Social and Personal Costs of Alcoholism
Treatment for Alcoholism: The Medical Model
Conclusion and Recommendations for Future Research
Few would disagree that alcoholism is costly for those identified as alcoholics and for those close to them, as well as for the culture that has identified alcoholism as a social problem. Even fewer, however, seem to agree on the best way of responding to it. Evidence that alcohol dependence is destructive, is balanced by compelling evidence that the methods brought to bear on overcoming such dependence are so variable and fraught with unanticipated consequences, whether in the clinic or the courtroom, that reasonable people might be forgiven for suggesting that alcoholism is a problem that cannot be solved. What is required first of all if the problem of alcoholism is to be effectively solved is clear thinking about it.
The fact that alcoholism has been recognized by clinicians as a disease has passed into general knowledge in the culture; however, characterizing alcoholism as a disease is a clinical practice of relatively recent origin. That is partly because controversy surrounds the issue of how to describe alcohol-related pathology. According to Bride and Nackerud (2002), the "disease model" of alcoholism had been proposed in the late 18th century and achieved acceptance over the course of the 19th century. In 1892, the American medical community accepted alcoholism as a treatable sickness not least in opposition to the notion of it as an index of moral failure. Writing in 1892, Enfield (1992) classifies it as a "chronic nervous disease" that can be cured with injections of chloride of gold, meant to be "properly and systematically given in combination with strychnia, atrophia, cocoa, quinine, sulphonal, and codea" (Enfield, 1992, p. 1403). The expectation was that this scientifically applied regimen would "change the habits of the [diseased] system and remove the  condition of the ne...