Addiction or illness- choice or no choice

Well put, nightowl Alcohol counsellors often talk about alcohol dependent people 'self-medicating' with alcohol. As with many people with a drug habit, they use alcohol or other substances to feel 'normal' once dependency has taken its hold. Not attending to the underlying difficulties of coping without such substances makes recovery all the more difficult. Even people who drink too much because their lifestyle is centred around socialising or relaxing with alcohol find they have to address how differently they will live without automatically fuelling themselves up with drink.

nightowl If I understand you correctly, you seem to be saying that alcoholism is a symptom, rather than a disease, illness, or condition in its own right.

I can see that might be so in some cases, but would you accept that there is a difference between heavy drinking, where an individual is still consuming 'unhealthy' amounts of alcohol, but retains control and choice over whether they drink or not, and alcoholism/addiction where that element of control has gone?

Yes, I see what you mean. Thanks.

I think that's what I was trying to say thatbags but found it difficult to put across. I do think 'stress' (in this case shorthand for almost any kind of mental health issue or psychological problem) is the 'illness' and drinking (or drug abuse) is the individual's chosen strategy to cope with that stress. So it's often used, for example, by people who have suffered childhood trauma as a way of self-medicating for the pain they continue to feel. In that sense, the alcoholism is not the illness, but the chosen 'cure'. Of course it doesn't work and it leads to other problems and measurable physical illnesses, but it's still not the alcoholism that's the illness, IMO. I'm still not sure I'm making any sense, but I know what I mean

I don't by any means think this is the only cause of alcoholism or drug addiction. Both can start as purely recreational activities that lead over time to dependence and addiction. I think that can be equally hard to reverse, but I think the treatments would be different as there is no underlying psychological cause for the addiction in the first place, IYSWIM.

I don't think calling alcoholism an illness or a disease gives someone permission to carry on drinking. The thing about most illnesses is that there is almost always either a cure or a way to control the illness, and addiction is not obviously (to me) any different.

nightowl and others, could a cause of alcoholism be stress in the sense of someone turning to alcohol (or another drug) because of stress that they are having difficulty dealing with? Could stress at certain levels be a mental health issue?

iam, I don't think anyone is categorising alcoholism (or another addiction) as 'simply' an illness, or even as 'simply' anything. It is clearly something very complex or it wouldn't be so difficult to overcome.

I posted on the Charles Kennedy thread before coming across this one so won't repeat that fairly long post.

I agree with night owl's post at 16.43 about the danger of confusing the causes of alcoholism with the addiction itself. Abuse of alcohol can be triggered by many things, including "enjoying a drink". KatyK and elena, as well as others, have posted about the long term impact on the children of alcoholics/drug addicts, from their own experience. I am not unsympathetic and I empathise with the stresses and strains in the lives of those who become dependent or addicted to drugs or alcohol. They have choice, their loved ones do not.

I don't feel it's helpful to categorise addictions/dependencies simply as illnesses. As others have said, most of us have no choice about the health problems we experience whereas drinkers/smokers/drug users have a choice each and every time they use their drug of choice. I'm not saying it's easy but I do believe we all have some choices about the way we live our lives. Those of us who are parents have responsibilities as well. There was a news item recently about the parents of a baby who spent the day in a Manchester city centre bar, leaving their child in the blaze of the sun whilst the mother drank 2 bottles of wine and the father enjoyed 9 pints of extra strong lager. Fortunately, waiters called the NSPCC who in turn called the police. GMP managed to locate the couple, whose home was littered with empty cans/alcohol bottles. The baby was taken into police protection and placed with its grandmother.

at the end of the day, whatever the reasons, the causes- there is always a choice- however hard, however difficult - some make that choice- for love.
Agreeing that it is a VERY difficult choice, and that full support and sympathy must be given - to say there is NO choice, because it is an illness- is WRONG and fatalist. Because if there is no choice for alcohol- there is not choice for violence, for crime, for sexual predation, for ....

Humans do and have the choice- and that is the whole point. It is however perhaps much harder for some than others to make the 'right' choice,I agree.

elena - my father died at 69 and there was no trace of liver disease. He was a chain smoker too and to be honest I don't ever remember him being ill in his whole life. He was very good looking (a real Irish charmer to the outside world) and used this to full effect with his constant womanising. It is very naïve of me to say this but if only people would stop and think of the psychological effect on their children of what they are doing. No child should live in constant fear, it stays with you for life. I am quite fearful of life in general now and me and all my siblings have suffered with depression and severe anxiety. None of my brothers and sisters have ever felt as good as other people, although we have all had decent jobs and good marriages. I would add that some of his violent outbursts were when he was sober so maybe nightowl's theory of mental illness comes into play somewhere. Strange how you get through these things as a child but then in later life it seems to come back to haunt you.

I think there's a danger of confusing the causes of alcoholism, which are varied but can include psychological or mental health problems, with the addiction itself. So drinking or drug abuse can begin as a coping strategy to deal with other problems.

I suppose what I'm saying is that alcoholism may be caused by some sort of mental illness, and it will very likely cause mental and physical illness and possibly death. That doesn't mean that it's an illness in itself. There are many models to explain addiction and the medical or illness model is only one of them, and is not universally accepted even by the medical profession (hence the Max Pemberton article I posted on the other thread). I think GillT57 is quite right about the fact that alcoholics are viewed differently because alcohol is acceptable in our culture. We don't generally afford drug addicts the same degree of sympathy.

Yep, bags is spot on.

Very well put Bags

There are several posts on this thread describing how alcoholics abused themselves and members of their families and how awful it was. I understand all that. What I don't understand is why anyone would do that to themselves unless there was something wrong with them. Alcoholism is an addiction, like nicotine addiction or heroin addiction. I think it's not a simple choice between drinking alcohol and not drinking alcohol. Everything I've read about alcohol addiction suggests to me that the drinking is a compulsion that can only be overcome by gargantuan efforts and then complete avoidance of the problem drug.

To me, having a compulsion like that is like an illness even if it isn't an illness. So I still think that alcoholism, or other drug addiction, is an affliction. I don't think it's something someone in their right mind would choose, which in turn suggests that they are not in their right mind when they overdose on alcohol and their behaviour and health deteriorates as a result.

I thought a disease was something person had no chose in but drink, drugs, gambling,shopping, cleaning etc anything that you cannot function daily without having is an addiction.

Sorry - I meant we tend to hear less about problems other than liver disease.

Thanks for your comments - it is odd he lasted so long. He was a physical and mental wreck, and his doctor used to get very directive with him and tell him he was killing himself, but strangely he had no liver disease. He survived because my mother looked after him well. I have since found out that although liver problems are very common with excessive drinking, they are not inevitable. We just tend to hear less about them.

Other people have experienced far worse than we did, because he was never actually violent - I feel very sad for you, KatyK.

It's notable that many of the problems of alcohol manifest themselves behind closed doors.

There is nothing glamorous or funny about drunkeness. The people who are the life and soul of the party after a few drinks are actually crashing bores, and self-centred with it, because they refuse to listen to people who love them who tell them they have a problem.

I wonder if the problem is to do with acceptance of alcohol? Fat shaming, blaming overweight people for all their own ailments and for allegedly bringing the NHS to its knees seems to be acceptable, even from people like Health Ministers who really should know better. Recreational drugs are reviled, criminalised, bring about prison sentences, even in some countries the death sentence, but public treatment of drinking excessive amounts of alcohol is very different. I am not talking about people clutching cans of strong lager and living on the streets; I am talking about people in the public eye, celebrities if you will; laughing, joking about excessive alcohol consumption. I once watched, horror struck as Sharon Osborne lurched on to stage at an awards ceremony; she was so plastered that she was slurring and staggering, couldnt find her own backside with both hands ( as my Grandad would have said), and yet, this was somehow funny?????If she had staggered on stage snorting cocaine there would have been a storm of protest, if she had wandered on eating a pork pie there would probably have been adverse comments about her diet/weight/unhealthy food, but somehow this disgusting display was funny. While there is this attitude then there will never be true understanding of the terrible lives lived in families of alcoholics.

That's awful elena.

How sad for you and your siblings Elena .It amazes me that some peoples physical constitution can withstand the abuse of alcohol for so long.

I haven't read the other thread.

I am like others here - uncomfortable with the idea of alcoholism as a disease.

My father was a heavy drinker from my late chlldhood onwards, and this caused mood swings (though no violence) which were unpleasant and scary. His drinking developed into alcoholism later and he never really accepted he had a problem, and while I have sympathy for those 'fighting addiction' he never properly fought it. He was in rehab once, for 12 weeks, and we later found out he was leaving the unit and bringing in alcohol (the regime was a bit lax....). He lied and manipulated, and damaged most close relationships. I begged him on a number of occasions to stop - as did my siblings. We told him his grandchildren had seen him drunk and passed out - it made no difference.

He ruined holidays and family occasions.

His physical health was badly affected, and yes, he fell and hurt himself many times.

I could go on! Eventually the drink (probably) killed him but he was in his 80s when it finally happened, so he might have died anyway.

He was not a bad person, but in this area of his life, he chose alcohol and chose to ignore his family's well-being. He didn't fight it. That's why for him, it was different from a disease.

Thanks for the link GK . A very apt title ,tho hopefully not all children with low self esteem will become alcoholics.

A good article by Ivan Massow on the subject:

www.huffingtonpost.co.uk/ivan-massow/alcoholism-disease-that-tells-you-theres-no-problem_b_7519936.html

Katyk No that doesn't sound unfeeling.. This person probably wrecked your childhood and unless people WANT to be helped I don't believe they can be. I'm sure many alcoholics are in denial and don't see themselves as such unless they start drinking after breakfast.

No I don't think that sounds unfeeling at all KatyK. As a child you didn't want the chaos and fear and I think it would be quite a normal response to just want that person to disappear, however they did it. I was talking about the so called 'functioning alcoholic' who appears to live and support their family while slowly killing themselves.

As Atqui and granjura have highlighted, that brings a range of ambivalent emotions for others in the addict's life, which can be very difficult for children in particular to manage; why is my mum/dad too tired to get up in the morning? Why are they in a bad mood when they do get up? Why do they promise to take me to football on Saturday and then let me down? Why are there bottles all over the living room? Why is mum/dad poorly all the time? And in the end, why don't they love me enough to take the first step to change this? And then when they die, having to listen to other people saying what a wonderful person they were (and maybe they truly were, like Charles Kennedy) and feeling very guilty because you feel incredibly angry with that wonderful person.

Anya and loopy and nightowl thank you. Nightowl - you mention someone destroying themselves. I totally agree but as a child I didn't see it as him destroying himself. I saw it as he was terrifying us and I was too ashamed to ask friends to the house and wanted a normal life.. I am ashamed to say that I wished he would destroy himself and then our lives would have been better. Sorry if that sounds unfeeling. I can see it differently as an adult. Maybe he could have been helped today.