Conference quark::human_relations-v1

         I will just skip the first 1,456 lines citing scientific
         studies defining the chemical and physiological aspects
         of addiction as disease...OK?  Trust
         me?
         
         ---
         
         First....the point was [I believe] that ADDICTION
         is a disease....not drugs or alcohol which are provable
         SUBSTANCES.
         
         Second....I don't believe anyone would argue your
         point that an addicted person takes a first step
         by using a particular substance....the kicker is,
         that once a person who has this disease *takes* the
         first step it is hundreds and then thousands and
         then millions of times harder to *not* take another
         and another because of the *disease*.
         
         Are there any of us who have not done "foolish" or
         "unwise" things when we have been lonely or dpressed
         or upset?  I doubt it. But some of us, find out the
         hard way that we "can't" do some foolish things even
         once...or the disease rears its head. And when it
         *first* rears its head....you don't even know what
         it is.  We are not raised to look for the classic
         hints of this disease...in fact we are raised to
         "ignore" them because they somehow infer a vulnerability
         that society does not wish us to admit.
         
         So, by the time "someone" sees it....we are too far
         gone to see anything until we hit the bottom so hard
         our teeth fall out....and then, if we are terribly
         lucky and awfully stubborn, we manage to crawl back
         out of our own personal abyss.  But from then on
         we walk a narrow path along its edge...a slight teeter
         and I am *all* the way in...there is no "just a little
         one"....ever again.
         
         ---
         
         If I had malaria....and I was visited occasionally by
         the tremors and fevers of that recurring malady,
         people would lay a comforting hand on my arm and
         they would politely look the other way when the devil
         had me in his grip...
         
         If I am a victim of addiction....and I must [in whatever
         way suits me and makes it work for me] stay away
         from a certain substance....or the tremors and fever
         and dibilitation will start all over again....people
         often will look at me and think...."you are doing
         this to yourself...you are weak..."
         
         Why does one physical disability demand compassion
         and another rejection?
         
         ---
         
         I do not need or want anyone's sympathy....sympathy
         will never help me stay on my narrow path above the
         abyss....I need simple acceptance and respect for
         what I accomplish from strangers....and I need the
         love of the people I call friends...Is that any
         different from what anyone else needs?
         
         I thought not.
         
         Melinda

I'm not sure addiction is a disease or not...

I know that I repled to 699 in the manner which I did because I can imagine what
it is like to be addicted, and how badly it can warp you, and how difficult it
can be to recover from.  They do need positive support and affirmation that they
don't deserve to be an addict, and that they are capable of more. 

This does not mean that I don't consider the person to not be responsible for
their actions.  They certainly are, and they ***need*** to become responsible
for their own actions to recover.  And they are certainly responsible for any
attrocities which they commit, and need to be shown the consequences for their
actions so that they can realize that they need to change.  The worst thing you
can do for an addict is to sympathize with them to the point that you enable
them to carry on with their addiction.  Then they have no motivation to change. 

You say it is not a disease because they have to initiate taking the drugs. The
point that you miss is that there is something wrong with them at that point
where they need to take drugs.  

In that sense, it is a sickness (a bit different in my mind from a disease;
disease doesn't quite fit for me), excpet that the drugs they are taking are
destructive rather then constructive, and they may not even wish to become well
on some level.  Addictions are a way of avoiding a problem and the solutions to
the problem. Quite often, it is a problem they cannot solve or even face because
of some deep seated misconception about themselves or the world around them.

I don't understand the saying that 'once an alcholic/* always an alcholic/*'.
Myself, I have been addicted to some things, say a video game :-), for a short
period of time, but it very soon loses my interest once I've explored it
thoughly.  Other addictions, while they may be great for avoiding a problem or
the solution to a problem, are just plain not usefull, and in short order I
realize that 'hey, this is dumb; this is not getting me anywhere!'  Perhaps
that's because I am a person who likes action rather then inaction.

But I suppose that saying is true for some people.  I just hate to see it
misapplied to every addiction.  That misapplication can cause a lot of harm
because it gives a sense of futility, and seperates the person from other people
and into a 'ghetto' of addicts even after they have 'recovered'. 

Jim.

RE:.2

Instead I will send you the clinical studies...[grin]

Shall I say...I disagree and leave it at that?

	From Webster's...

	Disease: (n) A condition of an organism that
	impairs normal physiological functioning.

[hmmm?]

M-

    I don't know if addiction is a disease or a behavior but I
    do know that people can be addicted to LEGAL drugs.  I agree that
    the people addicted to illegal drugs should never have tried them
    but what about the people that  get addicted to prescription drugs?
    Are you going to put down someone who was doing something they thought
    was suppose to help them?
    
    dv

re> 702.0
    
    Ed,
    
    I agree with you, and you are not too unsympathetic.
    
    
re> 702.1
    
    Melinda,
    
    I agree that everyone do something foolish in his/her live
    but that doesn't mean that we reach-out to a drug or alcohol
    because than almost the whole world should be have a "disease"
    we all having problems once.
    
    
re> 702.3 "There is something wrong with them"    
           
    Jim,
    
    When they have problems they could go to a psychiatrist or a very
    good friend.
    And video-games is something else then a alcoholic problem.
    
    
    Ellen.

>< Note 702.6 by FDCV06::VAUGHAN "kinda music that soothes the soul" >
>                     -< There are addictive LEGAL drugs  >-
>
>    I don't know if addiction is a disease or a behavior but I
>    do know that people can be addicted to LEGAL drugs.  I agree that
>    the people addicted to illegal drugs should never have tried them
>    but what about the people that  get addicted to prescription drugs?
>    Are you going to put down someone who was doing something they thought
>    was suppose to help them?
>    

I don't think that .0 meant to "put down" people who are addicted to drugs.  I
think he was just stating his belief that it is an addiction, not a disease.

In a case where the person becomes addicted to Legal drugs, the person at fault
is the doctor (if the person took them according to the directions of the
doctor).  It is the doctor's fault as much as it would be if a drug pusher holds
down someone and forces the drug on them or slips it to them unaware to get
someone hooked because their patient trusted them.  The doctor may have been one
of the following... 

1) dr didn't care if the patient became addicted (hope there aren't many)
2) dr didn't know enough about the drug to know if would cause addiction (ditto)
3) dr didn't follow up on his patient enough to notice the addiction.  (you
   have to get a refill perscription from your dr. so I would assume it would be
   noticed) 

I don't see how a dr could escape blame but I'm sure there are cases that I'm
not aware of.  But even if the blame was put on the dr. that doesn't make the
addiction any more or less a disease than if the drug was illegal. 

I personally don't see it as a disease, but that doesn't mean I "put down"
someone who is addicted.  They need help (in the form of treatment), friends and
understanding as well as someone with a disease. 

    >.10 the patient misleads the dr.
       What if the Patient is totally honest and admits to the doctor
    any previous conditions so he/she can priscribe better, and be aware
    of the patients health history, and the dr. still priscribes a drug
    long over the recommended time by "6" months, kept the wrong address
    for the patient and where the prescritions where filled were totally
    wrong. and as a result this patient couldn't go go off them cold
    turkey or by themselves, but had to be medically weaned off these
    medications?
      Please remember the patient has an eyewitness saying that the
    patient had admitted the health history.
    
    
    
    

    I did not intend to start a discussion of good/bad medical practices.
    I just wanted to point out the fact that not all people addicted
    to drugs have done something illegal to get addicted.
    
    As far as the original topic is concerned I really don't know if
    it is a disease or not.  I believe that you can have a tendancy
    towards addictive behavior the same way you can have a tendancy
    towards getting certain diseases, but I don't think that that
    qualifies it as a disease.
    
    Personally the couple times that people I've known have had problems
    with drug/alcahol addiction I was more concerned with what I could
    do to help then whether or not they had a disease.

    According to American Medical Association, alcoholism is a disease.
    
    					andrew

    "The principal reasons for the AMA's "disease" classification
    are that alcoholism and other addictions are 1) diagnosable
    and 2) treatable."  The source for this quote is Dr. John Wallace,
    director of clinical programs at Edgehill/Newport, a rehabilitation
    clinic.  There is at least one other very good reason for using
    the disease model: rehabilitation programs which embrace this
    model have worked for millions.  Treating the problem as a disease
    has had a far greater success rate than any other method.
    
    re: .5
    
    Since roughly 90% of how the brain functions is still a mystery
    (current and ongoing studies notwithstanding), I'm not sure what
    a "new" classification will tell us or how it will "confuse the
    situation" less than today.  Is it not likely that in "n" years
    from this "new" classification there will be yet another "newer"
    one?
    
    It seems to me that what matters in this problem is how it's treated
    (what can I say - among other things I'm an incurable pragmatic);
    if more people are helped by treating it as a disease, then, 'til
    a better method comes along, the disease model is "goodness" in
    my book.
    
    Steve
    

    
    In reply to your note.  What I don't understand here is how can
    you seperate drugs and alcohol.  Alcohol is a drug, you may be
    able to buy it over the counter, nevertheless it is a drug.  Also,
    alcoholism is most definitley a disease, therefore, if you are a
    alcoholic, and a drug is a drug is a drug, then you stay away from
    all drugs.  Not just the liquid kind.
    
    In dealing with drug addicts, alcoholics, I find the only people
    who have truely been able to understand this disease is the people
    who have experienced it.  It is very difficult to explain this disease
    to a person who has never, ever lived with it or around it.
    
    

.18>	Why do I think it is a disease.  From what I have learned in
    	dealing with diseases.  A disease is something that is treatable
    	not curable, such as diabetes.  Alcoholism/drug addiction is
    	not by any means curable, once you have crossed over the line
    	of social drink/drug use (whatever that maybe) into addiction,
    	you can never go back.  You may stop and treat it by therapy
    	groups, etc., but you will not be able to drink without it 
    	being in excess again.
    
    	This is why I believe it to be a disease, it is not curable
    	only TREATABLE.  
    
    

         Steve...
         
         Ok, if we [for discussion sake] buy into liberating
         the money used in obviously not-so-successful attempts
         at control...
         
         	1: WHO administrates it?
         
         	2: WHO sets the above [group?]'s objectives?
         
         	3: WHAT do they do f'rinstance?
         
         I am willing to "emotionally" buy into your suggestions.
         They make sense...but are they workable? How can
         we keep *ANY* group from succumbing to the same graft
         and corruption that exists for those organizations
         currently dealing with programs.
         
         It seems to me a sad commentary that those groups
         who *don't have any money are the ones that are doing
         the best jobs...and you give 'em money and they start
         *not* doing a good job?
         
         And finally...I *like* your comment about legalizing
         the whole shebang...[ya-but]...just how do we go
         about *that*???
         
         I hear you. I believe you. I even *agree* with you.
         Now, let's talk reality...how do you see any of this
         being put into position?
         
         Melinda

    re: .22
    
>    	As I pointed out earlier, many physical dysfunctions that are
>    not caused by an organism (and therefore not diseases according
>    to classical defintions) are treatable as diseases ...
    
    My dictionary (Taber's Cyclopedic Medical Dictionary, 15th ed.)
    provides the following definitions:
    
    disease - Literally the lack of ease; a pathological condition of the
    	body that presents a group of symptoms peculiar to it and that
    	sets the condition apart as an abnormal entity differing from other
    	normal or pathological body states.
    
    pathological - 1. Concerning pathology.  2. Diseased; due to a disease.
    
    pathology - 1. Study of the nature and cause of disease, which involves
    	changes in structure and function.  2. Condition produced by
    disease.
    
    
>    	Diabetes is not a disease, I stated that earlier.
    
    Diabetes IS a disease.  From the same source:
    
    diabetes - A general term for diseases characterized by excessive
    	urination.  Usually refers to diabetes mellitus.
    
    

    not recently....
    
    have you ever seen a alchoholics liver....?
    
    Bill

    re: .25

>	What is diseased in diabetes?

    In diabetes mellitus, the pancreas (beta cell functional deficiency);
    in diabetes insipidus it's the pituitary gland (inadequate secretion
    of vasopressin, an antidiuretic hormone); in endocrine diabetes
    mellitus, various diseases of the pituitary, thyroid, or adrenal
    glands.


>                      -< ever see a diabetic's pancreas? >-

    I don't see why the appearance of the pancreas is relevant.  An organ
    can be diseased without appearing to be abnormal, especially to the
    naked eye.

    
    Perhaps when people refer to drug addiction as a disease, they do
    not mean it in the clinical sense.  Because drug addiction (and
    I'm including alcoholism) seems to be running rampant at this time,
    maybe people are comparing its similarity to the spread of a disease.
    Also, when they speak of it as being a disease....could it be that
    they are referring to its "disease-like" effects upon society? 
    
    
    Personally, I think drug addiction can bring on disease to the user
    but in and of itself, is not a disease.       
                                          
    Kris
    

In my opinion, alcoholism (or any addictive behavior) is not a disease but, that
is really just arguing semantics. I agree with Mike Z. that the word disease was
applied in these cases to imply that it is not a moral problem, ie. the person 
suffering from it is not a morally bad person. I would have been more 
comfortable if they had used a term like 'emotional illness' or 'personality 
disorder' because I feel they more accurately describe the condition, but, 
anything that helps these 'victims' from being judged on a moral standard is OK 
in my book, including erroneously calling it a disease.

Pete

    re: .23 
    
    Good questions, Melinda, and ones that I *do* want to answer.  But,
    because time is going to be tight this week, it may be a while and
    I wanted to post this in the meantime so that my temporary silence 
    won't be interpreted as indifference or not having an few thoughts.  
    
    Then too, I'd like to see if I can whittle those "few" thoughts down 
    into, say, five or six major volumes before assaulting the readers
    herein. . .
    
    Steve

There is quick a bit of scientific evidence around physical basis for
alcoholism.  The genetic link was already mentioned.  Also, the liver
and brain react differently when processing alcohol in the alcholic.
Those in doubt may wish to check the literature.  (I'll type in some
references later).

The idea that disease is only that which is caused by some organism is
just that - an idea and a definition that alleopaths use (that is
MD's).  Other types of medicine view the situation differently.  We
could argue this piont for hours.  But let's not assume the
alleopathic definition is the only reality.

john

         If you cannot see the obvious difference between
         the culminating effect of blue eyes and alcoholism than
         far be it from any of us to disillusion you. 
         
         Aside from that....just what is your point?
         
         Does it being a disease or not being a disease alter
         the impact on children of alcoholic parents one little
         iota? Does it being or not being a disease change
         the havoc it can create in otherwise caring and
         productive individuals? Does it being or not being
         a disease make the least little difference to what
         needs to be done to get the big money interests out
         of the business of addicting hundreds of thousands
         of people for the almighty dollar?
         
         Or does it being or not being a disease merely make
         it more comfortable for us to shirk common decency
         and ignore the victims on the grounds of moral
         turpitude?
         
         What are we looking for an excuse *for* when we seek
         to un-define it as a disease? History teaches us
         that such *definitions* inevitably precede degradation
         and denial...so, enlighten us. Where are you headed 
         with this insistance? If it is *not* a disease....
         
         So what?
         
         Melinda

    re: .34
    
    Mike - for the third time: what positive outcome will we gain by
    calling addiction something other than a disease?  
    
    There is some interesting research underway currently that's focussing
    on the inability of the addict's body to metabolize certain substances.
    The cause is as yet unknown and, yes, this may or may not change
    whether or not addiction is labelled a "disease".  Just because
    medicine today doesn't understand all there is to know about a
    disease doesn't necessarily mean that it isn't a disease.  
    
    Witness cancer, for example.  There are studies being done today 
    which are looking into how the patient's attitude affects the disease; 
    it may well be that, as in addiction, the patient's will to get better
    has a great deal to do with recovery.  And like the diabetic, the
    addict doesn't choose to have the affliction; (s)he doesn't wake up 
    one morning and say, "Well, this is a nice day. . .I think I'll go out 
    and pick up a drink or drug and become an addict".  But like the
    diabetic, once the addict says, "I'm an addict and, though I didn't
    choose this disease, I *am* responsible for my own recovery", regaining
    health is possible.
    
    As John (.33) said, disease theory is a useful model to medicine in
    the treatment of human afflictions and that's why it's used - it 
    works better than anything else to date.  I have no problem calling
    it a "gezeltenschnargle" if, in so doing, it will help more people
    get better.
    
    Steve
    

    re: .38
    
    Since the disease model has proven to be the most effective (by
    far) for recovery, what makes you say that we're "barking up
    the wrong tree"?  So far all the other trees have been the
    wrong ones.  What other assumption might we be making and, more
    importantly, how might that assumption yield a better recovery
    rate?
    
    Steve
    	

From the vantage point of someone who does not (and, in all
likelihood, never will) know anything about either alcohol or drug
addiction, I find this discussion very interesting. At the same time,
I wonder if this is not an argument over semantics. 

Does one have to fit a problem into a strait jacket of a well known
model in order to treat it? Why should we care whether the problem
may be characterized as a disease, addiction, bodily dysfunction or
whatever? 

Once the problem characteristics, causes and outcome are known,
isn't that enough data for solution finding? 

-- Ron 

.41>    The mechanics of alcohol addiction are
.41>    almost 100% known now, you see, 

	No, I don't see.  I would like to know where you got this 
	information; what documented source you have?  Or are you
	a substance-abuse researcher doing a part time stint at
	DEC to tide you over until the "great breakthrough"

	I'm sorry - but this is all hits real close to home and I
	wonder what kind of background you have to be making all
	these claims to truth.

	Angeline

    re: .43
    
    What Mike may have meant was that the mechanics of alcohol 
    metabolism are very well understood (true enough).  What
    isn't well understood is *why* some individuals metabolise
    substances differently, just as scientists don't yet understand
    why some individual's immune system yields to cancer cells.  I
    agree with you, Angeline, that the mechanics of addiction are
    not well understood yet.
    
    Mike, if you did mean what you said, perhaps you could give us
    the source of your information.
    
    Steve
    

    If you define disease in physiological terms only, and apply a rigid
    mentality to addressing it, you will miss many of the disease of
    alcoholism's impacts... which dis-ease families, societies, and
    even (go watch the evening news) the ecosystem.  The disease of
    alcoholism is a systemic one... impacting far more than individuals
    and expressed in many more ways than a given body's ability to
    metabolize a given substance.
    
    Definitions are agreements... they are agreed to in order to make
    language useful... words have meanings both denotative and connotative,
    and multiple meanings.
    
    It seems to me that if you choose to define a word in the most rigid
    way you can, for whatever reasons of rigor you might state, and
    then to (in effect) call others wrong for disagreeing; then you
    may be more interested in being right than being effective... whatever
    your words to the contrary.
    
    The reductionistic belief that if we can just identify every variable
    by breaking something down to its smallest parts, we can then always
    find the magic bullet that will provide the cure, is only one way
    of thinking.  It has its uses... but if that is the sole lens through
    which you see the world, then you will not be able to see alternatives
    or share other kinds of insights.
    
    R.
    

.47>	I agree with you 100%.  
    
    	Alcoholism is a very complicated
    	disease for people, society, to understand.  It is almost
    	impossible to explain why it is a disease, when it is
    	misunderstood to begin with.
    
.48>   	As disease is defined in Webster's New World dictionary, it
        is:  1. any departure from health; illness in general 2. a
    	particular destructive process in an organ or organism, with
    	a specific cause and characteristic symptoms; specif., an illness
    	ailment 3. any harmful or destructive condition as of society.
    
    	To me it looks as though Alcoholism fits under the definition
    	of disease.  That is if you care look at the full definition
    	and not just part.
    
    	Also alcoholism in the same dictionary is defined as follows:
    
    	The habitual drinking of alcoholic liquor to excess, or a
    	DISEASED condition caused by this.
    
    	
    

    A liberal and slightly tongue-in-cheek translation...
    
    .48>                             -< I thought we dropped this >-
        
    .. I thought that I had handled all of your obvious ignorance on
    the topic...
           
    
    
    .48>	Yet more creative misuse of the word.
    
    ... obviously another idiot who can't speak English... and doesn't
    even have the good grace to know he's wrong and I am obviously right...
    
    
    The note more less proves the point, Mike...
    
    R.
    

"A disease is something that is treatable not curable, such as diabetes."

Many "diseases" are treatable and curable.

"Alcoholism/drug addiction is not by any means curable, once you have crossed
over the line of social drink/drug use (whatever that maybe) into addiction, you
can never go back.  You may stop and treat it by therapy groups, etc., but you
will not be able to drink without it being in excess again."

I think this is a lot of bull, and very harmfull to Alcholics to tell them
that they will always be Alcholics.  I know of several Alcholics who have
recovered from their "addiction" and have gone on with their lives to treat
Alchol responsibly.  I happen to belive Alcholism is an addiction pure and
simple.  Once you get rid of the addictive behavior and fix the force driving
you to addiction, you can go on to live a normal life.

"A disease is a bodily dysfunction brought on by an *organism*."

What organism is cancer caused by???

Jim.

    A debate over the definition of the word disease has continued in
    this note for many replies and has diverted to some extent the original
    question of the basenote.
    
    I would like to ask any individuals who wish to add to this note
    to please reread the base note before replying.
    
    Thanks,
    
    Joyce Co-Moderator

      Like another noter previously said most addicts start in their
    teens or younger! whether it's alcohol or street drugs! so no mater
    what they are illegial if they are under age.
      If * YOU* or anybody else out there can tell us the general public
    why some 52,000,000 world wide are alcoholics still active( with
    the number still climbing) what makes them more susceptible to the
    affects of drinking/drugging that makes them unable to put the drug
    down, unlike others that can see they are havinng trouble and can
    immediatly stop. Well I wish you'd impart that knowledge for the
    rest of us.
        When someone says they have thhe diease they are not trying
    to down play anything! It is a serious statement! They are saying
    in essence " I have an afflication the Medical Assocaition calles
    it a diease they tell me I can get treatment but I will never be
    cured. In order to help those people who don't have the diease or
    who have trouble understadning what the families and the acholic
    or drug addict goes through, Bill Wilson's( the co-founder of Alcoholics
    Anonymous) wife Lois started a group called Al-non. It is here the
    family tries to live the damage the alcholic inflicted in their
    lives. There are groups now called Alateen and Alatot. Believe it
    youngsters at the age of 2 can thinnk but not understand why
    daddy/mommy does this or that. Very confusing.
       The durg addcts and alcolohics are self admitted, that is the
    best way for them to seek treatment! They are held accountible for
    their actions, not responaible *Please no fights yet*  This can
    be related to the guy who does something really crazy and has no
    recellation of doing it, but he is stil held accountable! if he
    robbed a bank then he goes to jail, if he/she owes money they pay
    it back, they become honest/ "cash register honest"
       The only thing I can say from here on onthis topic to anyone
    who has any trouble with this reply is:
    
      Lord grant me te wisdom to know what I should say and do, 
    and the discernment to know when I have said enough. 
    
    
    Good Luck 
    
    Me

    
    Alcoholism is a disease.  Once you have, you have it. period.  It
    has more than simply physical characteristics which is why the
    treatment is lifelong.  Simply stopping the drinking does not
    constitute recovery from alcoholism.  That is only first step.
        
    There is a lot of stuff being said here about alcoholism by persons who
    clearly know nothing about it.  They ought to find out what they are
    talking about before running off at the mouth.  If the AMA is satisfied
    that alcoholism is a disease, just what special expertise do any of you
    claim in refuting that?  One might ask you why you are so heavily
    invested in discrediting the idea that alcoholism is a disease. Is it
    hitting too close for comfort? 
    
    Steve
    

    Re: .56
    
    > 	Ah, well then maybe you can tell me why simply starting to
    >   drink consitutes alcoholism.
    
    It doesn't, but I'm not much interested in telling you anything since
    reading your many replies leaves me doubtful that anyone can.
        
    Steve
    

>    It doesn't, but I'm not much interested in telling you anything since
>    reading your many replies leaves me doubtful that anyone can.

	 Well, Steve, then how 'bout telling me.  I have been a silent
	 reader of this note on alcoholism.  And I happen to agree
	 with where Mike is coming from.....  For the benefit of the
	 rest of us poor. misguided souls, could you please tell us
	 more?

	 kath    

    Re: .58
    
    If you're seriously interested then I refer you to the substance
    abuse section of any good bookstore.  You'll find plenty on the
    subject in more detail and more articulately expressed than you'll
    find here.
    
    Steve
    

      Perhaps it should be pointed out that a drup/alcohol abuser is not
      the same as an addict. There are problem drinkers who get drunk
      but aren't addicted to alcohol. Then there are true alcoholics who
      can't drink EVER because of some body chemistry that makes them
      addicts.

      I know LOTS of folks who have done drugs (of many varieties) that
      are working and functioning in society and if you did not know
      their background I KNOW you wouldn't be able to tell who they
      were. That's because they did not become addicts. Now, why they are
      different from the ones that did I can't say. I know people who
      have done acid, finished their college degrees, and work right
      along side their straight counterparts. I also know people who
      haven't used drugs who broke down and couldn't cope with life.
      I think if you have a disposition to be an addict it just happens.
      liesl

    Mike,
    
    
    I am very interested in finding out what books you have.  I would
    like to read the facts and the information that you are reading.
    Please let me know what books these are!!  

	 RE: .59

	 Perhaps you could just summarize it all for me.  I don't have
	 the time/money to go buy all these books at a
	 bookstore...After all, what is Human_Relations for, but to
	 express your opinion!

	 Have at it!  I'm eagerly awaiting...

	 

    re .60 (etc.)
    
    I would be interested in your specific references.  Especially a
    reference for your definition of disease (as in that an organism
    is required).  You've been asked to cite references at least twice,
    and have responded in general terms, while several of those questioning
    your view have supplied sources.
    
    Also, I'm curious about what got you interested in the issue... and
    why you do feel so strongly about your view.  That might help me
    to understand better.
    
    R.
    

    How about a title, author, etc.?

    Thanks...
    

    Re: .63
    
    I did.  Read the first paragraph of .55  What makes you think I
    have any more time to type it all into notes than you have to read
    the books.  What more do you want for nothing?
    
    Steve
    

    I am setting this note no/write for the time being.
    
    The discussion of a definition of the word disease is not in line
    with the base note and is in fact not particularly relevent to 
    H_R.
    
    From my limited information I believe the AMA has classified Alcoholism
    as a 'disease', if this is so I believe the discussion of the
    definition of the word disease would be welcomed in the Medical
    notes file.
    
    Thanks for your understanding and cooperation.
    
    Joyce
    Co_Moderator

I am re-opening this topic, with the request that people stick to the topic
of drug addiction as a disease and the ramifications of that classification,
rather than argue about the definition of the word disease itself.

I'll also remind people that this conference is intended for discussion of
topics about human relations, and that strictly medical discussions probably
belong elsewhere.

Thanks for your cooperation.

				Steve

I've come to this note late and via a round-about way and apologize if 
I'm addressing a dead topic.  I think an important point has been missed 
by most.

I agree that defining "disease" is not the issue and won't get into 
other criteria for that definition.  Classifying alcoholism and drug 
addiction as a disease, however, has import beyond the objection that it 
somehow "excuses" the afflicted individual.

How one classifies a problem in many ways determines how one approaches 
solving it.

Taking the VA's view that alcoholism is "willful misconduct" 
immediately says that criminal behavior is involved (after all, what is 
'willful misconduct' but conscious digression from societal norms-- 
carried far enough, you have criminal acts) and therefore should be 
solved via the criminal justice system.  At the least, no medical 
benefit dollars should be used which, I believe, is precisely the VA's 
goal.

Classifying alcoholism as a "behavioral disorder" firmly puts it into 
the mental health arena and should be solved by psychological therapy.
This route fails to address the observation that well-adjusted and 
secure individuals can also be alcoholics.

Calling alcoholism a disease opens up many avenues for treatment that 
would not otherwise be explored.  Research into causes encompasses not 
only psychological roots but also genetic and environmental etiologies.
Dollars for that research are also readily available.  Treatment is 
multidisciplinary and geared towards restoring an individual to a 
contributing member of society.

The disease classification does not exempt an individual from 
consequences of his actions, drunk or sober.  He may not be responsible 
for having alcoholism but he is very much accountable for what he does 
while afflicted.  The alcoholic who writes bad checks and drives drunk 
is no more excusable than the non-alcoholic who does the same.

One of the Twelve Steps to Recovery as put forth by Alcoholics Anonymous 
speaks about "making amends to others" which is a clear recognition of 
accountability.

The mental health model of "behavioral disorder" appears more likely to 
excuse actions than the disease model.  Most civilized societies hold 
that mentally incompetent individuals are both not responsible and not 
accountable.  The "temporarily insane" defense is a sacred tenant in 
Western jurisprudence.


Re .74:

Three things strike me:

From the article, all one can say is that Fingarette has evidence in 
support of the hypothesis that alcoholism is not genetically linked.  It 
certainly does not prove it's not a disease.

Secondly, the observation of self-control over drinking simply points 
out that aspect of treatment.  Many studies have shown that meditation 
will lower blood pressure but lack of meditation does not cause 
hypertension, a disease.  In that same way, lack of self-control does 
not cause alcoholism.

Thirdly, the furor over the perception of "disease = excuse" is due in 
part by the inability to distinguish between the true alcoholic and the 
individual who occasionally or periodically drinks to excess.  Although 
alcoholism has a disputable cause, it does have a complex but widely 
recognized symptomatology and a predictable course and predictable 
outcome if untreated.  Both may cause unacceptable acts while 
intoxicated and we may think or even know judges who will mitigate in 
favor of the alcoholic but both are equally accountable 
for the consequences.  

The alcoholic actually IS responsible-- responsible and accountable for 
keeping his affliction under control.  The diabetic is also responsible 
and accountable for keeping his affliction under control.  For the 
diabetic, failure to recognize and participate in this responsibility 
places severe psychological strain on his family and places an 
unnecessary burden on the medical care system by constantly rescuing 
him from his dereliction.  The same can be said for the alcoholic.

However unequal the comparison seems, neither of them are responsible 
for having the disease in the first place.

--andy

    >	Some researchers have begun to ask a controversial question:
    >"Are the groups' participants really driven by an uncontrollable
    >behavior that requires lifelong labeling as a disease and therapy
    >group participation?".
    
    	No.  
    
    	The purpose of AA and other so-called "12 Step" groups is
        not, as Peele contends, to "stem the tide of substance abuse."
        
        The purpose of these groups is to help individuals help
        themselves to stop compulsive/addictive behavior.  AA and
        these other programs are the most successful programs
        available at helping alcoholics and others to stay sober and
        sane.
        
        Successful members of AA do not characterize themselves as
        passive victims of disease, without feelings of efficacy --
        nor do they use the disease to excuse their behavior.
        
        It sounds like Peele has passed judgment on these programs without
        fully investigating them.   
        
        					andrew

Re:    <<< Note 702.78 by SSGBPM::KENAH "Healing the Fisher King's wounds" >>>

>        The purpose of these groups is to help individuals help
>        themselves to stop compulsive/addictive behavior.  

	No argument there...

>	 AA and
>        these other programs are the most successful programs
>        available at helping alcoholics and others to stay sober...

	I don't believe this has ever been proven - rigorously or
	not.  There are many paths to recovery.
        

	An excellent recent book on this topic is "Heavy Drinking -
	The Myth Of Alcoholism As A Disease" by Herbert Fingarette.
	Although he lets a bit of axe-grinding slip out now and then,
	this is overall a well written and researched (extensive
	bibliographies are included with each chapter) book.

	Bob

>.78>       The purpose of AA and other so-called "12 Step" groups is
>.78>     not, as Peele contends, to "stem the tide of substance abuse."
>
>	You're reading something that isn't there; Peele never says
>    that is the purpose of AA.
    
This is a quote from the article:
    
    	Peele maintains that the AA formula for recovery is not only
    ineffective in stemming the tide of substance abuse...
    
Sounds like that's what he seems to think the purpose of AA is.
    
					andrew

    One last question -- why is this so important to you, Mike?
    
    					andrew

    Okay -- what are they?
    
    					andrew

    Tourette's Syndrome is behavior, too.
    
    Not all behaviors are controlled.         
    
    If it were just a matter of altering behavior, then AA wouldn't
    be necessary, and cocaine addicts could stop smoking crack simply
    stopping -- it isn't that simple.
    
    I sense a LOT of negative judgment on your part -- a strong sense
    that addicts and alcohols are weak-willed and morally inferior
    because they're controlled by an addiction to a life-threatening
    substance.  Believe me, addicts and alcoholics have strong wills, 
    and many have a strong sense of spiritual values.
    
    Addiction is dangerous and difficult to overcome.  It can be done;
    and if you aren't personally affected by addiction, then may I suggest
    that you let those who are affected use whatever works for them --
    without you passing judgment on their methods.  
    
    					andrew

    You are partially right Mike... It starts as a behavior... but ends
    up an addiction... not everyone is physically addicted however..
    there are those who become psychologically addicted.  Also there
    is evidence now of genetic addiction people who are born to it and
    yes they have found genetic material responsible for it.  In treating
    it, it is treated as a learned behavior because this is the most
    effective method used... however, there is no such thing as a cured
    alcoholic... only a recovering one.  Once you're an alcoholic and
    start the road of recovering you can't go back and expect to stay
    in control later... it doesn't work that way.  
    
    What I really want to know is what difference does it make as to
    what you call it a learned behavior or a diesease or a genetic fault
    in the cromosomes or a psychological disorder in the brain?  For
    every explaination used to discribe it there are others that can
    be used to disprove it.  
    
    Such treatments as Schick offer are behavior modification techniques...
    That doesn't mean that it cures alcohol... it doesn't mean that
    alcoholism is a behavior, it means that to control it, the desire
    for it is replaced by something else.  Weather it is an association
    with pain, a desire to eat a piece of candy or whatever.  It still
    isn't known how effective these methods really are... so far they
    seem to work pretty good but until millions of people go through
    these methods of control and succeed/fail and studies of the results
    are compliled over a much longer period of time... no one can be
    certain if they work or not.  For all we know, tomorrow the first
    people to have gone through the method will be back in the bars
    or hidden in the closet or whatever taking another long pull from
    a bottle.  
    
    I'm not arguing with anyone... I've slipped in my views and asked
    the question of what difference the terminology makes so long as
    the selected method of cure works?
    
    Also... My grandmother was a alcoholic (recovering) I asked her
    about it once... she said that she craved the booze the rest of
    her life... and when she knew she was dying in the hospital asked
    my Grandfather to pour her a shot.  She died shortly after having
    her last drink.  If it's a behavior then after a while once it's
    been modified (behavior modification takes approximately 6 months
    in a worse case example) then the craving would have gone once the
    modification were complete.  
    
    In her case... she lived with the craving for the rest of her life.
    I don't know much about when or how she started, but it seems that
    it may have started as a behavior response at first that became
    and addiction and the powers that decide what is what have decided
    that addiction are a diesease.  I don't necessarily by that, you
    don't treat it like a diesease... but I don't by the behavior either.
    
    So what do you call it?  Again, like I said... what does it matter?
    So long as there is a treatment for it?
    
    For me, I simply leave it at "An addiction"
    
    Skip
    

    Mike,
    
    	It's funny how I often find myself agreeing with you in so many
    different conferences  :-)
    
    One of my observations regarding addiction treatments is the
    replacement factor.  Of all the people I know who are in AA (and are
    currently controlling the addiction) well over half of them are
    addicted to AA!  By this I mean that they display classic withdrawal
    behavior when "to much" time goes by between meetings.  I find that
    this is almost a transference of the addiction from a socially
    uncacceptable on to an acceptable one.  
    
    This is interesting in light of the disease/behavior discussion.  
    
    Sue
    
    P.S.  My family has rampant alcoholism...some controlled, some not.  I
    speak from experience.

    Re .89: 
    
    >       ... if addiction is a disease, how come some people can
    >    cure themselves with willpower?
    
    Alcoholics do not cure themselves, with willpower or anything else.
    
    Alcoholism, whether it's clinically a disease or not, is *NOT* the act
    of drinking too much; it's the desire/need/compulsion to drink.
    [Drastic oversimplification here.] What AA helps people to do is to
    control the symptoms, not "cure the disease" - they admit themselves
    that it isn't ever cured. (Sure, there may be people who can change
    from uncontrolled drinkers to controlled drinkers, and some of them may
    even be alcoholics, but when you've got a built-in weakness for booze
    it's dangerous to run such risks. I've talked to people who've had
    their lives come to the brink of destruction because of their drinking;
    to even suggest to them that, after a few years of sobriety, they ought
    to be able to handle a beer, seems awfully cold.)
    
    I agree that some people have a tendency to use the "it's a disease"
    argument to mean "so it's not my fault AND I CAN'T DO ANYTHING ABOUT
    IT", and for that reason I've never been crazy about the "disease"
    theory myself - heck, I don't even like hearing mental illness used as
    justification for criminal behavior! But it seems clear that some
    people are more vulnerable to the effects of booze than others, and
    until they've learned the difference (which can be hard to do in a
    society that equates the ability to hold your liquor with adulthood),
    they won't realize that they need to work harder to control themselves.
    
    From what I've seen and heard, one of the biggest advantages of AA is
    that it helps people to admit that they have a problem, and to
    recognize that they need help to control it. Sounds simple to those of
    us who aren't addicted to anything, but it can be a revelation to those
    who are. 
    
    -b

re: .89

    
>	Skip, if addiction is a disease, how come some people can
>    cure themselves with willpower?

    Many diseases cannot be cured, they can however be controlled with
    proper treatment (asthma, compulsive behaviors, epilepsy, heart
    disease)...
    
>	This is a fundamental question that should make it clear
>    to you that compulsive behaviors like using drugs, even being
>    addicted to them, is not a disease.

    Again, how do you tell cure from control.  I've heard several
    alcoholics admit they often think about drinking, have nightmares about
    drinking, fear alcohol even as they attempt to embrace it as the social
    skid-greaser the rest of society does.....even if the alcoholic is
    under control.....
    
>	Willpower and restraint do not cure diseases.

    Right.  They control them.
    
>	It's a *fact* that many people can go from out-of-control drinker
>    to in-control drinker.   I've SEEN it with my own eyes.  Until then,
>    I would never have believed it.

    Yup.  And gambling addicts can be reduced to slot machines where they
    only lose a couple of bucks.  And compulsive eaters can control their
    behavior such that they do not weigh 300 pounds.  I believe they are
    controlling their problem, not curing it.
    
>	It's too bad that what I think is the obvious truth is not
>    readily accepted.  It's about time the medical community stood up
>    and said it was AA who claims that alcoholism is a disease, not
>    the AMA, and AA is plain wrong.

    I think it's too bad you're not listening to all those doctors.  I
    think some of them must have a stronger research background then you. 
    I accept it's your opinion, but I feel that the AMA and the AA have
    more evidence for their cases, and a great deal more data.
    
>	Have you any idea how many people stop drinking, dry out,
>    and attend AA meetings, only to later fall right back into episodes
>    of uncontrolled drinking?

    Gee - relapse of a disease huh?  If they were cured as you said, this
    would never happen.....
    
>	By the way, one of the founders of Edgehill in Newport was
>    in the newspaper recently - his drinking is out-of-control again.
>    This man had access to one of the best, most successful facilities
>    in the area (he worked there full-time) yet here he is, back to
>    drinking heavily and out-of-control.
    
    Again - relapse of the disease.  It is NOT curable.  It CAN be
    controlled with effort and proper treatment.  
    
    -Jody

re: .93
    
>	If they say "alcoholism is not a disease, but a behavior", will
>    you listen to them?
    
    Yes.  If they find the reverse, will you?
    
    -Jody

.89
    Mike... 5 years ago a psycologist issued a statement that he found
    that some alcoholics could in fact return in complete control to
    drinking.  The results of his statement were terrible.  He did not
    say that in his study .1 percent of recovering alcoholics were able
    to do this.  Further as I said, there is physical addiction to 
    alcohol as well as mental or psycological addiction.  
    
    .90  you have just stated the idea of behavior modification... which
    I said is one method of treatment.  They have replaced the behavior
    of drinking with the behavior of attending AA.  It is now there
    "addiction" and serves as an alternative to alcohol. 
    
    Further, I've seen several people who have "controled" there drinking
    with sheer willpower myself... I don't say it is an impossibility.
    But of those people who do it, I've seen them go through a LOT more
    hell of learning how to do it then those who have gone out and found
    help in what they try to do.  One reason is because these "self
    motivated" people do not know what to do and go about it by trial
    and error.  Groups such as AA have worked through the different
    methods and can show the person the methods that work best, most
    effectively and quickest, plus give the psychological support that
    a person using the "self help" methods won't or may not get.  Add
    to that the support of people who have already gone through it and
    you tell me which is the better method?  I never said it was impossible
    to cure oneself.  
    
    I had an aunt who was a heroin addict... she cured herself.  She
    had my Uncle lock her in there basement with a slot cut in the door
    so she could take food.  The basement had a small bathroom so she
    could take care of herself.  
    
    She lived in that room for three months while her addiction was
    "kicked" and never touched the stuff again.  Although she has 
    discussed the nightmares and such of living that way for three months.
    
    There are methods for kicking a habit and there are prefered methods
    for kicking a habit.  
    
    The easier and quicker someone can go through it... the better it
    is in the long run, and the more likely they will stick to the 
    program of not doing it again.  
    
    Further... who's to say maybe you have seen it in the past maybe
    it lasted for the period of time you saw it happening... but how
    many of these people are still in contact with and can you be so
    certain that they havn't gone back on the bottle again? For that
    matter... you say you've seen it but how many people are you talking
    about?  Something else to consider, of those people how many where
    physically addicted (harder to kick) and how many were psycologically
    addicted?  For that matter how many people are you speaking of?
    1? 3?... 24?  enough to be documented as scientific fact?  Or that
    .1 percent that has been acknowledged to exist?
    
    Skip

    Yep, what I am saying is behavior modification.
    
    Read that again.  *BEHAVIOR MODIFICATION*.  I can't think of a disease
    off the top of my head that one can control through a change in their
    behavior.  I know a couple of cancer patients who would like to, tho...
    
    Sue

    Yo Mike, what is the big deal about this disease and behavior thing. 
    What do you care?  The last time I saw you in the H_R party, you didn't
    bring any booze but Perier (with a taste worse than any cheap booze). 
    Therefore, I absolutely and positively identify Perierolism as a
    disease.  I mean why would any healthy person drink that stuff?  I do
    buy a lot of bottled water, but that is a behavior.  Of course, there is
    always the slight chance that I am a bottledwaterolic, but I absolutely
    deny that.  That may qualify me as a denyholic.  
                                
    Tell ya what, some people get hooked on this CH3-CH2OH thing, and the 
    important thing is to get them help.  Does calling this thing a disease
    or a behavior really make any difference?
    
    Eugene

    .96... there is substantial proof that you are wrong right down
    to the bit about cancer.  They are modifiying behavior with cancer
    patients all the time these days by getting them to actively tell
    themselves that they can fight the disease.  They've found conclusvily
    that by modifying the behavior of giving up when you are pronounced
    incurable you can actually extend and in some cases bring it into
    a state of remission by inforcing the thoughts that you can cure
    the diesease even though it is incurable.  They've found that those
    patients who chose to fight it mentally as well as with the medical
    technology available today to help bring it into remission, have
    a longer life span over those who simply accept that they have cancer
    and are going to die.  In some cases mirical cures take affect and
    the only thing in common in each of these instances is a positive
    affermation within the person that they WILL get better.  This is
    behavior modification!  It works in every diesease known, they don't
    claim it works 100 percent but in a large majority of cases by
    conditioning the patient to believe they can be cured they have
    found that the recover faster from most diesease that are treatably
    cureable, That of those dieseases that can not be cured, by affirming
    that they can extend there life in a postivie way, they do! As compared
    to those who give up and decide they are simply going to die.  
    
    There are theories as well as studies that show that behavior
    modification can by changing a persons outlook about diesease..
    Create a healthier person over all.  Decrease "sick time" when a
    person does become ill, recuperation time can effectively and
    noticiably be decreased.  So lets see... 
    
    By modifying a persons outlooks about how they feel toward a
    pronouncement of a diesease... they can live longer be healthier
    and in some cases even cure themselves... simply by modifying there
    beliefs of how the diesease is affecting them.  In fact in treating
    cancer now a days behavior modification plays a BIG roll... I know,
    my sister went through it as well as my mother.  My sister's cancer
    was pronounced incurable... 11 years ago it went into remission
    and has not reaccured since, her doctor has said that for all intents
    and perposes that even if it should recure at this late date, she
    will more likely die of old age now then from the cancer itself.
    
    My mother wasn't as fortunate, she had a form of cancer that was
    found all through her blood stream.  The doctors gave her 2 weeks
    to three months to live once they found it, she took chemo therapy
    for 8 months after that pronouncement and continued to live an
    additional 4 months after the chemo stopped having any affect. 
    The funny thing about it is my mother's attitude changed shortly
    before the chemo stopped taking affect, she got tired of the
    treatments.  And although there is no evidence to prove it the doctor
    admitted the same thing.  Once you get tired of it, once you give
    up on it, it doesn't take long.
    
    So don't claim that behavior modification has no affect on diesease...
    it is a documented and proven fact to be just the opposite.  I admit
    that they are still studying the effects I've stated.  But... they've
    come far enough along in there studies to admit that a positive
    attitude has a positive effect in dealing with any diesease.  And
    if you modify a persons thought habits... that's behavior modification.
    
    Skip

    I have to agree with Skip on this one. I'm reading more articles all
    the time that equate a positive attitude and the willpower to survive
    with an increased chance of surviving diseases such as cancer. My
    personal opinion, and I've watched a lot of people dying in my previous
    career, is that it works. It's nowhere near 100%, and it's damn hard to
    prove, but I believe it works.

    Given the results that are comming out about how certain emotions and
    actions cause various chemicals to be released in our bodies is it so
    hard to believe that everything can't be black and white? If the fuzzy
    science of pschology can be found to have some basis in chemical fact
    is it so hard to accept that we might not know a disease from a
    behavior? Or that it might not make a difference in the cure? liesl

    re: .98, .99
    
    State of mind and mental attitude are not the same as behavior.
    
    re: discussion in general
    
    I suspect part of the disagreement over whether alcoholism is a disease
    arises from different concepts of disease.  It might be useful useful
    if the participants in the debate attempt to agree on a definition of
    the term disease before considering whether the definition applies to
    specific conditions.
    
    re: alcoholism as a disease
    
    I think it would help if the participants in this debate would first
    come to a common understanding of what a disease is before attempting
    to decide whether the definition applies to a specific condition.

    No but changing ones mental attitude and state of mind is behavior
    modification.
    
    The tendancy for one to simply give up when they are pronounced
    as incurable is a strong behavior pattern in many cancer patients
    By inforcing the drive of a will to live and continuelly inforcing
    the "I Will Get Better" attitude, you are modifying the behavior.
    And the technique rather accurate or not is called behavioral thinking.
    
    These are the words used to explain the reason for psychological
    treatments used when my sister was getting her cancer treatments
    by her doctor.  We were instructed to modify our thinking to inforce
    and modify her's.  We had to say such things as "When you get better
    we will...." instead of the natural tendancy to say "If you get
    better we will..."  These are behavior modifications.
    
    Skip

         Ya know, your logic seems valid, Mike.  You are, however, going to
    PO a few people. 
    
         ...but you make sense.
    
                                        Greg

    
.100>    State of mind and mental attitude are not the same as behavior.
    
.101>    No but changing ones mental attitude and state of mind is behavior
.101>    modification.
    
    If X and Y are not the same, then changing X is not the same as
    changing Y.

	Well, this is interesting. The old "tis a disease - tis not" debate.
Let's see, going by strict definition of the standard issue A.H.D., "disease"
is defined as a *condition* of [someone] that impairs normal physiological
functioning. You get glaucoma (the condition) and you cant see (the impairment
of physiological function). Glaucoma is therefore called a disease.

	Now, stretch your imagination a little and substitute the word 
"psychological" for physiological in the above definition. Certainly, full
psychological functioning is an important part of being a wholly functional
Human Being and any impairment of that is clearly a dysfunctionality on some 
level. Considering this, it's easy to comprehend the condition of Alcoholism
as a disease. Unless of course one believes that consuming alcohol has no 
effect on the Human psychological function in terms of "impairment". (Makes
it work *better*, right? None of those nasty "feelings" around to bother 
with! I've become "comfortably numb", as the song line goes...) 

	Disease, BTW, simply means "ill at ease" and may be applied in either
the physiological or psychological context - both of which are necessary,
both of which need to be in a healthy state, for someone to be "all together"
or whatever. In calling Alcoholism a disease, some modern day thinker has simply
included the psychological context in the standard definition.

	Not to tough to accept for me.

	Joe Jasniewski

 Ahhhh... skip it, this is a redundant argument until the study mike
    mentioned is over with anyhow.  Then the AMA who is supposedly the
    experts here will give a once n' fer all on what it is... will at
    least until the next time someone decides to try and classify it.
    And by then the rules will have changed and so will the definitions,
    as to what is and what isn't a disease... And to be complete honest...
    I've also heard Alcoholism called and illness, and a sickness...
    which is not the same thing as a diesease.  At least, that is, not
    by the apparent definitions being used for such in this argument.
    
    And as far as I can tell... we can beat the dead horse all year
    and not resolve anything herein.... 
    
    H. Beam Piper, in his short story "Ooomphel In The Sky" made a
    statement that would apply here...
    
    "What is the truth?....My Semantics Prof had the start of an answer.
    He defined truth as a statement having a practical correspondance
    with reality on the physical levels of structure and observatin
    and the verbal order of abstraction under consideration."
    
    "He defined truth as a statement.  A statement exists only in the
    mind of the person making it, and the mind of the person to whom
    it is made.  If the person to whom it is made can't understand or
    accept it, it isn't the the truth."
    
    "....It doesn't matter how conclusively you prove anything, if the
    person to whom you prove it can't accept your proof emotinally,
    it's false.  Not-real."
    
    Which is about where we seem to be here... no one can accept anyone
    else's statements emotionally so no truths are being established.
    
    Anyhow... that's all I have to say on it... if y'all wanna continue
    the arguement... do so with my blessin's but don't expect me to
    carry it any further... my arms tired from swinging the stick...
    :-)
    
    Skip

  RE:  Several previous replys


  It's amazing and sometimes amusing to see the direction that this
  discussion has gone.

  I do voluntary work with adolescents who are in recovery programs and 
  at one of the meetings, I heard someone who had several years of sobriety
  under their belt say the following and it really hit home:

  "A.A. does not teach people how to handle their drinking--It teaches 
  them how to handle sobriety."  

  Now looking at the above statement, I can see that it fits into every 
  12-step program that exists.  CA, OA, NA, SAA, DA, etc. etc.  These 
  programs are helping people to deal with reality as today's society 
  defines it! 

  I know people who have "just stopped drinking" and they are miserable 
  as hell because they have not or can not find happiness in sobriety.  This 
  is what they call a "dry drunk".  Many people have quit drinking but are 
  they really happy?  Until the alcoholic can find his/her innerself,
  an alcoholic is never happy even though they may appear to be.

  Why not go straight to the horse's mouth and ask an alcoholic if they feel
  that they have a disease or a behavioral problem?  Go to some open meetings
  and listen.  I'm sure your local A.A. chapter would be able to point you
  to some open groups.  It's amazing what one can pick up and begin to
  understand about an alcoholic life.

  It was mentioned earlier why can some people who were compulsive drinkers
  transition to become social drinkers?  Tell me, what does *society* consider
  to be a social drinker?  Someone who can have a glass of wine once a year at
  an anniversary or someone who goes out with the crowd every Friday 
  afternoon after work and has a couple of brews?   From what I have learned
  working with these groups, is that NOT ONE PERSON can go from being a 
  compulsive drinker to a social drinker.  Once the body and mind have
  reached that level of expectation, it will not settle for less.

  I myself believe that alcoholism is an illness coupled with a disease.


  Thanks,

  Kenn

Re: <<< Note 702.110 by CSC32::K_JACKSON "The only winning move is not to play" >>>
                              -< As I see it... >-
>  "A.A. does not teach people how to handle their drinking--It teaches 
>  them how to handle sobriety."  

To a point...

>  I know people who have "just stopped drinking" and they are miserable 
>  as hell because they have not or can not find happiness in sobriety.  

And I know first hand people that have years of sobriety in AA that have 
never grown emotionally.  AA helps folks get sober - if they are 
motivated to do so - but doesn't necessarily guide people to uncovering 
and dealing with whatever emotional demons fueled the drinking in the 
first place.

And now to main reason for replying:

> From what I have learned
>  working with these groups, is that NOT ONE PERSON can go from being a 
>  compulsive drinker to a social drinker.  

According to the book by Herbert Fingarette that I cited previously, 
what you have learned is wrong.

Please note, that once a preson gets into the physical addiction stage 
of alcoholism, then there is no going back.  The body's defenses are so 
broken down form abuse that it can no longer handle the poisoning.  From 
here on continued use of alcohol is fatal.

Bob

	
    	Mike,
    	
    	No, drinking Drano is not a disease, but its a symptom or 
    manifestation of a disease called mental illness because emotionally 
    healthy people simply would not do that kind of thing.

    	Someone's propensity toward self destructive behavior via any
    one of the well known "ism"s is a discernable condition. As such, it
    may be called a disease when it's clear that impairment of otherwise
    normal - let's say, emotional - functioning is the result. 

    	Why cant a "disease" be entirely psycho-cybernetic in nature,
    based entirely on someone's personal "programming" if you will?
    Does a disease necessarily have to be some creepy/crawly thing that
    invades one's body, or based on some genetic anomaly to be a disease?

    	Why do you feel that ascribing personal "fault" is so important? 
    I mean, if Alcoholism is considered a disease, then it's no one's
    fault that they're an Alcoholic, any more than it is their fault
    that they caught a cold last week. Yet I feel that you want to be
    able to say "You just didnt try hard enough!" or "You chose to be 
    this way" or "You have no willpower!" to someone.
    
    	Part of recovery from Alcoholism is the realization that it
    is a disease, which allows one to realize in turn that, as such,
    "my will alone is powerless against it". Perhaps the probability
    of someone accepting this particular tenant has as much to do with
    the low percentage rates of recovery as anything else. Human Beings
    are *very* willful in nature and most simply wont accept that they
    cant do whatever they want, however they want to by sheer strength 
    of determination alone.
    
    	Most of these folks are also the one's who are quick to say
    "well it's your fault - you didnt try hard enough - you didnt think
    ahead - you didnt do something right" to someone else, when that
    someone else is *psychologically* impaired.
    
    	Joe

I am seeing a lot of repetition in the notes here.  I'd like to ask that people
refrain from replying further unless they have something NEW to say.  Simply
repeating previous assertions is not sufficient.

I'd also suggest that those interested in arguing about the definition of
"disease" might consider taking it up in the HYDRA::MEDICAL conference.

				Steve

    Is this something new?
    
    I don't really care to define alcoholism, although I spent (or wasted)
    a lot of time over the question a few years ago.  As a non-alcoholic in
    one more dysfunctional family, I choose to think of (not define) 
    alcoholism as a disease.  When I do so, I am kinder to myself, and to the
    addicts in my life.
    
    aq                                                                    
    

    
    but how did they feel afterwards?  I've heard many smokers either can't
    stand the smell of smoke, or crave it - but they are never unaffected
    by it.  There is some residual affect of having been addicted - some
    residue from the nicotine-addicting disease they share....
    
    -Jody
    

    Just say no to drugs.
    
    		-mike z

     
    Re .118
    
    Just from my experience Jody, I didn't like the smell of smoke when
    I'd stopped. I'd brazen it out with "No REALLY I don't mind" because
    many of my friends still smoked and I didn't want to make them
    uncomfortable with me. But in the long run I believe that I would have
    stayed off the darn things if I'd stayed away from other smokers more.
    
    It was a real surprise to me when my sense of smell clicked back in
    (after about a week). I hated the smell of smoke and smokers.
    They do say that there's none so anti-smoking as a reformed smoker.
    They also say that there's no such thing as an ex-smoker - only a
    non-practicing one ;-)
    
    'gail (whose been off cigarettes - and on - and off - and on....)
                          
    

    
    	Well, Mike, I still dont know what your motivation could possibly
    be, to be seemingly so against some of the basic tenants of the
    "anonymous" programs. I mean things like viewing alcoholism as "a 
    disease for which there is no known cure" and perhaps even the idea 
    of "a power greater than yourself" (which of course implies that you 
    cant do it all on your own)
    
    	Maybe you just firmly believe that there is no power greater than
    one's self...and that's basically _all_ someone has to work with?
    
    	I can easily argue, if I may, that comparing cigarette's to
    beer is really an apples/oranges comparison. Yes, each contains
    an addictive chemical, and the addictive strength of each may be
    quantified. You can set looosy-goosy terms like "more strongly"
    beside one other on a piece of paper, compare them and easily draw 
    an erroneous, naive conclusion.
    
    	I say naive because one who knows something about these chemicals
    knows that their corresponding strength of addiction is *not* the
    only attribute that effects some person's ability to stop using
    them, and recover from the condition.
    
    	For example, alcohol is much more effective as an anesthetic
    than is nicotine. You could supposedly do an appendectomy on someone 
    using only alcohol as an anesthetic, and this is simply not true with 
    nicotine. The two are quite different.
    
    	Now, I ask you to stretch your imagination a bit. Simply 
    replace the word "physical" in the definition of anesthesia with
    psychological (or emotional), while considering alcohol as an
    anesthetic. It's easy to see that alcohol can also cause one to lose
    or partially lose their "emotional sensation", that is, alcohol
    can be viewed as an *emotional* anesthetic.
    
    	Nicotine is also an emotional anesthetic, but compared to alcohol,
    it's effectiveness as such is about the same as it's effectiveness
    would be as an anesthetic for an appendectomy! Many people can abuse
    cigarettes and still pretty much fully function emotionally, while
    this is simply not true with alcohol. With alcohol, one's emotional
    functioning is severly impaired, because it's been quite effectively 
    anesthetized.
    
    	I trust that you can understand the impact that a psychological 
    impairment could have on one's ability to do anything all on their own.
    
    	Joe
    

  RE:  .122

  Wish I could have said it as nice as you did...


  Kenn

    But Mike, you haven't said anything about more effective treatments --
    
    Why don't you talk about the alternative?  Assume that alcoholism
    does get classified as a condition other than a disease.  What kinds
    of treatment do you feel might effectively treat it, based on that
    assumption?
    
    					andrew

<	Mental exercises, diet changes, habit changes, drugs that ease
<    ease the depression associated with the crash (eg: methadone for
<<    heroin addicts) or that interact with the alcohol to fight the
<    "high".
    
        Now this is something I've been wondering about in regards to
    things like drug addiction. Why is it so all fired important to deny
    people a "high"? I just read an article about a possible medicine that
    could replace marijuana's medicinal uses without the high and the
    medical drawbacks. From the way they were talking this could have also
    kept the high, and why not?

    If there was a safe drug that was physically non-addictive but produced
    a high, I bet the "authorities" would still be against it. Why is it
    considered so dangerous for us to feel good this way? I know many
    people that have used, but not abused, recreational drugs and they are
    as successful in life as others I know who have never used drugs.

    I think there are some people who are natural "addicts". I mean,
    really, people get addicted to running for god's sake. They get
    addicted to vomiting so they won't gain weight. Now I'm hearing about
    kids drinking cough suryp, how far can we go in banning things? liesl

    >	Dissecting the behavior so that it is understood is a start.
    >
    >	Mental exercises, diet changes, habit changes, drugs that ease
    >ease the depression associated with the crash (eg: methadone for
    >heroin addicts) or that interact with the alcohol to fight the
    >"high".
    
    But -- but -- that's what's *already being done*!!!
    
    These are exactly the procedures that alcohol and drug treatment
    facilities use, and these are also the procedures used within 12-Step
    programs to help alcoholics and drug addicts deal with the physical
    parts of their addictions.
    
    So what's different about your method?
    
    					andrew

    Mike,
    
    "9 out of 10 ... "
    
    How about giving us some numbers; what was the sample of this study?
    100, 1000, 10000 people?
    
    You are not giving us much information.   What stage
    of addiction were these people in; psychologically dependent, 
    physiologically addicted? Just as some drinkers can go a life time without 
    becoming
    physiologically addicted, so can smokers.  where the line is drawn
    between the two, I'm not really sure, but I am sure that those who have
    not reached the point of physiological addiction, very well may be able to
    cease smoking or drinking on their own.  Does the study you are
    refering to address this issue?
    
    Second, As with all addiction therapy( for those who went beyond the
    psychological dependence) counseling and therapy is a relatively new
    field.  Addiction is no longer simply reducible to obsessive-compulsive 
    behavior.  Reductionist theories just will not apply, for either side
    of the argument.
    
    I'm not sure who posed the question about "ex-smokers" but I do
    consider myself one.  I have no, nor have had since quitting, desire to
    light up again.  Not even the slightest urge.  And since i had smoked
    over three packs a day for the last several several years of the twelve
    year span that I had been smoking, the probability was high that I was
    physically addicted. I couldn't have stopped without having been given
    an "offer I couldn't refuse, " by my father at the time.  his offer
    gave me the incentive to quit.
    
    
    
    Ernie                         

    re: .128
    
    Personally, if someone wants to abuse their body whether it's excessive
    drinking, smoking, doing drugs, overeating, or self-purging, as long as
    they keep it to themselves, it's their business.  Unfortunately, we have
    people driving and operating machinery under the influence.  We have
    people with uncontrollable behavior once becoming "high".
    
    Then there are the costs...rising insurance rates, products costing
    more to make up for lost employee hours, etc.  So I guess in the long
    run, the private cost of getting high does affect others.
    
       - Larry 

Re:            <<< Note 702.132 by QUIVER::STEFANI "Turn it on again" >>>

>    Then there are the costs...rising insurance rates, products costing
>    more to make up for lost employee hours, etc.  So I guess in the long
>    run, the private cost of getting high does affect others.

The same thing can be said about skiing, jogging, driving a car, using 
the tub/shower, traveling by airplane, playing softball, being a total 
couch potato, aerobics, getting a sun tan....

Bob

re: .131

>	Even though I believe people can stop any behavior when they're
>    ready to, with just willpower, I still realize that the task is
>    formidable.
    
    I think for some, quitting an addicting substance is like trying to
    stop breathing.  It has become such an integral part of their life they
    have trouble imagining life without it, let alone actualizing the
    reality of life without their substance.....
    
    -Jody

    re: .133
    
    Bob,
    
       I'm talking about employees that are even partially-stoned when they
    go to work or out on the road.  They are costing businesses
    mega-amounts of money, which then turns into higher prices for you and
    me.  If someone stayed home every weekend and smoked a few joints, it
    wouldn't make any difference.  If getting high is worth the health
    effects of smoking marijuana, more power to 'em.  As long as they're
    straight when they leave the house, fine.
    
       Personally, I don't see the big thrill of getting high through
    chemicals.  Go skiing, hangliding, or go a roller coaster ride.  There
    are plenty of natural ways to get a rush.  It may not last as long, but
    it's definitely more fun.
    
       - Larry
                  

    
    	Re .124, I understand that you're displeased with the success
    rate of the methodology that assumes the disease theory used for 
    treatment of these conditions (I've heard myself that it's around
    20%) and you're set out to show that much higher rates (around
    90%) are possible via treatments based on a different methodology.
    Specifically, ones that do not adhere to the disease theory, more
    specifically, ones that show success via "self will".  Correct?
    
    	Perhaps "self will" is the very factor that drives the apparently
    poor performance of the "anonymous" programs. I realize it would take 
    a _very_ open mind to consider that. Perhaps the 80% that fail to
    stop are those who simply "think they know everything" and are so 
    close minded.
    
    	Re .126, Cocaine is also a stimulant, but functions quite well
    as an "emotional anesthetic"; it's biggest attraction is that it
    makes you feel good, not so much that it keeps you awake at night...
    
    	Re .127, The people who are in an "anonymous" program are those
    who have tried all the other methods and found that they do not work
    for them. Your apparent self willed, "stiff upper lip" prescription 
    has typically already failed those who find success elsewhere.
        
    	Re .128, Why is it so fired important for people to have some
    "powdered happiness" available to them? It's considered dangerous
    for people to feel good that way simply because if there's an easy
    way around a problem, a lot of people will take it - even though
    that may not be the most healthy or psychologically progressive choice.
    
    	Consider that someone has a real "attitude", born from a previous 
    life event, and they have two choices: they can snoot up this stuff 
    and the "attitude" goes away, or they can face and accept the previous 
    life event (devastating as it may have been), work through their
    feelings about it (difficult as that may be) and do some growing 
    emotionally for themselves. If some "feel good" substance is easily 
    available, which choice do you think is most easy for people to
    take?
    
    	Re .130 - it's oftentimes a very caring "offer you cant refuse"
    that gives someone the incentive to quit.
    
    	Re .131 - As I mentioned above, some programs of recovery consider
    "self will" to be the antithesis of how that program works. You
    admit you're powerless against your condition. It may be precisely
    those who cannot accept this on faith, who have to do it "their 
    way" or do what "they think" is best, that fail in this type of
    program.
    
    	They dont realize that their best thinking and their best willed
    efforts got them where they are already. Of course, as in all things, 
    there are exceptions. I know a couple...
    
    	Re .132 - Unfortunately, we have people maintaining addictive
    and emotionally dysfunctional conditions for their entire lifetime, 
    during which the task of recovery is passed on to their children, if 
    they have any. If you have trouble with the disease concept, try this 
    one on: It's a multigenerational disease, and stays alive by traversing
    the generations in someone's family tree.
    
    	Re .134 - It's more like having the addictive substance's effect
    as such an integral part of their *psyche*, that not only do they
    have trouble imagining life without it, they're _incapable_ of
    actualizing the reality of life without it. The effect has become
    part of who they are, how they are known and what their life is
    all about.
    
    	Imagine the fear in someone who has anesthetized how they feel 
    for years, of what it'll be like when all those feelings come
    back after the drug's effect has been removed! They wont go near
    the idea and are quite powerless to stop their maintanence of that
    effected condition. They'll maintain it - typically - at the expense 
    of all else and by whatever it takes. They are effectively paralyzed 
    in their current state. *They dont even know* why they cant stop...
    
    	Joe

Mike'
    Somehow I overlooked the actual numbers the first time I read your reply. 

If the study you read didn't address the issue or clarify whether the people 
contacted were psychologically dependent, or truly addicted, it overlooked a 
very important point.  Behavior and addiction are not synonomous; yes, they 
are highly inter-related and the behavior may lead to the addiction but they 
are not one and the same.  What once appeared to be a simple behavior now is 
complicated by the physical addiction.  

And here is where the problem might lie.  What appears to be a simple behavior 
of taking a drink or lighting up a cigarette which may lead to an addiction, 
is really a very complex cognitive (at the least) process that resolves itself 
in that particular behavior.  It is difficult to get past the reductionist 
idea that implies that all one has to do is change the behavior and that will 
end the addiction.  As I stated earlier, I, myself don't like the idea of an 
adiction based on a disease model.  But until the "personal" relationship 
between the substance and the addict is broken- and this applies to any 
addiction-help is not possible. My instructors, who are practicing  
psychologists, admitted that because of what little we know about addictions, 
they not as successful in helping the addicted person become a functioning 
member of society. Also, the characteristic progression of Alcohol addiction 
and cigarette addiction, have quite different natures, although they may have 
similar stages; The fact that alcoholism requires many years, of drinking, 
compared to cigarette addiction, the epidemiology of each is quite different.  
From this aspect, it may be inaccurate to compare the "self-cure" rates of 
cigarette vs alcohol addiction even if the study you referred to is accurate.

The "Guidepost" which is put out by the American Association for Counseling 
and Development (AACD, of which I'm a member) has an article titled:  "Sex 
Addiction: Pros and Cons of the 12 step treatment Fuels Controversy."  This 
must be one of the longest articles I have seen in the paper.  The article 
ends with the paragraph in reference to the controversy between counselors and 
12 step advocates:

"We need cooperation and dialogue," Carnes stated. "To just get polemic 
doesn't help.  We need to get together and say 'This is what I'm seeing. What 
are you seeing?' That's the only way to help us help others who are trying to 
develop healthy lives."


Ernie
                                                        

    I borrowed this article form a frined of mine... I find it applies
    to this note and some of the vague refrences made here in.  It's
    a long article and I will be trying to summerize some of it.  But
    I won't be able to get it all in one note so I'll be entering it
    in "chapters" here as I get time.  I will refer them each to this
    note as a continuation.  You may want to wait until reading the
    entire thing before making any comments.
    
    New York Times, 26 June 1990, Science Section....
    
    SCIENTISTS PINPOINT BRAIN IRREGULARITIES IN DRUG ADDICTS
    
    ------
    Researchers seek treatments to alter chemical imbalances
    -----
    by Daniel Goleman
    
    -----
    Checmical Problems In the Brain-Brain activity, including emotion,
    depends on electro-chemical messengers called neurotransmitters
    that move from nerve cell to nerve cell.  Receptor defects or other
    problems may cause excesses or dificiencies.  Some addicts may take
    drugs (alcohol is included as a drug in this article) to repair
    brain chemistry.
    
    Source: "Drugs and the Brain," by Solomon H. Snyder
    
    ------
    
    A radically new approach to fighting drug abuse is emerging from
    discoveries of brain irregularities that make certain people much
    quicker to become addicted than others, and much harder to cure.
    
    For several years, scientists have suspected that at least some
    drug addicts suffer imbalances in brain chemistry that make them
    vulnerable tto depression, anxiety or intense restlessness.  For
    such people, addiction becmes a kind of self-medication in which
    drugs correct the chemical imbalance and bring a sort of relief.
    
    Now researchers are beginning to identify the particular imbalances
    associated with addictions to particular drugs like cocaine, heroin
    or alcohol.  Because scientists believe many of thses imbalances
    are inherited, they are seeking to identify genetic markers and
    other evidence, such as behavioral signs, that indicate a person
    is vulnerable.
    
    Eventually, scientists say, this research will result in an entirely
    new strategy for fighting drug addiction:  early identification
    of those most prone to a specific addiction and specific treatments
    to correct the chemical imbalances implicated.
    
    The new line of research is generating rising enthusiasm amoung
    Federal health officials.  The Alcohol, Drug Abuse and Mental Health
    Administraiton increased its support for studies on the genetic
    and biological basis of alcoholism alone to $53.5 million in the
    fiscal year l991, up from 41.7 million in l989.
    
    "We already can breed lab animals with these irregularities who
    selectively crave opiates or stimulants." said Dr. Frederick K.
    Goodwin, administrator of the agency.  "There's a direct analog
    to humans." 
    
    No one can yet say precisely what portion of addicts have the
    biological patters.  Dr. Goodwin estimated that a third to half
    of those addicted to a given drug may have genetic susceptibilities
    to it.
    
    The biological approach took a big step forward in April, when
    researchers reportedthe identification of a specific gene that may
    play a key role in some forms of slcoholism, as well as in other
    addictions.  Of the alcoholics they studied, 77 percent had the
    gene.  The discovery, announced by researchers at the University
    of Texas and the University of California at Los Angeles, is for
    a gene linked to the receptors for dopamine, a brain chemical involved
    in the sensation of pleasure.
    
    Such discoveries, scientists say, herald biological markers that
    may one day make possible early identification of those most at
    risk of becoming addicted, allowing more effective prevention or
    treatment.
    
    Skip

    
    	re .137 - Funny, how the counselor's need for "cooperation and
    dialog" and the exchange of perception is exactly what goes on
    already at the "12 step advocates" discussion meetings!
    
    	The "only way to help us help others" *is* the way "12 step
    advocates" are currently helping each other to recover and "develop 
    healthy lives".
    
    	But of course there's this 20% success rate and 12 steppers
    are known to adhere to the disease model of addiction, which is
    "wrong" and precisely why the rate of recovery is so low, right?
    
    	Maybe if the professional counselors, who've never been addicted
    themselves yet know everything, got their cooperation and dialog,
    only 20% of *them* would be open minded enough to willingly admit
    they were "wrong" about some things.
    
    	Perhaps, just perhaps, the average success rate of recovery from 
    an addiction has nothing to do with "how the addiction is modeled",
    or the corresponding treatment methodology. Maybe there's an obscuring
    factor - a character trait - in most people (80%!) that can, if not 
    changed, render just about any treatment program ineffective.
    
    	Joe
    

    Re. 139  read my entry .138
    
    I think you'll find some info that backs up what you are suggesting
    
    Skip

    This is a continuation of .138.... but first....
    
    Mike you are missing the point.. you started talking about treatment
    and don't see the potential of identification of the genetic marker.
    The BEST form of treatment for ANYTHING is preventive treatment...
    If they can identify the marker and treat the patient for the chemical
    imbalances that are creating the addiction before it becomes an
    addiction  (remember... Of the alcoholics they studied, 77 percent
    had the gene.... this covers the physically addicted and allows
    for the psychologically addicted numbers of an estimated 33 percent)
    Then they are on the road to finding a more effective method of
    treatment then just the 12 step program that you seem to be against.
    
    And how long have you known that there was a lack of dorphines in
    the brain that was causing the addiction?  Yes they found the gene
    and yes they've been talking about the belief that alcoholism is
    a genetic trait that can be passed from one generation to the other...
    but this is the first time I've read that it's a need to achieve
    a chemical balance in the brain that causes the adiction.  This
    imbalance sounds like it should be classified as a mental health
    disease or disorder or illness or however you chose to lable it...
    (it doesn't matter to me how you label it).  
    
    Anyhow.... 
    
    .138 (con't)...
    
    "My guiding hypothesis is that there are a specific neurotransmitter
    irregularities for each addiction,"  sad Dr. Kenneth Blum, director
    of the division of addictive diseases at the University of Texas
    Health Science Center in San Antonio, one of those who discovered
    the gene involved in alcoholism.
    
    Some conditions that lead to addiction, like depression, can already
    be treated with medications.  But some substances used to treat
    addicts, like methadone, are themselves addictive.  Scientists are
    seeking to tailor new drugs that will correct the imbalances without
    causing other addictions. 
    
    However, many social scientists criticize the biological research,
    saying it is wrong to focus only on biology and ignor the social
    forces at play, especially amoung the urban poor.  
    
    "I object to seeing the vulnerability in the person rather than
    in their poverty,: sand Robert Jessor, a sociologist at the University
    of Colorado.
    
    The greatest risk of drug abuse, he points out, is amoung children
    who come from impoverished, single-parent families in drug-ridden
    neighborhoods, with no strong counterbalance from church or school.
    
    Other objections are legal and ethical.  "I'd be very concerned
    about the issue of consent," said Leonard Rubenstein, director of
    the Mental Health Law Project in Washington, and advocacy Grop for
    the mentally ill.  "Even if the scientific evidence turns ou to
    be strng, people have the right to refuse being tested or given
    medications."
    
    He said he also worried that people would be denied insurance, rejected
    for emplyment or otherwise stigmatized.  "What would the social
    cost be if you were identified as a potential alcoholic or drug
    abuser in childhood?" he asked.
    
    Some backers of the new approach acknowledge these problems but
    say that, given the huge social costs of addiction, the benefits
    outweigh the rissks.  They said biological vulnerabilities may help
    untangle the puzzle of why some people can experiment with powerful
    drugs like cocaine and never becme addicted while others become
    addicts almost overnight.
    
    "For people who are biologically predisposed, the first drink or
    dose of the drug is immensely reinforcing, in a way others just
    don't experience it," said RAlph Tarter, a psychologist at the Western
    Psychiatric Institute and Clinic in Pittsburgh.  "Many recovering
    drug abusers tell me, 'The moment I took my first drug, I felt normal
    for the first time.' It stabilizes them physiologically, at least
    in the short term."
    
    Scientists stil express some uncertainty on the specific biological
    details of these vulnerabilities.  But from dozens of studies,
    prototypes are emerging of the brain chemical imbalance, temperament
    and life history that typifies those drawn to particular drugs.
    
    DEPRESSION
    
    First Conficence, Then Addiction...
    
    The woman was depressed and overweight as a teenager, until a friend
    gave her amphetamines.  She started taking them regularly at 17
    to lose weight; they also made her feel confident, even buoyant.
     She was 19 when her boyfriend offered her some cocaine.  She bacme
    addicted within a week.  By 25, she had an out-of-wedlock child,
    a chaotic life and a $5,000-a-week cocaine habit that she supported
    by helping distribute the drug.  She was hospitalized trwice for
    the deep depression that would come whenever she tried to stop taking
    cocaine.
    
    But when Dr. Edward Khantzian, a psychiatrist at Harvard Medical
    School, treated her with a small daily dose of the stimulant Ritalin
    she made a dramatic recovery.  She has not had acocaine in eight
    years.
    
    For Dr. Khantzian, a leading proponent of the "self medicaiton"
    theary of drug abuse, such alternate drug treatments, which seem
    to treat the biological irregularities underlying the addication,
    are a logical approach.  Although Dr. Khantzian acknowledged that
    using Ritalin is controversial because it can be addictive, he said
    he believed it was effective in weaning his patient from cocaine
    because it acts on dopamine receptors.
    
    Some kinds of depression are related to low levels of dopamine in
    the brain, and many antidepressants, like Ritalin, work by incresing
    dopamine levels.  Cocaine and other stimulants do the same, though
    by a different biochemical rute.
    
    "We suspect that cocaine is a way certain people medicate themselves
    for depression," said Dr. Khantzian.  
    
    The depression-cocaine link has emerged in several studies.  For
    example research in 1986 with 30 consectuve patients admitted for
    treatment of cocaine addiction in a drug unit at Yale Medical School
    fund that half suffered from pre-existing depression.  And the heavier
    the cocaine habit, the deeper the depression.
    
    
    **
    
    That's enough for now.... There's still more... and it's all
    interesting to read... some of it bares out things suggested in
    here earlier and some of it refutes it.  I'm not entering it to
    combat anyone I just found that much of what the article says about
    addiction overall and alcoholism specifically has a lot of bearing
    on this note.
    
    Skip

    Maybe I dind make the text clear, but the reference to "cooperation and
    Dialogue" was for this to be between the twelve step advocates and
    counselors/therapists.  
    To say that 12 steps is the only way is to exclude the possibility of
    us understanding anything about the therapeutic requirements for
    addicton therapy.  This field in counseling is very new and a lot is
    yet to be learned.  Perhaps, if there is more cooperation between "12
    steppers" and counselors/therapists, there might evolve, a higher
    recovery rate than exists for 12 step programs. Also, if a program's
    purpose is to get the addict off the substance and become somewhat
    functional, then perhaps the program is marginally successful. however,
    as a counselor, Me thinks that there is much more to life than just
    trading one dependency for another.
    	On second thought, perhaps I'm not so adverse to calling an
    addiction a disease; "Whatever gets you through the night is all
    right." Then in the morning, the light of day will let us see things
    perhaps more comprehensively.
    
    Ernie
    

    
    RE: -1, Ritalin is an amphetamine.  It is also used to treat 
    hyperactive children and certain neurological disorders such
    as narcolepsy.
    Ritalin is addictive.

	Yes, imbalances in someone's brain chemistry probably can be brought
back into balance through the introduction of extraneous chemicals. It's easy
to imagine how someone might "try" something at some point in their lives
and find "things go better with Coke" or whatever - for a physiological
reason, dur to a genetic condition that they happen to have.

	Physical attributes of some person, such as eye color, are not 
diseases unless of course that attribute impairs the normal physiological
functioning in some way. While the genetic information that leads to blue
eyes may not impair one's ability to see, different genetic information which
may cause cancer of the eye does - you go blind. Therefore, classifying a 
genetic based attribute as a disease is based on impairment of normal
function. *Any* function, IMHO.

	Someone's predisposition to addiction may not have a single "root 
cause" that is the "correct" reason why they are that way. As I tried to say 
before, it may also be due to someone's emotional programming. This emotional
programming is due to events that can have nothing to do with social class, 
the amount of drugs in the neighborhood or counterbalancing efforts on the part
of schools and churches.

	For someone who's "emotionally" predisposed, the same lines written
in .143 about a physiological predisposition could easily apply -

	- "(the) dose of the drug is immensely reinforcing, in a way others
	  just dont experience it"

	- "The moment I took my first drug, I felt normal for the first time"

	- "They also made her feel confident"

	- "(it's) a way certain people medicate themselves for depression"

	Depression, whether physiologically induced or a psychological 
artifact of some unresolved live event, is an emotional state, a feeling.
It's easy to see how someone who's been through some kind of emotional
trauma at some point in their lives may be predisposed to doing drugs,
perhaps also as a "self medication" effort. Those who are predisposed on
a psychological basis may achieve just as significant "medication" results 
- for them - as those who are predisposed as a result of a genetic anomaly.

	The emotional based predisposition is as classless as perhaps the
genetic based one is. There's Kitty Dukakis's self proclamation of being
an addict - and you know that she spent most of her days living in the slums!
It turns out that for her, much of her emotional programming was recieved
from her mother, who in turn was trying to keep a major secret in a social
atmosphere where looking good and having all your credentials was of paramount
importance. Kitty simply bore the brunt of her mother's stress and internal
emotional conflict - the impairment of normal emotional functioning was passed
on to her - and she has, as a result, an addictive predisposition.

	I could be that what's so confusing about addiction is that the root
causes exist in some kind of quadrature relationship, where both psychological
and physiological causes are at work. If so, the perhaps addressing either
one explicitly, without considering the other, is what fails for those who
do not recover when given one specific treatment.

	Joe

    
    re. 146
    
    AA works if you work it.  It is a guide, a tool and is for those
    who want it, not for all who need it (the daily meetings would be
    held in convention halls if that were the case.)
    
    People don't "fall off the wagon".  People choose to drink again
    because alcholism is a disease of denial.  And there is no better
    treatment than AA.  While the recovery rate for alcoholism is rather
    low, AA is still the most successful program available.
    
    Re:  cooperation with counselors:
    
    AA's General Service had a committe called the CPC which stands
    for Cooperating with the Professional Community.  This committee
    goes out and speaks to counselors, parole officers, police, schools,
    etc about what AA is and AA does.  They also set up information
    booths at conventions for counselors of alcoholics and drug addicts.
    There is currently a lot of cooperation between AA and the professional
    community.  Look into it.  Its there.
    
    Susan
    

    Re.147
    
    >> Kitty Dukakis..
    
    In a review of her book "Now You Know" 
    she stated in one sentence that there was a time that she 
    popped up the top of a hair spray and drank it. 
    Can this be attributed to physiological traits like her reddish-brown hair ?

    Yes.
    
    Yes.
    
    					andrew

    Mike -- why is it important to you that you win this particular
    battle?  I mean, you're expending an awful lot of energy in this, 
    and I'd like to know why -- because from where I sit, it isn't 
    just the intellectual exercise --
    
    What's the emotional hook?
    
    					andrew

    Exactly!  Tell us ya real gripe.  Don't mean to be nosy here, but until 
    ya tell us the real problem, this venerable self-appointed H_R 
    psychologist can't really help ya here.
    
    Personally (meaning applicable only to me), I consider it a character
    issue.  I mean if I ever get addicted to anything, I will consider it
    a character flaw of mine.  Of course, I have never been addicted 
    to anything (well, maybe to Beethoven's music, but that is another
    story), so it is not really appropriate for me to judge others who has
    been in that kind of situation.  To me, whether addiction is a disease or
    not is really a none issue.  It is like debating whether rap is a form
    of music.  Better yet, this debate so far resembles a deaf person telling 
    the rest of the world that rap is not real a form of music.  If we carry
    this analogy further, I become a fellow deaf person who is bewildered
    as to why a fellow Galludet graduate will argue vehemently with the
    rest of the world that rap is not really music.  From my point of view,
    the only possible conclusions I can draw are either
    
    1.  This guy is pulling people's legs (which I don't really believe
        given the serious arguments you have taken so far) or
    
    2.  This guy isn't really deaf.
    
    Eugene
                                        

    Mike, perhaps you are "addicted" to this idea of yours because as
    someone indicated earlier, you are doing it more than you want to,
    which you indicated in your last reply. (;'>  An addiction to an idea
    can be as disfunctional as an addiction to a drug, without using
    reductionism and generalization. 
    
    To all,  
    	Whether or not alcoholism is a disease or not, there is an issue
    that is overlooked by the 12 steppers et al:  That alcoholics are just
    as "codependent as their spouses and families."  The only difference is
    that for the alcoholic, the codependence has been transferred to the
    alcohol, or other chemical.  When intervention takes place, the
    co-dependence is redirected to his or her family.  From the literature
    I have read, this "new" codependence is not addressed by AA or the
    STEP program.  This information was provided by a recovering alcoholic
    and self-admitted co-dependent who started his own clinic.  Titles aside, 
    codependents are those who are very dependent on exernal sources of 
    self-esteem. Are externally motivated instead on internally motivated.  
    Now, If the AA actually does only require sobriety as its goal, (and I
    may be oversimplifying then their program cannot be extolled as a 
    "treatment" program of any sort. It is only the first step in a series of 
    steps in a comprehensive plan of treatment.  
    
    Ernie
    

    Mike,  I think what they want to find out is what the motivation
    is behind your argument... that is, I entered the fray because I
    have two grandparents who were alcoholics.  I spent one summer with
    them as a kid just after they joined AA, and remember the experience
    rather well when my Grandmother fell "off the wagon".  The theory
    and belief that alcoholism is genetic has made me wonder about myself,
    as well as my mother and sisters... I became involved, later because
    of my involvment I became a Drug and Alcohol Program Advisor in
    the Navy (DAPA).  I learned a little and counseled a lot of people...
    It was not a wonderful experience but as a result I saw the
    simularities between Drug abuse and Alcohol abuse, first hand.
    
    I grew up in a disfunctinal family and learned that most alcoholics
    dependents are subjected to the same things as a member of a
    disfuntional family... the difference is that the ones involved
    with alcohol had more resources available.  
    
    These and a friend who is an alcoholic but still to this day will
    not admit it (I only drink a case of beer a week a lot of people
    drink more pepsi in a week then I do beer).  are the reasons I have
    an interest in Alcoholism.
    
    What is your motivation?  The way you argue your points makes one
    wonder if someone in your personal life were an alcoholic and hurt
    you somehow... I could go on theorizing about your motivation but
    it would be speculation which might lead to rumours... rather then
    do that, it's better to ask why you persue your argument so strongly.
    
    Skip

    While I don't necessarily agree with Mike's conclusions I do believe he
    has a right not to explain in a personal manner why he holds them so
    dear. They are right or wrong regardless of his private motivation. His
    explaining might make some of us understand him better, but it's not
    required to prove the argument.

    We have two problems in regards to drinking and drugs. First is the
    question of what constitutes addiction. If the definiton of addiction
    is that "I'm taking more than I want to" am I not an addict if I drink
    to oblivion but don't feel I have a problem?

    Second, is addiction itself morally wrong? What about the runner who
    must run or feels terrible? What about the work-a-holic? Or are only
    certain addictions wrong? liesl

    Okay... here...
    
    According to the American Heritage Dictionary -
    
    Addict  - dict-ed, dicting, dicts.  To devote or give (oneself)
    habitually or compulsively:  addicted to alcohol. 1. One who is
    addicted, esp. to narcotics. 
    
    By this definition I am (and I admit it too) an addict to caffine...
    The difference in my addiction is that it harms no one in the process
    of satisfaction, when I am under it's influence I am still coherent
    and in control of myself.  
    
    Same thing with the runner anology... he hurts no one if he runs
    and stays in complete control of himself.
    
    However an alcoholic or drug addict can not make the same claim,
    there families suffer because of there addiction, put one in control
    of an automobile and they are deadly, allow one to walk down the
    sidewalk and it's quiet possible that they can stumble and fall
    into on coming traffic.  Hand one your favorite vase sometime and
    convince me you'll do it in complete confidence that it won't be
    dropped or otherwise mishandled.  
    
    There are safe addiction and unsafe addictions... the safe ones
    are usually mild and can be handled by a minimum of effort and self
    control (like drinking coffee) other's can't.  
    
    And if you want to go into the smoking issue... I consider it a
    dangerous habit... it not only harms oneself but anyone who is exposed
    to the "exhaust fumes" and second hand smoke that is present from
    the burning cigarette.  They don't impair one's judgement but they
    do kill and therefore warrent being considered a dangerous addiction.
    
    If all alcoholics as a part of the addicition were to confine
    themselves off the street until sober, maintained a hermits lifestyle,
    and live in seclusion with no one at all depending on them for
    anything, then it is quiet possible that it would never have become
    a social issue to the degree it has.  And to be quiet honest, I
    truly believe the only reason it became as strong an issue as it
    has is because of the "drink n' drive" attitudes that had been on
    a steady increase from the day the automobile was first available
    to us up through the late l970 and early l980's where an alcoholic
    caught driving has become and earned the reputation of being the
    same as a man with no moral restraints holding a loaded gun.  
    
    In otherwords it isn't the self danger that caused alcoholism and
    drug abuse to become social issues, it's the publicity of auto
    accidents, accidental shootings, and other tragic events related
    to being "under the influence" that have made it a social issue.
    
    Skip

    Oops, forgot somethin'...
    
    As to Mikes personal motivations... I was just trying to explain
    what the other's were after.  I used personal examples from myself
    so he would understand what they are asking for.  Although I do
    admit to some curiosity as to why he's carring on so strongly about
    the argument, I must admit that in my heart, I feel it's his own
    business and up to him to decide if he cares to share it or not...
    
    He is addressing an issue, and some of the people want to address
    the reasons why he seems to be obsessed with his argument.  
    
    Anyhow, I did something I said I wasn't going to do, I started to
    comment and get involved with the issue again... I'm going to return
    to entering the rest of the article I'd started and keep my mouth
    shut from here on out.
    
    Skip

         From where I sit, Mike doesn't seem any more "obsessed" with the
    issue than any of the folks opposing his view.
    
                                        Greg

>	"Once an addict, always an addict" is silly and ambiguous.
>    And it decries an ignorance of the physiology of chemical
>    addictions. Drug addictions do not manifest themselves without
>    the drugs!
    
 	Mike, your and perhaps the "NI of DA"'s simplistic approach to drug
addiction, apparently that it's purely a physiological phenomena, is what's
not allow you to understand that "silly and ambiguous" statement. I wrote a
lot in here about the psychological side of things and it either went right 
over your head or you simply refuse to consider it. Oh Well!
   
>    	Or, maybe you think that because I am not an alcoholic that
>    I'm unqualified to talk about what happens in the body when a
>    person is addicted to alcohol, what characterizes alcoholism, or
>    the alcoholic's role in the whole process.
    
    	Mike, precisely. The other person's speculative reply is based
on the only other qualifying circumstance that would allow someone to "Talk 
about ... what characterizes alcoholism" and *know* a little bit about what 
they're talking about!

>    	Whether or not alcoholism is a disease or not, there is an issue
>    that is overlooked by the 12 steppers et al:  That alcoholics are just
>    as "codependent as their spouses and families."  The only difference is

	Ernie, why dont you try attending a CODA or an Al-Anon meeting - both
of which are 12 step based - and see for yourself just how *naive* the above
statement is! 

	Dysfunctional is spelled with a "y". That implies disease, as in
Dyslexia - impairment of the ability to read.

>    ...am I not an addict if I drink to oblivion but don't feel I have a 
>    problem?

	liesl, if you had read a few notes back, it was mentioned that 
"alcoholism is a disease of denial". That means that a chief characteristic
of a true alcoholic is that they will *deny* they have any problem at all.
If you see someone in an oblivious state, claiming that they dont have a 
problem...

	Joe

         Hang in there, Mike.  When your motivation becomes the new target,
    it means that your points on the real issues are to good to oppose.
    
                                       Greg

    Greg... that's not necessarily so... If a person continues to argue
    an issue you start to wonder about his motivations... in a confernce
    designed to offer advice and help to others... you sometimes feel
    obliged to offer it to someone who doesn't seem to want to ask for
    it but instead skirts the problem and focuses on a issue related
    to the problem... 
    
    Mike... please realize that I'm NOT saying this is the situation
    with you in fact I went back and re read some of your notes and
    although I can't claim to understand your motivation... (and wonder
    why you have decided to stop arguing) You have brought up some very
    valid points, and have made me stop and reconsider my own views
    on alcoholism and drug adiction.  But the real issue here seems
    to be related to the definition of adiction... what consititutes
    an adict and what adiction actually is, seems everyone has there
    own opinion and no one wants to consider if there is any validity
    to anyone elses observations and comments.... 
    
    Anyhow, I just wanted to tell you that you HAVE given me "food
    for thought" and a desire to research a bit more on the subject...
    especially in the more current advancements on the subject.  I have
    checked my materials at hand and most of them are outdated by at
    least 2 years.  
    
    Skip 

        re .164, well, it may have gotten us somewhere, even if only
    to show how "powerless" any one person is in changing the thoughts,
    beliefs or feelings of another. One can really only make suggestions,
    perhaps propose a different way of seeing things, and then it's up to...

    	I hope that those who have not participated in this argument
    simply remember the ideas presented and forget about what they read 
    between the lines, regarding whomever's motivation for replying.
    That is, as was mentioned before, trully none of your business!
    
    	With that, I'm letting this one go on as it will.
    
    	Joe

    re .164-
    
    That's useful.  I'll remember that, Mike- now that you have been
    pushed to the point of admitting the futility of trying to explain 
    your point of view to someone who simply can't understand you, 
    perhaps you'll remember the experience the next time you do it to
    someone else.  Believe me, I'll remind you.
    
    DougO

    I know this is sort of old, but I would like to respond to a couple
    of points.
    
.97>>Alcoholism does not fit any conventional models for diseases.
    
    Actually, Mike, alcoholism *does* fit the conventional model for
    diseases.  I will get the information for you and enter it if you
    would like.
    
    AA is not the ones who decided alcoholism is a disease, the AMA did.
    The reason the AMA categorized it as a disease is that it follows a
    specific progression, and has a very specific termination if not put
    into remission: death.  That is the main thing to remember, alcoholism
    is a terminal disease, from which *1 in 36* recover.
    
    That is not 1 in 36 AA members recover, it is 1 in 36 alcoholics
    recover.
    
    As to being addicted to AA.  If a diabetic requires insulin every day,
    do you say that it is just another addiction?  No, of course not, it is
    her/his medicine.  Such is AA.  The fact that alcoholics don't need to
    be injected with chemicals to recover does not correspond with them 
    not needing medicine.  It's just a different type.
    
    Oh.  And the book that keeps getting talked about (and whose author of
    course I can not at this instant think of) was proven to have been 
    based on falsified research.  
    
    I understand that if someone does not want to believe something, even 
    when it is fact, than it is nearly impossible to change their mind for
    them; I also know that denial of a disease, any disease, has led to 
    countless unnecessary deaths.
    
    E Grace

Re:     <<< Note 702.170 by GWYNED::YUKONSEC "Leave the poor nits in peace!" >>>

>   That is the main thing to remember, alcoholism
>    is a terminal disease, from which *1 in 36* recover.

	Source of this information, please?
    
    That is not 1 in 36 AA members recover, it is 1 in 36 alcoholics
    recover.
    
>    Oh.  And the book that keeps getting talked about (and whose author of
>    course I can not at this instant think of) was proven to have been 
>    based on falsified research.  

	Which book?  And which was proven to be falsified by whom?
	Any refernences on this?

	Thanks,
	Bob

    With all due respect, mike, but there's got to be an alcoholic gene. 
    It is built in by evolution.  Just ask youself if you have ever been
    on a date without drinking some cheap booze.
    
    Eugene

RE: .176

	>I buy expensive booze.  :^)

    Liar!  :-)
    

    The following reply has been contributed by a member of our community
    who wishes to remain anonymous.  If you wish to contact the author by
    mail, please send your message to QUARK::HR_MODERATOR, specifying the
    conference name and note number. Your message will be forwarded with
    your name attached  unless you request otherwise.

				Steve






         Until now I've been a read-only member of this conference, and  I
         do  wish my first my first posting was not anonymous; as you read
         this you may understand why I chose the anonymous route.  I  feel
         compelled  to  respond  since  an increasing number of replies to
         this topic have degraded  to  ad  hominem  attacks:   "You  can't
         understand unless you've been there", "What's your motive?", "How
         can you comment on AA if you've never been?".  What I'm about  to
         write  is  based on my own personal experiences and observations,
         and unavoidably, is laced with some of my personal  opinions.   I
         will try to keep this as factual as I can.
    
         I am an alcoholic and have been in  "recovery"  for  almost  five
         years   now.    In  getting  there  I've  gone  the  full  route:
         individual therapy, Spofford Hall, Edgehill/Newport, two years of
         AA, etc.  There are histories of alcoholism both in my family and
         in my wife's.  Some have recovered, some haven't, and  some  have
         died either directly or indirectly from alcohol abuse.
    
         I do not deny that there are both physiological and psychological
         factors  that  cause  some  individuals  have a predisposition to
         alcoholism.  I do not deny that sustained heavy drinking  results
         in  profound  physical  and psychological changes.  I do not deny
         that alcohol can be physically addictive.  I do not deny  that  a
         significant   percentage   of   alcoholics   metabolize   alcohol
         differently from non-alcoholics.  I do not deny  that  Alcoholics
         Anonymous  currently  has  the  highest  success  rate of keeping
         alcoholics sober; virtually all rehabilitation  programs  include
         on-going  attendance  of  AA  meetings  after  completion  of the
         residential treatment.  A number  of  medical  and  psychological
         researchers have confirmed all of these assertions.
    
         I do vehemently disagree that alcohol addiction is a disease -  a
         behavioral  dysfunction and/or an addiction, yes.  A disease, no.
         And lest someone question my motivations, let me state them early
         on.   Granted  treating alcoholism under the disease/AA model has
         achieved a higher success rate than the earlier  "moral  problem"
         approach.   Despite  the  higher success rate, the statistics are
         still grim.  Only 10% of alcoholics make  a  serious  attempt  at
         recovery.   Approximately  50%  of alcoholics attempting recovery
         revert to drinking within 6 months.  Of the remaining  50%,  half
         of  those will revert within 2 years.  These statistics are based
         on a treatment regimen of residential rehabilitation, followed by
         regular attendance of AA after rehab.  Bill Wilson, co-founder of
         Alcoholics Anonymous, lamented that only 18% of active alcoholics
         were able to achieve recovery through AA alone.
    
         I  believe  that,  in  blindly  accepting  the   assertion   that
         alcoholism  is  a  disease  like  diabetes,  we are doing a grave
         disservice to those that need help by not investigating treatment
         methods with potentially higher success rates.
    
         Lately there has been a great  deal  of  discussion  regarding  a
         genetic   aspect   to  alcoholism.   While  it  is  true  that  a
         predisposition towards alcoholism tends to run in  families,  and
         studies of identical twins separated at birth tend to obviate the
         strict "learned behavior"  hypothesis,  social  acceptability  of
         drinking  factors into the incidence of alcoholism.  For example,
         it is estimated that 10% of all Americans are  alcoholics,  while
         alcoholism is virtually unheard of in Israel.  In both countries,
         the vast majority of the  population  are  either  immigrants  or
         descendants  of  immigrants,  coming  from virtually all over the
         world.  Hence, both nations have a well-mixed  genetic  pool.   A
         key difference is that alcohol abuse and its associated behaviors
         are not socially tolerated in Israel; in the United  States,  the
         intolerance is not as strong.
    
         Consider the assertion by  members  and  supporters  of  AA  that
         alcoholism  is  a  disease just like diabetes.  Does the diabetic
         wreak the same physical, emotional, mental, and  financial  havoc
         upon  themselves  and  others  as  the active alcoholic?  Can the
         diabetic  give   up   insulin   and   maintain   health   through
         participation  in  12-step  programs,  through  shear will-power,
         though hypnosis, or through acupuncture?  I  think  not.   It  is
         true that a primary symptom of alcoholism is denial.  By offering
         the recovering alcoholic the concept that he or she suffers  from
         a  disease,  alcoholics find it easier to abrogate their ultimate
         responsibility:  "Hey, I've got a disease.  I'm sick.  What I did
         wasn't  my  fault.   What  I  do now is not my fault because this
         disease is incurable." Not  only  is  the  alcoholic  spared  the
         anguish  of  accepting  responsibility for their past and current
         actions, but they  are  allowed  to  maintain  their  pattern  of
         avoidance and denial, albeit in a socially acceptable way.
    
         Also consider the proliferation of 12-step programs.   There  are
         now Gamblers Anonymous, Over-eaters Anonymous, Smokers Anonymous,
         Sexaholics Anonymous, Parents Anonymous, Narcotics Anonymous, and
         others  that  I  can't recall.  Are these diseases?  No.  They're
         addictions and behavioral dysfunctions.  But diseases - no.
    
         If one spends time attending AA and  begins  thinking  critically
         about  what  the  program says, you begin to find inconsistencies
         and begin to question whether or not AA is fully committed to the
         concept  that alcoholism is indeed a disease.  For example, steps
         4, 5, and 6 involve taking a "personal inventory",  asking  one's
         "higher power to remove defects in character", and making amends,
         with the strong implication that the individual's  alcoholism  is
         due, at least in part, to "defects in character".  Referring back
         to the popular diabetes  analogy,  are  the  diabetic's  symptoms
         caused entirely or in part by character defects?  The fundamental
         medical  problem  is  not.   However,  if  the  diabetic,   being
         cognizant  of  his  or  her  condition, fails to exercise care in
         their diet or fails to take insulin as prescribed, then  one  can
         argue that there is a behavioral component to their symptoms.  It
         can also be argued that, given the knowledge of their  condition,
         the  reults  of  failing  to  maintain  their dietary and insulin
         regimen can only be attributed to their own actions.
    
         Another staple of AA meeting is coffee  and  high  sugar  content
         foods  such  as cakes, donuts, and cookies.  Through research, it
         has  been  established  that  a  high  percentage  of  recovering
         alcoholics   suffer  from  hypoglycemia.   Anyone  familiar  with
         hypoglycemia knows both the physical and emotional  effects  that
         results  caffeine and high sugar intake.  Generally, caffeine and
         sugar create an initial "high" followed by a crash.   It  strikes
         me  that  if  AA is such a strong proponent of the disease model,
         then AA should pay attention  to  the  physiological  aspects  of
         recovery as well as the emotional aspects.
    
         In every AA meeting I've attended - and I've probably hit most of
         the  meeting  in  northeastern Massachusetts - it is forbidden to
         either read or discuss non-AA literature within the confines of a
         meeting.   If  AA  were  truly  committed  to  the  concept  that
         alcoholism is a disease, then it should be equally  committed  to
         educating  its members of the effects of the disease, both in the
         active  phase  and  in  the  recovery  phase.   By  limiting  the
         discussion  of  literature  to  that published by AA, a wealth of
         current research  and  discoveries  are  eliminated  by  default,
         informed   discussions   of  the  emotional,  psychological,  and
         physical  aspects  of  the  condition  cannot  take  place,   and
         adaptation   of   the   organization's  tenets  and  approach  to
         incorporate new and better methods of treatment will be  slow  at
         best.
    
         I think that if one thinks  about  the  tenets,  traditions,  and
         methods  of  AA,  the  hypothesis  of  alcoholism being a disease
         provides a vehicle for allowing the alcoholic to continue his  or
         her  denial/avoidance behavior, and that AA enables the alcoholic
         to  substitute  an  acceptable  compulsion  for   one   that   is
         unacceptable.    By  advocating  concepts  like  "Don't  compare,
         identify", by having readings from the  "Big  Book"  (_Alcoholics
         Anonymous_)  and  _12  Steps and 12 Traditions_ while proscribing
         non-AA literature  at  meetings,  by  asserting  that  any  sober
         alcoholic  must  be  leading  a  life  of misery if they're not a
         member of AA ("ours is the only  way",  see  reply  .110  for  an
         example    of    this),    by    celebrating   anniversaries   of
         membership/sobriety as "birthdays", and by heated  and  emotional
         attacks on those who challenge fundamental beliefs and tenets, it
         becomes a closed, protective, and  almost  cultish  organization.
         While  openly  advocating  the  disease model, AA actually treats
         alcoholism as a behavioral issue.
    
         From my own experience and from others  that  I  know  well,  I'm
         convinced  that alcoholism is basically a behavioral dysfunction,
         with physiological factors creating  both  a  predisposition  and
         symptomatic  complications  in  the active drinker.  For example,
         both times I went through rehabilitation, I was told  that  there
         would  be  short  and  long-term  withdrawl  symptoms:  "midnight
         sweats", anxiety attacks, mood swings, continued craving, etc.  I
         experienced  all of these.  However, when I went through hypnosis
         (which, by the way, was the successful mode of treatment for me),
         I  was  told  that I would not experience any withdrawl symptoms,
         nor would I have any cravings; there were none.  I am  personally
         aware of four individuals, exhibiting all the classic symptoms of
         alcoholism, who quit cold turkey.  No rehab,  no  counseling,  no
         relapses,  no  AA.   They reached the point where they recognized
         that it had to stop, and so it did.  These individuals have  been
         successful  from  6  to 11 years.  Another has been successful in
         transitioning from problematic drinking to social drinking.  None
         of  them,  nor  am  I,  experiencing the misery or "white knuckle
         syndrome" that AA claims will occur unless we are active  members
         of the organization.
    
         While the disease model for alcoholism has achieved a higher rate
         of  success  that  the  "moral  problem" model, the rate is still
         abysmal.  As long as the disease model is  the  preferred  model,
         the  success rate will remain low.  In order for a higher rate of
         success to be achieved, all aspects  of  alcoholism  need  to  be
         considered  in  designing  a  treatment  program:  physiological,
         genetic, psychological, emotional,  and  cultural.   Until  then,
         we'll still be in the Dark Ages.
    

    re: .178
    
    This is absolutely one of the most clearly stated, well thought out,
    and cogent replies to any topic that I have ever read.  
    
    That it addresses a topic of such significant import is even more
    impressive.
    
    I congratulate its author, and hope, someday, to read his/her thoughts
    on what might be done to better help alcoholics help themselves.
    
    tony

    Being one who seldom, if ever, writes here, but reads often, I am moved
    to respond to this recent entry.
    
    I found this thoughtful, intelligent, and moving.  You have expressed
    many of my thoughts over the years of dealing with an alcoholic in my
    family.  I commend you on your ability to so clearly state your
    thoughts and on your well thought out analysis of this issue.  I am
    taking your words home to share with my family, who are so closely
    touched by alcoholism.  I hope they will help us move even further
    along.  I know they will be the basis of many discussions over the next
    few weeks.
    
    Many thanks to you for speaking up and giving such thought-provoking
    ideas.

    Although overall I agree with the statement I wish to point outsome
    things...
    The orignal reason for AA's refusing to allow non-AA literature to be 
    discussed was because of incidents in the past where information was 
    miss represented and caused more harm then good.  There literature was 
    researched and proven before being submitted for publication and use in
    there groups.  As to if this is still true I can't say it's been 12
    years
    since I was involved with AA.  But, this was the original reason...
    they did not want want confusion Next... there are several types of
    addiction... psychological, physical, aand varied combinations of the
    two.  
    Finally, the Alcoholic who says "I have a dieses it's not my fault,
    therefore it's okay for me to drink"  is about the same as the Cancer
    patient who says "I've got cancer, I'm going to die, so it's okay for
    meto take this gun and splatter my brains out all over the ceiling"
    
    Finally, an issue that hasn't been addressed in this note yet is the 
    continual support that Alcoholics get from friends and cohorts... 
    Him?... An Alocoholic... heck he only drinks on the weekends... He only 
    drinks at night... he only drinks beer... hey... he's ill, hey, his
    wife 
    died, hey, give him a break he just lost his djob... hey lets hand him
    all
    the excuses we can and maybe the problem will cure itself when he
    finally
    drinks himself to death... Also, no one has bothered to mention that 
    before a alcoholic can be cured in any method or treatment... he first 
    has to admit to himself/herself that they are an alocholic and they DOP 
    have a problem... until they admit it and accept it as a true fact...
    (It's one thing to say "I'm an Alcoholic" it's another thin to accept
    it as a true fact within oneself) then all the treatment and cures
    and methods available today are so much toad water!
    
    Forgive the sloppy typing job... I'm working this from a set host in 
    Merrimack to my account in California... and the node is S L O W it
    makes
    corrections next to impossible since I can't wait for the screen to 
    show what I've typed.
    
    Skip

  re: .178

  I would like to commend you on your note.  I thought it was presented
  extremely well and it opens ones' mind...


  Kenn

    As a former liquor addict I agree that alchoholism is not necessarily a
    disease. I think it probably is a disease for some it wasn't a disease
    for me.
    The reason I drank at least one pint of liquor a day until I was 48
    years old was not because I was addicted to alchohol but rather because
    i was addicted to anaesthesia. There were many things that drinking
    enabled me to ignore. Once I stopped drinking I became unable to ignore
    those things. It has been very unpleasant. But drinking was even more
    unpleasant. 
    If I have a 'disease', the 'disease' is having had a lot of horrible
    things happen to me, alchohol was the pain killer; it could just as
    easily have been Cocaine, heroin, ...
    Will be celebrating my 6th year without booze in two weeks!
    
    				herb

    Regardless of the true nature of alcoholism, staying sober deserves
    praise.
    
    Congratulations, herb.

    re .184, Happy Birthday, Herb!
    
    aq
    

    thnx much for your thoughts folks. 'preciate it
    The gestation (not quite six years) continues.
    Some time soon, I hope -and expect- that the child within- will no
    longer be (within).
    
    
    				h

    re: .187 (Herb)
    
         Congratulations notwithstanding, I would hope that the
    child within never disappears, for that would be sad.  Rather
    I would hope that the child becomes the free child, and not
    the adaptive child that has probably been there to this point.
    
    Frederick
    

    my intent was to be communicating 
    "that the child within will no longer be (within), but rather be fully
    outside"
    
    
    				h

Happy anniversary, Herb, that is quite an accomplishment.
Congratulations!

Dan