So get this. Based on the “Diagnostic and Statistical Manual of Mental Disorders” by the American Psychiatric Association, there is no such thing as alcoholism. Instead, it is called a Severe Alcohol Use Disorder. I shit you not. In other words, the next time I go to AA, I’m going to say, “Hi, my name is Denton and I have a severe alcohol use disorder. That means I’m not an alcoholic. Because those don’t exist. That means this entire organization doesn’t exist. It’s just 83 years of LIES!!!!”
Under the classification of “Alcohol Use Disorder,” as alcoholism is now known, there are levels of severity broken down into mild, moderate, and severe “alcohol use disorder.” There are eleven symptoms that are used for criteria to determine the severity of your “alcohol use disorder.” If you have 2 or 3 symptoms, you’re mild, four or five symptoms is moderate, and six or more is a diagnosis of SEVERE “Alcohol Use Disorder.”
And before you read about these symptoms, I put “Addiction” in the title of this article instead of “Alcoholism” for a reason. All you have to do is replace the word “alcohol” with “drug” or “sex” or “junk food” or “cell phone use” and ALL of the symptoms still apply (and I’m not even a little bit joking about the cell phone addiction; plug it in these symptoms below and see if it doesn’t apply for some people.) That’s why it’s not just alcoholism that I’m addressing with this article. I’m saying that if alcoholism is a disease, then so is every other kind of addiction. So with that said, here’s the list of the eleven criteria they use to determine levels of severity:
- Alcohol is often taken in larger amounts or over a longer period than was intended.
- There is a persistent desire or unsuccessful efforts to cut down or control alcohol use.
- A great deal of time is spent in activities necessary to obtain alcohol, use alcohol, or recover from its effects.
- Craving, or a strong desire or urge to use alcohol.
- Recurrent alcohol use resulting in a failure to fulfill major role obligations at work, school, or home.
- Continued alcohol use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of alcohol.
- Important social, occupational, or recreational activities are given up or reduced because of alcohol use.
- Recurrent alcohol use in situations in which it is physically hazardous.
- Alcohol use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by alcohol.
- Tolerance, as defined by either of the following: a) A need for markedly increased amounts of alcohol to achieve intoxication or desired effect, or b) A markedly diminished effect with continued use of the same amount of alcohol.
- Withdrawal, as manifested by either of the following: a) The characteristic withdrawal syndrome for alcohol or b) Alcohol (or a closely related substance, such as a benzodiazepine) is taken to relieve or avoid withdrawal symptoms
Pretty safe to say I can stay with my original diagnosis of alcoholic, aka, “severe alcohol use disorder,” because I definitely met more than six of those criteria. But if you’ll notice, the American Psychiatric Association uses the word “disorder,” not disease. And what is the difference between a disorder and a disease, you might ask? Well, I have spent quite a bit of time trying to come up with an answer to that, but even the online dictionaries appear to not really know. Let’s put it this way: both definitions have the word “illness” in them and in some cases, they can be used interchangeably. The best I could determine was that “disorder” is broad, like saying lung disorder, while disease is specific, like asthma.
Regardless of whether or not it is alcoholism or alcohol use disorder, it is safe to say that I despise doctors and researchers with too much damn time on their hands and nothing to do but justify their salaries. I’m a f**king alcoholic, okay? You cannot offend me by calling me that. All they’re doing with this “alcohol use disorder” is trying to make alcoholics feel less shitty about themselves, but they shouldn’t. That’s part of the game with alcoholism. You absolutely SHOULD feel shitty about yourself. That shittiness helps when you finally get pissed off enough to quit or get help.
Anyway, I’ve been doing a lot of reading lately on the concept of alcoholism as a disease. Alcoholics Anonymous pushes that belief. The World Health Organization classifies alcoholism as a disease. So, too, do the American Medical Association, the American Hospital Association, the American Psychiatric Association (who also call it a disorder,) and the American College of Physicians, among others. Hell, the National Institutes of Health has an entirely separate institute just for the support, research, and attempted prevention of this “disease.” That’s a lot of smart ass people!!
That information, however, presumes that there must be other organizations in the country that do NOT classify alcoholism as a disease. And there might be. I just can’t find any. What I CAN find is a buttload of opinions from normal Joes like me to career intellectuals like Harvard professors having some issue with the classification.
Let’s start off with the reasons most organizations classify it a disease (or disorder, WTF ever.) For starters, it is technically referred to as CHRONIC disease, which essentially means that it lasts for more than 3 months and it will progressively get worse. Blah, blah, tell me something I don’t know.
One reason it is classified as a disease is because there is a genetic component. It can run in families. So can a dependency on welfare. Just saying.
Another reason alcoholism is considered a disease is that there are environmental factors that can affect the onset and seriousness of the disease. I kid you not, I read an example that said something like, “For instance, one environmental factor is whether alcohol is present in the home.” Really? We have chicken in the house. Will somebody be shoving raw breasts into my mouth without my consent, also? That’s how you get salmonella poisoning, right? I mean, based on this argument, that’s why people become alcoholics. It’s in the house, so if you don’t drink it, somebody WILL come shove it down your damn throat and force you to develop a disease.
The final reason that is even worth mentioning is that alcoholism goes through stages, kind of like stage one through stage four of cancer. The difference is that we call Hospice in during stage four of cancer. It’s a very somber but nostalgic and loving time. During stage four of alcoholism, somebody’s living under a bridge using a green loaf of bread for both a pillow and supper.
And now for the reasons people say it’s NOT a disease. The umbrella reason that all others fall under seems to be the entire “choice” argument. The alcoholic has a “choice” whether they take their first drink, just like a person can have a “choice” not to. It’s pretty hard to “catch” a “disease” when you make a “choice” not to expose yourself to it.
Falling under that umbrella are the hard-asses that say we are giving addicts an easy out and relieving them of personal responsibility by calling their condition a disease. Besides, millions of people came before them who were diagnosed with alcoholism, took responsibility for their actions, got the help they needed, and quit. There’s something to this argument. I’ve heard a lot of seasoned but sober alcoholics say that we are not responsible for our actions as alcoholics because we have a disease. Yes, hell, we ARE responsible for our actions. That argument needs to stop NOW. All we are doing with that argument is giving alcoholics an excuse when they screw up and fall off the wagon. “But, but, but, I’m not responsible. It’s my alcohol use disorder chronic disease malfunctionism disability.”
The final argument I’ll discuss here is that even though just about every medical association in America classifies alcoholism as a disease, the actual doctors do not treat it as a disease. For example, what kind of pill can they prescribe to help out an alkie? There are a few being tested now that help with symptoms of withdrawal and at least one drug that claims to help curb cravings, but nothing is approved for curing alcoholism. Besides, can’t doctors just prescribe time? Withdrawal and cravings will both go away (or at least lessen) with the passage of time. But they can’t prescribe that. There’s no money in that.
Honestly, I really could give a rat’s ass if it’s called a disease or not. That classification has some pretty profound implications within the insurance and addiction treatment communities, but since I’m part of neither, they could call alcoholism a phobia for all I care. There’s already a “fear of alcohol” phobia called methyphobia, but there isn’t a “fear of NO alcohol.” There’s some stupid phobia described as “fear of an empty glass,” but I’m going big here. If we’re calling alcoholism a phobia, it would have to be the fear of absolutely NO alcohol whatsoever. That’s terrifying to an addict. Truly terrifying. And since that phobia doesn’t exist, that means I get to name it. Let’s call it Ohmyfukinshitophobia.
We could even make it into a movie like that one about arachnophobia, but completely different. Instead of spiders multiplying and attacking us, all the beer, wine and liquor bottles would grow legs or wheels and become propelled by the very substance that they carry via little alcohol engines. Their propulsion – because they, too have developed a phobia about being consumed called consumptophobia – leads them straight to the nearest ocean in massive droves, leveling anything in their path, on a quest to live out their days bobbing up and down to the music of the seas.
Now that’s got “B” movie written all over it. Now that Sharknado is over, maybe Ian Ziering is available.
Anyway, off topic. The problem I have with alcoholism being classified a “disease” – and remember, I don’t really care one way or another – is this. It’s the argument of self-diagnosis. I probably read thirty articles about whether or not alcoholism was a disease, and I didn’t find that discussed anywhere. If it’s out there, I promise I didn’t plagiarize it. There are seriously a BUNCH of articles arguing whether or not alcoholism is a disease or not. I doubt mine is really a unique thought. But who knows, maybe it is. I think about this crap a lot, and I’ve BEEN thinking about it for two decades, so I guess somebody has to have the unique thoughts. Probably not me, though.
Except for Ohmyfukingshitophobia starring Ian Ziering. That’s ALL MINE!!!!
Anyway, from my research, here are the list of diseases, illnesses, or conditions that are commonly self-diagnosed: the common cold, headaches, head lice, menstrual cramps, skin abrasions, bug bites, and, in some cases, gluten intolerance. There are no doubt many more, but you get the idea. Not exactly a list of things that can tear a family apart, leave people in mental, physical, and financial ruin, or find you waking up from a crash with a School Crossing sign through your abdomen and three body bags nearby. And I’ve been shocked before, but I just don’t see a person under the influence of gluten or lice driving naked the wrong way down the interstate in a stolen garbage truck and barreling through a strip joint because Honey didn’t give a happy ending.
But isn’t that what is required of alcoholism and other addictions? We’re asking people to self-diagnose themselves. And really, there is no other option. If a man doesn’t want to be diagnosed, I can absolutely assure you that he will not be. EVERY addict, if they are anything like me, and I bet they are, diagnoses themselves many, many years before they ever “admit” it to anybody.
This admittance is, for all intents and purposes, a self-diagnosis of a disease, right? A normal joe – a man (or woman) you could not trust with a five dollar gift card and a promise to use it on toothpaste – is being asked to perform the duties of a medical doctor. Not only that, but he (or she) is also responsible for their own treatment plan. Do what?
When I was in my last years of active addiction, I was hiding beer and dip around the house or garage because I was already self-diagnosed and simply pushing off that treatment plan for as long as humanly possible. I was such an incorrigible liar that I had lost the trust of my wife to buy gas for my truck. I couldn’t be trusted at a gas station alone. All of my beer and dip buying was made possible by a checking account that I had hidden from my wife since the day we met. I went to work teaching high school kids hungover at least 95% of the time. I don’t remember very large chunks of my children’s lives or the first few years of my marriage.
And this is a man we want diagnosing a disease that is covered by insurance? When some of that insurance is subsidized or given tax credits by a government that spends upwards of half a TRILLION dollars a year on drug and alcohol abuse? And the only person who can actually diagnose it is the addict himself?
The short answer and the long answer are both the same on this. The answer all the way around is, “Yep. No other choice.” The addict is the ONLY person who can actually diagnose himself or herself with alcoholism or any other addiction. Even if a man overdoses or drinks himself into a coma and is rushed to the hospital, whereby a physician announces, “I diagnose this man an addict,” he’s late to the party. That addict diagnosed himself LONG ago. No addict needs a CAT scan or blood test or full cavity search to confirm their diagnosis. They already know it. And that is actually good news, believe it or not. In my opinion, it’s VERY good news for one very simple reason.
As soon as alcoholics accept that they are alcoholics (the self-diagnosis,) they have then accepted that their continued dependence after that date is a choice. It is VERY much like a sugar addiction or nicotine addiction after the self-diagnosis. Every cookie, cigarette, or beer is a choice. There really can’t be an argument to that. An alcoholic makes the choice to go to the store, makes the choice to buy the beer, makes the choice to drink a dozen, makes a choice to not stop.
And the reason all of THAT is good news is because we have a gigantic “man up” problem in this country, and I was as guilty as any addict in America for two decades. You do NOT need a doctor to tell you that you are overweight, addicted to cigarettes, an alcoholic, or addicted to boiled Pez dispensers. If you’re an addict and you’re reading this, YOU ALREADY KNOW. Time to man the f**k up and do something about it.
No doctor in America needs to run another damn blood test or give another screening test or pluck out hair follicles to determine if somebody is an addict. No doctor needs to diagnose it either. At all. Ever. And they should not sugar coat the shit and tell them they simply have an “alcohol use disorder.” That’s such bullshit. They’re addicts. But if a patient wants to discuss treatment options, by all means, they should go see their doctor. Their best bet is to find an old man who’s been sober for twenty years, but a doctor is fine, too. The first thing they should say when they walk in the door is, “Hi doc. I’m addicted to alcohol, Skoal, Marlboro Red, heroin, cinnamon rolls, and Pez dispensers. I’m ready to man the f**k up. Help me.”
That’s my big message about this entire topic. Man the f**k up. We have an enormous problem in this country. Forty million active addicts RIGHT NOW. I did some quick math and looked up the GDP of every country in the world. The amount our government spends on alcohol and drug abuse – the latest number I found was $442 billion – would be the 26th largest country in the world.
The amount of money we spend on substance abuse in one year is larger than the economies of Israel, Thailand, Norway, Austria, South Africa, and over 150 more. That’s staggering. That’s capable of crippling our economy.
Alcoholics do not need some chemist to create a pill that will “help curb their cravings.” Nicotine addicts have had one for years. It doesn’t work. Chantix makes you feel like you might bloat so badly that your internal organs might change places just to try to escape the gas. It’s an awful drug. You know what nicotine addicts need to do instead of taking it? Man the f**k up and quit.
I am the pot calling the kettle black, but this pot finally quit. It took me a LONG time to hit rock bottom, but I did it. I quit. It has NEVER mattered to me if alcoholism was a disease or not. Yeah, it would have been nice to have that insurance coverage if I had needed rehab or a place to detox (I just did it at home after I manned the f**k up,) but the fact that it is classified a disease has never affected me in any way.
Honestly, what happens if we declassify it? The only thing it really affects is insurance, right? So what. We’re already spending half a trillion dollars on substance abuse, we might as well just double it and pay for everybody’s detox and treatment center visits. Sure seems like we already are anyway. We can just go invade Belgium and use their money for the drunks.
The only real point I’ve made so far about whether alcoholism is a disease or not is that I really don’t care. But I’m okay if it keeps its disease classification. It’s fine with me. I’m all for screwing insurance companies. They take a third of my check every month. And I’m a freaking state employee. Another topic for another day.
But if alcoholism maintains its classification, I just think there needs to be some caveat or asterisk that says, “Yes, we feel this is a disease, but it is NOT like cancer or tuberculosis or ALS. It is a disease of choice that progresses in the same manner as other biological diseases, and it CAN kill and CAN require treatment, but a person with cancer cannot opt out the way an alcoholic can. They cannot make a choice to quit their disease. A person with ALS cannot go to ALS Anonymous, admit their disease, and have a very real chance (through their own choices) of beating it.”
Some numbers suggest that there are as many as 80 million Americans who are either addicts or such abusive users of various substances that they are teetering on the edge of addiction. That’s more than one in five people. That’s ridiculously high. It’s just mind-blowing.
Can you imagine the long term effects if this epidemic keeps growing? We have children who are watching their parents destroy their lives. Trust me, I know. I have a thirteen year old that watched me do it until sixteen months ago. What happens when they grow up? Who will they become if their role models slowly became worthless slobs who spent their college money renting Busch Light?
We have a national debt that is growing exponentially and half a trillion dollars a year is probably not helping. Duh. We have become a country not of Millenials and Baby Boomers and Gen X and Gen Y, but of blame, offense, apathy, and a refusal to take ownership of the shit we need to do to fix it.
So no more studies on alcoholism, okay? Somebody promise me that. No more pills with bloated promises. Pills that help with withdrawal symptoms? Sure. I am wholeheartedly in favor of that. But stop peddling pills that “help” people quit an addiction. Addiction is such a mental gang rape that no pill can outsmart the human mind. The mind will win. And it usually does. I don’t want to hear another addict say they “can’t” stop. I got so damn sick of hearing myself say it I think I might blow up at somebody if they say it to me.
If you’re an addict, most likely you’re hiding. You’re probably depressed. You probably want to stay right where you are and not change because change is f**king hard, your future without your addiction is empty and bleak, and you just LOVE being an addict. It’s your safe place. Your happy place. You also love knowing you have a “disease” because you think it protects you from having to ever display true contrition and repentance. It’s your addiction crutch. You also do not care enough about anything to allow the words I’ve said to affect you.
If so, you’re as sorry and worthless as I was. Man up. Prove me wrong. If you spend another day the way you are right now, you are draining the life out of this great country, your family, your future, and your life.
And you don’t give a rat’s ass, do you?