Why I don't call you an alcoholic

It's worth talking about a few words you won't see much of here - and why I think it's entirely up to you what you call yourself, or what you call your problem.

I don't tend to use the words 'Alcoholic', or 'Alcoholism'.

A lazy, unhelpful and insulting label?

Firstly, calling someone an alcoholic has always seemed to me to imply that everyone with a drinking problem is the same. It's also used very loosely in general conversation and in the media, and usually in a very negative and judgemental way.

Surely it's more helpful to treat each person on their merits, and to work out why they might have developed a drink problem, and how they might be able to resolve it?

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Secondly, if you think of 'alcoholism' as a disease, you might start thinking that it's not up to you whether you drink or not. “I'm helpless. What am I to do but to carry on drinking? I'm an alcoholic!”

I'd rather think that drinking is a choice - a bad choice made in the midst of a sometimes overwhelming compulsion.

The good news about looking at it like this is that you can take your life in your own hands and change things for the better.

That's why I wouldn't be so impertinent as to call you an alcoholic. However, if it helps you to make sense of things by calling yourself one, that's absolutely fine - you're in charge.

So is alcoholism - or problem drinking or whatever you want to call it - a disease?

I don't think that you can call addiction to anything a disease or an illness.

Yes, there are biological factors involved in both physical dependence and cravings. And there may well be certain people who are more susceptible to addiction than others - although it's hard to separate your genetics from your upbringing.

But any addiction is, however you approach it, ultimately conquered by choice. In this case, by choosing not to drink. Whether you decide not to drink by turning yourself over to a higher power or not, you're making choices.

Seeing 'alcoholism' as a disease may, however, be a very potent and useful metaphor for many people. Like a disease, compulsive drinking can destroy the body and the mind. Like a disease, it can be a progressive and chronic condition that get worse and worse until the patient dies. And even when the patient has stopped drinking for years, they must always be on the lookout for relapse - as if the disease has only been in remission.

There's a great scene in the The Wire (an American television drama), where the recovering addict Walon, played beautifully by the singer Steve Earle, addresses an NA meeting:

“I been clean a few 24 hours now, and I'm certain my disease wants me dead. My disease is out there in that parking lot, doing push-ups, on steroids, waiting for the chance to kick my ass up and down the street.”

A lovely example of using the idea of addiction as a disease to represent the ever-present possibility of self-sabotage and relapse.

(Watch it by searching for 'I got one more high left in me' on YouTube.)

Oh - one more thing! You might want to consider whether if addiction can be classed as a disease, then might anyone be looking to make more money out of it? Drug companies marketing a wonder cure? Or private rehabs that rely - in America especially - on money from health insurance policies?