Alcoholism is not a disease:

Dear Dr. Brilliant Cliché;

My dad is an alcoholic, sober for 23 years now. His sister was also an alcoholic, still drinking; I realize that it is something that runs in the family.
I can’t say that I have a drinking problem, but I do know that if I am not careful, I will start drinking too much. So I am very careful and don’t let it become a habit, I don’t drink alone, nor do I binge drink on the times I indulge socially.
I think that my consciousness about the problem in my family makes me aware enough that I can control myself.

However, I have a brother who is definitely on his way to becoming a problem drinker. His daily cocktail hour starts at dinner and continues through the evening. His wife says he never gets “drunk” per say. But the cautious voice in me senses a potential problem.

Anyway, here’s my question- how come people from the same family, who have similar dispositions and probably similar genetics, can react so differently to alcohol?
My dad can’t touch it; my brother probably shouldn’t but is a functioning drinker; I’m moderate as hell. It raises the question-
is alcoholism really a “disease” that runs in families? Is it inevitable and uncontrollable to anyone who has the wrong body chemistry?
Or is it something that we each either chose to control…or not?

Wendy Wonders

Dear Wendy,

Despite popular culture’s belief, alcoholism is not a disease. It is a complex of genetic predispositions wherein alcohol becomes the obvious solution.

You can’t catch alcoholism from people although substance abusers do like to initiate others into their addictions. Unlike a disease that enters into your body without permission substances have to be introduced into your system by your own behavior. You are always choosing to use when you use; or choosing not to, when you don’t.

You are being vigilant, consciously taking responsibility for your choices. The rest of your family is taking the route of least resistance. However, you should realize- addiction doesn’t always take an obvious form.

In every alcoholic family there is at least one designated driver, the one who carries the responsibility for all the others. Genetically, the designated driver is not any different but their particular addiction is that of obsessive guilt and hyper responsibility. One can be addicted to dysfunctional people or dysfunctional love as much as to a drug. Destructive habits such as cutting, gambling, sex addiction or anorexia are all interchangeable shortcuts as well.

The silly thing about addiction treatment in our country is the prevalent use of medications to treat addictions. Sure, they might work if you stay on them forever- but that isn’t success- it does not change the big picture. One substance is simply substituted for another. All the behaviors that predispose a person to addictions (a shortcut mentality, black&white thinking, heightened sensitivity to emotions, the misconstruing of other’s intent) continue to operate. The twelve step program of Alcoholics Anonymous deals with the bigger picture but, ironically, many people don’t work the steps if they are taking a medical prescription because they think they are cured.
In reality, constant vigilance is the only way to control addiction. You need to address and develop the skills necessary to counteract your genetics tendencies.

Dr. Brilliant Cliché

Granny says: I think that a great metaphor for addiction is the legend of the Vampire- he can only come into your house if you invite him in. Once he has been invited, you can’t keep him out.
Every addiction is a permission given by the person who has it. Everyone has their own reason, their own special explanation as to why it is OK, or how it works to keep them going. And they are right- when you are unbalanced, drugs and addictive behavior can help create an artificial balance that you can live with. The problem comes with the consequences…most addictive behaviors are eventually destructive on either, or all of, these levels- physical, emotional, spiritual, economic and social. The price they ask is too high. The balance is not sustainable.
If addiction occurred for intellectual reasons, an understanding of consequences would be enough to stop any potential addict. However, addiction does not come from our minds, or even our emotions. It comes from a black hole inside that is always aching, empty and hungry. It is like an element that rages unbidden. It is not a rational thing.
It is, and always will be, only a firm decision and commitment to change will ever precipitate the control of addictive behavior. We make bad decisions every day, telling ourselves we will do the right thing tomorrow. But as any food addict can tell you, by the time tomorrow comes, years can have gone by and we don’t just have five pounds to deal with- we have a hundred and fifty.

It’s always easiest to catch an addiction early. If you catch it after it is firmly entrenched, be prepared to have a long battle on your hands. The tentacles reach deep.


About Dr. Brilliant Cliché

Dr. Brilliant Cliché and the Granny Dr. are a fictional web presence and advice blog. Together we offer a joint perspective that is deep but not academic, entertaining but not fluff, and educated yet street smart. By joining the internet community we hope to share thoughts and stimulate insightful conversation around pressing issues that affect us all. Looking forward to hearing your thoughts. (This is not a site for therapy nor does it intend to replace medical or other professional care. ) You can leave comments here or email The Dr. at and don’t forget to like us on facebook. Our facebook page is Dr. Brilliant Cliche
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2 Responses to Alcoholism is not a disease:

  1. Another important issue about addiction that isn’t often talked about is the absolute pure nirvana of being 100% entirely in the emotional right brain. Normal life doesn’t allow this as the left brain ego is always in balance or conflict with the right brain’s emotional beingness. This 100% right brain pure emotion experience feels like finding god. Nothing in real life can compare and once experienced can pale normal existence. None of my clients are willing to give it up forever and it is a source of relapse or noncompliance with any treatment that requires never experiencing it again. It is the same with mania as 100% pure emotion without left brain reflection. Sobriety and stability requires a more sublimated and disciplined path to have this experience.

    Dr. B.C.

  2. A reader wrote in that she is an alcoholic. She found out at age 18 that the dad she knew wasn’t her biological dad. Her biological dad, whom she never met, was an alcoholic. Her son is a heroin addict. She asked, “isn’t this heritability a disease none of us asked for?”

    Dr. Brilliant responded: No, a genetic potential isn’t a disease as it still requires what Granny said, inviting it in the first place. The first drink or toke or whatnot, that was a choice.
    An alcoholic family usually has a designated driver someone who isn’t addicted but instead takes on the responsibility for everyone else. They have the same genetics as the rest of their family only their addiction is empathy, guilt, and sacrifice instead of a substance.

    Addicted individuals genetics behave differently to substances than non addicted people do. Where as non addicted people often get sick with substance use addicted individuals have a high tolerance and can completely loose themselves in the experience.

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