Of course alcoholics need help, but it’s NOT a disease
Over the course of my career, I’ve spent many years working with alcoholics. I know the battle they face and the torture they endure in facing their demons and giving up the bottle.
I’ve seen many succeed, but also many more fail. It’s a struggle that often gets right to the heart of who someone is and I wish Ant McPartlin all the best for his rehabilitation.
But after he was charged this week with drink driving I’m afraid my patience and sympathy are in short supply: by all means ruin your own life, but don’t put the lives of others at risk.
Having seen people die as a result of drink-drivers, I have zero tolerance for them.
When you’ve had to tell someone, as I have, that their child has died at the hands of a drink-driver, you quickly develop a hard carapace when it comes to drink- drivers’ self-obsessed pleas for leniency.
Yet I’ve already heard people talking about Ant’s battle with ‘the disease’ of alcoholism and it makes my heart sink. People want to show how understanding they are, but the idea that alcoholism is a disease — the so-called ‘disease model’ of addiction — helps no one, not least the alcoholic.
The argument is that although the use of alcohol is voluntary to start with, in some individuals it ‘flicks a switch’ in the brain that means they can no longer stop drinking.
This has never been proven and a review article in the highly respected medical journal Lancet Psychiatry in 2015 concluded that the research conducted into addiction does not support the simplified view that it is a disease.
The authors also challenged the idea that the disease model of addiction represented the consensus view among experts. In fact, like me, many doctors reject the idea that alcoholism is a disease.
That’s not to say it doesn’t need treatment and those who suffer from it don’t need help and support. Of course they do.
But viewing alcoholism as a disease is counter-productive.
Alcohol addiction represents an inappropriate coping strategy for intense emotional pain and psychological distress. Making alcoholism a ‘disease’ removes any sense of responsibility or ownership and flies in the face of the psychological work that is done with alcoholics. The fact is, people
to drink alcohol. This element of choice is not afforded to those with MS, cancer or cerebral palsy. That’s not to say that choice is easy or straightforward. But it’s a choice nonetheless.
To drink is an active decision they make each day and pretending otherwise is to rob them of the power to choose a different path — the process of recovering from alcoholism involves taking responsibility and realising they are the architects of their own misery.
THISis overwhelmingly scary for most at first. But over time it is incredibly liberating to realise that, while you are the cause of the despair you experience, you are also your own salvation.
The term ‘disease’ undermines this recovery process. It disempowers the individual, suggesting they are impotent in the face of their dependency when actually they are the only one who can change their behaviour.
What’s interesting is that although there is a group of people pushing for alcohol addiction to be called a disease, we don’t hear people saying the same thing so readily about drug addiction. We don’t hear talk about ‘the disease heroin addiction’, for instance. rather, the element of choice is emphasised, along with taking responsibility for your actions.
Why is this? The idea of a disease communicates sympathy and understanding. It says to people we’re not judging you, we are taking this seriously and know how hard this is for you.
I think this is why the idea of alcoholism as a disease is championed by many of the liberal elite — it’s a way of showing how caring they are and so it makes them feel better about themselves.
Similarly this is why people are wary of challenging the disease model — they’re fearful they’ll be accused of being cold-hearted.
But you can show compassion and care to the person struggling with alcohol dependence — just as doctors and nurses working in this area do — without removing their responsibility.
Why do we have to pretend that it’s something it’s not?