Alcoholism and Drug Addiction as Spiritual Maladies: A Challenge to the Disease Concept

The medical profession classifies addictions as diseases. This began largely as an attempt to reduce the awful social stigma attached to alcoholism that saw alcoholics as somehow weak, of low moral character, and of not having enough of whatever it was everyone else had that kept them from such extravagant overindulgence. The designation has since been used to cover most other forms of addiction as well. The medical justification for this designation came primarily through the research findings of Yale University psychologist E.M. Jellinek. As head of the World Health Organization in the 1950's, Jellinek studied the phenomena of alcoholism worldwide.

Jellinek's Classification of Alcoholics:

1. Alpha

   Alpha alcoholism he described as "undisciplined drinking", meaning that, while it featured craving for alcohol, a loss of control of the amount drank and one's behavior while intoxicated it did not include withdrawal symptoms (e.g. delirium tremens, tremors or seizures). This species is found primarily in North America and northern Europe. Jellinek did not consider this species of alcoholism to be a "disease" because of this absence of physical withdrawal symptoms.

2. Beta

   We see beta alcoholism primarily in poorer regions of the world where a rapid physical breakdown follows a relatively short period of heavy drinking. Malnutrition and some genetic factors seem to play a large role. This species of alcoholism is rare in the developed world.

3. Gamma

   Gamma alcoholism is the species most commonly found in North America and northern Europe. Like alpha, it features craving and loss of control, but also presents with physical withdrawal symptoms (i.e. seizures, tremors, and delirium tremens). It is these withdrawal symptoms that he claims cause an uncontrollable or “cellular” craving for more alcohol, that warrant calling this species a "disease." He also speculates that there may also be some genetic factors involved with this type.

4. Delta

   Delta alcoholism is characteristic of wine producing and consuming regions of the world, especially southern Europe and South America. It features craving and the presence of withdrawal symptoms but drinkers exhibit no loss of control. Typically such alcoholics will consume small amounts of wine all day long, but will never become "drunk" and lose control of their drinking and behaviour in the way alpha and gamma alcoholics do. Periods of enforced abstinence, such as a hospital stay, will produce delirium tremens or other withdrawal symptoms, marking them, along with gammas, as physically addicted to alcohol and as thus having a "disease."

5. Epsilon

   Epsilon alcoholics are the classic "binge" drinkers. They typically go for weeks or months without drinking then spend several days or weeks in states of extreme intoxication followed again by long periods of abstinence. They do not generally experience physical withdrawal symptoms and thus Jellinek does not classify this type of alcoholism as a disease either. This too is primarily a North American and northern European phenomenon. Thus we can only consider gamma and delta types diseases under Jellinek's classification system.

To Jellinek the onset of withdrawal symptoms triggers a response in alcoholics, that he refers to as "cellular craving", that is near to irresistible. Hence sufferers are not to be "blamed" for their condition but medically treated instead. To be sure, his work went a long way towards establishing a completely new attitude towards the problem of alcohol addiction. Alcoholics were no longer bad people; they were sick people in need of help. The disease concept of alcoholism also paved the way for the emergence of the alcoholism treatment industry, as alcoholics with a "disease" could now obtain medical insurance benefits to cover the cost of their treatment. This all seemed like an enlightened step forward.

However, does the disease concept of alcoholism really explain the puzzling obsession alcoholics have for alcohol (and by extension the obsession felt for other drugs too)? Or is it merely a well meaning attempt on the part of the medical profession to provide a socially acceptable explanation for a very intractable and anti, social set of behaviors? Unfortunately, a closer look at the disease concept reveals that it does not in fact explain much of anything. nor does the presence of withdrawal symptoms truly create an "irresistible" craving for alcohol or anything else. Craving is purely a psychological phenomenon, not a physical one.

To our bodies drugs like alcohol and heroin are poisons and they react swiftly to try to protect us from their harmful effects. We most frequently experience this reaction as tolerance. It now takes more of the drug to get us "in, toxicated" (i.e. poisoned) than previously because our nervous and other systems are working overtime to compensate for the presence of this substance. When we suddenly remove this drug our systems have no time to readjust and we experience things like tremors and seizures as they overwork without the drug against which to fight.