Alcoholism is on the increase. The number of sufferers is increasing dramatically as our society becomes inundated with more and more ways to buy and take alcohol.
To the general public, alcoholism is usually seen as some form of personal inherent weakness in the individual. A lack of will power, and very much mostly the fault of the sufferer.
However, both the National Council on Alcoholism and Drug Dependence and the American Society of Addiction Medicine define alcoholism as a 'primary chronic disease characterised by impaired control over drinking, preoccupation with the drug alcohol, use of alcohol despite adverse consequences, and distortion in thinking'.
Unfortunately, this recognition has not been universally accepted, and certainly not recognised as such by the population at large. This is not unique. Exactly the same scenario pertains in relation to obesity. Once considered to be the fault of the individual, it is now widely recognised by experts to be a genuine disease. Again, this acceptance by the professions is not mirrored in the general public.
It is my thesis that acceptance by the public that these conditions are chronic diseases is vital to the development of appropriate management protocols; including their funding. I believe that this acceptance can be moved forward by using analogies with other chronic diseases.
Therefore, from the outset, I would characterise alcoholism as a chronic, progressive, possibly (as yet) incurable and potentially fatal disease. Let's explore this a little.
It's just like asthma. Are we all agreed that asthma is a chronic, progressive, possibly incurable (as yet), and potentially fatal disease? Of course we are.
It's just like type 2 diabetes. Are we all agreed that type 2 diabetes is a chronic, progressive, possibly incurable (as yet), and potentially fatal disease? Of course we are.
Also, it's just like obesity. Are we all agreed that obesity is a chronic, progressive, possibly incurable (as yet), and potentially fatal disease? May be not, I guess.
"It's just the fat person's fault they are fat - it's because they over eat and don't do any exercise", I can hear you say. I can hear you say it because, throughout 25 years practising medicine, I have heard it a million times, both from lay people and the profession itself.
I would propose, and have done now for many years, that obesity is at epidemic proportions because:
Some people have a genetic predisposition to this disease; through many social, emotional and other circumstances, they turn to a recreational drug for solace and comfort; the recreational drug they 'choose' is food; they live in a toxic food environment, where their recreational drug of choice is - legal; readily available; and cheap their recreational drug of choice actually works. It does for them what they seek. It may have many other adverse problems and complications, but that does not matter. It works.
When I qualified in medicine in 1984, obesity was just 'fat people'. You eat a lot, you get fat. Simple. It's your fault. Either diet and exercise, or you will stay fat and die. And if you die, then that was your fault too. At that time, there were (and of course still are) lots of other disease that we all felt very sorry for the sufferers of.
Asthma, diabetes, heart disease, lots of cancers, strokes, hypertension, polycystic ovary syndrome, infertility, gall stones, depression, to name but a few, all took up thousands of pages of my text books and as many hours of my time. In the clinics and wards, I spent hundreds of hours dealing with patients with these conditions. And lots of them were fat too. Shame on them for being fat too!!
Within the last few years, it has finally dawned on the ever so slow medical profession that these weren't just diabetes (or whatever) patients who happened to be obese. The obesity was actually the cause of their diabetes (or heart disease, or infertility, or high blood pressure etc). You could throw any amount of diabetic or other medication at them to manage their diabetes, but if you could reverse their obesity, you could cure their diabetes, or high blood pressure. Further, you could significantly reduce their risk of developing lots of cancers.
How fantastic is that?
For many, but probably not all, people like us, we have an in-built predisposition to alcoholism (and maybe other addictions). Many, but again not all, of us also have personality traits that make us seek some form of solace, or comfort, or escape. I know I have. For us, our chosen recreational drug is alcohol, and we most certainly live in a toxic alcohol environment.
Therefore, alcoholism most definitely IS a disease.
That is why I consider us to be sufferers from alcoholism, just like there are sufferers from asthma, and sufferers from diabetes. I'm afraid that the term alcoholic is never going to reach the sympathy level of asthmatic or diabetic. Being an asthmatic is always going to be more acceptable than being an alcoholic. We will just have to accept that, I guess.
However, acknowledging the principle that alcoholism is a disease means that it must be dealt with as a disease. It needs to be managed, and hopefully eventually cured, not merely ignored and chastised. And funds must be made available to complete this honourable task.
Baclofen just might be the first step to finding a whole new approach to that cure.
I hope so.
And I believe so.