Alcoholism, also known as alcohol abuse disorder (AUD) or substance use disorder (SUD), is a pressing issue that impacts the lives of millions of people in the United States. For decades, the question of whether alcoholism is a disease has been debated among professionals and those that deal with the addiction themselves. Some argue it’s rooted in a choice and label it a behavioral problem, while others advocate for a disease model involving significant body and brain changes. And although both sides of the debate are valid, science can help us untangle exactly what alcoholism looks like and answer the question – is alcoholism a disease?
When exploring the debate of whether alcoholism is a disease, it’s imperative to acknowledge the psychological impacts of alcohol:
- Increased anxiety and depression
- Impaired focus, concentration, and short-term memory
- Worsened motor skills
- Stunted ability to learn and form new memories
One psychological component of alcoholism is often more impactful than the rest – control. Like many addictions, alcoholism starts with regular alcohol consumption. Eventually, the initial choice and intention behind picking up a glass become more of a compulsion. This is because once an addiction forms in the brain, it becomes harder and harder to resist alcohol. Simultaneously, a person’s tolerance increases, meaning they need more alcohol to satisfy the craving. This pipeline leads to an insatiable “need” to drink. While some people can maintain control over their addiction for a short period, any alcohol exposure could potentially cause a relapse. While this isn’t the case for everyone with alcohol addiction, the reality for most is a severe lack of control.
A willingness to engage in uncharacteristic behavior is a well-known side effect of alcoholism that’s also linked to an impaired sense of control. For example, say a person who is typically cautious and reserved spends a night out partying. They will be more likely to drive under the influence, have a severe injury, get alcohol poisoning, or be involved in risky sexual behavior.
How Alcohol Alters the Brain & Body
Without a regulated ability to control choices, a brain altered by addiction isn’t the same as one without. Alcohol dysregulates the brain’s reward system by increasing the release of dopamine, a neurotransmitter associated with pleasure and motivation. Over time, excessive drinking and other forms of alcohol consumption can alter the brain’s structure and function. A 2017 study from the University of Oxford found that the hippocampus, the area of the brain responsible for memory, had noticeable atrophy – 6x more than those who didn’t drink. When the hippocampus shrinks, challenges in memory and thinking emerge, making it much harder to function on a “normal” level.
However, the brain isn’t the only part of the body impacted by alcoholism. There are significant long-term physical health risks that come with alcohol dependence:
- Cardiovascular problems such as high blood pressure and heart disease
- An increased risk for cancer and stroke
- Severe damage to the liver
- Gastrointestinal issues, specifically with digestion
- Pregnancy complications, if applicable
- Reduced bone density
- Dysregulation of hormones
- Metabolic disorders like diabetes, insulin resistance, and obesity
- A weakened immune system
Alcoholism is also deeply entwined in a person’s genetics. Studies have identified specific genetic variations that increase an individual’s susceptibility to developing alcoholism: ADH1B, ALDH2, GABRA2, CHRM2, KCNJ6, and AUTS2. While genetic predisposition alone does not determine whether someone will become an alcoholic, it does contribute to the overall risk. This suggests that alcoholism, like many other diseases, has a hereditary component. Additionally, environmental factors such as upbringing, social influences, and stress can also play a significant role in the development of alcoholism, further supporting the argument that it is a multifaceted disease.
We know that prolonged alcohol consumption leads to tolerance, dependence, and withdrawal symptoms. In this situation, these changes are not simply a matter of personal choice. Rather, they are a complex interplay of genetic, environmental, and neurological factors. Each of these points to the fact that alcoholism is a disease, not necessarily a choice.
Despite the growing research on alcoholism and increased advocacy and awareness efforts, there is still a considerable stigma about viewing alcoholism as a disease. Reducing this stigma is essential for creating a more supportive and understanding environment for their recovery journeys. By acknowledging alcoholism as a legitimate medical condition rather than a moral failing, we can promote empathy, compassion, and effective treatment options.
Education and raising awareness about the complex physiological and psychological factors involved in alcoholism can help dispel misconceptions and stereotypes that cause people to disregard it as a disease. Creating a supportive environment where individuals feel safe to seek help and openly discuss their struggles without fear of judgment is crucial.
Finding Holistic Treatment for Alcoholism
However you view alcoholism, there’s no denying its detrimental effect on the overall well-being of a person. At American Treatment Network, we take a collaborative approach to treating alcoholism and other substance use disorders. By not limiting our clients to one way of thinking, we open the door for holistic healing – acknowledging addiction’s social, psychological, and physiological challenges. If you’re looking for treatment for alcoholism for yourself or a loved one, schedule a consultation with one of our specialists today to learn what options would work for you, or visit one of our locations in Havertown, PA, Upland, PA Newark, DE, and Dover, DE