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What Is the Disease Theory of Alcoholism?

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Following the end of World War II, health professionals and scientists postulated the mechanisms behind alcoholism. Today, their findings and models have been refined and adapted into the Disease Theory of Alcoholism, which is widely used to educate people on how addiction affects the brain.

Definition & History

The Disease Theory of Alcoholism states that alcohol addiction is a brain disease that alters the way a person thinks, feels, and makes decisions. A healthcare professional can diagnose, observe, and uncover the causes of alcoholism as they would any other medical illness.

In 1956, the American Medical Association (AMA) categorized alcohol dependence as an illness. In the early 1990s, the AMA officially categorized alcohol dependence as both a medical and psychiatric illness.

Diagnosis of Alcohol Dependence

The theory also supports that medical assessments can help determine optimal treatment for alcoholism on a case-by-case basis. To meet the criteria for an alcohol dependence diagnosis, a person must display four symptoms:

  • An alcohol tolerance that requires the person to drink more and more to experience the effects of intoxication
  • Withdrawal symptoms like trembling, nausea, confusion, depression, etc. upon stopping consumption
  • A loss of self-control and an inability to limit the amount of alcohol consumed
  • Subsequent physical, mental, and social limitations that result from these symptoms

Alcoholism as a Disease

From a disease perspective, alcohol dependence resembles a remission/relapse disease rooted in the brain. Ethanol can quickly spread throughout the body and damage the heart, liver, and brain. Left unchecked, alcoholism often increases in intensity, due to the diminishing returns (tolerance) and increased neurological effects.

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Alcoholism can have a powerful effect on a person’s professional, social, and personal life. Families grow apart, careers tumble, friendships break, and legal consequences may arise. The disease theory also supports treatment and a positive outlook. Tailored treatments are the most effective, and support from loved ones can make a significant difference in recovery outcomes.

What the Detractors Say

But some say that this is precisely the problem with the Disease Theory of Alcoholism. Once the stigma was removed, drinking – and drinking heavily – became socially acceptable, and even the liquor industry embraced the theory because it implied that most people can drink freely without the risk of becoming addicted to alcohol, according to addiction experts Reid Hester and Nancy Sheeby, who believe that this theory effectively removed personal choice and responsibility from the equation.

The Baldwin Institute agrees, suggesting that the Disease Theory’s central idea of alcoholism requiring medical intervention transferred the responsibility of problem drinking from the individual to the caretaker.

New Findings & Adaptations

Many breakthroughs in alcoholism research have stemmed from the original disease theory.

  • Biological Model – Biological studies propose a new biophysical disease theory of alcoholism. This model examines how genes and other biological influences can cause imbalances in certain brain chemicals. Alcohol disrupts normal lipid and enzyme functions in the brain, which may be more prominent in people with certain genetic qualities.
  • Genetic Model – Another genetic model suggests that a person with a family history of alcoholism is more likely to develop alcohol addiction. Recent studies point to the existence of a “tolerance gene,” which may promote alcohol dependence. However, having the gene is by no means an end-all determinant. Environment, education, and personal choices play significant roles in the alcoholism puzzle.
  • Psychological Model – Yet another model focuses on the psychological perspective, specifically that of denial and adaptation. Alcoholics are more likely to deny underlying issues in their lives and attempt to block them out with alcohol. They may not interpret alcoholism itself as a problem and fail to make positive changes.
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Countless other models revolve around the core principles of the disease theory, but it’s important to remember that individualized treatment is the defining factor in recovery. Professional clinicians can provide counseling and assess a person for other underlying disorders to create a personal treatment plan.


  1. Beresford, Thomas, Models of Alcoholism: Medical/Physiological Causes,, 14 January, 2014,


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