Disease Concept of Alcoholism

Throughout the nineteenth century attempts were made to propagate the conception of alcoholism as a disease (Schmidt, Smart, & Moss, 1968, p. 4). In fact, there was a small number of institutions in which alcoholics were treated as ill persons. However, by the late nineteenth century, most of these centers were closed or taken over for the treatment of mental disease. Some describe the failure of the various institutions for alcoholics to inefficient management and to a lack of clarity in the formulation of the illness concept of alcoholism. Added to these causes was the nineteenth-century view, shared by the community and the medical profession, that alcoholism was a vice of the poor.

In North American literature of the late nineteenth century and early twentieth centuries, there was a change of emphasis in the discussion of alcohol problems. Interest now centered on the prohibition of the manufacture and sale of alcoholic beverages, and the urban worker was seen as a possible voter in the prohibitionist cause rather than as an object of reform. In the political struggle which led to the passing of prohibition legislation, alcohol was pictured as a danger to all strata of society and the problems of alcoholism became submerged (Schmidt, Smart, & Moss, 1968, p. 5).

However after the repeal of Prohibition in 1933, a marked shift occurred in the popular conception of the alcoholic. A recurring theme of propagandistic and educational activities stressed that alcoholism

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igious ideas (Fingarette, 1988, p. 18). According to A.A. ideology, most people can drink socially without any problem. Some people, however, have a unique biological vulnerability to alcohol and they develop a special kind of "allergy." For these at-risk drinkers (alcoholics), alcohol triggers an uncontrollable need for more alcohol. The only way that alcoholics can halt the progressive deterioration of alcoholism is by complete abstinence (Fingarette, 1988, p. 18). A.A.'s teachings were derived from an amalgam of ideas that fit together loosely. There are appeals to the alcoholic's willpower, as well as an emphasis on his helplessness. In order to achieve abstinence, the alcoholic needs to acknowledge dependence on the help of others (specifically A.A.) and ultimately a "higher power," but the nature of this power is left to the individual. Drinking is interpreted as a symptom of the disease, and ritual public confession at A.A. meetings, the admission that one has an incurable vulnerability to alcohol, is a necessary part of the treatment (Fingarette, 1988, p. 18). For the first decade of its history, A.A. grew modestly. Lacking scientific confirmation, it remained a relatively small sectarian movement, occasionally r

Category: Medical - D