Talk:Disease theory of alcoholism/Archive 1

message: “The Disease model of addiction is probably the most controversial and debated topic in the entire field of substance abuse/addiction. One would have to be well informed on the subject to even attempt to understand the controversy intelligently. This site will not claim to know for sure one way or the other (disease/not disease) but will present a little of both sides of the on going debate with in the professional circles. First, we must accurately define Disease, since when the word disease is mentioned most think of something like cancer, aids, heart, etc., something which can be isolated in part and extracted from the body and visibly viewed and observed by the eye under a microscope or other apparatus. This is not the case with the "disease of alcoholism/addiction" or at least not at this time. According to Webster's Dictionary disease is defined as follows:
"Disease: Any departure from health presenting marked symptoms; malady; illness; disorder." Then we must go on to define concept as well, which according to Webster's is: "Concept: A notion, thought, or idea." 
This popular model of addiction is credited to E.M. Jellinek who presented a comprehensive disease model of alcoholism in 1960(13). The World Health Organization acknowledged alcoholism as a serious medical problem in 1951, and the American Medical Association declared alcoholism as a treatable illness in 1956. Following Jellinek's work, the American Psychiatric Association began to use the term disease to describe alcoholism in 1965, and the American Medical Association followed in 1966 (14). As with many concepts and theoretical models in the addiction field, the disease concept was originally applied to alcoholism and has been generalized to addiction to other drugs as well. The "disease of addiction" is viewed as a primary disease. That is, it exists in and of itself and is not secondary to some other condition. This is in contrast to the psychological model of Dual Diagnosis (discussed in the next section), which addictive behavior is seen as secondary to some psychological condition.
 
Arguments Against the Validity of the Disease Concept 
As earlier stated, the disease concept is controversial and not without critics. Two well-known critics are Stanton Peele (16) and Herbert Fingarette (15), both of whom have written books, as well as articles disputing the disease concept of addiction. 
Since the disease concept is attributed to Jellinek, a lot of criticism has been directed at his research, which was the basis for his conclusions about the disease concept. Jellinek's data were gathered from questionnaires that were distributed to AA members through its newsletter, "The Grapevine". Of 158 questionnaires returned, 60 were discarded because members had pooled and averaged their responses, and no questionnaires from women were used. Jellinek himself acknowledged that his data was limited. Therefore, one might wonder why Jellinek's concept of the disease of alcoholism received such widespread acceptance. 
One reason is that the disease concept is consistent with the philosophy of AA, which is by far the largest organized group dedicated to help for alcoholics. 
Secondly, as Peele noted: "The disease model has been so profitable and politically successful that it has spread to include problems of eating, child abuse, gambling, shopping, premenstrual tension, compulsive love affairs, and almost every other form of self-destructive behavior... From this perspective, nearly every American can be said to have a disease of addiction." (16) 
Herbert Fingarette goes on to state that the alcohol industry itself contributes to forming a public perception of alcoholism as a disease, as a marketing ploy: 
"By acknowledging that a small minority of the drinking population is susceptible to the disease of alcoholism, the industry can implicitly assure consumers that the vast majority of people who drink are not at risk. This compromise is far preferable to both the old temperance commitment to prohibition, which criminalized the entire liquor industry, and to newer approaches that look beyond the small group diagnosable as alcoholics to focus on the much larger group of heavy drinkers who develop serious physical, emotional, and social problems." (15) 
There are many other criticisms of the disease concept, however we will not go in to them at this time. Instead we will review some of the evidence to support the disease concept. 
Arguments Endorsing the Disease Concept
 
Since the introduction of the disease concept research studies have examined a possible genetic link in alcoholism/addiction. One such study demonstrates that the offspring of alcoholics are approximately three to five times more likely to develop alcoholism than offspring of non-alcoholics (18). However, the genetic influence on other drug addiction has received less research attention. Also, in 1983, there was a popular theory of alcohol addiction expressed by D.L. Ohlms in his book "The Disease Concept of Alcoholism"(17) that proposed that alcoholics produced a highly addictive substance called THIQ during the metabolism of alcohol. 
THIQ is normally produced when the body metabolizes heroin and is supposedly not metabolized by non-alcoholics when they drink. According to Ohlms, animal studies have shown that a small amount of THIQ injected into the brains of rats will produce alcoholic rats and that THIQ remains in the brain long after an animal has been injected. Therefore, the theory is that alcoholics are genetically predisposed to produce THIQ in response to alcohol, that the THIQ creates a craving for alcohol, and that the THIQ remains in the brain of the alcoholic long after the use of alcohol is discontinued. This would provide a physiological explanation for the fact that recovering alcoholics who relapse quickly return to their previous use patterns. More recent research on genetic causes of alcoholism has focused on some abnormality in a dopamine receptor gene and deficiencies in the neurotransmitter serotonin or in serotonin receptors (19).
 
As you can see from the above information there is still room for debate and I assure you that the controversy continues.”  Medical Man 03:37, 1 July 2006 (UTC)
replies: text: You've put your finger on the problem. On the one hand, the source that you've cited here recognizes that several groups support the disease concept of alcoholism, groups such as the World Health Organization, the American Medical Association, and the American Psychiatric Association. And then the source cites two individuals, both of whom are well-known in the field for their controversial perspective that is in disagreement with the community standard. Two individuals, however, do not make for a debate and controversy. They are simply standing up to speak out against the status quo. That action is commendable. Without people like them, the world wouldn't change. But the broad scientific, medical, and research communities are not in agreement with these two individuals. Their perspective should be noted, but their perspective does not mean that the entire scientific basis of a disease state should be tossed out by Wikipedia any more than by the academic community. You might assure me that the controversy continues because you wish it would, but in my day-to-day work in this field, with ongoing contact with academic, research, and the scientific communities, I have seen no evidence of any such controversy. There are indeed many controversies in the field...do medications work to treat alcoholics...what genes lead to a predisposition to alcoholism...what percent of patients can be reliably treated with self-help groups; but the broad definition of alcoholism and epidemiology of its incidence and prevalence are all well-known and well-accepted. Drgitlow 04:11, 1 July 2006 (UTC)
replies: text: Please don't read so selectively. The Research Society on Alcoholism and the American Psychological Association are not "two individuals. They can't be trivialized and ignored. It's obvious to anyone open to reality that "The Disease model of addiction is probably the most controversial and debated topic in the entire field of substance abuse/addiction". There is no consensus and you can't wish it into being.Medical Man 15:23, 1 July 2006 (UTC)
replies: text: The Research Society on Alcoholism and the American Psychological Association are not the two individuals I spoke of. Nor are those organizations opposed to the disease model of alcoholism. The two individuals are the ones cited just above, Fingarette and Peele. What is apparently obvious to you isn't to the majority of the scientific and medical communities. It may be that you are much brighter than they are, and that they have some catching up to do, or it may be that you aren't up to date on the topic. Either is a rational explanation. If you really think the RSA and A. Psychological A. are opposed to the disease model of alcoholism, why don't you just ask both organizations to write you a note saying as much. The RSA is founded on the principle that alcoholism is a disease; it's the whole point of the RSA's being in existence. And the A. Psychological Association also appears to have policy on alcoholism and addiction as disease states; I refer you to their website for further information. So you've unfortunately been misled. Why don't you make a phone call and get a letter from either group's board saying that they don't believe in the addiction=disease concept? I suspect you'd get nowhere very quickly. Drgitlow 16:01, 1 July 2006 (UTC)
thread_title:  "The Disease model of addiction is probably the most controversial and debated topic in the entire field of substance abuse/addiction" 

message: As explained in "The disease model of alcoholism: a Khunian paradigm" , "The disease model of alcoholism has a history dating back more than two hundred years, and is considered by many to be the dominant paradigm guiding scientific inquiry and treatment approaches for much of the 20th century. However, as early as the 1960s, the disease model came under attack due to the emergence of anomalous scientific and clinical findings. Outside of the United States, the disease model is considered by many to have been discredited, and has long been abandoned in favor of alternative models, such as social-learning theory (Heather & Robertson, 1997). Yet, in the United States, the disease model and its primary treatment goal of abstinence continue to over-whelmingly dominate the treatment of alcoholism (Rosenberg & Davis, 1994; Rosenberg, Devine, & Rothrock, 1995; Weisner, 1996). Among other explanations, the financial and political motives of the U.S. alcoholism treatment community have been offered to explain why the U.S. continues to lag behind other countries in moving beyond the disease model (Fingarette, 1988; Peele, 1989; Sobell & Sobell, 1995). However, an alternative reason for the reluctance of the alcoholism treatment community to relinquish the disease model is revealed by utilizing Kuhn's (1996) model of scientific progress in an historical analysis of the disease model."
Drgitlow, this seems inconsistent with your argument that 1976 was the tail end of the long disease controversy. What's your explanation?Medical Man 04:16, 2 July 2006 (UTC)
replies: text: Paging drgitlow....  What's your explanation???Medical Man 01:31, 3 July 2006 (UTC)

text: The author of the linked article is not a medical doctor or neuroscientist.  The debate about the disease theory should be based on the evidence presented by experts on disease. (Note: I changed the broken link to the one listed on the wiki page). elplatt 20:55, 20 January 2007 (UTC)

text: The disease theory is not strictly profitable in the US.  Consider TRAYNOR v. TURNAGE, 485 U.S. 535 (1988), in which a decision against the disease theory freed the government from financial responsibility to alcoholic veterans seeking education.  The disease theory poses significant financial loss to the government and medical insurance companies, who would be obligated to pay for treatment. elplatt 20:56, 20 January 2007 (UTC)

text: In recent decades, the US has led the world in neuroscience research.  Technologies such as fMRI, PET, etc. are not as available elsewhere.  There is no reason to believe that the US is "lagging behind" in the debate, and more reason to believe that the US is forging ahead. elplatt 21:04, 20 January 2007 (UTC)

text: "as early as the 1960s, the disease model came under attack due to the emergence of anomalous scientific and clinical findings."  I have seen no such findings from scientific sources.  Please provide references. elplatt 21:06, 20 January 2007 (UTC)
thread_title:  Disease model not popular in countries where it's not profitable 

message: A recent study of physicians and non-physician alcoholism treatment practioners in Canada  reported that 82% of nonspychiatriatrist and 84% of psychiatrist physicians believe that alcoholism is a "mental disorder,"  that physicians "largely espouse a disease notion of alcoholism," and  that "Physicians are more likely to endorse a disease concept of alcoholism than are nonphysician practioners."  Social workers tended to be neutral  and counselors tended to accept it on average very mildly. There’s clearly no consensus in the alcoholism treatment field.
Meza, E. et al. Alcoholism: beliefs and attitudes among Canadian alcoholism treatment practioners. Canadian Journal of Psychiatry, 2001, 46, 167-172. Medical Man 21:19, 4 July 2006 (UTC)
replies: text: Please do not clutter the introduction with 18 external links. A short sentence describing why it is thought that the "disease theory" may be wrong is what is appropriate, and the rest should be put in its own section. Something like, "However, others consider heavy alcohol use to be a wilful decision that is not caused by biological influences outside of the drinker's control." or "However, there is little confirmed evidence that heavy alcohol use is caused by forces outside of a person's control." —Centrx?talk • 21:45, 4 July 2006 (UTC)
replies: text: Reality check: If only 82% of nonpsychiatrist physicians endorse the disease concept, that's not conseensus. A substantial proportion of physicians, and an even larger of other treatment professionals, reject the hypothesis.Medical Man 00:05, 5 July 2006 (UTC)
thread_title:  More evidence: No consensus in alcohol treatment field 

message: When quoting legal cases, the full case must be reviewed to determine the origin of material. Here is the section of interest from Traynor v Turnage with respect to the quotation recently edited:
:Petitioners, however, perceive an inconsistency between 504 and the conclusive presumption that alcoholism not motivated by mental illness is necessarily "willful." They contend that 504 mandates an individualized determination of "willfulness" with respect to each veteran who claims to have been disabled by alcoholism. It would arguably be inconsistent with 504 for Congress to distinguish between categories of disabled veterans according to generalized determinations that lack any substantial basis. If primary alcoholism is not always "willful," as that term has been defined by Congress and the Veterans' Administration, some veterans denied benefits may well be excluded solely on the basis of their disability. We are unable to conclude that Congress failed to act in accordance with 504 in this instance, however, given what the District of Columbia Circuit accurately characterized as "a substantial body of medical literature that even contests the proposition that alcoholism is a disease, much less that it is a disease for which the victim bears no responsibility." 253 U.S. App. D.C., at 132-133, 792 F.2d, at 200-201. Indeed, even among many who consider alcoholism a "disease" to which its victims are genetically predisposed, the consumption of alcohol is not regarded as wholly involuntary.
The quotation, "a substantial body of medical literature...bears no responsibility," is not something Justice White said but rather is something that the District of Columbia Circuit Court stated in their decision. Justice White agreed with their decision. Note that the Supreme Court is not made up of scientists but of lawyers with political and fiduciary issues looming quite large in their minds. The basis of this case was in large part their knowledge that if indeed substance use disorders were to be considered on par with other diseases, the payment system in place would have been bankrupted. That is why so many mental health disorders are considered separately from other medical disorders by third party payors, Courts, and so forth. These decisions are unrelated to whether they are diseases or the degree to which they cause functional difficulty for the afflicted individual. 
I have corrected the entry to accurately state what Justice White said in his decision. An alternative approach could include using the original quotation that appeared, but referencing the DC Circuit instead of the Supreme Court. Drgitlow 13:53, 1 July 2006 (UTC)
replies: text: I think it's fixed now Mr Christopher 22:11, 1 July 2006 (UTC)
replies: text: Yup. Looks great. Thanks. Drgitlow 22:43, 1 July 2006 (UTC)
thread_title:  Justice White Quotation 

message: Make suggestions for new wording that meets WP:NPOV, WP:V, and NOR. Comment if you agree or make other suggestions FloNight talk 03:46, 2 July 2006 (UTC)
replies: text: Peele is a Phd. Psychologist (A Doctor, but not an MD or DO), as well as an attorney, and has treated people who were dignosed with the debated dignosis . We could also add DeLuca  to the list of those with qualms about the disease model, and he's actually an M.D./FASAM, and maybe also add in with Kern, Rotgers, Heit, Geller, Salsitz ... perhaps we could simply specify the credentials as we go, without trying to bias the reader? There's certainly no shortage of examples. Ronabop 06:58, 2 July 2006 (UTC)
replies: text: Ronabop very good idea.  The question "who are these people who question the AMA?" is one that should be answered in the article.  I'll wait for others to add their ideas and see what sort of consensus we have prior to making any changes.  Mr Christopher 13:42, 2 July 2006 (UTC)
replies: text: And I forgot, I vote no to calling anyone in this article a "pundit" or use terms like "non-md" as both terms in the context of this article would appear POV if not down right hostile  Do others have an opinion one way or another?  Mr Christopher 13:46, 2 July 2006 (UTC)
replies: text: I'm fine with that. I didn't mean pundit to sound pejorative so I'm fine with our not using it. And I never said Peele wasn't a doctor. I said he wasn't medical, which is true. DeLuca would probably be a better choice, Ronabop. Thanks. There isn't any issue of questioning the AMA. The AMA simply forms policy based on input from other organizations.Drgitlow 15:22, 2 July 2006 (UTC)

text: Actually, I'm puzzled now. I just reviewed Dr. DeLuca's position on his website; I don't see where he is supportive of your position (alcoholism is not a disease). He has had difficulties in the past based upon his confusion of the harm reduction model for treatment of opioid dependence and the abstinence-based treatment model for the treatment of sedative/alcohol dependence. This in part led to his leaving Smithers, if I recall the events there properly. But I don't think he's ever said that sedative dependence isn't a disease. He certainly has extensive background in the field, both in providing treatment and in training; if he is on the non-disease side, he would be a great reference to use here. Drgitlow 15:32, 2 July 2006 (UTC)
replies: text: Well, it's not just my position, but I think it might better to summarize his (DeLuca's) position as a) excessive drinking may be a problem, and b) other medical conditions can lead to excessive drinking. Thus, drinking to extremes may be a dis-ease in its own right, or it may merely be a *symptom* of greater dis-ease. Victims of "consumption" who drank would not be cured by avoidance of drink, they would simply be hurt more.Ronabop 10:11, 10 July 2006 (UTC)
thread_title:  Work on new wording for "a few non-medical alcoholism pundits" 

message: Miscellaneous trivia regarding Dr. Benjamin Rush can be placed at Benjamin Rush and doesn't belong in this entry since this isn't an entry about Dr. Rush. 
The controversy regarding EM Jellinek's degree can be found at E. Morton Jellinek and also doesn't belong in this entry since this isn't an entry about Jellinek. Drgitlow 16:24, 3 July 2006 (UTC)
replies: text:  I can understand why you want to censor this information about two of the major developers of the disease theory of alcoholism. However, it is essential information to help readers assess their credibility. By vandalizing it, you show a lack of good faith.Medical Man 18:33, 3 July 2006 (UTC)
replies: text: No, I show a willingness to discuss it here before something controversial gets put into the article. If you want to help readers assess the credibility of Jellinek and Rush, you'd have to do one of the following: a) refer readers to the full reference of Jellinek and Rush, or b) put extensive information into this article demonstrating the full range of Rush's and Jellinek's biographies. You can't simply say that you're going to put inflammatory statements about them here into this entry and that it's essential information for readers. That's not the way this works. Drgitlow 18:38, 3 July 2006 (UTC)
replies: text: Medical man, you have now added inflammatory material to the article on three successive occasions. Rather than simply revert the article yet again in response to your action, I think I'll just wait for the mediation to take place on this topic. Drgitlow 19:32, 3 July 2006 (UTC)
thread_title:  Miscellaneous Trivia 

message: We have 17 references in the first section. I've turned some from empty numbered links to fuller references but 17 really is over the top. Could somebody group them in some coherent way e.g. A, B and C argue X while D, E, and F argue Y? Nunquam Dormio 20:21, 26 July 2006 (UTC)
thread_title:  References 

message: I recently added 2 cats to this article, "Alcohol abuse" and "Medical terms". If anyone can think of other cats that would be appropriate it would help increase the article's exposure. BTW - I've been away a while and this article has come a long way. Good work :) --Doc Tropics Message in a bottle 22:58, 27 October 2006 (UTC)
replies: text: Following suggestions from a more experienced editor, I also changed the first sentence to include a "bolded title". I tried to do it without changing much else, especially the intended meaning. The bolded title is considered a standard stylistic element (hence, needs to be there), but if anyone can write the opening more clearly, feel free. --Doc Tropics Message in a bottle 16:50, 28 October 2006 (UTC)
thread_title:  Categories 

message: It has been suggested (by Elonka) that the "Cited papers" section should be moved into "References" either directly or through in-line cites. Unfortunately, even after reading WP:CITE I'm afraid that if I try to do it myself I'll just make a mess of things. If someone else can tackle this, it's the last thing that needs to be done before removing the "wikify" tag. --Doc Tropics Message in a bottle 17:37, 28 October 2006 (UTC)
replies: text: Job done Nunquam Dormio 18:29, 28 October 2006 (UTC)
replies: text: Wow, good job! Thanks ND. I've removed the "wikify" tag. --Doc Tropics Message in a bottle 18:32, 28 October 2006 (UTC)
thread_title:  Cited papers 

message: I know that EMJ is extremely controversial and the subject of some heated debates. After reading the cite I made a couple of changes which seem to be more accurate and less POV. Specifically, the cite did not state that EMJ has "been called a liar and a fraud". Also, there doesn't seem to any controversy about his Masters degree, only his Doctorate. --Doc Tropics Message in a bottle 17:44, 28 October 2006 (UTC)
thread_title:  Jellinek 

message: There are a wide range of opinions on the disease thoery, and they can't all be right.  Furthermore, the affect of addictive substances on the brain and body is far from completely understood, even by experts.  Given that some of the existing opinions must be at least somewhat misconstrued, and that all are based on partial information, we should avoid using the number of people who take a given opinion as justification for it.  Instead, we should focus on reputable scientific results in presenting the argument.  Of course we should present information on how widely the disease theory is accepted for completeness, we just shouldn't use it as justification.  Elplatt 21:23, 20 January 2007 (UTC)
thread_title:  Avoiding circular logic 

message: I found this new NPOV edit and am not comfortable lack of references.  I am undoing the edit.  It stated:
"During the past decade, a key physiological difference between alcoholics and non-alcoholics was discovered. A medical scientist named Virginia Davis studied the surgically dissected brains of recently deceased winos. She discovered Tetrahydrolsoquinoline – (hereinafter THIQ), in the brains of dissected alcoholics. In metabolizing alcohol, drinker’s bodies first convert alcohol into acetaldehyde. Acetaldehyde is metabolized into acetic acid (vinegar) and then into carbon dioxide and water towards elimination. During the process of metabolizing acetaldehyde, alcoholics derive THIQ, which is stored in their brain.
  	 	
THIQ appears to be manufactured in the brain, and is not produced in the brain of an ordinary drinker of alcohol. Heroin addicts also produce and store THIQ in their brains. THIQ is a potent painkiller, and is far more addicting than morphine. Injecting THIQ into test animals has artificially created alcoholism in laboratory animals. Clear and convincing empirical evidence substantiating the disease concept of alcoholism exists."
--DisneyFreak96 23:13, 20 January 2007 (UTC)
replies: text: Agreed.  The lack of references is concerning.  I checked it out and found multiple references to the research, but no information on the research itself.  All references I found cited can be traced back to The disease concept of alcoholism by David L. Ohlms.  His credentials and the original research should be looked into further. Elplatt 23:46, 20 January 2007 (UTC)
thread_title:  THIQ 

message: I've significantly restructured the article.  However, I've made no significant changes to the content of the article.  The new structure distinguishes the theory, history, and controversy from each other, resulting in a clearer and more precise article.  Please discuss any further changes to the structure here before making them. --Elplatt 00:36, 24 January 2007 (UTC)
replies: text: Nice work.  Mr Christopher 02:03, 24 January 2007 (UTC)
replies: text:  I agree.  It is much clearer than last time I visited. --DisneyFreak96 07:32, 4 February 2007 (UTC)
thread_title:  Article structure 

message: The phrase
: The disease theory is generally accepted by the medical community
was removed from the intro for being "POV and unsubstantiated."  This is not POV, this is fact.  Furthermore, this is substatiated in the disease theory of alcoholism#Current acceptance section.  Please read the whole article before messing with it. --Elplatt 07:32, 5 February 2007 (UTC)
thread_title:  Acceptance 

message: :Most medical clinicians consider alcoholism a disease influenced by genetic, psychological, and social factors and characterized by compulsive drinking with impaired control and preoccupation with and use of alcohol despite adverse consequences. However, the disease theory is still controversial among the public at large. US Supreme Court decisions, books, and scientific journal articles demonstrate this lack of consensus.
This section is a bit confusing and needs to be clarified. Is the 'scientific journal' part referring to studies relating to the acceptance of alcholism as a disease by the public or is it referring to studies about whether alcholism is a disease. If it's the later, then who are the scientists who still doubt alcoholism is a disease? Since the first sentence and the rest of the article suggest it's not those involve in medical research anyway... (N.B. the fact that there are some studies suggesting alcoholism is not a disease does not indicate a lack of consensus. This would require a resonable large number of studies and/or a resonable number of scientist doubting the theory. The fact that a scientist publishes or is involved in which which may suggest alcoholism is not a disease also should not be taken in itself as evidence the scientist does not accept the theory that alcoholism is a disease.) Nil Einne 15:13, 21 March 2007 (UTC)
thread_title:  Confusing 

message: This had a "citation added" tag since feb.  I removed it because no one had come up with the citation, and it is not true.  Someone returned it, with a phony looking source.  FYI:
"Full citations
All citation techniques require detailed full citations to be provided for each source used. Full citations must contain enough information for other editors to identify the specific published work you used.
Full citations for books typically include: the name of the author, the title of the book or article, and the date of publication. The name of the publisher, city of publication, and ISBN are optional. For journal articles, include volume number, issue number and page numbers." (official wiki policy on citations)
I am removing this unverifiable claim.
:Speaking of citations, does anyone know why there is a link to the American Public Health Association? I can't find anything on there about the disease theory of alcoholism. — DavidMack 03:48, 1 July 2007 (UTC)
thread_title:  Acceptance by medical community of disease concept 

message: I would like to hear what people think about renaming this page to Disease concept of alcoholism. Rationale: there is no single disease theory, there is a concept of alcoholism as a disease, with many possible theories on whether it is or is not a disease and what type of disease it might or might not be. See, for example, alcoholism, disease concept of in the World Health Organization's Lexicon of alcohol and drug terms. — DavidMack 23:28, 29 June 2007 (UTC)
thread_title:  Possibility of renaming page 

message: I wonder if we should put a qualifier in for Dr. Thomas Szasz's opposition to the desease model of alcoholism, as he has an extremely controversial position on all mental diseases.Desoto10 (talk) 21:50, 11 April 2008 (UTC)
thread_title:  Opponents 

message: I've made quite a few minor changes, removed some of the more bizarre bits, edited down, and a structural change to this little article. I think in needs looking at by an expert in the field.
I've put the bits that don't relate to the debate in a Miscellanea section. I think those three items should probably be removed as they don't add anything to the article really. Mr Miles (talk) 23:52, 28 April 2008 (UTC)
thread_title:  Changes 

message: Very good book on the topic. -- Scarpy (talk) 19:50, 29 April 2008 (UTC)
replies: text: Does this book include neurological approaches to the understanding of addiction? Mr Miles (talk) 14:00, 6 May 2008 (UTC)
thread_title:  Diseases of the Will: Alcohol and the Dilemmas of Freedom 

message: There is currently no consensus in support of the disease theory, nor has there been one recently as the following documents demonstrate:
*Korhonen, M. Alcohol Problems and Approaches: Theories, Evidence and Northern Practice. Ottawa: National Aboriginal Health Organizations, 2004  
*Nackerud, L. The disease model of alcoholism: a Khunian paradigm. Journal of Sociology and Social Welfare, 2002 (Presented above but awaiting response from dritlow)
*Kelly, D. Understanding the Nature of Alcoholism (2001). Discusses the disease controversy. 
*Schaler, J. A. Thinking about drinking: the power of self-fulfilling prophecies. The International Journal of Drug Policy, 1996, 7(3), 187-191  
*Doweiko, H. E. Concepts of Chemical dependency. NY: Brooks-Cole, 1996.
*Levy, M.S. The disease controversy and psychotherapy with alcoholics. Journal of Psychoactive Drugs, 1992, 24(3), 251-256. 
*Maltzman, I. Is alcoholism a disease?  A critical review of a controversy. Integrative Physiological and Behavioral Science: The Official Journal of the Pavlovian Society, 1991, 26(3), 200-210 {
.
:The above unsigned contribution is completely incorrect. There is very strong consensus that alcoholism is a disease in the scientific and medical community worldwide. This is well-documented in the current version of the article. The only question is to what extent and in what manner the fringe views of those opposed to the concept that alcoholism is a disease should be represented in this article, or whether such views should perhaps be represented in a separate article. I have changed the title of this section of Talk appropriately.AussieBoy (talk) 05:42, 4 June 2008 (UTC)
thread_title:  Views on disease theory of alcoholism 

message: ...is bizarre. Repeating over and over, especially in the history section, that alcoholics can return to normal/controlled drinking. Then the Current Acceptance section lists a majority of medical associations accepting the disease and abstinence theory.
Either the US establishment has it all wrong or this article was written by someone intent on pushing a POV. Needs a little time spending on it by some kind soul. Mr Miles (talk) 13:20, 6 May 2008 (UTC)
replies: text: I agree completely. I am not part of some "US establishment", but as an Australian medical research scientist, I am well aware of the very strong prevailing view among experts worldwide that alcoholism is a disease. This article makes it appear that this is not the case and that there is genuine continuing debate. Not true. I feel that POV pushing is very much in evidence in the current version. There is a better history of the disease concept in the article on E. Morton Jellinek. As I get time I will try to introduce some of that material and remove more of the POV. I will also try add more material concerning the genetics of alcoholism, insofar as it has relevance. AussieBoy (talk) 11:27, 25 May 2008 (UTC)
replies: text: Will appreciate it if you can. Thanks Mr Miles (talk) 18:53, 26 May 2008 (UTC)

text: Welcome AussieBoy!  I completely agree with you.  I spent a lot of time on both this article and the Alcoholism article trying to get more representation for the currently accepted medical and scientific view.  There tends to be a lot of resistance to change on these articles.  The main reason is that there are only a handful of regular editors, and not many have a science/medicine background, so things tend to get deadlocked.  As a science student myself, I've pleaded with neuroscientists to help set the record straight on these articles, but most of them have scoffed at the idea of "wasting their time" on wikipedia.  I commend you for recognizing the problems with this page, and their importance! --Elplatt (talk) 01:25, 27 May 2008 (UTC)
replies: text: Thanks everyone for your kind words. I have just revised the History section (see below). Any thoughts? AussieBoy (talk) 07:35, 30 May 2008 (UTC)
thread_title:  This article... 

message: I have amended the portion of this section concerned with the US Supreme Court decision in 1988. I also corrected the reference so that it goes directly to the full judgement. Previously, portions of the majority opinion appeared to be selected to give the impression that the judgement was concerned with the correctness of the disease theory of alcoholism. As all the opinions now cited make clear, that was not so. In any case, I do not believe that a US Supreme Court judgement is relevant to this article, since the Justices are not experts in this area and can only rely on the opinions of those who are (or in some cases, aren't). Therefore, I suggest deleting this portion of the History section completely on the grounds of irrelevance. What does everyone think?
I should also note that there was an earlier Supreme Court judgement relating to this topic, Powell vs Texas 1964. AussieBoy (talk) 07:21, 30 May 2008 (UTC)
replies: text: Correction-Powell vs Texas was 1968 (not 1964). See:  AussieBoy (talk) 10:45, 10 June 2008 (UTC)
replies: text: I placed the US Supreme Court case of 1988 in a separate section headed "Legal considerations" for reasons related to my comments above. I added information and a reference concerning the American Bar Association's position that alcoholism is a disease. I still think it could be best to remove this section as irrelevant.  —Preceding unsigned comment added by AussieBoy (talk • contribs) 11:40, 10 June 2008 (UTC)
thread_title:  History section 

message: The Larimer et al (1999) paper simply discusses the earlier findings of Miller et al (1996) on this point and does not add any new material. That is why I replaced the Larimer citation with a reference to the original work of Miller et al. This finding has been made once only, and it gives undue emphasis to cite two papers, when there is only one piece of work.AussieBoy (talk) 07:33, 12 June 2008 (UTC)
thread_title:  Belief in Disease Theory 

message: This page has improved remarkably lately!  One thing we should work on is integrating the misc section with the rest of the article in accordance with the WP:TRIV policy.  As such, I've added a box to the section as a reminder. --Elplatt (talk) 03:34, 2 July 2008 (UTC)
thread_title:  Misc section 

message: "Current evidence indicates that in both men and women, alcoholism is 50-60% genetically determined, leaving 40-50% for environmental and other influences."
This is the last sentence of two consecutive sections and is also cited as 5 and 7 which are also the exact same article. I do not know how to clean up references or I would remove one of these duplicate citations and delete this sentence from one of the paragraphs. WesUGAdawg (talk) 21:53, 26 March 2010 (UTC)
thread_title:  Repeated Sentence and Cite 

message: It JUST doesn't sound neutral. We can keep the information but can we tweak the wording so it doesn't sound so, I don't know, defensive? Or accusatory? I tried adding the NPOV tag but it just messes up the entire page for some reason Monkeytheboy (talk) 05:56, 8 May 2015 (UTC)
thread_title: Criticism

message: Hello fellow Wikipedians,
I have just added archive links to  on Disease theory of alcoholism. Please take a moment to review my edit. If necessary, add  after the link to keep me from modifying it. Alternatively, you can add  to keep me off the page altogether. I made the following changes:
*Added archive https://web.archive.org/20080415000151/http://soc.qc.cuny.edu:80/Staff/levine/doa.htm to http://soc.qc.cuny.edu/Staff/levine/doa.htm
*Added archive https://web.archive.org/20080509165736/http://www.niaaa.nih.gov/FAQs/General-English/default.htm to http://www.niaaa.nih.gov/FAQs/General-English/default.htm
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Cheers.—cyberbot IITalk to my owner:Online 21:54, 16 January 2016 (UTC)
thread_title:  External links modified 

message: Hello fellow Wikipedians,
I have just added archive links to  on Disease theory of alcoholism. Please take a moment to review my edit. If necessary, add  after the link to keep me from modifying it. Alternatively, you can add  to keep me off the page altogether. I made the following changes:
*Added archive https://web.archive.org/20120429124822/http://www.niaaa.nih.gov:80/FAQs/General-English/default.htm to http://www.niaaa.nih.gov/FAQs/General-English/default.htm
*Added archive https://web.archive.org/20120329061653/http://www.alcholics-anonymous.com/what-is-alcoholism.htm to http://alcholics-anonymous.com/what-is-alcoholism.htm
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thread_title:  External links modified 

message: Hello fellow Wikipedians,
I have just added archive links to  on Disease theory of alcoholism. Please take a moment to review my edit. If necessary, add  after the link to keep me from modifying it. Alternatively, you can add  to keep me off the page altogether. I made the following changes:
*Added archive http://web.archive.org/web/20080509165736/http://www.niaaa.nih.gov/FAQs/General-English/default.htm to http://www.niaaa.nih.gov/FAQs/General-English/default.htm
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Cheers.—cyberbot IITalk to my owner:Online 11:59, 21 March 2016 (UTC)
thread_title:  External links modified 

message: The section on controlled drinking seems to focus on the relation of moderation or controlled drinking to disease theory. It would not seem to cover situations like a homeless shelter where alcohol is rationed. In such a case theory is not involved, nor, really, self-control as a viable alternative to abstinence. See http://www.theguardian.com/society/2016/apr/26/homeless-shelter-ottawa-gives-wine-to-alcoholics User:Fred Bauder Talk 08:04, 26 April 2016 (UTC)
replies: text: See Harm_reduction#Alcohol User:Fred Bauder Talk 09:32, 26 April 2016 (UTC)
replies: text: See Disease theory of alcoholism#Managed drinking for what I added. User:Fred Bauder Talk 13:02, 26 April 2016 (UTC)
thread_title: Controlled drinking section