Addiction or illness- choice or no choice

bags Mon 08-Jun-15 15:55:58

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.

Exactly. A compassionate viewpoint.

I don't want to speak about my experience on an open forum but I know the absolute hell that is addiction. I feel for those of you who have had to suffer the effects of living with an alcoholic.

I got a bit sidetracked from this discussion this evening, so I'm interested to see the new posts. I'm a bit confused about who you think is using the thread to be self righteous absent .

I think it matters a great deal whether one defines addiction as an illness or not, because the definition will determine the treatment.

I'm sorry I didn't reply to your question to me at 19.23 janea. I'm not exactly saying alcoholism is a symptom of illness, I'm saying it can be used as a coping strategy by some people. So rather than a symptom it's an illusory 'cure'.

I'm really not sure whether 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? I genuinely don't know where the line is drawn between those two points. I'm not sure I believe the first person has that much control over how much they drink. It's a very slippery slope.

Even though I don't think addiction is an illness, I would always be in favour of a compassionate approach, but not necessarily a sympathetic one.

There is no single cause of alcoholism. It is often caused by a variety of factors that include the age at which you started drinking, your mental health and social or cultural factors, like having a partner or friends who drink a lot. The most important risk factor, however, which most reliably predicts alcoholism, is family history. Even without looking at the genes involved, research shows that this disease runs in families.

It definitely doesn't have a genetic/hereditary factor in BIL's family Anya; nowhere can we find anyone who drank. In fact because his family for many previous generations have been strict Baptist with alcohol and any stimulants completely forbidden, they wouldn't even go to events where alcohol was served!

I didn't say it was the single factor Loopy I distinctly avoided saying that. I said it was the 'most important risk factor' while acknowledging at the beginning of my post the other 'variety of factors'.

I could write an essay on this topic, but think I might be branded as 'self-righteous' by a certain person. So better not.

Actuall, Loopy it is entirely possible, theoretically, that your BiL does carry an influential gene. In his family's case it could be environmental factors linked to their strict beliefs which has saved them from activating that particular gene. Interesting.

Anya If you wrote your essay in a judgmental and condemnatory – or, worse still, a holier-than-thou – way, then it is very possible that a certain person might regard you as self-righteous. However, from what you have already posted, it seems very unlikely that you would take that approach. Please don't be so ready to feel affronted by my posts unless you feel confident that I am criticising you or your posts.

There are some interesting posts on this thread.

Write your essay Anya.

nightowl - can you explain a bit more about why it matters as regards treatment, whether alcoholism is defined as an illness or not?

I don't wish to be simplistic about this, and have read all the arguments for and against addiction, (as in uncontrollable use of a substance to the detriment of one's mental and physical health) being an illness or not. But surely, if a parent can see the damage being done to his family, and despite their pleas to stop continues to drink, if a parent is told time and time again that if they continue to inject/smoke heroin their children will be taken from them and adopted, if they continue to take crack then their unborn child will be born addicted, and so on.....then surely there has to be a mental health illness here? There surely is a physical and mental addiction to the substance whatever it is, we would all kill for our children so it is very hard to imagine how a pregnant woman for example, can continue to ingest alcohol/drugs knowing the damage that will be done. I dont think that the tell them just to stop attitude is right ( not from many on here of course), as someone who is overweight, but knows exactly what to do about it ( but doesn't) i am in no position to tell an alcoholic or drug addict to just pull themselves together and stop.

Apologies Absent .. I'm probably rather touchy on this subject.

soontobe I can't put it better than Max Pemberton so I will post the link I posted in the thread about Charkes Kennedy.

www.dailymail.co.uk/health/article-3112825/DR-MAX-MIND-DOCTOR-pity-Charles-Kennedy-alcoholic-NOT-disease.html

What he is saying us that by treating something as an illness we then offer sympathy and understanding, but can encourage the person (patient?) to feel helpless in terms of their condition. Using an illness model of anything suggests that treatment or cure lies in the hands of 'experts' outside of yourself. Yes you need to take the tablets or have the operation but essentially the doctors know best.

This article suggests, and I agree, that responding in this way to anyone with a dependence on alcohol or drugs fails to address the fact that they are the only ones who can take the first step towards their own 'cure'. That's not to say they shouldn't be offered all the support and treatment services available on the NHS but all of that is useless without their commitment to change.

I know my earlier posts may have appeared to be nitpicking in terms of whether I think alcohol dependency (and the rest) is an illness but I think that unless the different elements are separated out there is a danger of becoming sucked into the addict's view of the problem, where we will be no help to anybody. Hence I think sympathy (which to me implies a passive 'poor you' approach) is of no use to people in this situation, whereas compassion (which I think implies something more active) is vital.

I seem to have written an essay myself.

Totally agree Nightowl no one can 'treat' an alcoholic - the motivation has to come from within themselves, and it has to last. By that I mean, even when they recognise the problem and agree to act, many fall back because the addiction is so powerful.

I really, really admire the alcoholics I know who stay off drink for years in end. They are remarkable people indeed.

Me too Anya. It's a lifetime struggle.

I like this quote from the article

Among all the alcoholics I’ve worked with, the only ones who have successfully conquered their addiction are those who have refused to hide behind the victimhood of saying that they have a disease.

I like that too

Very interesting. I do have compassion for addicts - I had compassion for my father. But while not being self-righteous about it, I hope, I did judge him, for his weak, inconsistent attempts to tackle his condition, and the arrogance (because it was that, at least in his case) that he knew better than anyone else, including the medics, about what he was doing to his health and his relationships.

He was not mentally ill. Some addicts have attendant mental problems that make it more difficult to seek help and act upon it, or personality disorders that work against them. Some addicts have such low self-esteem they don't think they deserve to be helped (though they may not rationalise it in that way). None of this applied to him.

My father had very HIGH self esteem I believe. He thought he was cock of the walk. I think he enjoyed his lifestyle. He saw himself as a hell raiser. Well he certainly raised hell for his family. I don't think he was mentally ill, just selfish. It was a shame because he was an intelligent man who, at times (when I was an adult) could be good company.