. IV. Further evidence for regional and behavioral specificity.Archives of General Psychiatry, 45, 616–622.

    PubMed  Google Scholar 

  • Blakiston’s Gould Medical Dictionary. (1979). (Fourth Edition). New York: McGraw-Hill.

  • Cala, L.A. (1987). Is CT scan a valid indicator of brain atrophy in alcoholism?Acta Medica Scandinavica, 717, 27–32.

    PubMed  Google Scholar 

  • Cohen, H. (1961). The evolution of the concept of disease. In B. Lush (Ed.).Concepts of Medicine. (pp. 159–169). New York: Pergamon Press.

    Google Scholar 

  • Davies, D.L. (1962). Normal drinking in recovered alcohol addicts.Quarterly Journal of Studies on Alcohol, 23, 94–104.

    PubMed  Google Scholar 

  • Dubos, R. (1968).Man, medicine, and environment. London: Pall Mall Press.

    Google Scholar 

  • Edwards, G. (1985). A later follow-up of a classic case series: D.L. Davies’s 1962 report and its significance for the present.Journal of Studies on Alcohol, 46, 181–190.

    PubMed  Google Scholar 

  • Engel, G.L. (1977). The need for a new medical model: A Challenge for biomedicine.Science, 196, 129–136.

    Article  PubMed  Google Scholar 

  • Fingarette, H. (1988).Heavy Drinking. Berkeley: University of California Press.

    Google Scholar 

  • Foy, D.W., Nunn, L.B., & Rychtarik, F.G. (1984). Broad-spectrum behavioral treatment for chronic alcoholics: Effects of training controlled drinking skills.Journal of Consulting and Clinical Psychology, 52, 218–230.

    Article  PubMed  Google Scholar 

  • Graber, R.A., & Miller, W.R. (1988). Abstinence or controlled drinking goals for problem drinkers: A randomized clinical trial.Psychology of Addictive Behaviors, 2, 20–33.

    Article  Google Scholar 

  • Harper, C., Kril, J., & Daly, J. (1987). Are we drinking our neurones away?British Medical Journal, 294, 534–536.

    Article  PubMed  Google Scholar 

  • Heather, N., & Robertson, I. (1983).Controlled Drinking. (Revised Edition). London: Methuen.

    Google Scholar 

  • Hodgson, R., Rankin, H., & Stockwell, T. (1979). Alcohol dependence and the priming effect.Behaviour Research and Therapy, 17, 379–387.

    Article  PubMed  Google Scholar 

  • Jellinek, E.M. (1952). Phases of alcohol addiction.Quarterly Journal of Studies on Alchol, 13, 673–684.

    Google Scholar 

  • Jellinek, E.M. (1960).The disease concept of alcoholism. New Brunswick, N.J.: Hillhouse Press.

    Google Scholar 

  • King, L.S. (1954). What is disease?Philosophy of Science, 21, 193–203.

    Article  Google Scholar 

  • Knight, L.J., Barbaree, H.E., & Boland, F.J. (1986). Alcohol and the balanced-placebo design: The role of experimenter demands in expectancy.Journal of Abnormal Psychology, 95, 335–340.

    Article  PubMed  Google Scholar 

  • Korytnyk, N.X. & Perkins, D.V. (1983). Effects of alcohol versus expectancy for alcohol on the incidence of graffiti following an experimental task.Journal of Abnormal Psychology, 92, 382–385.

    Article  PubMed  Google Scholar 

  • Lemere, F. (1956). The nature and significance of brain damage from alcoholism.The American Journal of Psychiatry, 113, 361–362.

    PubMed  Google Scholar 

  • Lhermitte, F. (1986). Human autonomy and the frontal lobes. Part II: Patient behavior in complex and social situations: The “environmental dependency syndrome.”Annals of Neurology, 19, 335–343.

    Article  PubMed  Google Scholar 

  • Luria, A.R. (1980).Higher cortical functions in man. (Second Edition) New York: Basic Books.

    Google Scholar 

  • Lyvers, M.F. & Maltzman, I. (1991). Selective effects of alcohol on Wisconsin Card Sorting Test Performance.British Journal of Addiction, 86, 399–407.

    Article  PubMed  Google Scholar 

  • Maltzman, I. (1987). Controlled drinking and the treatment of alcoholism.Journal of the American Medical Association.257, 927, 3229.

    Article  PubMed  Google Scholar 

  • Margolis, J. (1976). The concept of disease.The Journal of Medicine and Philosophy, 1, 238–255.

    Google Scholar 

  • Marlatt, G.A. (1979). Alcohol use and problem drinking & cognitive-behavioral analysis. In P.C. Kendall, and S.D. Hollon (Eds.).Cognitive-behavioral interventions: Theory, research, and procedures. (pp. 319–355). New York: Academic Press.

    Google Scholar 

  • Marlatt, G.A. (1983). The controlled-drinking controversy: A Commentary.American Psychologist, 38, 1097–1110.

    Article  PubMed  Google Scholar 

  • Marlett, G.A., Demming, B., & Reid, J.B. (1973). Loss of control drinking in alcoholics: An experimental analogue.Journal of Abnormal Psychology, 81, 233–241.

    Article  Google Scholar 

  • McQueen, D.V., & Siegrist, J. (1982). Social factors in the etiology of chronic disease: An overview.Social Science and Medicine, 16, 353–367.

    Article  PubMed  Google Scholar 

  • Miller, W.R., Leckman, A.L., & Tinkcom, M. (1987). Controlled drinking and the treatment of alcoholism.Journal of the American Medical Association, 257, 3228–3229.

    Article  PubMed  Google Scholar 

  • Orne, M.T. (1962). On the social psychology of the psychological experiment: With particular reference to demand characteristics and their implications.American Psychologist, 17, 776–783.

    Article  Google Scholar 

  • Peele, S. (1988). Can alcoholism and other drug addiction problems be treated away or is the current treatment binge doing more harm than good?Journal of Psychoactive Drugs, 20, 375–383.

    PubMed  Google Scholar 

  • Pendery, M.L., Maltzman, I.M., & West, L.J. (1982). Controlled drinking by alcoholics? New findings and a reevaluation of a major affirmative study.Science, 217, 169–175.

    Article  PubMed  Google Scholar 

  • Piazza, N.J. & Wise, S.L. (1988). An order-theoretic analysis of Jellinek’s disease model of alcoholism.The International Journal of the Addictions, 23, 387–397.

    PubMed  Google Scholar 

  • Pokorny, A.D., & Kanas, T.E. (1980). Stages in the development of alcoholism. In W.E. Fann, I. Karacan, A.D. Pokorny, and R.L. Williams, (Eds.).Phenomenology and treatment of alcoholism. (pp. 45–68). New York: Spectrum Publications.

    Google Scholar 

  • Polich, J.M., Armor, D.J., & Braiker, H.B. (1980).The course of alcoholism: Four years after treatment. Report R-2433-NIAAA. Santa Monica, CA.: Rand Corporation.

    Google Scholar 

  • Rychtarik, R.G., Foy, D.W., Scott, T., Lokey, L., & Prue, D.D. (1987). Five-six-year follow-up of broad-spectrum behavioral treatment for alcoholism: Effects of training controlled drinking skills.Journal of Consulting and Clinical Psychology, 55, 106–108.

    Article  PubMed  Google Scholar 

  • Selye, H. (1956).The stress of life. New York: McGraw-Hill.

    Google Scholar 

  • Smith, J.W. & Frawley, P.J. (1990). Long-term abstinence from alcohol in patients receiving aversion therapy as part of a multimodal inpatient program.Journal of Substance Abuse Treatment, 7, 77–82.

    Article  PubMed  Google Scholar 

  • Sobell, M.B. & Sobell, L.C. (1978).Behavioral treatment of alcohol problems: Individualized therapy and controlled drinking. New York: Plenum Press.

    Google Scholar 

  • Sobell, M.B. & Sobell, L.C. (1987a). Conceptual issues regarding goals in the treatment of alcohol problems. In M.B. Sobell and L.C. Sobell (Eds.),Moderation as a goal or outcome of treatment for alcohol problems: A Dialogue. (pp. 1–37). New York: The Haworth Press.

    Google Scholar 

  • Sobell, M.B. & Sobell, L.C. (1987b). Stalking white elephants.British Journal of Addiction, 82, 245–247.

    Article  Google Scholar 

  • Stockwell, T.R., Hodgson, R.J., Rankin, H.J., & Taylor, C. (1982). Alcohol dependence, beliefs and the priming effect.Behaviour Research and Therapy, 20, 513–522.

    Article  PubMed  Google Scholar 

  • Stuss, D.T. & Benson, D.F. (1984). Neuropsychological studies of the frontal lobes.Psychological Bulletin, 95, 3–28.

    Article  PubMed  Google Scholar 

  • Taylor, J.R., Helzer, J.E., & Robins, L.N. (1986). Moderate drinking in ex-alcoholics: Recent studies.Journal of Studies on Alcohol, 47, 116–121.

    Google Scholar 

  • Walker, N.D. (1987). Long term outcome for alcoholic patients treated in a hospital based unit.New Zealand Medical Journal, 100, 554–556.

    PubMed  Google Scholar 

  • Wallace, J. (1989). Can Stanton Peele’s opinions be taken seriously? A reply to Peele.Journal of Psychoactive Drugs, 21, 259–271.

    PubMed  Google Scholar 

  • Wallace, J. (1990). Controlled drinking, treatment effectiveness, and the disease model of addiction: A commentary on the ideological wishes of Stanton Peele.Journal of Psychoactive Drugs, 22, 261–284.

    PubMed  Google Scholar 

  • Wallace, J., McNeill, D., Gilfillan, D., MacLean, K., & Fanella, F. (1988). I. Six-month treatment outcomes in socially stable alcoholics: Abstinence rates.Journal of Substance Abuse Treatment, 5, 247–252.

    Article  PubMed  Google Scholar 

  • Weinberger, D.R., Berman, K.F., & Zec, R.F. (1986). Physiologic dysfunction of dorsolateral prefrontal cortex in schizophrenia.Archives of General Psychiatry, 43, 114–124.

    PubMed  Google Scholar 

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Maltzman, I. Is alcoholism a disease?. Integr. psych. behav. 26, 200–210 (1991). https://doi.org/10.1007/BF02912511

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