The word “alcoholism” does not describe a disease but rather it’s a behavior. Behavior is self-determined by choice.  Choice, then, is the cure for alcoholism and any other form of drug abuse.  In fact, personal choice is the only method by which people stop alcohol and drug abuse.

“Men at some time are masters of their fates: The fault, dear Brutus, is not in our stars, but in ourselves, that we are underlings.” ~ Julius Caesar Act I, Scene II

For at least the last 500 years man has tried to blame unwanted behavior on anything and everything but himself: as in, “If there is a disease for overindulging in alcohol or other drug, then I am not really responsible for my drinking and drugging behavior.”

I am not alone in the assertion that alcoholism and drug additions are not diseases. So, let’s set aside the hysteria and look at this from a common sense point of view.

In science, nothing exists that has no proof of existence.  That which has no proof, but is thought to exist, exists as a matter of conjecture and faith, not science.  In the case of disease, meaning “a condition that results in medically significant symptoms in a human,” there exists no credible evidence supporting the notion that regular excessive use of any substance is a disease.  This conclusion is based on the normally accepted understanding of the word “disease.”

Diseases are determined and described by the scientific method.   If, indeed, the excessive consumption of alcohol is a disease there must exist some scientific study that determined it to be a disease.  Such a study would describe a specific and predictable set of symptoms that would involuntarily manifested in the sufferer.  No such study exists.

Consider the facts surrounding the disease theory, and its development, which provides evidence that the “disease of alcoholism,” indeed alcoholism itself, is merely folklore and not established by way of the scientific method.

When adding “alcoholism” to the Diagnostic and Statistical Manual of Mental Disorders in 1956 the American Psychiatric Association was, for the most part, relying on the work conducted by Dr. E.M. Jellinek at Yale University during the  the 1940’s.  Subsequently, Jellinek’s study was determined to be flawed according to Yale University. At the request of Yale University, Jellinek retracted all of his conclusions, stopping just short of admitting that his research was fraudulent.  Later, Jellinek was found to be a fraud:  The schools where he claimed to have earned his degrees had no record of him receiving any. The point here is not to malign Jellinek or Yale, but to merely provide an historical account with respect to the origin of “alcoholism, the disease.”

It is important to understand that the disease theory is just that – a theory. Additionally, it is important to understand that this theory is only accepted as fact by the treatment industry here in the United States. The rest of the world considers the disease theory for alcoholism unsubstantiated. In his book Why We Should Reject The Disease Concept of Alcoholism, Herbert Fingarette, Ph.D., makes the following observations:

“…In the United States, but not in other countries such as Great Britain (Robertson and Heather, 1982), the standard answer is to call the behavior a disease – ‘alcoholism’ – whose key symptom is a pattern of uncontrollable drinking. This myth, now widely advertised and widely accepted, is neither helpfully compassionate nor scientifically valid. It promotes false beliefs and inappropriate attitudes, as well as harmful, wasteful, and ineffective social policies.”

The myth is embodied in the following four scientifically baseless propositions:

1. Heavy problem drinkers show a single distinctive pattern of ever greater alcohol use leading to ever greater bodily, mental, and social deterioration.
2. The condition once it appears persists involuntarily: the craving is irresistible and the drinking is uncontrollable once it has begun.
3. Medical expertise is needed to understand and relieve the condition (“cure the disease”) or at least ameliorate its symptoms.
4. Alcoholics are no more responsible legally or morally for their drinking and its consequences than epileptics are responsible for the consequences of their movements during seizures.

The idea that alcoholism is a disease has always been a political and moral notion with no scientific basis. It was first promoted in the United States around 1800 as a speculation based on erroneous physiological theory (Levine, 1978), and later became a theme of the temperance movement (Gusfield, 1963). It was revived in the 1930s by the founders of Alcoholics Anonymous (AA), who derived their views from an amalgam of religious ideas, personal experiences and observations, and the unsubstantiated theories of a contemporary physician (Robinson, David, 1979)

Another observation is offered by Jeffery Schaler, Ph.D.  in June of 1995:

“Extensive research supports the idea that addiction is a voluntary process, a behavior that is better explained by individual psychological and environmental factors, than physiology and the chemical properties of drugs.”

In another article authored by Dr. Phil Stringer entitled Disease, Victimization, and Personal Responsibility, he raises the question:

“How many people who never decide to drink would ‘catch’ the ‘disease’ of alcoholism?”

The obvious answer is none. In the traditional meaning of the word “disease,” a chosen behavior does not define a disease because one can just as reasonably choose not to drink or use drugs. The disease theory simply provides the person with a drug or alcohol problem an easy out from taking responsibility for themselves, their behavior, and the problems they cause.

There are hundreds of researchers who have looked carefully at the alcoholism disease theory. Most have rejected the notion that alcoholism is a disease. The only studies that support the disease theory are those conducted by organizations and individuals who have a vested interest in the over consumption of alcohol or other drugs being a disease (e.g. Alcoholics Anonymous, NIAAA and NCADD). The studies that have touted alcoholism as a disease are researchers who derive a living, in one way or another, from the treatment industry. These are hardly sources that can be trusted.

Finally, consider the paradoxical nature of the disease theory: the theory contends that once the disease is in place (diagnosed), the alcoholic has lost the power of choosing not to drink or the drug addict to not use drugs. But, how can that be true when millions of “diagnosed” alcoholics have stopped drinking and never return to problem drinking and drug addicts have stopped using drugs? If, indeed, they lost their power to choose to not use alcohol or other drugs, how did these millions of people with drug and alcohol problems stop drinking or drugging? Are we to believe that counselors and other professionals can make the choice for their patients because their patients have “lost their personal power of choice?” Or perhaps Alcoholics Anonymous and other 12-step programs provide some “magic” that gives members their choice back, but only “one day at a time.” Or maybe we are to believe that there is some universal power (choice power) that is channeled only through licensed counselors and other would-be professionals.

When common sense prevails, often the right answer is what we have known all along: The fault, dear Brutus …is in ourselves. Alcoholism and drug addiction is not disease. There is not now, nor has there ever been, any scientific evidence of such a nonsensical assertion.

I want to be clear: I am in no way asserting that physical addiction to a substance does not exist. It is a fact that the human body does become accustomed to, and even learn to relay on, unhealthy and even poisonous substances. The human body is extremely adaptable, even to extremely adverse conditions. The result of physical drug addiction can be observed as the withdrawal symptoms seen when drugs or alcohol stop being introduced to body: it is caused by the body trying to again learn, or adapt, to regulating body functions without the interference of the substance. However, once the sustenance has been cleansed from the body, only the psychological effects remain. Just as drug use is a learned behavior, overcoming the habitual and destructive thought processes associated with  drug use are skills that can be acquired, practiced, and eventually mastered. It is not a lifetime disability; it’s a choice.

Don’t be fooled by the propaganda that attempts to make you believe you are helpless and have a lifetime incurable disease. You can choose to learn how to be well, and stay well for the rest of your life. While it can be difficult, and take time to learn to how to overcome unhealthy habits and thought processes, it is possible.

Many newcomers to Self Management and Recovery Training (SMART) meetings have previous experience with Alcoholics Anonymous (AA). Although they have decided to investigate SMART because of dissatisfaction with AA, frequently with its “spiritual” component, they are still unclear about both what they themselves are looking for (aside from either not drinking or cutting back), and what SMART specifically stands for and how it differs from AA. One member of the Washington, DC Area SMART groups offers some thoughts on the subject (which may differ from other members of the groups):

1. SMART Recovery is not an ideology, that is, a fixed set of beliefs. The emphasis is not on belief, but on rational analysis and action. Unlike AA, SMART works to provide an analytical framework which allows each participant to chart his or her own path to freedom from addiction. The mainstay of this framework is Albert Ellis’ Rational-Emotive Behavior Therapy (REBT), but this is not the only approach used in our meetings. SMART’s view, unlike AA’s, is that we should “utilize and analyze.”
2. It follows from this that SMART does not consider that all addicts are alike. Thus, no one “solution” fits all. Objective scientific studies have shown that everything from drinking patterns (for example, daily use to binge drinking) to degree of dependency, age at the outset of addiction, sex, family patterns, psychological reasons to use (i.e., to get “high” or to avoid feelings of inadequacy or discomfort) etc., produce strikingly different types of addicts.
3. Therefore, SMART does not claim that it is the best program for everyone with addiction problems. SMART emphasizes the goal of abstinence, as does AA. SMART might be best for some, AA for others, Moderation Management for others, religious denomination-based programs for others, or even personal determination to quit. The only way for a person with an addiction habit he or she wishes to end is to experience SMART Recovery or AA or some other program and see if it works; if it doesn’t something else should be tried.
4. Thus, we see that, SMART emphasizes personal choice and responsibility for one’s actions. It is up to each addict to determine what is best for him or her, not have the choice forced upon him or her. This point is in particularly strong contrast with AA’s emphasis on “powerless.” Rather, SMART believe strongly in rational analysis leading to freedom for the individual and his or her empowerment through self-knowledge leading to control over one’s decisions.
5. While SMART fully respects diverse religious views, and indeed some of its participants hold personal religious and spiritual beliefs, they do not view religious and spiritual beliefs as essential in solving our problems of addiction. SMART does not consider that a malevolent or benevolent “Higher Power” is either responsible for our addiction problems nor will it intervene to aid us in our individual efforts to overcome them.
6. SMART also does not consider “alcoholism” a life-long preoccupation. They prefer the term “addiction,” which refers to the physical addiction experienced while using (and for some time thereafter during withdrawal). After this physical addiction is over, the real problem is psychological—and solvable by the individual. Following this—or occurring simultaneously with it—the individual can move on to work on his or her other goals in life.
7. Simple observation as well as scientific studies show that there is no single “alcoholic personality” type or profile which can usefully describe an individual and his or her addictive actions. SMART instead observes that conflicting desires exist within each individual, some strong to use, but others equally earnestly desiring to end the addiction. We do not dwell on the historical sources of these desires, as is often done in traditional psychoanalysis, but instead on identifying and analyzing the underlying rational and irrational beliefs causing these desires in the here and now.
8. SMART meetings are self-help groups, not support groups. While attendees sympathize with, and try to assist others in the group, the primary goal of participants in our meetings is to support and strengthen their own efforts to be free of addiction. Unlike AA, probing discussion through cross-talk and feedback is encouraged. Like AA, however, these groups are confidential and administered by their own participants. Also like AA, SMART meetings are free, with minimal contributions encouraged but not required.
9. SMART has no definitive and incontrovertible text, such as AA’s Big Book. They have developed and continue to develop our own suggested reading material, which is available at meetings, but also draw on other sources in our discussions.

For more information on Self Management and Recovery Training and their meetings, please visit SMARTRecovery.org.

Differences Between SMART an AA