Is alcoholism a disease?

Mona Charen

October 01, 1993|By Mona Charen

JAMES McKelvey and Eugene Traynor were drunk for more than a decade. After they joined Alcoholics Anonymous and sobered up, they discovered that they were no longer eligible for government education benefits. Veterans Administration rules required that claims be filed within 10 years unless prevented by "a physical or mental disability which was not the result of their own willful misconduct."

Mr. Traynor and Mr. McKelvey, steeped in the "I am sick, not bad" philosophy which has become something of a mantra for Alcoholics Anonymous, sued the VA, claiming that alcoholism is a disease, not "willful misconduct," and that their 10-year benders should be regarded as disabilities beyond their control.

On April 20, 1988, the Supreme Court ruled against them, but on the narrow grounds of statutory interpretation, declining to answer the question of whether alcoholism is a disease.

Alcohol may be, metaphorically, a poison -- but that doesn't make alcoholism a disease. To urge that it be so regarded by the law and by society is to commit the sin of offensive analogy.

President Reagan committed it during the Bitburg episode when, in an attempt to express compassion for the simple German soldiers who had died carrying out Hitler's monomaniacal mission, he opined, "Those soldiers were victims every bit as much as the people in the concentration camps."

Not by a long shot. It is a similarly offensive analogy to say that alcoholics are just like anyone else suffering from an illness. Does that include cerebral palsy or diabetes? AA's own program of self-help and mutual support belies the claim. If victims of cerebral palsy and other crippling diseases could learn to walk again by attending weekly meetings and confronting the truth about their illness -- by announcing to a crowded room, "My name is Jane Doe, and I have cerebral palsy" -- there would be scarcely a wheelchair left in the world.

Proponents of the alcoholism-as-disease theory point to new scientific evidence suggesting that a weakness for alcohol may be inherited. Sons of alcoholic fathers have similar brain wave patterns, even before they take their first drink. And children of alcoholics who are adopted and raised by non-drinkers are several times more likely to become alcoholics than other adopted children.

But even if the weakness for alcoholism is inherited, there is as yet no way to determine how many people are born with the weakness yet reach inside themselves for the strength to overcome it. So the evidence of a genetic link, while interesting, does not dispose of the question of volition and personal responsibility.

Scientists are becoming ever more sophisticated in identifying the biological and environmental roots of behavior. Robert Wright of the New Republic reported that character traits like stinginess, altruism and risk-taking all seem to have a genetic component. Indeed, it may turn out that a weakness for alcohol and the willpower to overcome that weakness are both, to some extent, inborn.

So where does that leave us? Alcoholics Anonymous and others believe that the disease concept is crucial to helping cure the afflicted. Fault and blame, they say, are harsh words lacerating the hearts of some alcoholics already wracked by guilt. Perhaps this is true, though AA may be an unrepresentative and highly guilt-conscious segment of the alcoholic population.

But blame is just a harder word for responsibility. And our society is grounded upon the dignity and autonomy of the individual. That's what makes freedom possible. Blame for mistakes is the unavoidable flip side of credit for achievements.

Moreover, the AA position is logically muddled. It wants it both ways. On the one hand, it wants absolution from guilt by calling abuse of alcohol a disease -- something utterly beyond a person's control. On the other hand, it wants credit for being able to overcome the compulsion to drink.

It isn't necessary to twist logic into a pretzel in order to get alcoholics the help they need. People are able to overcome bad tempers and smoking without first labeling their inclinations a disease.

Alcoholics should be able to confess that they -- like all of the rest of us in various ways -- are weak. That won't make them feel as blameless as a diabetes victim. But it should give them heart to know that guts, spirit and determination can defeat weakness -- whereas they are powerless against disease.

Mona Charen is on maternity leave. This column was first published in 1988.

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