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Alcoholism: The Volitional Disease
The Canned Response Letter

By: Officer S. Garry Nowak

Dear ­­­­­­­­­­­­­­­­­­­­­­_________,

Regarding your inquiry, here is my response:

I believe the best argument against disease model of alcoholism is to look at alcoholism conversely.  By looking at alcoholism conversely, I mean this:  Those who support the disease model of alcoholism would want 'us' to believe that any one or combinations of the following postulates are true.  (I use the word postulate because as of this writing there is no doctoral level study or research that has defined any etiology for alcoholism; i.e., the causation of alcoholism is unknown.  As a small side point here, there are no warning labels on alcohol warning the drinker that alcoholism may result similar to the warning labels on cigarettes advising of the possibility of cancer resulting from smoking.)

  • 'They' would want 'us' to believe that the etiology of alcoholism may lie in the form of a disease entity.  I would define a disease entity as some sort of an infectious or invasive pathogen within the human body. However, you are free to define disease as you see most appropriate.

  • 'They' would want 'us' to believe that the etiology of alcoholism may lie in genetics.  Genetics is defined as the passing on of traits, heritable factors, to the filial generation.  (Genetics is immutable - try volitionally changing your eye color, skin color, etc.  It cannot be done volitionally.)

  • 'They' would want 'us' to believe that the etiology of alcoholism may lie in neurotransmitters or somewhere within neurotransmission.  (Neurotransmission is as immutable via volitional efforts as are genetic traits.)

  • 'They' would want 'us' to believe that the etiology of alcoholism may lie in some neuro-chemical imbalance of the brain.  (Again, brain chemistry is not altered via volitional efforts)

NOTE:  Feel free to ask any doctor, neurologist, etc., the following question:  Please tell 'me' what the correct chemical balance of the human brain consists of?  Accept an answer that includes weights, percentages, or quantities.  No one can answer that question because no one knows the answer. 

Secondly: to date best estimates are that only half of the neurotransmitters have been discovered so no answer is even possible. 

In essence, there is no such thing as a chemically balanced brain.  What 'they' would like you to believe is that since a patient's behavior is somehow abnormal prior to taking a psychotropic drug AND after taking said medication that patient's behavior is more normative or controllable, his/her brain chemistry has subsequently been balanced.  Not true given the side effects of diarrhea, constipation, dry mouth, drooling, sexual dysfunction, gastric disturbances, sleep disturbances, etc.  Those side effects represent some balancing of the brain. Why are these very life disrupting side effects not considered to be imbalances of brain chemistry? 

IF you do not believe me, pay attention to the ads on TV.  You will hear the entire list in the 'fine print' at the end of the commercial.  You will hear the voice list them all very quickly and quietly. You really have to pay attention to what the speaker is saying in order to hear the warning about side effects. The warning is very easy to miss just as is the fine print on any label. BUT, the important thing to note is that the warnings of these side effects are there - as well as on the prescription bottle itself. These are very serious side effects that are just as serious, if not more serious, than the original condition for which the medication is/was intended to treat.

Back to my response: All of the above represents either an invasive intrusion within the alcoholic's body OR some biological fault within the most basic nature of human composition (genetics, neurotransmitters, neurotransmission, and/or a chemical imbalance of the brain's bio-chemical nature). 

Now I am going to add more fuel to the disease debate:  Given that by all statistical accounts the overwhelming majority of alcoholics (80% appears as a very consistent AND acceptable figure in the research) become abstinent without any third party assistance; i.e., the majority of alcoholics make a decision to become abstinent and subsequently become abstinent.  They do not utilize AA, counseling, etc. So now, another very important question must be asked and answered: 

Exactly how does one volitionally alter the genetics, neurotransmitters, neurotransmission, and/or a chemical imbalance of the brain in order to become abstinent????

Now add to the number of alcoholics who become abstinent due to their own personal volition the number of alcoholics who recover or remiss via AA, counseling, clinics, interventions, etc. and the number of alcoholics who recover exceeds 90%.  The whole number of ‘drink-till-you-die’ type of alcoholic is very small when compared to the number of alcholics who are able, capable, and have become abstinent or otherwise remising their 'disease'.   

So the question remains – exactly how does one volitionally alter one's faulty genetics, neurotransmitters, neurotransmission, and/or a chemical imbalance of the brain?????

The answer is . . . (drum roll please) Neither genetics, neurotransmitters, neurotransmission, and/or a chemical imbalance of the brain can be altered through volition OR with the help of AA. The very significant point here is it takes extremely intrusive, extremely high tech, cutting edge technology to alter any of them.

In the United States, the only acceptable therapeutic modality for an alcoholic suffering from alcoholism is Alcoholics Anonymous (A.A.).  A.A. is considered to be the only credible and/or valid therapeutic modality for an alcoholic suffering from alcoholism.  A.A. is reputed to be so very successful that A.A.’s 12-Step Treatment program has become the paradigm for the overwhelming majority of alcohol treatment modalities in the United States.  Over 90% of addictive treatment modalities model themselves after the AA 12-Step program in some form or another.

So now another very important question must be asked and answered:  

How does Alcoholics Anonymous so positively affect the alcoholic’s genetics, neurotransmitters, a chemical imbalance of brain chemistry, or other possible invasive pathogen(s) that may comprise the ‘disease’ of alcoholism?

A.A. is comprised of disorganized (their descriptor, not mine), nonprofessional (their descriptor, not mine), fellowship of 'true experts' (recovered/recovering alcoholics, again, their descriptor, not mine) AND it is not required of these true experts to possess any undergraduate, graduate, medical or Ph.D. degrees; AND it is also true that none of these true experts are particularly trained nor do they possess any experience in any psychotherapy or therapeutic counseling; AND, not to be redundant, but the only 'credentialing' requirement mandated by A.A. for becoming a 'true expert' is to once being a drunk (their descriptor, not mine) and subsequent abstention via A.A.'s 12-Step treatment modality; AND their therapeutic modality is a group therapeutic modality primarily consisting of drunkalogs (war stories) and prayer.

Given the above indisputable facts regarding A.A. and their success in treating alcoholism (their website clearly states that they are a treatment modality for alcoholism), combined with the facts of what the disease model of alcoholism proponents would like 'us' to believe, then a A.A. member sustains the burden to answer the following question:    

Given what A.A. consists of, please explain to me exactly how does A.A. so positively affect the genetics, neurotransmitters, chemical imbalance of brain chemistry, or any invasive disease pathogen within the alcoholic’s biology, anatomy and/or physiology?

The answer remains as previously stated . . . AA can no more effect one's genetics, neurotransmitters, neurotransmission, and/or a chemical imbalance of the brain than can one alter any of them via volition.

As illustrated by the above fact pattern and question, to me it becomes quite clear that alcoholism cannot be defined as a disease by any definition that includes genetics, neurotransmitters, chemical imbalance of brain chemistry or even an invasive pathogen(s).  Why?  Because there is nothing within one's volition OR within the AA therapeutic modality that has even the remotest of possibilities of affecting one’s genetics, neurotransmitters, chemical imbalance of brain chemistry, or any invasive disease pathogen within human biology, anatomy and/or physiology.

I do not mean to disrespect A.A. anymore than I would disrespect one's religion or one's belief in God.  A.A. is not without its successes but it is no where near 100% successful as Bill W. alleges in his Big Book. (Chapter 5 of The Big Book states in the first paragraph: “Rarely have we seen a person fail who has thoroughly followed our path” . . . absolutely, 100% false.)

Personally, I am in quest of a modality that positively deals with the remission of alcoholism.  In so doing, questions are raised which must be answered.  Religion is based on faith.  In my opinion, alcoholism in its own way is 'faith-based'.   A.A. as a therapeutic modality offers support in an open, verbal forum.  This form of a psychotherapeutic treatment is nothing more than a group therapy modality. This is most definitely an accepted, mainstream modality.  However, group therapy has never been offered as a treatment for either a genetic error, poor neurotransmission, or for an imbalance of brain chemistry.  The idea that A.A. can somehow alter one's genetic foundation, neurotransmission, or brain chemistry is not possible nor does it even make sense.

What A.A. does offer for the successful member is to give support where support is needed.  It provides education by clearly illustrating via drunkalogs how and where others have failed.  A.A. is a therapeutic modality that educates its membership in how to cope, adapt, and overcome one's perseverated, maladaptive thinking pattern.  AA is educational.  It teaches one how to adaptively think which subsequently alters one's behavior.  Nothing more. Nothing less. 

In the case of alcoholism, empiricism (experience and observation) trumps science and research.  Why?  Because as of this writing, there is not one doctoral level study nor is there any credentialed medical research that has definitively defined alcoholism as a disease or as even having a definitive etiology. 

Most respectfully,

Garry Nowak

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Last updated 2006/06/13

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