Is Alcoholism a Disease?


The alcoholism disease is a deviation from or interruption of the normal structure or function of any body part, organ, or system. A disease is manifested by a characteristic set of symptoms and signs whose etiology, pathology, and prognosis may be known or unknown.

Another definition of disease is a pathological condition of a part, organ, or system of an organism resulting from various causes, such as infection, genetic defect, or environmental stress. A disease is characterized by an identifiable group of signs or symptoms.

Whether or not alcoholism is a disease is a heated debate but the evidence is clear.


The CYP2E1 gene is linked to sensitivity to alcohol. The manipulation of this gene may be very helpful in the field of alcohol treatment. Read about it here.

Alcohol affects neurotransmitters. Neurotransmitters are crucial to brain processes, mood and behavior patterns. Happiness is directly related to one of these neurotransmitters, Serotonin. Neurotransmitters affect mental health. Addiction treatment and alcohol treatment should take into consideration meditation treatment to help with a neurotransmitter imbalance.  Read more about the effects of alcohol on Serotonin here.

3. Researchers focused on an area of the brain that is involved in alcohol relapse. This area is called the nucleus accumbens (NAcb) core and it drives motivated, goal-directed behaviors. Researchers studying a new drug that could help prevent alcohol relapse, Chlorzoxazone, found increased excitability in the NAcb core facilitates motivation to seek alcohol after abstinence. Read more about it here.


Despite overwhelming evidence supporting the effect of alcohol on the brain, we are skeptical. We tend to say things like “Why can’t you just put it down?!” “Why can’t you just quit?” “What’s wrong with you?”

The disease model of addiction does not imply that we are powerless and  incapable of recovery, nor does it excuse alcoholism. Informed treatment can help outsmart the disease. Typically, information helps us be less judgmental and more accepting. When it comes to alcoholism, it doesn’t.

The disease model implies that there are biological, psychological and social factors that determine the course of the disease and recovery, similar to obesity or diabetes. Biological predisposition, psychological make-up and societal influences combined may lead to alcoholism.

Ultimately, we can all come together to help each other live healthier, happier lives.

2 thoughts on “Is Alcoholism a Disease?

  1. I take it you are not pro-Stanton Peele, M.D. or pro-CBT?

    For me, I’ve wasted so many years debating this disease model in my head (and the powerless assertion) and have spoken to so, so many addicts – homeless ones at the center where I volunteer and on the bus, to a father of two who is a daily blackout addict – and so many have refused to enter the twelve steps. The 12-steppers of course say that it is because of the denial of/that is a part of their disease. But it seems that their is another dynamic here at work: With so much vested in the achievement of quitting, the admission of powerlessness is the zeroing out of their self-esteem and so it is not denial at work – but the preservation of what little self-esteem they have left.

    It seems to me that America is fraught with addictions because America is being provided with a dominant recovery approach that doesn’t work in concert with the side them that feels there is no logical rationale to the 12-step approach.

    With no alternative approach in their sight – this subsequent continual bottoming-out strengthens the emotional and intellectual relationship they have with their behavior. Being focused on it for years without an approach that works in concert with their gut feeling that something direly significant in the 12-step approach is wrong reinforces the focus, until the behavior with the substance or activity becomes, in essence, like a lover. It’s all kind of Romeo and Juliet, really – the more you tell me you’re right, when you’re not – the more I will stand where I am. Even if it’s in a place of addiction.

    Personally, I believe that the disease is life itself, that’s all. But that’s saying much. Especially in the increasing complexity of life and the world in which we live….

    And when you say that the “the disease model implies that there are biological, psychological and social factors” – is that really true of disease? That there are *social* factors that determine the course of the disease and recovery of breast cancer or diabetes? Social?

    It seems the disease model, which is fraught with language like “drugs that *could* help” or phrases like “seem to be”. Indeed it is. It seems more like evidence is being found to *make* things true.

    As for the 12-steps, which seem to be based on the disease model – regardless of whether or not it is a disease anyway (which indeed does imply at least *some* unchangeable powerlessness in its identification of addiction as unchangeable – ever-recovering and never in remission) – telling someone they are powerless is something I would never do to a breast cancer patient, a child, or even another human being. That’s what some addicts, I believe, are fighting against. Fiercely. Possibly foolishly as well, like myself – but also fiercely.

    And of the twelve steps themselves, if one examines the philosophical underpinnings that lie underneath them, at least seven of them are actually *dis-*empowering, if anything at all.

    And the concept of *shared* responsibility does little to define the role of the addict himself in his own life. Where does his or her responsibility and the friends’ families’ responsibilities end and begin? It it good to teach people, who are already often in weakened and destroyed relationships, a blurred and unclear line of demarcation in regards to responsibility? Every twelve stepper I’ve come in contact with, especially those who have been steeped in it for years, tend to become hostile or immature all too soon enough, when things have not gone their way. So I wonder if this concept of shared responsibility, while helping them during initial phases of recovery, shoot them in their future feet….

  2. Thank for your well-thought response. When I talk about the disease model of alcoholism I am not thinking about AA. I think AA downplays the role of biology and overplays the role of character defects in a way that can be detrimental to someone’s recovery. Many of my clients have found AA helpful and as many have found it ineffective. There is very little scientific evidence that AA is effective. It’s more of an epmirical, word of mouth, evidece, so to speak. There is more best practice evidence that supports medication assisted therapies in addiction and alcoholism treatment (which AA doesn’t particularly support). I’m an evidence-based therapist and I do use CBT and Motivational Interviewing in trying to help clients. But that’s not enough.
    Also, the biopsychosocial model is specific to the disease model of alcoholism not of disease in general. I am not a medical doctor, but I would argue that there are psychological and environmental factors that are related to cancer, HBP, diabetes such as lifestyle choices, environmental cancerogens (even in the food we eat everyday)etc. There are well-known lifestyle choices that are associated with diabetes, HBP and cancer (i.e smoking). Certanly we have to be careful not to confuse correlation with causality. I would though argue that the environment and one’s psychological make-up, can be responsible for one’s ability to recover and/or manage disease. Same with alcoholism.
    I agree with you about the issue of responsability. That is a much larger issue that involves political, economical and larger cultural issues related to alcoholism.
    The whole point of this post was to highlight the biological/medical basis of alcoholism which is unique to the disease model. Obviously, there is valid criticism to the model especially around the implied lifelong/chronic nature of the disease. But this is an important model in helping people understand the nature of their problem in all it’s complexity without feeling like there is something wrong with their character or willpower for craving alcohol or struggling with staying sober or chronically relapsing and so on.

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