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Alcoholism: The Volitional Disease

By: Officer S. Garry Nowak

(originally at

Continued from page 1

The construct of disease theory alcoholism is closer to being a religion than it is to being a disease. Why do I say this? Because in order to believe in the different tenets of disease theory alcoholism, similar to religion, you must have faith. None of the tenets of disease theory alcoholism have ever been supported by scientific or doctoral level research. It is faith alone which allows these tenets to exist. If you support disease theory alcoholism, you have to have faith and believe in the following:

  1. Alcoholism can afflict anyone regardless of race, creed, religion, etc. This is not true. Alcoholism is statistically so low in Jews, Cantonese Chinese, and Amish that it is safe to say that alcoholism does not exist in those cultures. Why? Because studies show that where either a strong religious base where alcoholism is not accepted or a cultural base where alcoholism is not accepted, alcoholism simply does not exist. It may sound simplistic but it is true.

  2. There are no protective factors against alcoholism - everyone is a potential alcoholic. This is not true. As shown by Jews, Cantonese Chinese, and Amish, a strong religious or cultural grouping that refuses to support the tenets of disease theory alcoholism offers very protective factors against alcoholism since alcoholism is non-existent in those religions/cultures. Also, by definition, if alcoholism is a heritable, genetic trait, then there will be those who do not possess that heritable, genetic trait. Therefore, those who do not possess the gene for alcoholism would in fact possess a protective factor against alcoholism. This tenet contradicts other tenets of disease theory alcoholism.

  3. Alcoholism is genetic. Cantonese Chinese and Ojibwa Indians are considered to be genetically similar if not identical regarding alcoholism. Why? Because both of these cultural peoples manifest a 'Chinese flush' after consuming alcohol; i.e., a reddening of the face. If alcoholism is genetic; and if both of these cultural peoples are genetically similar then both groups should suffer similar rates of alcoholism. Yet, alcoholism is nonexistent within the Cantonese Chinese while absolutely decimating the Ojibwa Indians. What is the difference in belief systems? The Ojibwa Indians believe that alcohol is stronger than a parent's love of his/her child while the Cantonese Chinese believe that drunken misbehavior is a manifestation of one's personality regardless of one's sobriety. The individual takes responsibility for his/her behavior whether sober or inebriated.

  4. Alcoholism is heritable. This tenet completely disregards learned behavior; i.e., a child learns how to drink from parents, role models, peers, etc. IF alcoholism were a 10% heritable or genetic trait, then it would be immutable. Why? Because genetics cannot be changed volitionally and statistically 85% of all alcoholics volitionally stop their alcohol consumption without any outside interventions, therapies, hospitalizations, etc. One cannot volitionally change their eye color, hair color, or skin color volitionally, yet alcoholism has a significantly higher success rate through volition than through any other means. There is no research that scientifically supports alcoholism as being heritable.

  5. What is the possibility that alcoholism is genetic and heritable? Per the Human Genome Project, there are 80,000 genes with approximately 3 billion different interacting combinations that exist in the human genome (the sum total of heritable, genetic material in a human being). Even the proponents of disease theory alcoholism have acknowledged that finding the gene that causes alcoholism would be like finding the gene that causes one to like basketball. The idea that alcoholism is 100% genetic and heritable is highly unlikely by all studies and statistics.

  6. Loss of control. Studies have consistently shown that alcoholics drink to achieve a certain level of intoxication that they personally find desirable. Alcoholics will alter their drinking pattern (consume less) if so doing benefits them. By definition, IF alcoholism were a disease that was truly an irresistible impulse of uncontrollability then alcoholics would consistently drink until they are unconscious or until they overdosed on alcohol. That is simply not true.

  7. Denial. A major tenet of disease theory alcoholism is denial. Denial is an unconscious defense mechanism that in theory is implemented to protect the ego from unpleasantness. If one is to believe in denial then one has to believe that in spite of everything that is obvious and negative in an alcoholic's life; i.e., divorce, loss of employment, loss of family, medical problems, legal problems, etc., the alcoholic is incapable of associating these negatives in his/her life with his/her consumption of alcohol. Even AA's Big Book addresses this as conscious lying, not denial. Also, it has to be noted that a typical alcoholic is not the stereotypical skid row type. Statistically, alcoholics are slightly smarter than average, hold better jobs, hold professional jobs, managerial positions, etc. Yet, according to this tenet of alcoholism they are not smart enough to associate the obvious negative aspects of their lives with their consumption of alcohol.

  8. There is a chemical imbalance of the brain. This is one of the newer theories pertaining to disease alcoholism. It is questionable how there can be an imbalance of the brain when there are no standards of what a chemically balanced brain is; i.e., what chemicals comprise a balanced brain in terms of percentages or weights, qualities, quantities, etc. What is a normal, chemically balanced brain? It is assumed that a brain becomes 'balanced' when drugs alleviate symptoms. The alleviation of symptoms never includes the adverse side effects of the prescriptive drug. Side effects may include one or any combination of dry mouth, drooling, diarrhea, constipation, sleep disturbance, eating disorders, sexual dysfunction just to name a few. Yet proponents of this theoretical construct do not look at these very serious side effects as being included as an imbalance of brain chemistry.

  9. Neurotransmitters. This is another new theoretical construct of disease alcoholism. This theory proposes that neurotransmitters such as dopamine and/or seratonin become particularly influenced towards alcohol consumption; i.e., these neurotransmitters require alcohol in order to trigger their function within the body. What this theory fails to address is how a generic neurotransmitter such as dopamine (the continuum of pleasure) or seratonin (the continuum of mood, affect and sleep) become highly specific and targeted towards alcoholism? There is merely associative, anecdotal evidence to support this tenet of alcoholism. Also, this theory fails to address how genetically similar people such as Cantonese Chinese and Ojibwa Indians can be so different in terms of the effects of alcohol and alcoholism yet be genetically similar? This theory implies that if a Jew becomes an alcoholic, then his neurotransmitters or brain chemistry has spontaneously become altered. Not only is this not a compelling theory, it tends to contradict itself.

  10. Brain Waves or images. No similar brain waves have been found between different alcoholics. All brain waves appear to be more similar to fingerprints; i.e., each person's brain waves are unique unto themselves.

  11. Addictive Personality. Addictive personality is defined as having an existing premorbid condition prior to the onset of alcoholism. There are no studies that have found any existing premorbid condition prior to the onset of alcoholism among alcoholics. Therefore, this tenet of disease alcoholism falls flat. There does not appear to be any such entity as an addictive personality. This is a media construct, not a scientifically based construct.

  12. It the first drink that gets you drunk. An AA aphorism meaning that once an alcoholic consumes the first drink, he/she is then an alcoholic. This is not true. This is not even supported by proponents of disease theory alcoholism. Even the proponents of disease theory alcoholism acknowledge that alcoholism takes at least several years to develop. There is no scientific foundation or substantiation for this saying.

Alcoholism is a behavior. Behaviors are not disease entities, they are bad habits perseverated by obsessive repetition and habituation. Habituated, substance induced behaviors cannot be reduced to a single etiology anymore than non-substance induced behaviors can be reduced to a single etiology. Sex, eating, gambling, computers, computer games, and unrequited love are normative behaviors that have been declared diseases. Sex, gambling, computers, computer games, and unrequited love do not involve the ingestion of any substance yet abstinence from these habituated behaviors may incite withdrawal symptoms identical to substance withdrawal symptoms. The answer to the eradication of alcoholism lies in our national perspective of alcoholism. Do we want to perpetuate the myth of alcoholism being a disease entity that is out of the realm of one's discretional, volitional control or do we tell the truth? Do we let the dirty secret out of the bag and tell everyone that, like Dorothy in the Wizard of Oz, they already possess the power to hole dominion over alcoholism.

"The doctor said: "You have the mind of a chronic alcoholic. I have never seen on single case recover, where that state of mind existed to the extent that it does in you." (Carl Jung to Bill W. - Chapter 2, p.4, html version The Big Book).

Click here to read The Canned Response Letter by Officer Nowak.

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Last updated 2006/06/13 - Nowak submitted his canned response letter. Link added.
Created 2006/03/18

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