This is an archive of past discussions about Alcoholism. Do not edit the contents of this page. If you wish to start a new discussion or revive an old one, please do so on the current talk page.

To and From the authors of this article and from again

Latest comment: 18 years ago12 comments4 people in discussion

Mythobeast sez: I'm going to try to break this down into arguments on individual points. Please try to keep the individual arguments on individual points, and please hold off on name calling and presenting personal opinions as conclusions.

Alcoholism is an illness

MoP: alcoholism isn't a sickness. It can be interpreted as one, yes, but fundamentally it is a chemical dependence much like tobacco addiction.

Mythobeast: I believe that this one is addressed in this article, and in several portions of the discussion page. I'm currently looking for someone who can present a list of scientifically supported reasons why it is an illness. Something more than anecdotal evidence, please.

Alcoholism is not an addiction

The first sentence in the article states, as if it were fact, that alcoholism is an addicttion. This is what needs to be neutralized. Theyshallsee God 19:22, 15 June 2006 (UTC)

MoP: Alcoholism is physiological, yes, and has similarities to drug addictions, but it also has strong differences, both physically and in other ways. Theyshallsee God 19:22, 15 June 2006 (UTC)

MoP: Alcoholism is an addiction, which is a fact. It does all the things other addictions do; make you dependent on it, make you happier when you're drinking, and give you withdrawal problems when you're trying to stop. It makes you think you need it to live. So, we have groups like AA which provide mental support to make quitting easier. Master of Puppets ^{Giant Enemy Crab!} 19:51, 15 June 2006 (UTC)

Mythobeast: Specifically, the neurochemical portion of alcoholism is an addiction essentially identical to opiate addiction. Opiates are naturally occuring chemicals which closely resemble endorphins. Endorphins are released by our system when we drink alcohol causing the same biological reaction as if we had artificially introduced opiates directly.
Mythobeast: This, however, only covers one of the three factors which encourage us to drink alcohol. Social/psychological/spiritual is a second one, also as addressed by the article, and physical dependence is a third, again mentioned in the article. Detox corrects the third, and AA is very effective at addressing the second, but neither treat the first.

Asking a chemical dependency counselor about alcoholism is about tantamount to asking an illiterate person to teach you how to read.

MoP: Counselling can help. If it can't, then millions of people have lied to us about how they stopped being alchoholics. TSSG: I'd like these millions of people to show exactly how it has helped. Counselors like the man said above, are in it for the money. They can 'help' by adding to a person't pile of bills. Theyshallsee God 19:22, 15 June 2006 (UTC) MoP: The world is corrupt and greedy, I know, I've heard it before. However, counselling can help much in the same way groups like AA do, only AA is more efficient; a counsellor can help you discover why you may be drinking so much, etc. Sometimes only other people can help with your internal problems. TSSG: It's interesting how you'll believe millions of people by reading some book or whatever that says millions of people say it has helped, but you won't listen to the millions of alcoholics in Alcoholics Anonymous that says AA works. Theyshallsee God 19:22, 15 June 2006 (UTC) MoP: Que? Your statement is a bit... puzzling. I meant that millions of people have fought off alcoholism, and most of them did so by counselling/support groups. So yes, I am listening to the millions that say AA works. Master of Puppets ^{Giant Enemy Crab!} 19:56, 15 June 2006 (UTC)

Mythobeast: This is an ad-hominem attack on dependency councilors, essentially can be boiled down to "my treatment is better than your treatment". Please give statistical evidence and site your sources.

If you want to know about alcoholism ask a recovered alcohlic not a counselor that has read some books.

Mythobeast: Follow up studies of alcoholics from all categories show an extremely high relapse rate. Most studies, in fact, tend to cite their success on "mean time until first drink" or "mean time until reversion to heavy drinking". Follow up studies are a common and highly reliable way of "asking a recovered alcoholic". As a side note, the "pill" I mentioned has a nearly non-existent relaspe rate for those who continue to take their $3 pill before drinking - something like 1% - and the patients typically drink about one or two drinks, once a week.

TSSG: I don't need to read some uninformed article here or anywhere else to know that the solution to alcoholism is in participation in AA, not in paying some hoke-ass counslor all kinds of money, to tell someone they're an alcoholic, after reading a few crapical books. Theyshallsee God 19:22, 15 June 2006 (UTC)

Mythobeast: This tells me that you have no interest in listening to what others have to say, that your mind is made up, and that trying to explain the opinions of others to you is pointless. Is this really how you feel?

AA does not claim to have a corner on the treatment of alcoholism. However, it has the greatest success rate of any

TSSG: AA has done more than research for 72 years. Theyshallsee God 19:22, 15 June 2006 (UTC)

Someone said something about a cure to alcoholism. There is none.

MoP: There isn't a cure in the way that you can just pop a pill and be done with it, but the "cure" (so to speak) is getting help from counsellors. See article, and above.

Mythobeast: Master of Puppets, I need to correct you on one point of your response. As a rule, there is no "take a pill and get better" solution for any disease. In most cases its "Take a pill and HOPE you get better". With alcohol, such a cure exists for the neurochemical addiction component of it, which is unaddressed by the majority of treatments in existence. As I've added to the article, the use of endorphin antagonists coupled with the continuation of normal drinking habits results in the person losing interest in their normal drinking habits, with a roughly 87% success rate. This technique also addresses the physical addiction. After these two are handled, the psychological/social factors of addiction can be handled much more effectively by existing methods. Mythobeast 17:57, 15 June 2006 (UTC)

MoP: Hmm, I didn't know there was a cure as in pill...

TSSG: This irresponsible statement, "the use of endorphin antagonists coupled with the continuation of normal drinking habits results in the person losing interest in their normal drinking habits, with a roughly 87% success rate." is exactly the sort of thing that actually helps kill alcoholics. Theyshallsee God 19:22, 15 June 2006 (UTC)

Alcoholsim is a physical disease with a spiritual solution.

TSSG: It isn't a disease, and the solution is mental, not spiritual. Actually it is a three-fold illness.

physical
mental
spiritual

And mental (pychiatric) approaches to alcoholism have been a phenomenal flop. Theyshallsee God 19:22, 15 June 2006 (UTC)

MoP: Welcome to Wikipedia. Firstly, WP:NPOV. Mainly, don't try to impose your views on the majority's. Research the topic a bit if you're unsure of the information's quality; if you aren't, talk about it on the talk page first. I mean, if you're strongly opposed to it you can act without asking others, but this is generally considered to be the wrong thing to do. Master of Puppets ^{Giant Enemy Crab!} 19:56, 15 June 2006 (UTC)

Mythobeast: Hello, TheyShallSee. As Master mentioned, it is the job of Wikipedia to present all information on a particular topic, and hopefully provide some insight into the controversies involved with it. What you are presenting is your personal opinion about it, which is to say, one side of the controversy. Alcoholism is particularly complicated in that there are many ways that people look at it, and we've attempted to present all of them with the information available from other sources as necessary to enlighten the reader. This includes all of the "inane nonsense" that has resulted from the past 50 or so years of research.

TSSG: I'm not imposing my views or opinion, I'm sharing my experience. I resesrched the topic for 42 years, from one end to the other. You said, "generally considered to be the wrong thing to do?" I'll talk about it here if you like, as I can see it's benefits, but back to reality, Wikipedia itself says be bold. Theyshallsee God 19:22, 15 June 2006 (UTC)

A "spiritual illness"? And of course the "cure" is Jesus or a god of some sort? Mr Christopher 20:23, 16 June 2006 (UTC)

Hey

Latest comment: 18 years ago4 comments3 people in discussion

No. It does involve getting to coming to believe in and then accepting and then relying on a God of your own understanding. There is no religion forced down your throats.

There is no known cure. There is a solution. It is in attendance at AA meetings, joining a group, getting a sponsor, and then your sponsor taking you through the steps. This has nothing to do with counselors, or treatment centers, or taking pills. A person who calls himself an AA counselor cannot be trusted. There is NO such thing. AA is made up of sober drunks helping newcomers. It is a totally spiritual solution, no dues to pay, no axes to grind..just altruism..one drunk helping another. It works. Theyshallsee God 09:19, 17 June 2006 (UTC)

Stop stating as if it were fact that alcoholism is an addiction. I removed most of the addiction stuff because they are palpable lies. The misinformation that is in this article is exactly what kills drunks. How do you feel knowing that these bald faced lies are helping to kill alcoholics? Start showing some references before you put that addiction crap back in the article. You are messing with the wrong person where this topic is concerned. If you care to know I can show you how alcohlism is not an addiction. Just ask. Theyshallsee God 09:16, 19 June 2006 (UTC)

The contributors to this article have presented many scientific studies that demonstrate that the information they have presented in this article has factual basis. Your lack of desire to actually click through the links and study a few of them does not make for a case for removal of these points. I believe they have adequately argued their case and presented evidence, while you have provided us with nothing except accusations, invectives, and threats. I believe that the burden of evidence lies on your side. Mythobeast 02:33, 20 June 2006 (UTC)

Here's the problem. Theyshallsee God has a point - indeed the disease alcoholism isn't the equivalent of addiction in the manner that the term is frequently used. The disease is about continued use of alcohol despite oneself and one's own best interests, and once alcohol use has ceased it is about refraining from such use and rebuilding one's life. That being said, the APA is on the verge of changing their terminology as they move from DSM-IV to DSM-V; one of the current considerations is to rename "alcohol dependence" (which is the psychiatrists' very poor way of referring to alcoholism) as "alcohol addiction." That would be a terrible mistake IMHO for a wide variety of reasons. In terms of terminology that makes sense to the public, I suspect we should define our terminology as part of the article. Addiction should likely refer to the physiologic entity in which a human will suffer from physiologically measurable withdrawal should alcohol suddenly be stopped. Alcoholism should likely refer to the disease entity described in our current first ¶ and within which patients sometimes suffer from alcohol addiction. But we should recognize that the medical community is moving away from this separation of terms.Drgitlow 03:15, 27 June 2006 (UTC)

Physical Dependence vs. Addiction

Latest comment: 18 years ago3 comments2 people in discussion

Both physical dependence and chemical dependency -- neither very good articles in their own right -- both list alcoholism as a "dependence". Does the chemistry of the body truly change such that it requires alcohol to survive? Or do people just feel they need it so badly that they'll die without it? I realize this is probably one of "those" debates, but I haven't seen where anyone has really produced an answer, which (it seems) should be easy to do given the fact that surely citable experiments have been performed that would demonstrate whether or not alcoholism is something one eventually feels compelled to WANT or if it's something the body eventually comes to truly NEED. I also think it's no good to have articles featuring alcoholism as something it's not purely as a part of being on a soapbox. Turly-burly 06:57, 20 June 2006 (UTC)

Hi, there. There are two physical parts to alcoholism, and this probably causes your confusion. The "dependence" part of alcoholism is the body's aclimation to having alcohol in the system. For heavy drinkers, the complete and sudden removal of alcohol can kill a person. The other part is the neurochemical addiction, which is essentially identical to a morphine addiction. This part couldn't be called a dependence because you can lock a person in a room and deprive them of the substance without killing them. They would just be very, very miserable.

Any citation for any of this? And how would it kill them? Would they break down and kill themselves, or would their body actually cease functioning? Turly-burly 23:56, 20 June 2006 (UTC)

I believe the specific mechanism for this is heart failure due to neurological maladjustment. See Delerium tremens for lots of details on the most significant alcohol withdrawl symptoms. If you want to go off-wiki for information, check out MedicinePlus's article on the topic, or the one on eMedicine. They have many cites there. - Mythobeast 16:19, 22 June 2006 (UTC)

Leave Arguing about Alcohol to Medical Professionals

Latest comment: 18 years ago7 comments3 people in discussion

It is reasonable to leave the editing of this article to medical professionals. That said, the discussion here is representative of the disagreement within the lay community and has validity as a result. I'd suggest that we keep a section of the article in which various opposing views can be represented. Drgitlow 02:26, 26 June 2006 (UTC)

Your comments are astonishing. Leave the editing of this article to medical professionals who say this is a disease yet they have failed to ever prove that claim, they want you/us to accept what they say on faith. These so called medical professionals cannot seem to grasp the difference between a definition and an actual disease. No thanks Doc, we should stick to supported, cited evidence and I suggest we beware of self-described "experts" and AA counselors if you ask me. Their livelyhoods are all dependent on the public's blind acceptance of this unproven, so called "disease" Not exactly an unbiased group of editors, no? Mr Christopher 16:20, 26 June 2006 (UTC)

Sorry, Dr. Gitlow, but I find your reasoning to be suspect. The medical community does not agree on what causes alcoholism, nor on how to treat it. Various groups of authority have official stands on it, but these stands are also in disagreement. You cannot claim to speak for the entire medical community because they do not speak with one voice.

I didn't say that the medical community agrees as to what causes alcoholism, nor did I say that they agree as to how to treat it. They simply agree that it is a disease, that there are a variety of factors leading to its existence, and that there are a variety of symptoms that typify the presence of the illness. They also agree that there are a variety of potential treatment modalities. You're right that I cannot claim to speak for the entire medical community but you're wrong that they do not speak with one voice. All state and specialty medical societies are part of a federation of medical organizations that speak through the American Medical Association via the AMA's House of Delegates. In fact, the AMA has policy, approved by its House, stating that alcoholism is a disease (among other things).Drgitlow 19:55, 28 June 2006 (UTC)

Even if it did speak with one voice, it would still not be acceptable to take their viewpoint as the only one acceptable. It is a doctor's hubris to believe that they know all there is to know on a subject. Medical science, psychiatry, psychology, and sociology combined have yet to provide a solid reason for alcoholics continuing to drink. If it did, it should be able to provide a way of undoing the effect. Until it does so, all avenues must be considered.

That isn't a doctor's hubris, but rather an educated opinion through years of education and years of experience. The next time you're traveling in a commercial airliner and the pilot encounters a weather phenomenon or faulty engine, would you rather the pilot make the decision as to what to do, or would you prefer that the guy in 11C go up there and deliver his opinion? Unless the guy in 11C is also an experienced commercial pilot, I'd prefer he share his opinion later...on the ground. You're right that there are many opinions, but the opinions that a knowledgable and educated public prefer to listen to are the ones that are based in sound education and experience. We don't even know why people get headaches, how aspirin works, or why we dream. We don't know the basis of cancer, diabetes, or multiple sclerosis. Yet for some reason, you don't see these arguments in those Wiki entries. I'm not sure why you're going off in this direction.Drgitlow 19:55, 28 June 2006 (UTC)

My experiences with the medical community in regards to alcohol is that various people have differing opinions about various treatments, and everyone involved is EXTREMELY attached to their opinions. Like you, it is typical for medical professionals to discount anything that doesn't come from another medical professional, even if what comes from them is a compilation of placebo controlled peer reviewed studies performed by qualified research doctors.

Furthermore, any actual cure for alcoholism would result in the destruction of many large, well funded institutions. In a world where corporate interest has a stranglehold on science, it is unreasonable to assume that word of any such thing would come through official channels. This, coupled with the trickle-down effect that this has on physicians like yourself makes the medical community suspect. Mythobeast 17:34, 27 June 2006 (UTC)

I totally agree with this last point.Drgitlow 19:55, 28 June 2006 (UTC)

And as an addiction medicine specialist myself (I'm a physician), my livelihood is in no way dependent upon the public's blind acceptance of whether alcoholism is a disease or not. I've treated hundreds of patients over the years with about 85% of those with alcoholism continuing to do well (abstinence) in treatment. My practice has grown only from referrals from friends/family/colleagues of treated patients. That's typical for addiction MD's; we don't need to advertise. The prevalence of the disease is enormous and the availability of skilled MD's who have board certification in addiction medicine or addiction psychiatry is minimal. You're probably right that I have a personal bias - like I said, I've seen hundreds of patients get better first-hand. But again, there is no controversy in the field that patients get better with treatment.Drgitlow 21:20, 26 June 2006 (UTC)

Alcoholism is clearly not a disease

Latest comment: 18 years ago1 comment1 person in discussion

The disease model of alcoholism is widely rejected by scientists. Anyone not completely blinded by ideology can recognize this fact. See, for example, the section titled "Conflict Between the Disease Theory and Social Science Research" in "The Cultural Context...," a scholarly article first published in The American Psychologist and reprinted in the book, Alcoholism [1] See also

Supreme Court [2]
World Health Organization (WHO) [3]
From the medical journal, Lancet: Disease theory is controversial [4]
Med Help International [5]
American Heritage dictionary [6]
Dictionary definition [7]
Webster's Collegiate dictionary, 10th ed. [8]
Depression Dictionary [9]
Havard Medical [10]
National GAINS Center [11]
Health Science Center [12]
Nature of Alcoholism [13]
Biology Online [14]
Presbyterian Health Plans [15]
Online Learning Center [16]
Black Women's Health [17]
Datasync [18]
What is Alcohol? [19]
Johns Hopkins University [20]
Genetics Topics Dictionary [21]
Family Health Guide [22]
Addiction Center [23]
Rosemary Hennessey [24]
e-Medicine [25]
Dr. Ann Reyes [26]
Dr. Jeffrey Schaler [27]
Dr. Mark Lender [28] (posted from above)Medical Man 02:41, 28 June 2006 (UTC)

Using the AMA/APA POV for this article

Latest comment: 18 years ago4 comments3 people in discussion

It's nonsense like this

Of importance is that frequency and quantity of alcohol use are not related to the presence of the disease (definition, as per 1992 JAMA article cited below); that is, individuals can drink a great deal without necessarily being alcoholic, and alcoholics may drink minimally and/or infrequently.

that makes this article so pathetic (in places) and makes the motives of the AA doctors and counselors here so transparent. What the good AA doctor is suggesting is that minimal and/or infrequesnt drinking is also a sign of this mysterious, unproven disease. This is complete nonsense when the medical community tells you that very little drinking is also a sign of alcoholism. So, if you drink alot you may be a alcoholic and need life time treatment, if you drink every little you may be an alcoholic and need life time treatment. They pretty much cover the bases so pretty much everyone on the planet is a candidate for life time treatment. Treatment of course is handing over your money, talking alot, and being subject to religious indoctrination and instruction.

How can I invest in this multi-billion dollar racket? The fact that the introduction that was the result of editor consensus continues to be changed to reflect the POV of the AA based treatment industry.

When it comes to alcohol related problems the AMA and APA are not exactly neutral parties when it comes to embracing the AA vision and ideology. Are you guys aware of how deep the AA influence is in the medical community and the AMA specifically? Any doc who has an alcohol problem is forced to attend AA meetings or have their license taken away. They can go to AA or NA and those are their only choices. Find a higher power or lose your medical license is the course of "treatment". It's called the State Physician Impairment programs. You can find the specifics for each state here http://www.ama-assn.org/ama/pub/category/6020.html. Yes Virginia, under the threat of having their license taken away, the American Medical Association forces its own members with alcohol problems to go to AA or NA. So it is no surprise that our local AA doc and "treatment" expert wants us to promote the AMA POV in this article. He's admitted he'd like the editorship limited to "treatment" folks. That would be the most effective way of limiting the article to the AMA/APA pro A.A. POV. Mr Christopher 20:08, 28 June 2006 (UTC)

It's not nonsense, but fact. Not controversial fact, just fact. Frequency of alcohol intake and quantity of intake are not related to the presence of disease. I know it might seem counterintuitive, but realize that you can have diabetes with a glucose of 100 (normal). You can have hypertension with no subjective symptoms at all. That's the way diseases work. Alcoholics are still alcoholics even when they're not drinking. And some folks (look at any college) drink a great deal without having any substance use disorder. That's just the way it is, and you may not like it (for whatever reason) but that doesn't change anything. I'm not suggesting that minimal and/or infrequent drinking is a sign of the disease, and if you re-read the topic you'll see that. I'm simply saying that alcohol intake quantity and frequency is not germane to making a diagnosis. By the way, the AMA doesn't force anything upon its members - the state physician impairment programs are run by the state boards at the behest of the state populations - the AMA has kindly posted the information at their site but they don't run, oversee, or in any way regulate these programs. I've also said next to nothing in any of my content about AA. This article is about alcoholism, not AA, so I'm unsure why you refer to me as an "AA Doc." As for promoting the AMA POV within the article, that would be reasonable. The AMA as the voice of American Medicine is a reasonable standard to use for incorporating medical information within any encyclopedia of content. Not doing that would leave the entry without any firm scientific basis. 68.9.164.90 20:31, 28 June 2006 (UTC)Drgitlow 20:33, 28 June 2006 (UTC)

Promoting the AMA POV here is innapropriate. The article should be NPOV and the AMA is one of many views. And your analogy about alcoholism and diabetes is absurd if not insulting. Mr Christopher 20:43, 28 June 2006 (UTC)

I'm sorry you don't understand. My analogy of alcoholism with diabetes is neither absurd nor insulting, and there is published literature that uses the exact analogy (Run a PubMed lit search on alcohol and diabetes and you'll find it). Drgitlow 21:19, 28 June 2006 (UTC)

Intro Redo III

Latest comment: 18 years ago3 comments1 person in discussion

We need to rework the introduction (again) and go back to a NPOV one. We should cite the AMA (and whomever else) but not make the introduction and definition the AMA POV. I'm tired right now so maybe someone else can throw some ideas together here and we can get some consensus again. What we had before was much less POV than what we have now. As difficult as it is for the AA treatment people here to understand, Wiki article is not supposed to reflect a POV. The AMA is a source, an extreemly biased source, but a source nonetheless, and not the final authority on this article. Mr Christopher 20:52, 28 June 2006 (UTC)

To be clear - I think our readers will be best served by a non-biased definition of alcoholism, one that does not come from the treatment industry or any other organization that profits (monetarily or by increased membership) from a certain viewpoint concerning alcoholism. Using the AMA or APA definition for alcoholism is a blatant act of POV pushing. I am not suggesting we ignore the AMA/APA viewpoint, those should be included in the article, but not use their viewpoint as the foundation for this article. We're not here to line the pockets of the treatment industry or push their controversial and disputed perspective. The fact that the AMA/APA assert alcoholism is a disease, they have never proven this claim, and they make billions off of this notion does not make them a neutral party. Mr Christopher 21:13, 28 June 2006 (UTC)

The latest edit by Medical Man is an improvement, much of the POV was removed so we're making some progress. Mr Christopher 16:43, 29 June 2006 (UTC)

Consensus

Latest comment: 18 years ago3 comments2 people in discussion

The discussion on this page has been interesting. It appears that we have at least two perspectives being shared. On the one hand are the perspectives like mine: alcoholism is a disease, much like any other lifelong chronic illness, with well-accepted definitions in the field as to symptom profile, course, and recommended forms of treatment. The other perspective is personified by Mr. Christopher's statements: alcoholism is not a disease, and much controversy exists among learned individuals regarding alcohol and associated issues. In some ways, I feel as if we could write two entirely separate articles which would barely overlap. The addiction medicine community would disagree with Mr. Christopher's perspective, but obviously there are those who would disagree with the addiction medicine community's perspective as well. So the real question is: What should we do about this? I don't know that Wiki is open to a point/counterpoint type of article, and I doubt we could have two parallel articles in the system. But it's madness for us to continue bickering when it's clear that neither side is about to convince the other as to the merits of their points. So what's the next step?Drgitlow 23:28, 28 June 2006 (UTC)

My point is the the disease of alcoholism currently exists as a definition and not a scientific fact. I am not alone in this recognition and there is debate within the medical communuty as well, not just here. Although the disease "concept" is abpout as dumb as it gets, my point is it is an unproven disease, not that it is not a disease. Science might one day discover an alcoholism disease, they might also discover Elvis walks the moon. I cannot rule out either.

As dumb as I personally think the disease concept is, I am not suggesting we claim alcoholism is not a disease in the article, I am saying we should avoid taking sides in this debate and treat it on neutral grounds (aka "NPOV"). You, on the other hand want to push the AMA/AA treatment industry POV and act as if this disease is anything other than a definition or assertion. An unsubstantiated assertion made by a medical community that makes billions of dollars from these unproven claims. You keep pushing the AA and/or the AA treatment industry POV (subtle difference). You would do well to learn about Wikipedia and what goes in an article, what constitutes NPOV and POV.

You can pretend I am the only guy in the world who is hip to these facts all day long but you know better. How long have you been a member of AA? Mr Christopher

OK...that clarifies your point. Among the reasons why the medical profession agrees (per the 1992 consensus statement in JAMA, among other references) that alcoholism is a disease is that the symptoms, course, and dysfunction are predictable and replicable. I don't think you're the only person in the world who disagrees, but the fact that alcoholism is a disease is not one that is refuted within the medical community. Of course there are those out there who think major depression isn't a disease and that diabetes isn't a disease, but that doesn't mean they aren't treated as diseases by the medical community and to a large part the general public. Alcoholism is in the same group. I know you don't like that, but that's just the way it is. You keep asking for scientific fact, and I'm not sure what you're looking for. The literature has extensive scientific backing of alcoholism as a genetic entity. I don't know whether you've read those articles and disagree or if you haven't seen them. I therefore can't tell if you support your position as a result of being naive or if you have a well-educated reasoning that you'd like to share. I feel like I'm trying to convince someone that the world is round - he's saying there's no proof and I'm trying to argue a point based upon extensive astrophysics literature that he hasn't read or isn't familiar with. You might think it's dumb that alcoholism is thought of as a disease, but that doesn't change the fact that it is thought of as a disease - by medical professionals, by the vast majority of the public, all except a few folks who tend to be very vocal.

You also keep speaking of POV's, or perspectives. Let's say we were writing about reciprocating engines. You'd want the writer to have a background in engines, perhaps be an engineer or automobile designer. You'd want to leave out arguments about whether gasoline is the downfall of our society. You wouldn't want to sound like you're from GM or Ford, but rather would simply describe how the engine works. How it works would be fact, and while there would be some who disagree, that wouldn't stop the facts from being correct. Here, we're writing about alcoholism. That means we'd like the article written by someone who specializes in the treatment of the disease, or by someone who has the disease, or by someone who otherwise has a great deal of expertise in the field. My bias is that I don't have the illness, don't attend AA, and therefore can't write the article with that perspective. It would be nice to have input from someone who has the insights gained from such an experience. Can you share with the rest of us the basis upon which you're contributing to this article? Drgitlow 00:38, 29 June 2006 (UTC)

Good to see you still working away, Gitlow! Some points to address, though:

If I was writing an encylopedia article about reciprocating engines, I would be expected to know something about them. Most engineers and automobile designers lack the ability to actually *fix* their own cars, sadly enough... they aren't shadetree mechanics. Having a working knowledge of some area of the field is helpful, of course, for the sake of contribution, but it's far from actually completely knowing a field.
On wikipedia, credentials mean nothing, because credentials are so easily faked over the internet, and experts are often overly-biased in their pet theories about a field. (Hence, acrimonious debates over alcoholism genes, conditioned/learned behavior, etc.)
On wikipedia (and this is IMPORTANT to remember), facts are irrelevant. This may come as a surprise. Our golden standard here is VERIFIABILITY. I doesn't matter what any editor thinks is a fact, or not, what matters is if we can cite and *verify* that somebody else thinks that something is a fact.
As far as the gasoline debate, we *do* have articles on that topic (just not in the engine article), so we may want to migrate out the "disease/behavior" debate in such a way that we have an article on what alcoholism is commonly accepted to be, and put the debates elsewhere.
Your statement "specializes in the treatment of the disease" belies an underlying POV (one which we had discussed way back..). Hopefully, you can also "write for the enemy", to explain their POV in a neutral way.
My personal experience comes from working daily with several thousand drinkers of varying types of behaviors, some who label themselves as having a drinking problem if they "talk back" to their spouses after having a single glass of wine, to people who were drinking 30-40 standard drinks a day, homeless, jobless, and clinically depressed.
You are wrong that there is complete consensus that alcoholism, in toto, is considered a disease, in toto, by the whole of the medical community. Perhaps part of the problem is that *much* of the community considers *many* of the symptoms to be common, but after that, it somewhat falls apart. To convince me that alcoholism is a genetic disease is quite simple: Find me the one study, accepted and published, that shows *identical* twins are *identical* alcoholics. You can't, it's already been tried. Maybe something is affecting gene expression, which means that the disease is only present in *some* people with specific genetic factors.
Any finally, (quite sadly), most of the drinkers I deal with feel totally let down by treatments offered under the existing disease model, in that treating drinking as a disease did not improve their health (and in some cases, increased their drinking, worsening their health). "Do no harm" is being intentionally ignored, perhaps, because current medical practices are often thought by some to be "the best we have".

Good to see this article hasn't been abandoned yet, I know it's a tough topic with literally billions of dollars associated with it. Ronabop 06:12, 2 July 2006 (UTC)

Logical Moves

Latest comment: 18 years ago3 comments2 people in discussion

We had diagnostic entries in the alcoholism as a disease category, and disease info in the diagnostic category. I tried to move each entry to their logical place. Mr Christopher 20:35, 29 June 2006 (UTC)

Looks good. I'll work on obtaining some of the citations this evening. It looks as though some of the footnotes aren't present. Some citations were obviously made at some point in the past but the footnotes have since been deleted or never added. I'll see if I can find them as well. This may take a few days.Drgitlow 21:19, 29 June 2006 (UTC)

Can you also cite some of the quoted definitions and ideally provide a link or something where the reader can go directly to the source? I think most of the APA/AMA/et al definitions can be found online. I need to look at the manual of style again because I think there is a specific format we should be using when quoting a person or organization and I forget whether we are supposed to use italics or just "quotes" or

blockquotes

...Mr Christopher 21:29, 29 June 2006 (UTC)

Alcoholism as a disease

Latest comment: 18 years ago4 comments2 people in discussion

Alcoholism might be a disease but there is no consensus within the medical research community that is is, in fact, a disease. I don't know whether it is or or not; I'd put the odds at perhaps 50-50. But our personal beliefs about the question of disease/not-disease are completely and totally irrelevant.

Until such time as there is scientific consensus among researchers (not consensus among therapists, practioners and others with an ideological or financial self-interest), we are obligated to assume that alcoholism is not a disease.

That's how science operates, and that's how an encyclopedia article needs to present the matter. We can't assume that alcohol is a disease. The only honest way to handle the matter is to present the question as an open one about which there is no scientific consensus.

Within that context, balanced arguments from both sides of the issue can then be presented.

If we do that we have prepared an honest, objective encyclopedia article on a controversial subject about which we can all justifiably be proudMedical Man 21:57, 29 June 2006 (UTC)

Your conclusion, Medical Man, is an interesting one. There has been scientific consensus among researchers for decades on the topic of alcoholism as a disease. The US government knows it (look at NIDA and NIAAA), the medical community knows it (look at the AMA, ASAM, and the APA), and current research is dedicated to determining the origins of the illness. Other encyclopedias (look at Britannica, for example) note that alcoholism is a disease. Your argument is therefore wanting. Presenting both sides of an issue is sensible when the verdict isn't in. This verdict has been in since the late '50s. Your not knowing that doesn't mean that we should follow your lead.Drgitlow 23:49, 29 June 2006 (UTC)

Honesty and integrity needed

Drgitlow asserts that Encyclopedia Britannica defines alcoholism as a disease. I don’t understand how any intelligent and honest person could interpret the Britannica’s definition and article in that way. Appears to be another of Gitlow's many distorted and deceptive "facts."

Britannica's definition of alcoholism:

"excessive and repetitive drinking of alcoholic beverages to the extent that the drinker repeatedly is harmed or harms others. The harm may be physical or mental; it may also be social, legal, or economic. Because such use is usually considered to be compulsive and under markedly diminished voluntary control, alcoholism is considered by a majority of, but not all, clinicians as an addiction and a disease." [http://www.britannica.com/eb/article-9110089?query=alcoholism&ct= ]

Britannica's alcoholism article:

Alcoholism is a complex, many-sided phenomenon, and its many formal definitions vary according to the point of view of the definer. A simplistic definition calls alcoholism a disease caused by chronic, compulsive drinking. A purely pharmacological-physiological definition of alcoholism classifies it as a drug addiction that requires imbibing increasing doses to produce desired effects and that causes a withdrawal syndrome when drinking is stopped. This definition is inadequate, however, because alcoholics, unlike other drug addicts, do not always need ever-increasing doses of alcohol. Opium addicts, on the other hand, become so adapted to the drug that they can survive more than a hundred times the normal lethal dose, but the increased amounts to which alcoholics become adapted are rarely above the normal single lethal dose. Moreover, the withdrawal syndromes in alcoholism occur inconsistently, sometimes failing to appear in a person who has experienced them before and never occurring in some drinkers whose destructive behaviour is otherwise not distinguishable from that of someone who is pharmacologically dependent on alcohol.

(Membership required to obtain missing text)

A third definition, behavioral in nature, defines alcoholism as a disorder in which alcohol assumes marked salience in the individual's life and in which the individual experiences a loss of control over its desired use. In this definition, alcoholism may or may not involve physiological dependence, but invariably it is characterized by alcohol consumption that is sufficiently great to cause regret and repeated physical, mental, social, economic, or legal difficulties. Clinicians call such a behavioral disorder a disease [Editorial Note: presumably "most clinicians," given Britannica's definition above] because it persists for years, is strongly hereditary, and is a major cause of death and disability. In addition, alcohol permanently alters the brain's plasticity with regard to free choice over beginning or stopping drinking episodes. As with other medical diseases but unlike most bad habits, prospective studies demonstrate that willpower per se is of little predictive significance. An informed minority opinion, especially among sociologists, believes that the medicalization of alcoholism is an error. Unlike most disease symptoms, the loss of control over drinking does not hold true at all times or in all situations. The alcoholic is not always under internal pressure to drink and can sometimes resist the impulse to drink or can drink in a controlled way. The early symptoms of alcoholism vary from culture to culture, and recreational public drunkenness may sometimes be mislabeled alcoholism by the prejudiced observer. In the general population, variation in daily alcohol consumption is distributed along a smooth continuum. This characteristic is inconsistent with the medical model, which implies that alcoholism is either present or absent—as is the case, for example, with pregnancy or a brain tumour. For such reasons, the sociological definition regards alcoholism as merely one symptom of social deviance and believes its diagnosis often lies in the eyes and value system of the beholder. For example, periodic intoxication can cause sickness necessitating days of absence from work. In a modern industrial community, this makes alcoholism similar to a disease. In a rural Andean society, however, the periodic drunkenness that occurs at appointed communal fiestas and results in sickness and suspension of work for several days is normal behaviour. It should be noted that this drunkenness at fiestas is a choice and does not produce regret. If the sociological model were entirely correct, alcoholism should often be expected to disappear with maturation as is the case with many other symptoms of social deviance. This does not occur, however. Finally, epidemiologists need a definition of alcoholism that enables them to identify alcoholics within a population that may not be available for individual examination. To define alcoholism they may rely on quantity and frequency measurements of reported community drinking and alcohol-related hospitalizations, on a formula based on the frequency of deaths from cirrhosis within the population, or on arrests for alcohol-related misbehaviour.(Emphases added) [http://www.britannica.com/eb/article-251752?query=alcoholism&ct= ]Medical Man 19:42, 3 July 2006 (UTC)

Yes, Honesty and Integrity would be useful

Encyclopedia Britannica's definition, as posted online, reads (emphasis mine):

Excessive habitual consumption of alcoholic beverages despite physical, mental, social, or economic harm (e.g., cirrhosis, drunk driving and accidents, family strife, frequently missing work).

Persons who drink large amounts of alcohol over time become tolerant to its effects. Alcoholism is usually considered an addiction and a disease. The causes are unclear, but there may be a genetic predisposition. It is more common in men, but women are more likely to hide it. Treatment may be physiological (with drugs that cause vomiting and a feeling of panic when alcohol is consumed; not an effective long-term treatment), psychological (with therapy and rehabilitation), or social (with group therapies). Group therapies such as Alcoholics Anonymous are the most effective treatments. Suddenly stopping heavy drinking can lead to withdrawal symptoms, including delirium tremens.

This information is readily available at: http://concise.britannica.com/ebc/article-9354910/alcoholism

I stand by my original statement. Drgitlow 20:26, 3 July 2006 (UTC)

drgitlow edits

Latest comment: 18 years ago11 comments2 people in discussion

gitlow, the ^{[citation needed]} instances you just overwrote were appropriate and what you replaced them does not conform with Wiki standards. Saying something like "is referenced in the above section" or what not is not how sentences are cited. I know you are new here but can you start citing an entry at the entry and not allude to another one elsewhere in the article? Cheers! Mr Christopher 22:09, 29 June 2006 (UTC)

gitlow, feel free to knock off the vandalism as well and stop removing this referenced and appropriate entry:

Most argue that because the American Medical Association (AMA) has proclaimed alcoholism a disease, the idea is without reproach. But, the fact is that the AMA made this determination in the absence of empirical evidence. After reviewing the history of the decision, it would not be unreasonable to suggest that the AMA has been pursuing its own self-interest agenda in the face of evidence negating the validity of alcoholism....The promulgation of the disease concept, in conjunction with AMA approval, has created a multi-billion dollar treatment industry that contributes billions to the health care industry....The promulgation of the disease concept, in conjunction with AMA approval, has created a multi-billion dollar treatment industry that contributes billions to the health care industry.[29]

I am getting tired of fixing your vandalism to this article. Mr Christopher 22:20, 29 June 2006 (UTC)

The AMA claims alcoholism is a disease, this has been defined but never proven scientifically. I added a piece that is critical of the AMA claim about alcoholism as a disease. This is relevance, please stop removing this information from the article, gitlow.

You and your sock puppet have removed it at least 3 or 4 times, you also removed it after I had request here you not do so.  That is what we call bad faith.  Please knock it off, if you object to the entry then discuss it here. Mr Christopher 02:02, 30 June 2006 (UTC)

Feel free to stop anytime. I'm requesting mediation for this page. It's obvious that a group of people are mishandling the entry. It's also obvious that we both feel the other one is responsible for the problem. Drgitlow 00:33, 30 June 2006 (UTC)

What the heck is going on, we now have a disease model section and another disease section...holw cow Mr Christopher

Sigh...the AMA has made no such claim. The AMA is simply a policy-oriented association. The AMA does in fact have policy stating that the medical community as a whole is in agreement that alcoholism is a disease. This has been defined, demonstrated, and rigorously borne out in the literature. Your lack of knowledge about the field does not give you the right to single-handedly rewrite the scientific knowledge base. If in fact you do have knowledge about the field, please share with us where this knowledge comes from. Perhaps then we'll take your perspective more seriously.Drgitlow 02:09, 30 June 2006 (UTC)

That was not my perspective you have deleted now 4 or 5 times, it was the Baldwin research Institute's. Obviously you are going to treat this article as your own personal domain and have no intention of playing by the Wiki guidelines. Mr Christopher 02:15, 30 June 2006 (UTC)

Have you looked at the credentials for the Baldwin Research Institute? Again, many entries in an encyclopedia will have alternative views that could be contributed. Typically, one incorporates alternative views from valid sources. I don't see that any physicians (or doctorates) work at the Baldwin Research Institute. While the fact that they disagree with the scientific community is without argument, their banter is not material to the content of this article. Feel free to incorporate a reference to their website so that readers can obtain their alternative views. Their comments about the AMA, however, would be more appropriate on a Wiki entry about the AMA, not here at the Alcoholism entry. Drgitlow 02:27, 30 June 2006 (UTC)

Obviously I wasn't clear, I'll try again,

That was not my perspective you have deleted now 4 or 5 times, it was the Baldwin Research Institute's. Obviously you are going to treat this article as your own personal domain and have no intention of playing by the Wiki guidelines.

It is not your role to determine which viewpoints are to be considered, you are not the sole judge and jury of a reference's integrity. We are discussing competing ideas, not the size of their diplomas. And limiting the references only to viewpoints from the AMA, APA and other organizations that not only reap billions of dollars each year as a result of the disease of alcoholism, they are steeped deeply in a pro-AA ideology, is way out of line.

Your obvious attempts to silence any legitimate reference that is critical of these controlling bodies and their ideas is way out of line here. A controversy exists, we owe it to our readers to inform them of the varying viewpoints. You seem to think you have the right to regulate viewpoints here.

Some of us have been working on this crippled, contentious article for quite some time now. When exactly did you arrive again, and who exactly hired you to?

You are way out of line here. And a stunning example of what is wrong with the modern alcoholism treatment industry. Mr Christopher 03:01, 30 June 2006 (UTC)

I arrived in January. You arrived several months later and began crippling what had previously been a consensus-driven entry. Noone hired me. You and I both have the same right to be here. Drgitlow 03:50, 30 June 2006 (UTC)

gitlow, in view of the fact you are a psychiatrist, work in an academic setting (where doctors are taught about alcoholism), have published pamphlets and books on the subject, the things you continue to remove from this article are amazing if not shocking. You even removed the part where the Supreme court justice wrote "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".

Its as if you are hell bent on keeping ANYTHING that points out the lack of scientific evidence for the disease or the lack of consensus amongst scientists out of the article. You keep removing anything that is critical of the AMA or APA or the disease concept. Astonishing. Mr Christopher 17:32, 30 June 2006 (UTC)

You've been misinformed. I've never published a pamphlet. I have written a book, but only the one. And I don't work in an academic setting (though I indeed am on academic faculty). It's interesting though that you've attempted to find out more about me. Why don't you just ask? Feel free. I've certainly been curious as to your background, but you've not told us anything at all. Drgitlow 16:14, 1 July 2006 (UTC)

Alcoholism as a disease

Latest comment: 18 years ago12 comments3 people in discussion

There is no consensus within the scientific research community that alcoholism is a disease. The American Hospital Association, the AMA and other physician and other healt provider organizations are not scientific bodies but professional organization designed to promote the interests of their members. Practicing physicians and other treatment personnel are not scientists. Nor are the members of the National Council on Alcoholism and Drug Dependence, an organization founded by Marty Mann, the first woman member of AA. I await evidence of consensus within the scientific research community that alcoholism is a disease.Medical Man 02:40, 30 June 2006 (UTC)

You are correct that the AHA, AMA, and other physician organizations are not scientific bodies. You are incorrect, however, that practicing physicians are not scientists. They are doctorate level experts in the medical profession with training and background in biology, chemistry, and physics, and easily fitting in with the scientific ranks. The scientific community of treatment professionals (and there are many related organizations) are in agreement as to alcoholism being a disease. The fact that NCADD started with Marty Mann is irrelevant to its acceptance by the broad community. If you're awaiting consensus that arrived decades ago, perhaps you missed the mail. Drgitlow 02:45, 30 June 2006 (UTC) (NCAAA is a de facto AA group that has falsely claimed for years that the APA defines alcohollism as a disease when, in fact, it has explicitly rejected that view.) [30]Medical Man 20:23, 30 June 2006 (UTC)

Physicians are trained as scientists but those who practice medicine are engaging in the art of medicine that is backed by science but is not itself science. Practicing medical scientists are most often M.D.s, Ph.D.s, and D.Sc.s. Practicing physicians and M.D. scientists have largely different self-interests.

There is consensus within AA, twelve-step programs, most alcoholism treatment providers (including their profesional organizations) that alcoholism is a disease.

But there is no consensus within the scientific research community that alcoholism is a disease.

You've obviously received junk mail.Medical Man 03:19, 30 June 2006 (UTC)

LOL. Your point about self-interests is very well taken. If I understand you correctly, you're arguing that the economic bias of physicians and the medical treatment community is subrogating their medical ethic to do the right thing by their patients. If you truly believe that, how do you treat your own or your family's medical symptoms when they arise? Are you not concerned that your physician is simply trying to line his pocket rather than to see that you get better as rapidly and in as risk-free a manner as possible? Yes, the economic interests of the two groups are different, but for the purposes of this article, the consensus is the same: I urge you to look at the findings of pure scientific groups: The Research Society on Alcoholism, The National Institute on Drug Abuse, the National Institute on Alcohol Abuse and Alcoholism. I'd also urge you to present here any findings of a widely accepted research body that indicate alcoholism to be some entity other than an illness. Drgitlow 03:28, 30 June 2006 (UTC)

Alcohol researchers know a great deal about alcoholism. Practicing physicians generally know very little. Examining a CME (continuing medical education) course on alcohol and alcoholism reveals that it is very rudimentary. Most practicing physicians will not have even that low level of knowledge about alcoholism. Their views are irrelevant.

NIDA and NIAAA are government bureaucracies that promote federal policies at any given time and are not scientific organizations. The Research Society on Alcoholism is a scientific organization. It does not define alcoholism as a disease but rather refers to it as a condition and a disorder.Medical Man 16:27, 30 June 2006 (UTC)

Speaking of the APA and NIDA...I just found an interesting article on the APA's web site. It's written by Dr Alan I Leshner, who is the Director of the prestigeous National Institute on Drug Abuse. Not the cook in the NIDA cafeteria, not the guy who works in the mail room, but the Director.

In this article[31] the good doctor tell us addiction (aka alcoholism) is actually a

brain disease
a brain disease expressed as compulsive behavior
the quintessential biobehavioral disorder
complex biobehavioral disorder
true brain disease

Of course he doesn't provide s a shred of evidence for any of these wild claims. Predictably, he tells us how treatment is going to fix it all and there's help even for law breakers:

Understanding the bio-behavioral nature of addiction also helps in thinking about strategies to deal with addicted criminal offenders. That they have this brain disease helps explain why untreated addicted offenders have such high post-incarceration rates of recidivism both to drug use and criminality.

Amazing he can diagnose law breakers without ever meeting them. Apparently breaking the law and drinking/drugging too much is a sign you have this disease, brain disease, quintessential biobehavioral disorder, complex biobehavioral disorder. Yes that explains it all. I think it is safe to say that NIDA Is not a scientific organization and they seem to promote ideas that promote more treatment for more people and they have this amazing ability to diagnose entire groups of people with brain disease.

You got to read this article to believe it and keep in mind guys like this are shaping our alcoholism and addiction public policy and awareness and obviously they have no problem just making stuff up on the fly. Mr Christopher 22:08, 30 June 2006 (UTC)

Reading the Director of NIDA's article again made me wonder what other "brain diseases" are "treated" with spiritualism? Mr Christopher 22:19, 30 June 2006 (UTC)

Do either of you two have any kind of educational background in the field. I feel like I'm arguing scientific semantic points with someone who has received no education in the area. Are you both physicians, scientists, or are you simply interested in the field? If you're just interested, please let those of us who work in the field 24/7 get this job done. If you're truly knowledgable, then why not work toward the eventual goal instead of wasting all of our time here?Drgitlow 22:29, 30 June 2006 (UTC)

Stuart, lighten up. Even a well respected AA counselor such as your self has to admit that article from the Director of NIDA was a knee slapper. I was getting dizzy from all those definitions of the same thing. Even you have to admit the treatment industry who wants to see the whole world signed up for life time "treatment" are a crack up sometimes. Come man, lighten up - it was f-u-n-n-y. Mr Christopher 15:01, 1 July 2006 (UTC)

Chris, I'm not an AA counselor and have never made any such claim. Alcoholics often need to remain in treatment just as those with other chronic diseases often do. Your failure to recognize this, while unfortunate, is not important unless you're in a profession where you are responsible for the lives of patients with this disease. And if you were, you'd quickly recognize how important it is for successful outcomes that patients remain in some form of treatment (whether self-help, at no cost, or through professional care). With the number of people who die of this disease on a daily basis, the fact that you find the whole thing funny is rather telling. Drgitlow 16:09, 1 July 2006 (UTC)

stuart, we're having another communication break down again. My fault I'm sure. I am not saying people with alcohol problems are funny, that's not funny at all. What some of the self serving people in the "treatment" indutstry say and write (with a straight face) about alcoholism and addiction and "treatment" is a laff riot. That was my point and this guy was a very good example. Sorry I wasn't clear. Mr Christopher 22:54, 1 July 2006 (UTC)

Chris, it seems that the major point on which we disagree is whether alcoholism is a disease, and that may be due to our differing definitions of "disease" rather than differing beliefs about "alcoholism." Can you describe for me what you feel alcoholism is? Perhaps that will help us to build a consensus on the topic -- we can work on issues OTHER THAN whether alcoholism is a disease. (We obviously have other disagreements, but we can always come back to those. Personally, I'm with you on the CAGE, but the CAGE has been field validated for reliability and validity in properly assessing the presence of alcoholism, so the science is against us both on that one.) I often find myself in disagreement with the folks at NIDA and NIAAA, but at least they are generally attempting to base their statements upon the latest research. By the way, there are a number of other illnesses that are treated with methods similar to those used for alcoholism -- eating disorders quickly come to mind. When control issues are present as part of a disease process, the symptoms lend themselves to this kind of treatment and therapy. Drgitlow 23:22, 1 July 2006 (UTC)

Mediation

Latest comment: 18 years ago4 comments2 people in discussion

I've made a formal request for mediation. Mr Christopher 13:57, 30 June 2006 (UTC)

Many thanks, Mr. Christopher.Medical Man 15:57, 30 June 2006 (UTC)

Feel free to help me out with the request template, it's a maze and they have already nuked one of mine. I am going to put you down as a mediation party. Mr Christopher 16:29, 30 June 2006 (UTC)

Any editor here who wants to participate (or not) in the mediation process can agree or disagree to that process here http://en.wikipedia.org/wiki/Wikipedia:Requests_for_mediation#Alcoholism Mr Christopher 16:38, 30 June 2006 (UTC)

Encouragement

Latest comment: 18 years ago2 comments2 people in discussion

The article needs to reflect as completely as possible all aspects of alcoholism. This means that each verifiable aspect of alcoholism should be written about in a neutral point of view using reliable sources. Every major and significant minor theory should be included. You all are doing a pretty good job of staying focused on the content and not dwelling on the editor. Mediation is a good idea if you cannot agree. Settling a content dispute is hard work and can be time consuming. Do not expect that everything will fall into place immediately. If you keep working toward agreement eventually it will. Keep up the good work. FloNight ^talk 19:09, 30 June 2006 (UTC)

Thanks for these reminders, FloNight ^talk, especially the neutral point of view link. Mr Christopher 20:51, 30 June 2006 (UTC)

Accuracy and integrity are essential

Latest comment: 18 years ago4 comments3 people in discussion

George Vaillant has written that:

“The American Medical Association, American Psychiatric Association, American Public Health Association, American Hospital Association, American Psychological Association, National Association of Social Workers, World Health Organization, and the American College of Physicians have now each and all officially pronounced alcoholism as a disease. The rest of us can do no less. (70)”

Reference: "70. Vaillant, Natural History, 3. Vaillant's source for this quote is S.E. Gitlow, "Alcoholism: A disease," in Alcoholism: Progress in Research and Treatment, eds. P.B. Bourne and R. Fox (Academic Press, 1973), 8. The statement is inaccurate, however, in at least one and perhaps more instances. G.R. Vandenbos, acting chief executive officer of the American Psychological Association (APA), wrote me (29 March 1989) that the APA has never taken the position that alcoholism is a disease and that, in fact, it had explicitly rejected adopting this position. Nonetheless, the National Council on Alcoholism has stated in public documents for a number of years that the APA supports the view that alcoholism is a disease." [32]

So much for honesty and integrity. They seem to be ignored when blindly defending the ideology of "alcoholism is a disease" is at stake. I think it's time for someone to recuse himself.Medical Man 19:33, 30 June 2006 (UTC)

Very interesting. So George Vaillant, a famous and well-respected researcher in the field of addictive disease, and you, with an unknown background, are in disagreement. And the American Psychological Association wouldn't necessarily take up any perspective on disease since it is not a medical organization. The APA that we speak of within the article is the American Psychiatric Association, which is a medical organization. (The former is a group of psychologists while the latter is a group of psychiatrists). NCA refers to the psychiatric group, not the psychologic group. You appear to have been confused by this issue, which is admittedly confusing.

I'm also not surprised that you disagree with SE Gitlow's article in the research journal you cited. That Gitlow has hundreds of citations and was one of the founding members of the American Society of Addiction Medicine, the medical organization that is now the representing group of the addiction field in the medical federation. It is not unusual for individuals to disagree with science or with scientific progress, but we must not mistake such disagreement as being representative of a nonexistent scientific controversy. Drgitlow 23:20, 30 June 2006 (UTC)

Fascinating. So it appears this S.E. Gitlow was writing things that were not true about the current state of the debate concerning alcoholism as a disease all the way back in the 1970s? His "we should all go along with the herd because the truth is always on the side of the herd" is bad enough, but misleading people for their own good as well?

Since Stanton Peele called his dishonesty out, I bet this S.E. Gitlow views guys like Stanton Peele as "pundits" and would rather the opposition to the alcoholism disease theory not be a part of this article. If he were only here to read it, I bet he would get steamed that we are posting all the viewpoints concerning alcoholism that directly conflict with books he has written and claims he has made.

Is it me or are certain members of the alcoholism "treatment" industry somewhat Orwellian in their practices? If you drink you much you're an alcoholic, if you don't drink very much you're an alcoholic. Denying the disease of alcoholism is a sign you are an alcoholic, denying you are an alcoholic is a sure sign you're an alcoholic. The most effective treatment for alcoholism is life long self-help meetings and medical treatment/therapy... Mr Christopher 20:28, 30 June 2006 (UTC)

I can't tell given your sarcastic tone, but you do understand that SE Gitlow is not me, right?Drgitlow 22:19, 30 June 2006 (UTC)

There is no consensus

Latest comment: 18 years ago5 comments3 people in discussion

In his Counselor journal article, "Addiction disease concept: Advocates and critics," ([33]William White describes the rise of the disease concept in the early 18th century, its later fall, "its resurrection in the mid-20th century, and the subsequent growing debate in the late 20th century regarding its scientific validity and personal and social usefulness."

There clearly is no consensus regarding whether or not alcoholism is a disease and the encyclopedia article must reflect that fact.Medical Man 20:15, 30 June 2006 (UTC)

As a regular columnist in Counselor magazine, I know the editor and understand that she likes to make sure all perspectives are given a voice. Note that the magazine is not a scientific journal, but simply a magazine. And despite your argument, there is indeed a consensus. Drgitlow 22:20, 30 June 2006 (UTC)

What a fantastic policy they have there at Counselor Magazine, perhaps we should try and abide by the Wiki policy of assuming a NPOV and making sure all perspectives are given a voice. Especially since Wikipedia is an online encyclopedia and not a scientific journal. What do you think, s gitlow? That way we can allow those who are not a part of your imaginary consensus to voice their ideas. You see, you keep deleting all the comments that do not support your consensus myth. There is a Wiki policy which forbids this, s gitlow. Mr Christopher 22:25, 30 June 2006 (UTC)

Obviously you've set yourself up as the chief bottle washer here. Luckily, the rest of us can ignore you and get the job done, even if it means we have to do it repetitively.Drgitlow 22:41, 30 June 2006 (UTC)

By the way, you can keep saying that there is no consensus even though there is. I suppose since YOU disagree with the scientific community, there is indeed no consensus. I agree that we should be more specific. The scientific communty has consensus. Drgitlow 23:54, 30 June 2006 (UTC)

Paging Doctor S Gitlow

Latest comment: 18 years ago3 comments3 people in discussion

gitlow, before you start removing ideas in this article that you personally do not like, please follow the liks left here by FloNight. She is an admin here and when its wise to listen when any admin speaks of Wiki standards. Please familiarize yourself with the the Wiki links she provided before you make any more changes or deletions to the article. This will show a good faith effort on your part to work with your peers here. I think if you learn more about Wiki standards and policies we'll be able to work much more effeciently in the immediate future. Thank you for your cooporation. Mr Christopher 22:30, 30 June 2006 (UTC)

Mr Christopher, please refrain from altering a scientific article further until you share with us the basis upon which you make the wild claims that you've made.Drgitlow 22:41, 30 June 2006 (UTC)

Please read our policies. Verifiability comes first, credentials mean nothing. Ronabop 06:24, 2 July 2006 (UTC)

The Benjamin Rush edit

Latest comment: 18 years ago3 comments2 people in discussion

I'm not tied to having anything about Benjamin Rush in here. There have been repeated attempts to add material about Benjamin Rush to this article rather than simply referring viewers to the Benjamin Rush article. While I've removed the material multiple times, it keeps being returned. If you have something of value to say about Dr. Rush, say it on the entry about him.Drgitlow 23:12, 30 June 2006 (UTC)

That's revealingvery . Apparently you believe the alcoholism page is yours and that you get to decide on your own what stays and what goes!Medical Man 01:20, 1 July 2006 (UTC)

No, not mine. But not yours either. Are you and Mr. Christopher one and the same? I note that you both are always here more or less simultaneously.Drgitlow 01:56, 1 July 2006 (UTC)

POV Arguments

Latest comment: 18 years ago5 comments2 people in discussion

There have been repeated arguments within this discussion that the alcoholism article is presenting an AMA or APA or AA point of view. If we had an article on Apollo 11 and its voyage to the moon, some would likely argue that the article presents a NASA or government point of view, when reality is that we never really went to the moon and the entire thing was simply designed to draw attention away from Vietnam. Does that belong in the Apollo 11 article. Yes, as a one sentence statement indicating that there are some individuals who disagree with reality. The same holds true here. The standard of care in the nation is based upon alcoholism's recognition as a disease by government, physicians, insurance companies, and scientists. There are a few people out there, who like the Apollo 11 nonbelievers, are trying to refute what is already an accepted scientific consensus. They deserve a few sentences at the close of an otherwise scientifically-based article about a medical illness.Drgitlow 23:50, 30 June 2006 (UTC)

For starters I would encourage you to read the links provided by an admin earlier today. This will help you understand what constitutes POV vs NPOV as well as broaden your understanding of what Wiki is and is not. Sorry this is been such a challenge for you, gitlow. I can tell your getting frustrated. We all are but the sooner you invest some time actually understanding what Wiki is the sooner we can work together improving this article. Mr Christopher 01:12, 1 July 2006 (UTC)

You speak as if you've been here at Wiki longer than the rest of us. That's actually not the case - perhaps you should take your own advice. You're right, however, that I'm frustrated. I've not run into this type of problem in my work on other entries. You should closely read what the admin wrote about using reliable sources. Again, if you don't understand this, you should review what I wrote about Apollo 11. A quotation from a pundit does not mean you've used a reliable source as a basis of an entry on a scientific subject. And NPOV doesn't mean one should bring up all the junk that exists on the topic or we'd have a worthless encyclopedia. Drgitlow 01:54, 1 July 2006 (UTC)

Let's start with this, I am not one of your students, I am not one of your patients, I am not one of your children, the sooner you drop these infantile analogies the sooner we can have an adult conversation and then get down to the business of improving this article. If you want to discuss Apollo 11 please do so on the Apollo 11 article, do you understand me? And every single cited reference that you continue to delete will be going right back in this article. But not on a Friday night, I have far better things to do at the moment. The night is young! :-) Mr Christopher 03:34, 1 July 2006 (UTC)

Now you're just trying to be petty and to argue. We'll pick this up when you've cooled down. Drgitlow 04:13, 1 July 2006 (UTC)

MedicalMan Edits

Latest comment: 18 years ago3 comments1 person in discussion

MedicalMan, your latest edits look good. I added the need for a citation to one of your statements in the Disease-Con section where you say the medical research community is not in agreement with respect to alcoholism as a disease. Could you cite an example within the article of a reliable and respected research organization that does not concur? Drgitlow 02:17, 1 July 2006 (UTC)

Also, I wonder since we have a Disease Hypothesis section (I'm changing the header to match your terminology elsewhere), it begs the question as to what the alternative is. That is, some say alcoholism is a disease, while others say it is a ______. We could have another header dedicated to the pros and cons of this additional hypothesis. Drgitlow 02:20, 1 July 2006 (UTC)

Hmmm...the RSA has their introduction as: The Research Society on Alcoholism (RSA) provides a forum for communication among researchers, who share common interests, in alcoholism. The Society's purpose is to promote research that can lead the way toward prevention and treatment of alcoholism.

What would you call something that a medical research society wants to prevent and/or treat? It's a roundabout argument, but isn't that a disease?

I'll leave the citation there, but I don't know if the RSA would agree with their being cited in that way. Should we check with them to see if they have an official policy or statement on the topic? Drgitlow 03:03, 1 July 2006 (UTC)

What's a pundit?

Latest comment: 18 years ago1 comment1 person in discussion

Pundit: An expert in a particular subject or field who is frequently called on to give opinions about it to the public (according to my computer's dictionary). My use of this term to refer to such individuals was removed. Did someone think it meant something else? Drgitlow 03:05, 1 July 2006 (UTC)

Can we move the Disease argument to its own entry?

Latest comment: 18 years ago3 comments3 people in discussion

The vast majority of arguing on this topic is in regard to "is Alcoholism a disease". I'm firmly of the belief that this is a semantic argument, and is of little or no benefit to those suffering from or attempting to understand the problem. I'd like to suggest that we create an entry "Disease theory of Alcholism" and move all of those arguments to there.

My personal perspective is that if the AMA says it's a disease, then I'll call it a disease. However, since the AMA fails to actually provide an explanation for why people can't just put the bottle down, it remains an opinion on their part and not an authoritative statement. Until someone CAN actually give a physics/chemistry/whatever based explanation for why people can't just put the bottle down, all statements on the matter are opinions and will remain opinions. We can pile opinions up until we're all neck deep in quotes, but they will all remain opinions.

Which is to day there IS no definitive answer, and the debate can go on indefinitely without coming to a resolution. If someone can give a physics/chemistry based explanation for why people can't just put the bottle down, please correct me and we can start arguing about whether that explanation qualifies as a disease, but in the mean time I want to request that we set it aside as being distractive from information which people might actually find useful. Robert Rapplean 21:34, 3 July 2006 (UTC)

Thanks, Robert. I can actually give you an explanation, but it's a theoretical model and not definitive. So the bottom line is that the AMA position is a consensus, and it's a consensus of medical experts and the scientific community. But you're correct: consensus doesn't mean fact. It's sort of a semantic thing anyway, isn't it, as you point out. It depends as much on the definition of "disease" as it does on how we perceive alcoholism. Yell if you want the explanation...I think it might be too detailed for the entry but I'm happy to share it here. Drgitlow 00:59, 4 July 2006 (UTC)

Hi Robert- I think you’re right that this is largely a semantic problem. However the matter has very important implications for helping alcoholics.

It has long been argued that calling alcoholism a disease reduces the stigma attached to it and encoourages alcoholics to seek treatment, clearly a positive outcome. However, some alcoholics report being offended by the idea that they have a disease and are less likely to seek treatment. Their logic escapes me, but that's how they perceive it. I've never seen any analysis of whether the net result is positive or negative.

Of course the issue is of vital importance to those who are able to obtain third party payment for their services only if alcoholism is a disease. For the AMA, it was an economic rather than a scientific issue. That’s why we can’t rely on groups that have an economic self-interest for an answer.

I sugest that what we believe about the issue is totally irrelevant and that we waste our time to the extent we discuss it. The only issue is whether or not there is consensus that alcoholism is a disease. If there is not, I think the article must reflect this fact, present both pro and con arguments, and not take sides.Medical Man 02:21, 4 July 2006 (UTC)

Perhaps we should copy the ADHD approach

Latest comment: 18 years ago3 comments3 people in discussion

The folks writing the ADHD article have been where we are at now. Take a look at how it was handled there. They've done two things: a) they've set up a separate entry for Controversies about ADHD, and b) they incorporated an overview of the controversies into a segment of the ADHD entry itself. That seems to be a reasonable and rational approach. Do others agree that this would be a reasonable course of action to take, perhaps not yet, but at some point in the future if we continue to have significant disagreement regarding content? Drgitlow 02:17, 4 July 2006 (UTC)

I'll take a look at that article. Mr Christopher 15:22, 4 July 2006 (UTC)

I agree with this approach. It's also the approach taken on the War on Drugs / Arguments for and against drug prohibition entry, and it seems to work well there. Robert Rapplean 22:22, 13 July 2006 (UTC)

The Debate

Latest comment: 18 years ago2 comments2 people in discussion

I have a suggestion. We might establish a venue where those who wish to debate the disease theory can openly do so. Seriously and I'm not being cute. Much like how the Intelligent Design editors will often guide people to the Evolution Talk pages (sorry I don't have a link handy) where they can engage in lively debate about the evidence for and against evolution and intelligent design. That way those who want to debate the subject can enjoy the back and forth and meanwhile on the talk page here we could focus our attention on how to improve this article.

I don't want to silence the debate here at all, but it is difficult to sort through it when you're in the mood to work on the article. Can someone establish something where such a debate/discussion could occur? I don't feel up to participating myself but I would imagine others might. Anyhow, the talk page is growing exponentially so I think it might be a way to make things more effective and manageable. Mr Christopher 05:03, 4 July 2006 (UTC)

Yet another reason to give the Disease theory of alcoholism it's own page, so this could be argued on THAT talk page instead of THIS one. Robert Rapplean 22:24, 13 July 2006 (UTC)

Improved Effects section (Reposted comment from archive)

Latest comment: 18 years ago1 comment1 person in discussion

Despite the difficulties that we've had of late, the entry is coming together nicely. I'm looking over the EFFECTS section, which has a good deal of information on alcohol itself, and the impact of alcohol USE. It is difficult to tease out the effects of alcoholism versus the effects of alcohol. The effects of alcoholism when an alcoholic is in recovery, for example, would be different from the effects of alcoholism while an individual is drinking on a daily basis. (This is similar, of course, to the situation with other diseases - the effects of diabetes when an individual has well-controlled blood glucoses are different from the effects of untreated diabetes). Nevertheless, I wonder whether the entire section would be more appropriately found in the alcohol article rather than here in the alcoholism article. Can we build a consensus regarding this area? Drgitlow 05:29, 1 July 2006 (UTC) —Reposted 07:15, 4 July 2006 (UTC)

Request for a Vote

Latest comment: 18 years ago13 comments7 people in discussion

Can we move the debate about the disease model, and any other seriously debatable issues to its own page? We can leave condensed references to them on the Alcoholism page to maintain a completeness of information, but I think that this page would benefit greatly from such a move. I'd like to hear from Dr. Gitlow, Mr. Christopher, Medical Man, Doc Tropics and Centrx before making this move.

Approve
Disapprove

Approve Robert Rapplean 23:00, 13 July 2006 (UTC)
Approve (though with concern that if we move this, we'll find ourselves in the same place with respect to treatment) Drgitlow 05:12, 14 July 2006 (UTC)
Approve, there's a lot of discussion on it, without consensus. Ronabop 09:47, 16 July 2006 (UTC)
Approve.Medical Man 02:58, 19 July 2006 (UTC)
Disapprove, please see my explanation below. --Doc Tropics ^{Message in a bottle} 03:52, 19 July 2006 (UTC)
Approve with conditions I'll notebelow Mr Christopher 15:25, 19 July 2006 (UTC)

I don't think that the treatment thing will be that much of an issue. As long as we don't try to stick to medically approved treatments, we should be able to do good coverage on it. Robert Rapplean 05:35, 14 July 2006 (UTC)

What is usually done is stale discussions are archived, and if anyone wants to refer to them again, they bring it up as a new section on the main Talk page, while referring to relevant past discussions in the archive by section if appropriate. The result of moving a topic to a separate place is usually that the discussion at that other place is not seen by some, especially new contributors to the article, or that people just end up discussing it on the main Talk page anyway. When discussing things that have been discussed before, you are going to need to link to exactly what you are referring to anyway, like Talk:Alcoholism/Archive1#Evidentiary support for biological component.

Very active articles like United States or articles with long histories like Policy and Style pages keep all recent matters, whatever they are, in the main Talk page, and have, for example Talk:United States/Frequently asked questions, and with policies, new proposals or answers to questions refer back to archived discussions about past matters relating to, say, requirements for reliable sources. I am not opposed to the possibility, I am just saying what is normally done in these situations and the reasons why that works. —Centrx→talk • 10:28, 16 July 2006 (UTC)

In response to this, Centrx, I'd like to suggest that, specifically, the debate over the disease theory of alcoholism contains enough information to warrant an entry on its own. In fact, I feel that it belongs in its own entry not just because there is enough for its own article, but also because the volume of information on that specific topic is capable of overwhelming the parent topic of alcoholism, and that this information is mostly tangential to the parent topic. It really deserves its own article, and the health of the Alcoholism article will improve because of it. Other debates may or may not warrant such treatment, but I think that they will be less cumbersome once the disease debate has been deferred to its own article. Robert Rapplean 16:09, 17 July 2006 (UTC)

For the reasons mentioned by Centrx I think the talk should all stay here. However, I also think that it's time to let that particular debate wind down. Ample evidence has been presented for each point of view and further discussion would probably just be rehash. In order for the article itself to proceed we need to simply agree on how to present these views and evidence in a neutral and factual manner. At the same time I would strongly support Robert Rapplean's suggestion to create a seperate article that focuses specifically on the debate/controversy in more extensive detail (in which case they would obviously be crosslinked). I'm still reeling from jetlag right now so I'll get back again after some serious sleep :) --Doc Tropics ^{Message in a bottle} 04:11, 19 July 2006 (UTC)

I think the debate merits it's own article (other subjects in this article will probably be good candidates as well) but we'll still need to provide an overview of that debate in this article. And sorry I have not been around much lately, I'm buried in "real life" as they say. Mr Christopher 15:25, 19 July 2006 (UTC)

Ok, we seem to have come to a consensus regarding giving the disease theory of alcoholism its own page, and putting an overview of it on this page. Unless anybody objects, I'll go about doing that tomorrow. I'll also move the sections in this conversation that specifically pertain to that onto that article's talk page. I think we can consider any other debates for spawning articles based on their individual merits, after our heads have cleared a little from this one. Robert Rapplean 21:41, 19 July 2006 (UTC)

That should do it. I put a stub reference in for the disease thing, please review it, but also please limit arguments to whether or not it reflects the consensus obtained on the Disease Theory of Alcoholism page, not about whether or not alcoholism is a disease, and how much evidence there is one way or another. Robert Rapplean 17:03, 20 July 2006 (UTC)

Mediation content archived after mediation has been removed

Working through content disputes

Latest comment: 18 years ago1 comment1 person in discussion

The editors of this article need to resolve the their article content disputes using WP:Consensus and Dispute resolution. It is time consuming to do this but necessary according to Wikipedia policy. Since this article is controversial every non-minor edit probably needs to be discussed on the talk page. This includes putting information in the article and taking it out.

Since material is included in the article based on Wikipedia policies instead of the qualifications of the contributor, I'm going to insist that that you stop speculating about why an editor is contributing any specific material. This type of discussion never helps the situation. At best it draws your attention away from the proper criteria for inclusion, and at worst it increases the conflict and tension in the dispute.

It is my belief that all Wikipedia users have a responsibility to try and resolve their conflicts with other editors in the least disruptive way possible. This means that every editor needs to try and work with the other editors by assuming good faith. WP:AGF is a cornerstone Wikipedia policy.

If there is a particlular passage of text, external link, or some other content that is objected to by one or more editors it needs to talk out on the article talk page. If the editors can not come to an argreement then the steps for dispute resolution need to be followed. As a first step, getting the input of a larger number of editors is probably a good idea. This can be done by asking for other editors to give an opinion. I'll ask a few editors to stop by and give their opinion. Please list a few specific areas of conflict so that outside editors can understand the issues.

Last but not least remember our important new official ~~policy~~ decree Wikipedia:No climbing the Reichstag dressed as Spider-Man I'm an offical member of the Rouge admin cabal and will enforse this ~~policy~~ decree as needed to keep the editors of this article safe. FloNight ^talk 03:13, 2 July 2006 (UTC)

Garden-variety content dispute

Latest comment: 18 years ago2 comments2 people in discussion

The editors of this article are having garden-variety content dispute. Instead of proving that the other editor is a biased knuckle head intent on ruining Wikipedia, let’s assume good faith and focus on consensus editing the article. FloNight ^talk 14:08, 2 July 2006 (UTC)

Anyone have any links that provides a road map or guidelines for getting consensus amongst editors? Mr Christopher 16:39, 2 July 2006 (UTC)

Talk:Alcoholism/Archive 2

Contents

To and From the authors of this article and from again

Alcoholism is an illness

Alcoholism is not an addiction

Asking a chemical dependency counselor about alcoholism is about tantamount to asking an illiterate person to teach you how to read.

If you want to know about alcoholism ask a recovered alcohlic not a counselor that has read some books.

AA does not claim to have a corner on the treatment of alcoholism. However, it has the greatest success rate of any

Someone said something about a cure to alcoholism. There is none.

Alcoholsim is a physical disease with a spiritual solution.

Hey

Physical Dependence vs. Addiction

Leave Arguing about Alcohol to Medical Professionals

Tags

Alcoholism is clearly not a disease

Using the AMA/APA POV for this article

Intro Redo III

Consensus

Logical Moves

Alcoholism as a disease

drgitlow edits

Alcoholism as a disease

Mediation

Encouragement

Accuracy and integrity are essential

There is no consensus

Paging Doctor S Gitlow

The Benjamin Rush edit

POV Arguments

MedicalMan Edits

What's a pundit?

Can we move the Disease argument to its own entry?

Perhaps we should copy the ADHD approach

The Debate

Improved Effects section (Reposted comment from archive)

Request for a Vote

Mediation content archived after mediation has been removed

Working through content disputes

Garden-variety content dispute