Alcoholism: Disease or Behavior - Research Paper Example

Alcoholism: Disease or Behavior “More than 100,000 U.S. deaths are caused by excessive alcohol consumption each year. Alcohol is the most commonly used and widely abused psychoactive drug in the world”1. Moderate use of alcohol is not a big problem; however excessive use of alcohol can create addiction which may lead towards health problems such as liver problems, pancreas problems, epilepsy, alcoholic dementia, heart disease, cancer, nutritional deficiencies, sexual dysfunction, anxiety, depression, psychosis, schizophrenia etc. Divorce, loss of employment, domestic violence, accidents due to drunken driving etc are some of the social and family problems alcoholism can generate. Nobody has any doubt or second opinions about the consequences of alcoholism. However, people have different opinions while defining alcoholism. This is because of the fact that the reasons for alcoholism are still unknown or the medical experts, psychologists and sociologists have different views in their perceptions about alcoholism. Medical science has contrasting views about alcoholism; Physicians consider alcoholism as a disease whereas psychologists and sociologists consider it as a behavioral problem. Many people argue that alcoholism is labeled as a physical disease only to exploit the commercial side of alcoholism. American medical association (AMA) declared alcoholism as a disease around 55 years before. Now AMA thinks that alcoholism has dual nature; elements of disease and behavioral problems can be witnessed in alcoholism. Some of the modern theories argue that alcoholism is a disease caused by the some of the dysfunctions of brain. This paper analyses various arguments in favor and against alcoholism as a disease and behavioral problem. Ilana Mercer (2005) has argued that all addictions are the outcomes of behavioral problems. In his opinion, “perhaps the greatest error made in the attempt at humane formulations about addiction is to cast as a disease what is essentially a problem of behavior”2Psychologist, Timothy B. Baker of University of Wisconsin in Madison, also expressed similar opinions. In his opinion, "Addiction occurs in the environment, not in the liver, genes or synapses"3. It is an accepted fact that both heredity and environment plays an important role in the shaping of the behavior of a person. In other words, children of binge drinkers or the children brought up in unhealthy environment may become addicted to alcohol. It is not necessary that any physical disease caused their binge drinking behavior. Most of the people get the first taste of alcohol from the family or friends. Even the son of a saint may become binge drinker if he happens to be in the company of drinkers. The same person may not become a binge drinker if he happens to be in the company of good people. Under such circumstances, it is illogical to argue that some physical diseases cause alcoholism. Dr. Herbert Fingarette, a professor at the University of California and an internationally distinguished scholar, has written a book titled Heavy Drinking: The Myth of Alcoholism as a Disease. In the United States, the standard answer is to call the behavior a disease, alcoholism, whose key symptom is a pattern of uncontrollable drinking. This myth, now widely advertised and widely accepted, is neither helpfully compassionate nor scientifically valid. It promotes false beliefs and inappropriate attitudes as well as harmful, wasteful, and ineffective social policies4 Americans always like to perceive bad habits or behaviors as the outcomes of some kind of diseases in order to justify their actions. They do not want to blame the individual for his antisocial behavior. They attribute all the behavioral problems to some kind of physical or psychological diseases. Even doctors or scholars like Herbert Fingarette believe alcoholism as a behavioral problem. If alcoholism is a behavioral problem, then it is difficult for the binge drinker to put the blame on other sources. He has himself to blame if alcoholism is a behavioral problem. In order to avoid that, Americans usually connect all the behavioral problems to some kind of diseases. However, even after years of medical treatments for stopping binge drinking, there are many cases in which drinkers resume their drinking habits once they left the hospital. In other words, medical treatments are ineffective in controlling binge drinking. “Both independent and government research show expensive disease-oriented treatment programs to be largely a waste of money and human resources”5 “Social factors such as the influence of family, peers, society, availability of alcohol, and psychological factors such as elevated levels of stress, inadequate coping mechanisms, and reinforcement of alcohol use from other drinkers can contribute to alcoholism”6. The above observation clearly shows that alcoholism is a learned behavior learned motivated by the environmental factors. It should be noted that in Saudi Arabia like countries where alcohol usage is prohibited strictly, incidents of binge drinking is not reported at all. It is difficult to argue that nobody in Saudi Arabia has any physical diseases which may cause alcoholism. It is evident from the above fact that alcoholism is a behavior driven by the suitable environment, rather than a disease. “Studies have indicated that religiosity is inversely related to drinking and sociability positively related to drinking”7. Alcoholism is less prevalent where religions have strong hold. Most of the religions discourage alcoholism. Deliberate attempt to dislodge the consciousness is considered as a sin by religions. When religious belief increases alcoholism decreases and when religious belief decreases alcoholism increases. It is evident from the above fact that alcoholism is caused by the problems related to the environment, belief and behavior. A person who has strong belief in God may stay away from alcoholism. It is difficult to think that believers may not be affected by the physical disease which may cause alcoholism. In short, alcoholism is a behavioral problem rather than a disease. In experiments manipulating the cognitions and expectations of alcoholics concerning their alcohol consumption, it has been found that the loss of control phenomenon cannot be attributed to any physiological reaction or adaptation to alcohol consumption but rather, is related to the expectations of what the person is drinking. If they are consuming alcohol but believe they are drinking a non-alcoholic beverage, the loss of control which is predicted according to the disease model is not exhibited8 Many of the alcohol addicted people behave normally when they are not under the control of alcohol. At the same time they may behave differently when they consume alcohol. This is not because of the effects of alcohol on behavior, but because of the preconception about the impacts of alcohol addiction on behavior. Alcohol addicts have the belief that alcohol will make some changes in their behavior which is quite natural. But in reality, the above belief is not right. The illusions about alcohol effects on body and mind force the addicts to tune their behavior in a particular manner once they consume alcohol. So far we have discussed behavioral problems as the major reason for alcoholism. However, there are strong evidences which support alcoholism as a disease rather than a behavioral problem. Among the first to propose that excessive alcohol use might be a disorder, rather than willful or sinful behavior, were the physicians Benjamin Rush, in the United States, and Thomas Trotter, in Great Britain. Both Rush and Trotter believed that some individuals developed a pernicious "habit" of drinking and that it was necessary to undo the habit to restore those individuals to health. Trotter saw "the habit of drunkenness" as "a disease of the will," while Rush saw drunkenness as a disease in which alcohol was the causal agent, loss of control over drinking behavior the characteristic symptom, and total abstinence the only effective cure9 The development of psychology forced medical experts to think alcoholism in terms of a disease. The symptoms of psychological problems or mental disorders can be witnessed in the behavior of a person. In other words, behavioral problems are the outcomes of mental disorders. In that sense, assuming alcoholism as a disease can be justified. “The National Council on Alcoholism and Drug Dependence defined alcoholism, as a mental obsession that causes a physical compulsion to drink"10. Mental obsessions are not deliberate acts. In other words, we have no control over some kind of thoughts which is referred as mental obsessions. Even if we tried hard it is difficult for us to avoid obsession. Under such circumstances, it is logical to assume obsession as a mental disorder and alcoholism as a mental disease driven by obsession. “Relatively recent research has implicated a gene (D2 dopamine receptor gene) that, when inherited in a specific form, might increase a persons chance of developing alcoholism”11. The role of genetics in alcoholism is established beyond doubt. Studies have identified a specific gene called dopamine which promotes alcoholism. Dopamine is a gene which affects the brain’s reward system. Studies have shown that the dopamine deficiency can trigger the thirst for alcoholism. The children of alcoholic parents may have low levels of dopamine which may generate thoughts of non-recognition. Such children are in search of recognition and the first taste of alcohol may change the whole course of their life. Another interest finding about alcoholism is that lack of endorphin may cause alcoholism. “Beta-endorphin is a kind of "morphine" released by the brain in response to several situations, such as pain”12. When the amount of beta endorphin decreases our body will try to seek external sources to fill the vacancy. Alcohol can stimulate the production of beta endorphin which may lead the person towards alcoholism unknowingly. Many people who are addicted to alcoholism may feel withdrawal symptom once they stop their drinking habits, which again proves that alcoholism has elements of disease. It is not necessary that all the people who stop alcoholism may feel withdrawal symptom. Those who have physical or mental diseases as reasons for alcoholism may generate withdrawal symptom whereas those who have habitual or behavioral reasons for alcoholism may not develop withdrawal symptom. “Some people may be so drawn to drinking that they literally cant stop once they start, others may be able to control it with behavioral cues”13. The above difference in the capabilities of binge drinkers in controlling their behavior did force the medical experts to think in terms of elements of both diseases and behavioral problems as the reasons for alcoholism. Those who were successful in stopping their binge drinking behavior should have behavioral problems whereas others failed to do so because of the elements of diseases in controlling their binge drinking behavior. Alcoholism has several stages. In the first stage it appears as a behavioral problem or defense mechanism to escape from emotional problems and stresses. During the second stage, alcoholism may appear in more severe form than in the first stage. At this stage the drinker knows about the consequences of his behavior and will make unsuccessful efforts to get rid of his drinking behavior. During the third sage, the drinker may become more problematic and he may lose control of his drinking habits. The conversion of alcoholism from a behavioral problem to a disease may begin at this stage. During the fourth stage, alcoholism may become chronic and it can be considered as a disease from here onwards. To conclude, no single element can be cited as the major reasons for causing alcohol addiction. The debate about the differences in perceptions about alcohol addiction may continue at least for few more decades. The available evidences suggest that both the elements of diseases and behavioral problems are equally important in causing alcoholism. In other words, alcoholism is a disease and a behavioral problem, at the same time. In many people alcoholism appears as a behavioral problem initially and then it may attain the proportions of a disease. Some people get addicted to alcoholism because of their behavioral problems whereas others are addicted to it because of the physical or psychological diseases. In any case, alcoholism starts as a behavioral problem in many people and attain the proportions of a disease when it enters the chronic stage. Identification of the root cause of alcohol addiction is necessary in the treatment of alcohol addiction. Those who have behavioral problems should undergo psychological treatments for controlling their alcohol addiction whereas those who have physical problems should undergo physical treatments to get rid of their alcohol addiction. Both heredity and the environment play vital roles in causing alcoholism. Dopamine, endorphin etc are some of the genetic elements associated with alcoholism. At the same time environment seems to be the most important factor which controls the development of a person as alcoholic or non-alcoholic. The services of a physician and a psychologist are necessary in the treatment and rehabilitation of an alcohol addict. Works Cited 1. “Alcohol”. Web. 27 April 2011. 2. “Alcohol Abuse Is Hereditary”. 2007. Web. 27 April 2011. 3. “Alcoholism”. 2009. Web. 27 April 2011 4. Bobgan, Martin & Bobgan, Deidre. “Behavior or Disease?”. Biblical Medical Ethics Inc. Web. 27 April 2011. 5. Bower, Bruce. “Intoxicating Habits: Some Alcoholism Researchers Say They Are Studying a Learned Behavior, Not a Disease”. 1998. Web. 27 April 2011. 6. Buddy T. Alcoholism As a Disease. 2011. Web. 27 April 2011. 7. David. “Alcoholism: Disease v. Behavior”. 2008. Web. 27 April 2011. 8. “Disease Concept of Alcoholism and Drug Abuse”. 2011. Web. 27 April 2011. 9. Goldman, Mark S. Ph.D. Boyd, Gayle M. Ph.D. & Faden, Vivian, Ph.D., “College Drinking, What It Is, and What To Do about It: A Review of the State of the Science”. 2002. Web. 27 April 2011. 10. Mercer, Ilana. “Addictions Are About Behavior, Not Disease”. 2005. Web. 27 April 2011. 11. Niedermayer,Daryle. “The Disease Model of Alcoholism Revisited: Why People Drink”. Web. 27 April 2011. Read More