As for alcoholism being a disease, there are points that you may not have considered:
- Just like with diabetes, heart disease, cancer, and schizophrenia, there is a genetic component. Native Americans have a shallow gene pool, and are susceptible to it just like diabetes or high blood pressure.
- It takes awhile (often many years) for an alcoholic to work up to a huge intake of alcohol per day (“tolerance”). If such an alcoholic goes sober for a long time–even if it’s ten years–and then starts drinking again, the tolerance starts (usually in a few weeks) right where it left off ten years earlier. This means that there are persistant biochemical changes in an alcoholic’s metabolism . . . which is something in common with diabetes.
- There are different versions of an enzyme called “alcohol dehydrogenase” that metabolize alcohol in different ways . . . and there is very strong (but controversial) evidence that alcoholics have inherited specific versions of the enzyme that predispose a person to alcoholism . . . and, again, I make a comparison to diabetes because of a defect in the hormone that manages sugar (although there is a difference between a hormone and an enzyme, and they should not be confused with each other).
- When identical twins are separated at birth, they have similar incidence of alcoholism, while fraternal twins seperated at birth do not.
We can get into a debate about defining what a disease is, but in alcoholism we have a defective metabolism of a substance like we do in diabetes, we have a hereditary component like we do in diabetes and/or cancer, and it goes into remission or can flare up again just like diabetes, it interferes with nutrition like diabetes.
I could also compare it with other disorders like phenylketonuria, where a genetic component keeps a person from metabolizing phenylalanine properly, and must limit it in the diet . . . again, because of a defective enzyme.
Alcoholism has so much in common with other conditions that we refer to as diseases that I’m comfortable calling it a disease . . . as I’m a practical person, and approaching it as a disease–which should be treated–seems like the best approach.
I know everyone likes to fact check (as they should, as I like to fact check), so I will put in links later because I have to get ready for work.