Is Alcoholism a Disease?

Alcoholism is a condition that affects the lives of countless people around the world. In England, UK Government statistics estimate that almost 600,000 people are dependent on alcohol. Yet, there is much contention on whether alcoholism functions as a disease with biological characteristics or stems more from behaviours, habits and choices.

We look at how alcoholism is classified in the “disease model” and why this distinction matters for so many people battling addiction. We hope to guide you and be a voice of support for those in need of recovery.

Is alcoholism classified as a disease?

Though there certainly is room for debate, many regions of the world recognise alcohol use disorder (AUD) as a chronic brain disease.

According to the largest association of physicians, the American Medical Association (AMA), alcoholism was first declared as an “illness” as early as 1956. The AMA went on to officially term addiction as a disease. The groundwork for understanding alcoholism as a disease stems from research on biological, neurological and behavioural factors.

Classifying alcoholism as a disease may be more than just a technicality. Viewing it as a disease has far-reaching implications for how we treat and support people struggling with addiction.

Let us first take time to understand the long-term effects of alcoholism on the body and brain:

How alcohol affects the brain and body

Prolonged drinking has a deep impact on the way our brain and body operate. When we drink, alcohol interferes with important communication pathways in the mind, especially in areas linked to reward, motivation, memory and decision-making. Over time, these disruptions can physically alter the brain’s chemistry, leading to a cycle of compulsive drinking.

Chronic alcohol use also leaves indelible marks on a person’s physical health. Long-term drinking markedly impairs the functioning of the liver, leading to conditions and diseases like cirrhosis and alcoholic hepatitis.

Most importantly, cyclical alcohol misuse lays the groundwork for addictive behaviours as it alters brain structure, which lends credence to the classification of alcoholism as a disease, rather than a simple choice.

What are the counterarguments?

While many leading health institutions, including the World Health Organization and the American Medical Association, follow the theory that alcoholism is a disease, not every professional agrees with this view. We should consider both sides of the argument to understand the depths of alcoholism better and whether it is more beneficial to see it this way.

There are some arguments that labelling alcoholism as a disease removes some of the personal responsibility in choosing to begin drinking. The crux of this argument is that addiction involves a choice. As we can envision, the initial decision to take a risk and drink in our teens is one of choice, as much as our parents might have tried to dissuade us from it. This line of reasoning ultimately arrives at alcoholism being the consequence of habits, coping mechanisms and environmental factors, rather than a biological condition.

There are other debates on whether alcoholism meets traditional definitions of disease. Unlike conditions such as diabetes or cancer, critics will point out that alcohol use doesn’t involve clear-cut pathogens or biological defects. Points are also raised that framing addiction solely as a disease may overlook the psychological, social and spiritual dimensions of recovery.

Boiling the question down as to whether alcoholism is or isn’t a disease is not a simple process, as experts on both sides will find points they agree with in the opposing argument.

Why the disease model matters

Now that we have laid out some counterarguments for alcoholism being a disease, we should look at the professional understanding of AUD in the disease model, or the concept of alcoholism as both a disease and a condition.

The disease model was conceptualised by the Alcoholics Anonymous movement of the 1940s. Without this empathetic concept, both clinical practice and treatment would be very different from what it is today in the Western world.

Our societal, cultural and historic views on alcoholism can sometimes make it difficult for us to conceptualise AUD as a disease or condition. Many of us still tell ourselves that alcoholism is simply a choice. However, much like other chronic illnesses like diabetes and heart disease, alcoholism is influenced by pre-existing factors that can make a person more prone to alcohol addiction.

Here are some of the most prevalent ways that the disease model can help support those who are struggling with alcohol addiction:

Reducing shame and stigma

Viewing alcoholism as a disease may help challenge the stigma that surrounds it. Instead of seeing alcoholism as a person’s weakness or as a moral flaw, we can become more adept at giving empathy and support to people who need it. Removing our judgements can make it easier for an alcoholic person to open up and truly vocalise the help they need. Addiction often revolves around feelings of shame and self-punishment. If we can arrive at a point where most stigma has been removed, people may stop internalising the shame that keeps them trapped in the cycle of addiction.

Encouraging treatment-seeking

When the door of understanding is opened to alcoholism being a disease, then people with an AUD may feel reinforced in seeking professional help. Recovering from a deep addiction takes more than willpower alone. Evidence-based care is so much more effective than trying to battle a return to substance use. Therapy, detox programmes and alcohol rehab services place people in better stead for complete recovery.

A catalyst for medical-based solutions and support

The disease model has been a powerful force in shaping alcohol addiction treatment, especially in fields relating to neuroscience and pharmacology. Though the model has limitations, like psychological and environmental factors, it continues to evolve and inspire a more holistic approach to treatment. Many treatment providers now blend the disease model with research from behavioural scientists and trauma-informed care providers. The future for comprehensive addiction treatment may lie in bridging the gap between scientific understanding and how treatment is applied in real-world settings.

Do genetics play a role in alcoholism?

The contributors to alcoholism are broad and multifaceted, including a myriad of environmental and societal factors. There is also a growing body of research that suggests a person’s genetics can increase their susceptibility to developing alcohol dependence. Family and twin studies highlight that genetic factors can account for roughly half of a person’s risk for developing AUD.

Rather than finding a single “alcoholism gene,” researchers have found numerous genes that affect how your body processes alcohol. For example, variations in the ALDH2 gene can cause unpleasant reactions to alcohol, while changes in the DRD2 dopamine receptor gene are more common in people with alcohol addiction.

There are still influences from a person’s environment, mental health conditions and learned behaviours that affect whether addictions form. While the disease model view focuses largely on the biological aspects, growing bodies of research support a more integrated approach that looks at psychological, genetic and environmental factors together.

It’s crucial to remember that having a genetic predisposition does not make alcoholism inevitable. Even if you worry about the fact that your parents or grandparents may have passed down a gene that affects your drinking, your future is not predetermined and you are still able to break free. Use the support available to step into the life you truly want to lead, free from addiction and substance use.

Where can I find help for alcoholism?

Whether you see alcoholism as a disease, a condition, or something else entirely, one truth remains: struggling with alcohol doesn’t mean you’ve failed, and you don’t have to face it alone.

At UKAT, we understand the complex roots of addiction. Our programmes are tailored to support you at every stage of your recovery, from detox and therapy to long-term relapse prevention. Our expert staff deliver evidence-based care to help you take control and move toward lasting recovery the addiction left behind you.

Reach out today to take the first step toward a healthier, alcohol-free life.