Alcoholism Myths and Realities
Removing the Stigma of Society's
Most Destructive Disease


This book is intended to expose the myths about alcoholism that permeate our society’s thinking. Most believe that we give the benefit of the doubt by suggesting explanations other than alcoholism as the root of misbehaviors. Instead, we need to assume the opposite and look for alcoholism first. Rather than thinking we are helping by providing a safety net, we need to understand that pain is by far the most effective motivator in guiding the alcoholic into treatment. By discrediting the myths that surround this disease, the stigma that instills emotion in the identification of alcoholism can be eliminated. Only then can those affected, whether family, friends, co-workers or society, offer tough love with a clear conscience.

Alcoholism* is the most misunderstood of all diseases. This is rather surprising, since one out of ten people has this disease and we are all directly or indirectly affected. Yet the doctors and psychologists whom we trust to treat diseases and mental disorders are almost completely untrained in understanding and diagnosing the affliction. Medical doctors take as few as 24 classroom hours on the subject, virtually all on treating withdrawal and none on diagnosis. Psychologists are schooled in the idea that childhood trauma and other negative environmental factors can cause alcoholism, even though the evidence shows that such influences only shape its course.

Secondary diseases are usually diagnosed long before alcoholism is identified, even though the latter is the root cause or primary contributing factor to at least 300 other illnesses and disorders. Emergency room medical personnel treat symptoms of addiction, including accidents, in an estimated 50 to 80% of admissions, yet rarely test for alcohol or other drugs in the system. The schools implore adolescents to “just say no to drugs!” focusing on the drug rather than the person on it, a primary problem for only 10% of users. The media misinform by failing to connect the dots between bad behaviors and alcoholism; the movies do so by making the portrayal of alcoholism obvious only in its latter stages, or when illegal drugs are involved. Most people balk at calling someone of like politics or personality “an alcoholic,” even if some of their behaviors are bizarre or destructive. Yet, many wouldn’t hesitate to suggest that a person with whom they differ who drinks the equivalent of a bottle of wine every day “must be an alcoholic.” Aspects essential to the identification of alcoholism, including the time frame over which the drinking occurred, the drinker’s weight and change in behaviors, are rarely considered.

This gross unawareness results from the stigma, which makes others reluctant to diagnose or even suggest the possibility of alcoholism. Epilepsy, diabetes, leprosy, tuberculosis and other diseases were attributed in past centuries to character defects such as lack of morals or witchcraft until their true causes were identified.1 Over one hundred years after the stigma of the last of these diseases was largely removed, those labeled as alcoholics continue to suffer disgrace. This is evident in society’s attitude toward alcoholism. Almost all with addicted family members in rehab are ashamed. One who is called “an alcoholic” can bring a lawsuit for defamation of character, as if alcoholism makes the person inherently evil. If someone engages in bad behavior, most think the benefit of the doubt is given by suggesting anything other than alcoholism. In other words, it’s better to think the cause of misbehaviors is that the person is fundamentally flawed, has incredibly poor judgment, or suffers from mental illness, than to label him “alcoholic.”

Even chemical dependency experts, who have been trained to understand the disease, along with recovering alcoholics who have lived it, help perpetuate this stigma. As we will see later, using a flawed definition, the words and phrases employed to describe alcoholism evoke false impressions. Alcoholism is said to require loss of control over use, which makes it sound more like a character flaw than a disease. Yet, loss of control is but a latter-stage symptom, generally not occurring until decades after its inception. Terms such as “denial” and “abuse” convey a grossly distorted view of alcoholics and their perceptions, while phrases such as “he can’t control his drinking” and “he’s a problem drinker” serve to mislead alcoholics and non-alcoholics alike. As a result, those in early recovery often experience extraordinary shame, which can lead to severe depression, relapse and suicide.

Experts rarely stress the need to impose consequences for misbehaviors. As a result, society ends up protecting addicts from consequences without having any idea that doing so only extends the period of active addiction and, therefore, misery for everyone exposed. While lip service is given to the idea of privately imposing consequences, family and friends rarely assist alcoholics in experiencing proper repercussions for inappropriate behavior. Experts and recovering alcoholics alike hardly ever emphasize that the imposition of responsibility is a vital part of what, for many, is essentially a “cure” for alcoholism: keeping a promise to never use again. Recovering addicts almost uniformly fail to thank those who initiated part of that cure, leaving the rest of us wondering whether we can truly help by being so harsh. Uncompromising tough love is usually offered only when there are no other options. Because so much of what occurred while drinking is buried in the subconscious or, simply, not remembered, recovering alcoholics rarely explain that extreme actions on the part of close persons were necessary to get them sober.

The biochemistry of alcoholism has never been adequately and simply described. Early-stage alcoholism is rarely, if ever, identified, while the media report on adolescent-like, bizarre or destructive behaviors of celebrities, politicians and others without suggesting that the impetus behind such conduct is almost always this disease. By debunking the myths, we can eliminate the stigma that allows the typical addict to engage in dozens or even hundreds of incidents adversely affecting the lives of others, while the cause goes unrecognized. Only then will we have a chance at identifying the addict before the oftentimes decades-long creep toward latter-stage alcoholism causes the body to give out. Intervention and recovery is possible only with such identification; yet, the addict is incapable of self-diagnosis. The rest of us need to stop being afraid of making the call.

“Some people believe that the label ‘alcoholic’ transforms a person into an outcast akin to a leper. But, if leprosy is a disease, should a doctor who has proof that a person has leprosy keep that fact a secret lest he label the person a leper? Is not the real challenge for the doctor to continue making the diagnosis to change society’s views toward leprosy?”

                                         — George E. Vaillant

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