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Why Is Alcoholism Classified As A Mental Illness?

July 19th, 2011 – Posted by James W. West M.D. F.A.C.S. in Doctors Office


Question:  If alcoholism has a high death rate, why is it classified as a mental illness? I thought people died of physical disorders.

 Answer:  They do, so alcohol combines the elements of both mental illness and physical disease. Alcoholism is classified as a substance abuse disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM-III). Mental and emotional symptoms of alcoholism exist long before the grave physical complications of the disease appear. The mental symptoms consist of loss of control (taking in larger amounts of alcohol over a longer period of time than the person intends); persistent desire to drink (one or more unsuccessful efforts to cut down or control drinking); continued drinking in spite of adverse social, occupational, or legal consequences; and frequent intoxication or withdrawal symptoms when expected to fulfill major obligations at work, school, or home. These are all behavioral or mental symptoms, which, unless interrupted permanently by treatment, will inevitably lead to physical complications of alcoholism. Cirrhosis of the liver, chronic brain deterioration, and other grave organic consequences occur as a result of long-term heavy drinking, but the core of the disease is the cluster of behavioral symptoms that constitute the mental disorder called alcoholism. Consequently, the treatment of alcoholism targets the mind rather than any physical system. So alcoholism and all other substance abuse disorders are mental disorders, with a high physical complication rate.

Related posts:

  1. Is alcoholism a mental disease?
  2. Do alcoholics also have a mental disorder?
  3. What is the treatment for addictive disease?
  4. What is addiction treatment?
  5. What does dual diagnosis mean?


11 Responses to “Why is alcoholism classified as a mental illness?”

  1. jennifer says:

    so, why then did the AMA (American Medical Association) diagnosis Alcoholism as a physical disease in the 1950’s and mental treatment programs, including AA, only have a success rate in the 20’s%. when the one treatment program out there (in the Minneapolis,MN) area has around a 90% success rate. Alcoholism has a large genetic component (predisposition) just like Diabetes. Genetics along with environmental exposure determines the severity of the illness. You can’t talk someone out of being a alcoholic anymore than you can talk a diabetic out of being a diabetic. Support groups help with the mental component, but physical healing is still the larger component, and is almost never addressed in most abuse treatment programs.
    As someone that has been through almost every type of program out there, we have to stop putting so much emphasis on the mental side – too many people are dying due to depression and PAW (post acute withdrawal) symptoms, usually by suicide – even months or years after remaining sober -, when this very important part of the recovery of an alcoholic is ignored and a lot of times ridiculed by the “main stream” treatment programs that are all that most people with alcohol problems can afford. Most will not even realize there are better options out there. I found it because of my background as a Biologist RN and my passion for doing research.
    Please do not ignore the physical healing that needs to be a large part to a recovering alcoholic. After the physical abuse of the substance there needs to be a corresponding physical healing; it is not just exercise and eating a balanced diet. Large doses of vitamins, that have been absent in a active alcoholics diet, the right foods (just like a diabetic has to eat a diabetic diet if they want to remain healthy).

  2. Steve says:

    So can we say Alcoholism is not a disease, but an addiction which can result in disease?

  3. Beth says:

    Jennifer, Please tell us the name of the place in MN that has the 90% success rate. Someone I love dearly life depends on it!

  4. Kathleen says:

    I don’t believe for a minute there is anywhere out there that has a 90% success rate. And success would have to be 5 or more years of uninterrupted sobriety in my opinion. This is the number of years that often indicates a good chance of lifetime success. What is the name of this miracle program, and why haven’t you shared it?

  5. Jimmy says:

    Regarding Jennifer’s comment – She’s referring to a Scientology-related program called Narconon that is commonly sold as having such high success rates, though without much in the way of supporting evidence. Anyone reading that comment should certainly heed Kathleen’s hesitancy, and if you google Narconon 90% you’ll find more information about the claims.

  6. Jason says:

    Jennifer’s advice is dangerous imho:
    She says, ” stop putting so much emphasis on the mental side – too many people are dying due to depression … usually by suicide … even months or years after remaining sober.” In other words, she is pointing out MENTAL HEALTH issues.

  7. Julie F. says:

    I have two brothers who went to Narconon, they are two people which contribute to that 90%. Narconon is very expensive; years ago when they went, it was 25,000USD. One of the big problems with a lot of other programs is that they do not teach you how to change your lifestyle and have set goals, replace the alcohol or drugs with productive things, become financially independent and learn the tools to maintain a drug free lifestyle. Alcohol IS a drug by the way. When you are an addict for years, you forget how to function in daily situations, how to take responsibility for your actions and your moral standards are absolutely completely off.
    Anyway, yes, Narconon is a scientology based program, but every program teaches you to give yourself to a higher power, Scientology becomes their higher power. Who cares what it is that makes it work for the addict if it helps them lead a happy and healthy lifestyle? Most people revert back to the disease because they never learn how to function and cope without it.

  8. Dave S. says:

    AA is successful when people follow the directions. Most people who say “it doesn’t work” decided they knew better or they wanted to run the show or they didn’t like one of the directions and did things “a little differently” and so whoops–big surprise–they relapsed. Often when that happens, it’s simply because people are upset that they’re not God and they can’t control everything. Instead of making an honest attempt to find the solution that MILLIONS of people have used, they find something they don’t like so they can reject it. The irony is that this usually ends with more pain, more suffering, and great resentment against the very program that would solve their problems and improve their lives.

    If you conducted a study where people did exactly as suggested according to the AA program (as written in the book “Alcoholics Anonymous”), you would see over 90% success rate. Past proof: over 90% of early (mid 20th-century – before treatment centers became popular) AA participants remained sober. My present-day proof: 9+ years of being completely sober (no booze, no drugs and not even nicotine), and I know hundreds–maybe thousands–of people with long-term, continuous, high-quality sobriety.

  9. Betty Ford Center says:

    Thank you for sharing your feelings about 12 Step support – we appreciate you taking the time to express yourself so clearly.

  10. Gerald B. says:

    Alcoholism is a metabolic disorder like diabetes and not a mental illness. Most type 2 diabetics have a really bad abstinence rate, too, even though not being abstinent from bad food is killing them. Unlike mental illness, most alcoholics lead normal lives when not drinking. It is the effect of alcohol that creates what appears to be a mental illness. Take the alcohol out of the picture for alcoholics and within a year, their psychological profiles match the general population statistical percentages. Without alcohol, there is the same number of depressives and wife beaters as the general population. By the way, a cure means that an alcoholic can drink like a normal person. That means, like a diabetic eating pasta or chocolate, if we were cured we could have a little this month and not care if we ever had it again. It would be the equivalent of drinking water. No, there is no cure for alcoholism or diabetes. The best one can do is complete abstinence from that which starts the obsession to have some more.

  11. Harry O. says:

    I believe drug abuse (e.g. alcohol, meth, cocaine, etc.) to the point that the brain is indeed altered physically and/or “mentally” is a PHYSICAL disease LOCATED IN the brain – rather than a “mental disorder” of the brain. If the brain is rewired or partly destroyed, then that is physical – not “mental” (what, our mental thoughts and emotions are diseased? That’s deranged x2). What is “mental” anyway? Can anyone define that? A state of mind? A mood? Learned response to receive desired reaction? If there is something wrong with the brain’s chemistry, it is still a physical component out of whack, so to speak, rather than “mental.” I just think there is too much mysteriousness, hocus-pocus placed on “mental”, when it is either physical brain disorder or bad thinking. Am I close, way off?

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