Preface
Hi! It's me, prolificisticationist notorioso of the board; the Energizer bunny author layman/researcher of DrugBuyers.com. And this is my latest work, which off and on has taken about 4 days to complete, proof, edit, double-double check-check.... and being just one man I'm near POSITIVE I got some things off. But point them out if they're factual. I want to know.

Enjoy the read.

AS I HAVE DEMONSTRATED, alcoholism is an antiquated term describing more than acute addiction to substance EtOH with the letters "-ism" tacked on.

As with many addictive substances and habitual behaviors--even overeating--there may be "a gene" associated with alcoholism, but just as with smoking; just as with over eating:

It isn't spiritual.

It isn't... the devil in you.

And it certainly isn't because you're of a greedy or otherwise morally defective character.

I said this before, and here repeat it edited for brevity and typos.

I and many others feel that the public slings around the term "disease" far too easily. There is no comparison between diabetes, a cancerous legion, malaria, diphtheria and addictions.

Addictions are BEHAVIOR DRIVEN while a disease is a quantifiable condition which is life-threatening in and of itself.

It is a huge intellectual leap to claim addiction fits the medical model of disease. There is simply too much personal will involved, or lack of will, at different stages.

What addiction is
Well it's a very complex behavioral, medical, and eventually societal syndrome, meaning it encompasses many challenges.

This is a long post so if you read nothing else, get this. Understand that scientists like Stanton Peele do not title their non-academic works with names like "Diseasing of America" for nothing. In medicalizing behaviorally-predicated life problems and syndromes as "diseases" we start down an insidious path of making every bad habit, every obsession or compulsion a (!) disease (!).

Suddenly depression... becomes a "disease." Gambling. Spousal cheating. The compulsion for sexual gratification becomes "addiction"--> becomes "disease."

Among the many texts I have read, in the eighties I studied two seminal, defining works on alcoholism in the 20th century of which I'm sure Nephro will be familiar. One was The Disease Concept of Alcoholism published in 1960 by Elvin Jellinek M.D., who worked at the Yale Center of Alcohol Studies. And the other was The Natural History of Alcoholism by George E. Vaillant, M.D. published in 1983. ("Natural history" of a disease refers to its characteristic course; i.e., the known length and behavior of the flu.)

They're both fairly academic, heady reads but I poured and poured over that last one, studying case-histories of people who'd supposedly returned to nondestructive drinking (you have to remember I was still obsessed with controlling my drinking then - circa '86).

Selling addiction as disease
Although AA was always instrumental in glorifying the disease concept, the defining work was done by Jellinek in 1960--who officially coined the term, disease concept of alcoholism. In that sense, he is famous for one famously flawed study--incorporating a small, ONE TIME sample of AA members and having them.....

Fill out a questionnaire.

You read it right. However brilliant; however much knowledge Jellinek contributed over the years, he is now as much known for being too attached to AA and a singular ambition--cracking the code of "alcoholism" via defining it as disease.

The American Medical Association (AMA)'s endorsement of the disease concept of alcoholism
Through research that was often idea-driven and of questionable soundness in adherence to The Scientiic Method, Jellinek's published work nonetheless bolstered the AMA's designation of alcoholism as a bonda bide disease four years earlier.

The committee came to such a resolution for two primary reasons: 1) to have Congress allocate funding for research, cures, and causes; and 2) to destigmatize the addiction as "sinful" or pure debauchery in the mind of the public.

The ultimate harm in labeling addictions as diseases and people as diseased
In psychology we have a growth concept termed self-efficacy, which you may look up elsewhere so that I don't take up more and more space. The most destructive adverse consequence of making substance-addiction a problem over which people are powerless is you strip them of this confidence. And that's the first thing--the first which Alcoholics anonymous does. You are powerless. You're "insane." You need saving by some unseen force outside yourself because YOU... are not enough.

Relearning how to think for yourself
The parallels to deprogramming from cults is creepy because you listen to anything among a group of people for long enough, you'll start to mysteriously identify" and surrender your own ideals.

I remember once in treatment being told one of the dumbest damn things I have ever heard in my life. lol

'Remember. Your BEST thinking got you here.'

Do wh.. Come again!? No ma'am, I think not! It was my worst thinking--which grew worse still as I attended meetings and 'came to believe' all manner of cult-like, chanting stuff.

You have to discard the now-conventional thinking and remember alcoholism is just an addiction to alcohol with an obsolete "-ism" tacked onto it. In no real way does it meet medical criteria of "disease."

A word for therapists
It is my opinion that you are doing your clients are a disservice by heading them down this path. Ninety percent of the time, those hallowed 12 Steps sound nonsensical and counterintuitive at first because much of it is balderdash. There are many other sensible approaches these days, SMART Recovery being the current leader. SMART is a direct descendent from the principles of REBT and got its start with the first, well-received "Small Book" published in '89 followed in '96 and followed by the book "Rational Recovery" (both of which I still have!), a more fleshed out text of the movement.

I have just outlined how, if you go back and do just a little research into real historical motives, you can see the diseasing of America has been largely pop-trendy and political. There are quite empirical, measurable, or quantifiable reference criteria by which to measure these behavorially-predicated (or driven) neuroses.


Feel free to debate - it's how I learn; it's how am able to teach.

Stits

Not being an addict I can't relate on a personal level. But there does seem to be a very strong genetic component to addiction (ie., something you have no control over just like a disease.) To me it seems that the term disease carries less stigma than addict or alcoholic. So if it helps someone to admit that they have a problem maybe it's not so bad? How many times have you heard someone with depression say "I have a chemical imbalance in my brain?" Despite the fact that the research has not shown this to be true. If it helps them to accept their mental illness I don't see the harm.

Now, as far as AA I remember watching the Penn & Teller episode of BS on it. They were very much against AA. What stood out to me is that there have been almost no published studies of the success rates of the various treatment programs (AA being by far the most popular.) The one study they could find showed that 85-90% of addicts will relapse. That would certainly explain they lack of published research (if you don't like the result, bury it.)

LOL, yeah Penn & Teller ripped them (it's not incredibly hard to do).

 Originally Posted By: LAmike

How many times have you heard someone with depression say "I have a chemical imbalance in my brain?" Despite the fact that the research has not shown this to be true. If it helps them to accept their mental illness I don't see the harm.

The harm, Mike, is twofold, no threefold. One, the medical community clearly feels okay with lying and talking down to us in doing so. We're not children. We're patients who deserve truth for what it is. Two, if psychiatry doesn't really know how these things work, ignorance conveys them no right to postulate about it and pass it off as truth. Last, drug companies are trained to lie or slant the truth for profit motive.

If saying, "Oh, why you have a chemical imbalance, here buy this pill and it will fix you" rakes in billions of dollars per year," that is unethical.

Permanent or long-term harm is being done right now by pushing antidepressant drugs for anything and everything, then reeling people in for life because of the neurochemical need they create.

I am a victim of this sham, which is governmentally sanctioned. As we find out more and more how much the Food and Drug Administration is in bed large pharmaceutical companies, the conflict of interest becomes clearer to all.

Stits

Stits,
After reading the response you wrote to LAMike's post, it almost appears to me as though you are looking to blame someone else for your addiction. You said,"Permanent or long-term harm is being done right now by pushing antidepressant drugs for anything and everything, then reeling people in for life because of the neurochemical need they create.

I am a victim of this sham, which is governmentally sanctioned. As we find out more and more how much the Food and Drug Administration is in bed large pharmaceutical companies, the conflict of interest becomes clearer to all."
That implies to me as a reader, that you want to blame pharmaceutical companies for "pushing antidepressant drugs", and not take any responsibility for something that you yourself call, "Addictions are BEHAVIOR DRIVEN while a disease is a quantifiable condition which is life-threatening in and of itself.".
Please help me understand exactly what you are trying to say here. On one hand you call addiction a "behavior", which is definitely something everyone makes conscious decisions about, and on the other you call it a "neurochemical need", which to me implies disease.
Just trying to make sure I am clear on which one of these you believe!
Thanks again for posting this thought provoking thread!

Oh yeah.......for the record, I am one of those "Addiction is a disease" people!!!

totally and positively without a doubt not only disagree -- but you are wrong. i defnitely am an addict and definitely have it through genetics but also other reasons. i would never, however label my problem as a disease. it is not cancer, or ms or chrones or cp and i believe comparing oneself to diseased beings makes one mindless and self centered.

every person does have some control over what they eat or drink or drug. i am not saying it ain't hard as hell to control it and sometimes i just don't. but pfizer, or eli lily or merck or forrest do not come to my home and feed me drugs while i am tied to the chair. they do help many people and if one is not able to use common sense about following or not following any doctor -- they can at least do some research.

otherwise the disease is not addiction --- but stupidity!

and i look forward to any and all flames! is anyone ever responsible for anything?

 Originally Posted By: stits

It isn't spiritual.


Stits

How do you know that , if I might ask.

stevevi,

what does this have anything to do with spirituality? i am not understanding the connection and just would like to understand what you mean...

thanks.

Recruiter, I am a little confused by your response, and am not really sure if you were addressing it to me, or stits, or both!
Honestly, I am not sure that any answer is "right" or "wrong" here. I think we are dealing with opinions, and not fact.
You can NOT argue the genetics in one breath, then the behaviors in another. If you do, then the same can be said for many "conditions" that
you DO consider fit the criteria for "diseases". If you have diabetes, you don't eat sugar, or you get sick. (I understand the very primitive way that sounds, but it is straight to the point)If you have coronary problems, then you don't eat foods that raise your HDL. etc.....
SAME difference with addiction. If you are an addict, you don't partake in substances to which you addicted!!!
If you want to take the side of addiction is not a disease, then don't use that example or excuse, as it just doesn't fly.....or make sense!!!!
Oh, and for the record, I am neither mindless nor self centered!!!

 Originally Posted By: recruiterlo

stevevi,

what does this have anything to do with spirituality? i am not understanding the connection and just would like to understand what you mean...

thanks.

I'm not sure that it does or doesn't (I am very much on the fence). I am not the one who made the statement that it has nothing to do with spirituality. That is from Stits post. I am simply asking where he got that information from. Or if you have that info, that would be great.

okay -- behavior can be controlled. and behaviors are definitely inherited -- i just believe that addiction can be inherited for sure -- but one can choose to control it. listen -- i believe it is so very hard to do and i fail many times. but--i fail for persoanl reasons.

i cannot and will not compare my genetic flaws that i overcome sometimes to anyone who is physically ill through whatever means.

i agree that it is an opinion -- but a very strong one. and how do you compare a child for instance, (let's say your child) -- that has to go through life diseased with someone who is addicted to whatever? do they have a choice to either go into the toilet or let the child go into the toilet because of your disease? you say no -- if your diseased you can't and i say you can. that's all i mean. sorry about the mindless -- !

When one has an allergy to a substance (whatever that substance may be) no symptoms are present until the person comes in contact with that substance. This could also be said of addictions. If the addict does not come in contact with the addictive substance then they generally will see no negative consequences. As soon as the addict is in contact with that substance the "symptoms" or negative consequenses will manifest themselves. Do you consider allergies a disease? Is lactos intollerence a disease? My behavior can irritate my disease (by consuming mountains of ice cream unctrollably) or I can choose not to consume the ice cream and be OK.

The fact that the substance affects me negatively is the disease part. Millions of people can drink and stop after one or two and not experience any negative consequences from it. I do not believe the behavioral issues of addiction disqualify it from being a disease. Stits I think you are missing something when you say that addiction is BEHAVIOR DRIVEN and thus not a disease. Many what you would consider bona fide diseases only manifest themselves out of the patients behavior. Example, I have asthma and allergies. If I stay away from the things that trigger my symptoms I need no medication to control this disease. If my behavior dictates that I french kiss a poodle you better believe I am going to need medical attention and quick.

The disease of addiction lies in the negative consequences that come from the abuse of the substance. It's behavioral element lies within the persons ability to stay away from the substance.

Hope this made sence just my .02 worth.

Here is what I believe (I think it may be what you are saying, stits):

If you continue to do something to excess over and over, your body has no choice but to become physically dependant on that substance. I think that is true of EVERYONE.

While it is true that there are those that can simply quite drinking after one drink and still have fun, it is also true that if that same person started drinking heavily every day then their body would crave it.

Just as I am dependant on cymbalta. I know that I am addicted to it and I will go through withdrawls if I quit. I know this because I have stopped cold turkey when I thought I was pregnant and I will never do that again.

Is cymbalts bad? Should I be called an addict because my body craves it and I cannot function without it? Should I start attending NA meetings? No, to all of those.

So, if I am reading you right, stits, that is another version of what you are saying.

Please correct me if I'm wrong and others can flame away. My skin is thick.

What you are refering to with your Cymbalta example is the difference between dependance and addiction. You are dependant on the medication but not neccessarily addicted to it. Addiction would occur if you continued use of the drug dispite negative concequenses (the clinical defenition of addiction). The question is why can most people stop drinking or ingesting drugs before the negative consequenses begin and others can not. And why does drinking or ingesting drugs cause negative consequences in some peoples lives but not others?

WHEW!!!
First of all: Thanks to gr8fulcpa! Awesome answer, and I totally agree. The comparison to allergic reactions was simply perfect!!
Next to jpbp: There is a treemendous difference in dependance and addiction.
Now back to recruiterlo: As we all know, genetics is so complex that none of us will ever truly understand it. However, a predisposition, does not make it a fact.
So, I am an addict, my children have inherited that gene from me. Does that mean they are doomed to be addicts themselves? ABSOLUTELY NOT!!! Just as they are not definitely going to suffer from the Heart ailments of their father.
We go right back to the "choice behaviors" region. If my children choose to lead unhealthy lifestyles, then they are much more likely to end up with either of these inheritances than the average Joe whose genes are not tainted, however, even then it is not a given that they will become afflicted if they booze it up 24/7, and have an HDL of 300.
Gosh I hope that made sense!!! It did in my head while I was typing!!!

and round and around...but i know what your saying -- but it is not clear obviously what i am saying. so here is a my quandry -- my dad was a huge addict and killed himself. my older brother and sister had no pre-disposition to anything except being boring. now i am totally different from them in every way and smoked pot when no one did in high school as well as other stuff but no hard drugs ever. (my dad did drugs in the late 50's and died in 1961 when no one remotely heard of drugs).

my son has none of those genes -- but was born with a rare and painful condition. so what i mean is i could have let my addiction control me which would put my child in harms way or do everything possible to be responsible for his hospitalizations.

in my opinion my son has a disease and i have addicition problems. i battle them but always won until he became independent. so there ya go -- and why i feel strongly about labeling addiction a disease.

Edited by recruiterlo (07/14/08 07:48 PM)

Cymbalta and the other antidepressants has no reinforcing properties, which is why the manufacturers of these drugs can say they are not addictive. You don't take Cymbalta the first time and think, "Hmmm, that was great; I'll do that again!", unlike the serious drugs of abuse. In other words, you won't get any money for selling it on the street.

 Originally Posted By: melpat

So, I am an addict, my children have inherited that gene from me. Does that mean they are doomed to be addicts themselves?

I feel the need to correct you here, even if both parents have the addictive gene there is only a 50% chance of passing it onto a child. But I agree that even having the addictive gene does not guarantee addiction. Sadly though, I think that more than half who inherit the gene will abuse a substance at some point in their life.

another thing is the addict (i include myself when i say this stuff even that i don't do drugs most of the time) -- does meds that make them feel good. i would not ever include an anti-depressant as i hate them. but i defer to ludes vet actually as those old drugs were my best timesi remember...and that may sound sick and sure that it is. but, i hung out with some great druggies.

and am just lucky i am not dead.

I just used cymbalta as a silly excuse for the absurd notion that alcohol/drugs are any less different.

To rephrase-if a social drinker decides to drink more (let's say becuase of a depressing time in life) and does it every day, then that person's body will crave the substance. Because, as we all know, your body will require more to stay out of the funk.

I think that my thoughts are not actually making to the post.

So, I will just stop here and agree with stits. I believe drugs/alcohol is a bahavior problem.

Edited by jpbp (07/14/08 08:21 PM)

i too agree with stits. so where is TEH mouth from TEH south?

 Originally Posted By: stevevi

 Originally Posted By: stits

It isn't spiritual.


Stits

How do you know that , if I might ask.

I asked God.

 Originally Posted By: melpat

Thanks again for posting this thought provoking thread!

Pat -

Thanks!

"Please help me understand exactly what you are trying to say here. On one hand you call addiction a "behavior", which is definitely something everyone makes conscious decisions about, and on the other you call it a "neurochemical need", which to me implies disease."

Sorry Pat, Mike & I crossed two separate issues--BigPharma (on selling depression as disease) and addiction.

Regardless I do not believe a neurochemical need, whatever the cause, means a disease. Again, we're mixing two *seperate* issues, namely that of antidepressant discontinuation syndrome and the withdrawal from drugs which are addictive in the traditional sense of the word, addiction.

Understand that ADs can cause a fundamental shifting and 'remodulation' if you will of mood-altering neurotransmitters about -about which we know very little- and they do this is in an entirely different way than drugs like heroin, alcohol, amphetamine, even synthetic barbs do.

ADs can take weeks to work. We don't know why precisely. Drugs of abuse which I just named are altogether different in modality.

Stits

 Originally Posted By: stits

I and many others feel that the public slings around the term "disease" far too easily. There is no comparison between diabetes, a cancerous legion, malaria, diphtheria and addictions.

Addictions are BEHAVIOR DRIVEN while a disease is a quantifiable condition which is life-threatening in and of itself.

It is a huge intellectual leap to claim addiction fits the medical model of disease. There is simply too much personal will involved, or lack of will, at different stages.

I could not agree more.

I mean lets think about, if someone is told that their addiction is a disease and to surrender to it, well that to me would make addicts feel that there is just no cure, so many probably say "why bother since I have been told I have a incurable disease"

Addiction can be cured, it is not a disease, but to cure addiction an addict must know that can take control over their lives and what they do not need to hear is that have a disease that will stay with them their entire lives. That will only make them feel that they will be an addict always and then of course either replase or feel real bad about their addiction(s).

Yes I do agree that many people will crave their drug of choice, still addiction is not a disease that they have be told that "once an addict always an addict" It is simply not true.

For anyone interested here is the link again to a book written by the founder of Passages, which is the number 1 rehab for curing addiction, they cure addiction and do not tell people that they are powerless, because we are not powerless over addiction. Example, MS and AIDS are real diseases, MS cannot be cured AIDS cannot be cured, but addiction can be cured so therefore it is not a disease. Anything that can be cured is not a disease.

http://www.theaddictioncure.com/?gclid=COLr45SIwZQCFQZlswodgmkCUg

OK, I did not read all the replies, I am sorry about that. I do hope what I posted is on topic with what stits original posted.

stits and I have talked about the issue of addiction being a disease or a non disease in depth. I hope I didn't go way off topic, if I did I am very sorry.




Ruggie

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