There are a couple of misconceptions about alcoholism and addiction that need to be set straight from time to time.  One has to do with the actual causes of addiction (including alcohol addiction), the other with volition and morality.

Alcoholism is a disease.  So is addiction.  A disease is “…an abnormal condition of the body or mind that causes discomfort or dysfunction; distinct from injury insofar as the latter is usually instantaneously acquired.”

There is no competent debate about this issue.  Alcoholism was recognized as a disease by the American Medical Association in 1956.  The American Psychological Association followed a very few years later.  Both organizations recognized other addictions as diseases a bit later still.  There can be no question about either, according to the above, or any other accurate definition.  Back in the mid-20th Century they were not sure about the causes, but the discomfort and profound dysfunction were obvious.

We now know that between five and ten percent of the population are born with a genetic predisposition to addiction. We know that, among heavy drinkers, roughly 30% will develop a alcohol abuse problem at some point in their lives.  Some will be able to stop drinking with relative ease, but too many others will not.

We know that both alcohol and other drugs* cause actual physical changes in the brain that cause us to perceive, on a level well below consciousness in the primitive parts of our brain, that if we do not get our drugs we may die.  This sort of thing is a pretty powerful motivator when we are considering it consciously (imagine your reaction, for example, if faced with the five-inch claws of a full-grown brown bear in the wilderness).  When our subconscious and our physical sense of well-being are sending us the same messages, and we are helpless to run, hide or fight back, the effect is devastating.

If it is true, as the saying goes, that the difference between a civilized man and a savage is a few square meals, then it is equally true of an alcoholic or addict who needs her fix.  And, just as it’s hard to convince a starving man that he needed to lose weight anyway, so do the benefits of abstinence miss the mark with alcoholics and other addicts.  This is due not only to the reptilian brain’s cry for drugs, but also to profound changes in perspective and attitudes toward life that are engendered by those powerful cravings (and sometimes by the ends we have gone to to satisfy them).

Given the above, volition and morals are hardly issues.  Just as the starving man, forced to steal food in order to live, will eventually accommodate emotionally and rationalize the need to steal for his needs, so do addicts unconsciously adjust their outlooks on life to allow them to deal with the very real need to obtain their drug of choice — by whatever means.  This varies with the individual and the means at his disposal.  A rich man may support a heroin habit for many years without outward signs of change, and without exploiting anyone, while his poorer fellow-addict from the streets will so rapidly be pulled down by his needs that he becomes literally unknowable to his family, his friends and — ultimately — himself as well.  Both are addicts; it is just more difficult for one of them to realize it and decide to change. In that sense, the street druggie is the lucky one.

So, while morals — in the sense that most people think of them — may suffer extreme degradation by the imperatives of addiction, there is little choice involved beyond the decision, early on, to stop using.  Before long, it becomes too late to make such “moral” decisions.  This is not the place to discuss the psychological mechanisms that we use to justify and allow ourselves to change our way of living and our sense of ethics.  It is sufficient merely to note that such changes are almost inevitable in full-blown addicts of whatever stripe.

Is a diabetic immoral because she failed to watch her diet and other health factors back in the days when she could?  Is a teenager — because he drank in a society that glorifies alcohol but unknowingly reached the point where he lost control?

None of the above is an attempt to justify the behavior of any addict or alcoholic.  We are responsible for our actions, whether of commission or omission.  However, we need to view such things in the light of reason.  We need to understand that, after getting clean, we have to do what we can to make things right — not for the benefit of others, but to set things right in our own heads.  And those who have been wronged need to afford their addicts the opportunity to do so.  There is an old saying, “Don’t throw the baby out with the bathwater.”  It is easy, in our own self-righteousness, to throw the baby out, yet keep the poisoned bathwater of our resentment.

*Alcohol is a drug, and alcoholics are drug addicts, like it or not.