Many Doctors Reject Alcoholism as Disease (Theory Lacks Evidence)

Many doctors reject alcoholism as a disease. There are many public pronouncements that alcoholism is a disease. However, as Dr. Lynne Appleton observes, “medical practice rejects treating it as such. Not only does alcoholism not follow the model of a ‘disease,’ it is not amenable to standard medical treatment.”1

Dr. Appleton explains that “medical research on alcoholism does not support the disease model.” She adds “highly respected and influential medical authorities do not promote the theory and treatment of alcoholism as a disease.”2

Nation-wide Study

doctors reject alcoholism as disease
E.M. Jellinek popularized disease theory of alcoholism.

Researchers asked a nation-wide sample of physicians in the U.S. their beliefs about alcoholism. Did they personally believe it’s mainly a disease or mainly a personal or moral weakness? Fifteen percent thought it’s mainly a personal or moral weakness

Then they asked the sample what proportion of alcoholism is a disease and what proportion is a personal weakness. The average proportion that M.D.s judged to be personal weakness was 31%. Only 12% of physicians believed that alcoholism is 100% a disease.3

Large Survey

Researchers made a survey of over 88,000 physicians in the U.S.  “Only 49% of the physicians characterized alcoholism as a disease.” Over 75% believed that the major causes of alcoholism are “personality and emotional problems.”4

V.A. Study

A survey of psychiatrists and psychologists employed by the Veterans Administration was conducted by Dr. Wilma Knox. “Their attitudes were remarkably similar. Both groups rejected the disease concept in preference to characterizing alcoholism as a behavior problem, symptom complex, or escape mechanism. Both groups were inconsistent in advocating neuropsychiatric hospitalization while considering treatment benefits very limited. Members of both groups were reluctant to participate personally to any degree in rendering this treatment.”5

Other Studies

One survey of physicians found that only about 20% believed substance addiction to be a disease.6 Another survey found that only 27% of physicians believed that alcoholism is a disease. The majority viewed alcoholism as a social or psychological problem rather than disease.7

Scholars surveyed doctors attending an annual conference of the International Doctors in Alcoholics Anonymous. They found that 80% of its members believed that alcoholism is simply bad behavior – – not a disease.8

“Many doctors have been loath to prescribe drugs to treat alcoholism.” This is “sometimes because of the belief that alcoholism is a moral disorder rather than a disease.”9 Indeed, in a survey of physicians’ beliefs about alcoholism, 55% said that there is “no effective treatment” for it.

Official Rejections

Many professionals rely on the definitions and diagnostic criteria of the American Psychiatric Association (APA). And they have done so since 1952. They include doctors, researchers, clinicians, therapists, insurance companies, courts, and many others. Between 1952 and 1980, the APA defined alcoholism as a disease.

However, based on scientific and medical evidence, it rejected the disease theory of alcoholism in 1981. It no longer defines it as such. Even earlier (1979) the World Health Organization (WHO) rejected the disease theory of alcoholism and continues to do so.

The U.S. Supreme Court has also rejected the disease theory of alcoholism.

Self-serving Decisions?

In 1956 the American Medical Association passed a resolution declaring alcoholism to be a disease. This enabled doctors to bill insurance companies for treating alcoholics. Had it not defined alcoholism as a disease, physicians wouldn’t be able to receive insurance payments. As one defender of the action asserted, “a disease is anything doctors choose to call a disease.”10

The American Hospital Association similarly passed a resolution defining alcoholism as a disease. That enables hospitals to receive payment for patients being treated for alcoholism in their facilities.

Yet in spite of those self-serving organizational actions, many doctors reject alcoholism as a disease. In fact, it’s a very substantial proportion. That’s a testament to their open-minded acceptance of scientific evidence.

References: Many Doctors Reject Alcoholism as Disease

  • 1. Appleton, L. Rethinking Medicalization: Alcoholism and Anomalies. In: Best, J. (Ed.) Images of Issues. NY: Aldine de Gruyter, 1995, p. 65.
  • 2. ______, p. 69.
  • 3. Peter D. Hart Research Assoc. The Road to Recovery. Washington: Rush, 1998, pp. 5-7.
  • 4. Jones, R., and Helrich, A. Treatment of alcoholism by physicians in private practice: a national survey. Q J Stud Alco, 1972, 33(1), 117.
  • 5. Knox, W. Attitudes of psychiatrists and psychologists toward alcoholism. Am J Psych, 1971, 127(12), 1675-1679.
  • 6. McLellan, T. Re-Considering Addiction Treatment. How Can Treatment be More Accountable and Effective? A CME course. Cranston, RI: Assoc Med Ed & Res on Sub Abuse, 2006.
  • 7. Mignon, S.  Physicians’ perceptions of alcoholics—the disease concept reconsidered. Alco Treat Q, 1996, 14(4), 33–45.
  • 8. Hobbs, T. Managing alcoholism as a disease. Physician’s News Digest, 1998 (Feb), p. 1.
  • 9. Hathaway, W. Headache pill eases alcohol cravings. Hartford Courant, Oct 10, 2007.
  • 10. Jellinek, E. The Disease Concept of Alcoholism. New Haven, CT: Hillhouse, 1960, p. 23. E.M. Jellinek was a strange character. Learn some of his secrets!