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The Disease Concept of Alcoholism

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Part of the Research Advances in Alcohol and Drug Problems book series (AADP,volume 7)

Abstract

“The disease concept of alcoholism,” as introduced by Jellinek(23) in 1960 in a book bearing that name, has been an inordinately productive concept both in the range of issues which it raised and also in its medical and social utility. Jellinek derived his concepts from a wealth of clinical experience; the book reflected his attempt to extract certain common denominators characteristic of alcoholism. As a result of his extensive observations, he recognized that not all alcoholics followed the same course. On that basis, he elaborated his clinical typology in which he distinguished alpha and beta alcoholics in whom the symptomatology of physical dependence was not a significant clinical characteristic from gamma and delta alcoholics in whom it was. As physiological concomitants of physical dependence, he postulated the development of craving, loss of control, and inability to abstain, mechanisms which exacerbated the self-reinforcing nature of alcoholism thus making the attainment of abstinence more difficult.

Keywords

  • Alcohol Dependence
  • Physical Dependence
  • Drinking Pattern
  • Heroin Addict
  • Alcohol Withdrawal Syndrome

These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. Armor, D. J., Polich, M. J., and Stambul, H. B., 1976, Alcoholism and Treatment, Rand Technical Report R-1739-NIAAA, Rand Corporation, Santa Monica, California.

    Google Scholar 

  2. Barnes, G. E., 1979, The alcoholic personality: A reanalysis of the literature, J. Stud. Alcohol40: 571.

    Google Scholar 

  3. Begleiter, H., and Projesz, B., 1978, Protracted brain hyperexcitability after withdrawal fromethanol in rats. Presented at NCA Conference on Alcoholism, St. Louis, Missouri, May 1978. Also abstract in Alcoholism Clin Exp. Res. 2:192.

    Google Scholar 

  4. Begleiter, H., DeNoble, V., and Projesz, B., 1980, Protracted brain dysfunction after alcohol withdrawal in monkeys, Biological Effects of Alcohol (H. Begleiter, ed.), pp.231-250, New York and London.

    Google Scholar 

  5. Branchey, M., Rauscher, G., and Kissin, B. ( 1971, Modifications in the response to alcohol following the establishment of physical dependence, Psychopharmacologia (Berl.) 22:314.

    Google Scholar 

  6. Buchsbaum, M., and Silverman, J. 1968, Stimulus intensity control on the cortical evoked response, Psychosomat. Med.30:12.

    Google Scholar 

  7. Cahalan, D., 1976, Some background considerations in estimating needs for state's services dealing with alcohol related problems. Paper presented at Conference for Need Methodology for Formula Grants, NIAAA, Rockville, Md., July, 1976 (quoted in Furst, C. J., Beckman, L. J., Nakamura, C. Y., and Kemmerer, K. A., 1979 ).

    Google Scholar 

  8. Cahalan, D., and Room, R. 1974, Problem Drinking Among American Men, Rutgers Center of Alcohol Studies, New Brunswick, New Jersey.

    Google Scholar 

  9. Cahalan, D., Cisin, I., and Crossley, H. 1974, American Drinking Practices, Rutgers Center of Alcohol Studies, New Brunswick, New Jersey.

    Google Scholar 

  10. Cartwright, A.K. J., Shaw, S.J., and Spratley, T. A., 1977, The validity of per capita consumption as an indicator of the prevalence of alcohol related problems: An evaluation based on national statistics and survey data, in: Alcoholism and Drug Dependence-A Multidisciplinary Approach (J. S. Madden, R. Walker, and W. H. Kenyon, eds.), pp. 71–85, Plenum Press, New York and London.

    Google Scholar 

  11. DeNoble, V. J., and Begleiter, H., 1978, Alcohol self-administration in monkeys (Macaca radiata): The effects of prior alcohol exposure, Pharmacol. Biochem. Behav. 8:391.

    Google Scholar 

  12. Ewing, J. A., and Rouse, B. A., 1976, Failure of an experimental treatment program to inculcate controlled drinking in alcoholics. Br. J. Addict. 71:123.

    Google Scholar 

  13. Fox, R. A., 1957, A multidisciplinary approach to the treatment of alcoholism, Am. J. Psych. 123: 769.

    Google Scholar 

  14. Furst, C. J., Beckman, L. J., Nakamura, C. Y., and Kemmerer, K. A., 1979, Alcoholism prevalence estimation: A review of current methods and controversies. Unpublished manuscript.

    Google Scholar 

  15. Gitlow, S. E., Bentkover, S. H., Dziedzic, S. W., and Khazan, N., 1973, Persistence of abnormal REM sleep response to ethanol as a result of previous ethanol ingestion, Psychopharmacologia 33:135.

    Google Scholar 

  16. Gitlow, S. E., Dziedzic, S. W., and Dziedzic, L. M., 1977, Tolerance to ethanol after prolonged abstinence, in: Alcohol Intoxication and Withdrawal, Experimental Studies III ( M. M. Gross, ed.), Plenum Press, New York and London.

    Google Scholar 

  17. Goodwin, D. W., Schulsinger, F., Hermansen, L. Guze, S. B., and Winokur, G., 1973, Alcohol problems in adoptees raised apart from alcoholic biological parents. Arch. Gen. Psychiatry 28: 238.

    Google Scholar 

  18. Gottheil, E., Thornton, C. c., Skoloda, T. F., and Alterman, A.I., 1982, Follow-upofabstinent and nonabstinent alcoholics, Am. J. Psychiatry 139(1982):560-565.

    Google Scholar 

  19. Hoffman, H., Loper, R. G., and Kammeier, M. L., 1974, Identifying future alcoholics with MMPI alcoholism scales. Q. J. Stud. Alcohol 35:490.

    Google Scholar 

  20. Hore, B. D., 1971, Factors in alcoholic response, Br. J. Addict. 66:1.

    Google Scholar 

  21. Hore, B. D., 1972, Craving for alcohol. Presented at 30th International Congress on Alcoholism and Drug Dependence, Sept. 4 - 9, 1972.

    Google Scholar 

  22. Isbell, H. Fraser, H. F., Wikler, A., Belleville, R. D., and Eisenman, A. J., 1955, An experimental study of the etiology of “rum fits” and delirium tremens, Q. J. Stud. Alcohol 12: 179.

    Google Scholar 

  23. Jellinek, E. M., 1960, The Disease Concept of Alcoholism, Hillhouse Press, New Haven.

    Google Scholar 

  24. Jones, M. C., 1968, Personality correlates and antecedents of drinking patterns in adult males, J. Consult. Clin. Psychol. 32:2.

    Google Scholar 

  25. Kammeier, M. L., Hoffman, H., and Loper, R. G., 1973, Personality characteristics of alcoholics as college freshman and at time of treatment, Q. J. Stud. Alcohol 34: 390.

    Google Scholar 

  26. Kaufman, E., 1974, The psychodynamics of opiate dependence: A new look. Am. J. Drug Alcohol Abuse 1:349.

    Google Scholar 

  27. Keller, M., 1975, Problems of epidemiology in alcohol problems, J. Stud. Alcohol 36: 1442.

    Google Scholar 

  28. Kissin, B., 1974, The pharmacodynamics and natural history of alocholism, in: Clinical Pathology, The Biology of Alcoholism Vol. 3 ( B. Kissin and H. Begleiter, eds.), pp. 1–36, Plenum Press, New York and London.

    Google Scholar 

  29. Kissin, B., 1977, Theory and practice in the treatment of alcoholism, in: Treatment and Rehabilitation of the Chronic Alcoholic, The Biology of Alcoholism Vol. 5 (B. Kissin and H. Begleiter, pp. 1 - 52, Plenum Press, New York and London.

    Google Scholar 

  30. Kissin, B., Schenker, V., and Schenker, A., 1959, The acute effects of ethyl alcohol and chlorpromazine on certain physiological functions in alcoholics, Q. J. Stud. Alcohol 20: 480.

    Google Scholar 

  31. Kissin, B., Platz, A., and Su, W. H., 1970, Social and psychological factors in the treatment of chronic alcoholism, J. Psychiatr. Res. 8:13.

    Google Scholar 

  32. Linsky, A. S., 1977, Theories of behavior and the social control of alcoholism, in: Emerging Concepts of Alcohol Dependence ( E. M. Pattison, M. B. Sobell, and L. C. Sobell, eds.), pp. 41–50, Springer, New York.

    Google Scholar 

  33. Loper, R. G., Kammeier, M. L., and Hoffman, H., 1973, MMPI characteristics of college freshmen males who later become alcoholics, J. Abnorm. Psychol. 82:159.

    Google Scholar 

  34. Ludwig, A. M., 1983, Why do alcoholics drink?, in: Psycho-social pathogenesis of Alcoholism, The Biology of Alcoholism Vol. 6 ( B. Kissin and H. Begleiter, eds.), pp. 197–214, Plenum Press, New York and London.

    Google Scholar 

  35. Ludwig, A. M., and Stark, L. H., 1974, Alcohol craving: Subjective and situational aspects, Q. J. Stud. Alcohol 35:899.

    Google Scholar 

  36. Ludwig, A. M., Cain, R. B., Wikler, A., Taylor, R. M., and Bendfeldt, F., 1977, Physiological and situational determinants of drinking behavior, in: Alcohol Intoxication and Withdrawal, Experimental Studies 11/ ( M. M. Gross, ed.), Plenum Press, New York and London.

    Google Scholar 

  37. McCord, W., and McCord, J. 1968 A longitudinal study of the personality of alcoholics, in: Society, Culture and Drinking Patterns ( D. J. Pittman and C. R. Snyder, eds.), pp. 413–430, Wiley, New York.

    Google Scholar 

  38. Machover, S., and Puzzo, F. S., 1959, Clinical and objective studies of personality variables in alcoholism, II: Clinical study of personality correlates of remission from active alcoholism, Q. J. Stud. Alcohol 20: 520.

    Google Scholar 

  39. Makela, K., 1978, Level of consumption and social consequences of drinking, in: Research Advances in Alcohol and Drug Problems Vol. 4 ( Y. Israel, F. B. Glaser, H. Kolant, R. E. Popham, W. Schmidt, and R. G. Smart, eds.), pp. 303–348, Plenum Press, New York and London.

    Google Scholar 

  40. Martin, W. R., and Jasinksi, D. R., 1969, Physiological parameters of morphine dependence in man-tolerance, early abstinence, protracted abstinence, J. Psychiatr. Res. 7:9.

    Google Scholar 

  41. Mendelson, J. H., Stein, S., and McGuire, M. T., 1966, Comparative psychophysiological studies of alcoholic and non-alocholic subjects undergoing experimentally induced ethanol intoxication, Psychosom. Med. 28:1.

    Google Scholar 

  42. Menninger, K., with Mayman, M., and Pruyser, L., 1963, The Vital Balance, Viking Press, New York.

    Google Scholar 

  43. Orford, J., 1973, A comparison of alcoholics whose drinking is totally uncontrolled and those whose drinking is mainly controlled, Behav. Res. Ther. 11:565.

    Google Scholar 

  44. Paredes, A., Hood, W. R., Seymour, H., and Gollob, M., 1977, Loss of control in alcoholism: An investigation of the hypothesis with experimental findings, in: Emerging Concepts of Alcohol Dependence ( Paredes, A., Hood, W. R., Seymour, H., and Gollob, M., eds.), pp. 103–119, New York.

    Google Scholar 

  45. Pattison, E. M., Sobell, M. B., and Sobell, L. C., 1977, Emerging Concepts of Alcohol Dependence, Springer, New York.

    Google Scholar 

  46. Petrie, A., 1967, Individuality in Pain and Suffering, University of Chicago Press, Chicago, Illinois.

    Google Scholar 

  47. Projesz, B., and Begleiter, H., 1979, Visual evoked potentials and brain dysfunction in chronic alcoholics, in: Evoked brain potentials and Behavior ( H. Begleiter, ed.), pp. 227 - 302, Plenum Press, New York and London.

    Google Scholar 

  48. Robins, L. N., Bates, W. M., and O’Neal, P., 1962, Adult drinking patterns of former problem children, in: Society, Culture and Drinking Patterns ( D. J. Pittman and C. R. Snyder, eds.), pp. 395–412, Wiley, New York.

    Google Scholar 

  49. Robins, L. N., Helzer, J. E., Hesselbrock, M., and Wish, E., 1977, Vietnam veterans three years after Vietnam: How our study changed our view of heroin, in: Problems of Drug Dependence, pp. 24 - 40, Committee on Problems of Drug Dependence, Cambridge, Massachusetts.

    Google Scholar 

  50. Room, R., 1970, Assumptions and implications of disease concepts of alcoholism. Paper presented at the 29th International Conference on Alcoholism and Drug Dependence, Sydney, Australia, 1970 (quoted in Furst, C. J., Beckman, L. I., Nakamura, C. Y., and Kemmerer, K. A., 1979 ).

    Google Scholar 

  51. Schaeffer, H. H., 1972, Twelve month follow-up of behaviorally trained ex-alcoholic social drinkers, Behav. Ther. 3:286.

    Google Scholar 

  52. Schmidt, W., 1973, Analysis of alcohol consumption data: The use of consumption data for research purposed, in: The Epidemiol08Y of Dru8 Dependence-Report to a Conference, London, 25-29 September, 1972, Regional Office for Europe WHO, Copenhagen.

    Google Scholar 

  53. Schuckit, M. A., Goodwin, D. W., and Winokur, G., 1972, A half sibling study in alcoholism, Am. J. Psychiatr., 128:1132.

    Google Scholar 

  54. Seever, M. H., 1968, Psychopharmacological elements of drug dependence, J. Am. Med. Assoc. 206: 1263.

    Google Scholar 

  55. Skinner, H. A., Glaser, F. B., and Annis, H. M., 1979, A difference of kind or a difference of degree: Comparison of self-identified alcoholics and non-alcoholics. Unpublished manuscript.

    Google Scholar 

  56. Sobell, M. B., and Sobell, L. C., 1976, Second-year treatment outcome of alcoholics treated by individualized behavior therapy: Results, Behav. Res. Ther. 14:195.

    Google Scholar 

  57. Straus, R., and McCarthy, R. D., 1951, Nonaddictive pathological drinking patterns of homeless men, Q. J. Stud. Alcohol. 12:601.

    Google Scholar 

  58. Tokar, J. T., Brunse, A. J., Stefflre, V. J., Napior, D. A., and Sodergren, J. A., 1973, Emotional states and behavioral patterns in alcoholics and non-alcoholics, Q. J. Stud. Alcohol 34: 133.

    Google Scholar 

  59. Wagman, A. M. I., and Allen, R. P., 1975, Effects of alcohol ingestion and abstinence in slow wave sleep of alcoholics, in: Alcohol Intoxication and Withdrawal, Experimental Studies II ( M. M. Gross, ed.), pp. 453 - 466, Plenum Press, New York and London.

    Google Scholar 

  60. Witkin, H. A., Karp, S. A., and Goodenough, D. R., 1959, Dependence in alcoholics, Q. J. Stud. Alcohol 20: 493.

    Google Scholar 

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Kissin, B. (1983). The Disease Concept of Alcoholism. In: Research Advances in Alcohol and Drug Problems. Research Advances in Alcohol and Drug Problems, vol 7. Springer, Boston, MA. https://doi.org/10.1007/978-1-4613-3626-6_3

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  • DOI: https://doi.org/10.1007/978-1-4613-3626-6_3

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