It therefore gives little attention to more wholistic approaches which consider the control of alcohol availability or other environmental factors. According to the prevailing conventional wisdom at that time, there was no need to restrain access to alcohol or develop programmes for the majority of nondependent drinkers who were not afflicted with the disease of alcoholism. The disease concept of alcoholism was consonant with the development of specialized inpatient, medically oriented treatment. It reached its zenith in the 1950s and 1960s in Canada. However, over the past two decades, the disease concept of alcohol problems has been seriously called to question by public health agencies and epidemiologists in Canada.
Alcoholism is only one of many health and social problems associated with alcohol use.
It has been demonstrated that alcohol consumption well below that of clinical alcoholics can greatly elevate the risk of cirrhosis and other health problems. There is no magic threshold at which a person suddenly becomes an alcoholic or becomes likely to experience an alcohol-related health or social problem. Drugs can similarly have adverse effects among nondependent users. Most illicit drug users never become addicted, and those who do tend to drift in and out of dependence, depending on their social and economic circumstances. All of these findings challenge the disease concept of alcohol and drug problems.