The Disease Theory

The disease theory of addiction, in this case alcoholism, might lead us to believe that people have little or no control over their drinking, because substance use (alcohol or drugs) is a brain disease. The concept of substance use being a disease alas is not new. Some of the earliest attempts to define alcohol use as a disease date back to the 19 century (Schaller, 2009, p.49) and what grew from them was a culture focused on defining alcohol and/or substance users in a way that will give “rational” explanation of the choices they make before, during and after drinking, as these choices are more often than not deemed socially unacceptable.

What do we know about “addicts”, as described by the disease model? It turns out  the disease model knows a lot more about a person’s drinking or drug use than that person him/herself. For example, according to the disease model, if a person has a drinking problem, he or she is diseased, but most often in denial of that fact. If a person who drinks excessively is refusing to accept and recognize their substance use as an addiction, the disease model teaches us that this person is in denial.

The disease model is also working hard to convince society and the substance user that a person under the influence has no control over their choices, actions and behavior whatsoever. Not only that, but we are forced to believe that the only way to overcome an “addiction” is through treatment, because after all, this is what we do with people who are diseased- we treat them.

However, in order to be treated, a person first must recognize that they are “sick” with this incurable disease for the rest of their lives and they can do absolutely and positively nothing, to change that “fact”.  In fact, these people are so “sick” that they will need treatment and support for the rest of their lives, and be considered constantly at risk of returning to their old habits.

 But that is not all; the disease model goes way above that, stating that people are genetically prone to becoming “addicts”.  In other words if a parent is “diseased” (i.e. alcoholic), the chances of his/her children being “diseased” are that much greater. The disease model doesn’t deem this to be a learned behavior in generational alcoholism, no. After all, these people are “sick” with incurable and hereditary disease, don’t forget. 

Reading through the description of the disease model, is it difficult then to see that the stream of thought that is introduced by it, and more often forced upon the substance user and society in general, leads in a manner of speaking to a self-fulfilling prophecy?

 Just imagine the gradation:

  • People are told they are sick. ( Bad)
  • Then they are told the disease is incurable. ( Worse)
  • Finally they are assured they cannot do anything to change the fact they are an “addict” (Worst)

But of course, substance users are assured none of this is their fault for the above mentioned reasons, and that is the only “positive” side of the disease model. It clears the substance user of all responsibility.

And here is where the line has to be drawn. If a substance user believes he or she holds no responsibility over their choices, actions and behavior, they will not do a single thing to change them. They will simply continue the learned pattern and “slip up” from time to time, because this is normal, acceptable and even expected, when you have the incurable disease “addiction”. In a way, when a person settles down in the comfortable chair of “addiction”, certain behaviors and choices are expected of them, in order to keep up with the disease charade, like relapsing for example.

The truth of the matter is that “there is much empirical support for the claim that addiction emerges as a function of the rules of everyday choice.”( Heyman, 2013) In other words, things are not as black and white as the disease model might want us to think.  There are alternatives to the traditional alcohol treatment philosophy and the alcohol user can absolutely take action to overcome their alcohol problem that do not involve treatment and relinquishing their free will and choice.


How does alcohol affect your life? Your health? Your relationships? Do you have regrets based on choices, behavior and actions that you have taken when under the influence? If you are having trouble being honest with yourself, maybe it is not a bad idea to hear  how the people around you are evaluating your drinking. Try to understand their reasoning, but do not force it upon yourself. Nobody knows better than you what the situation is, so give it your best try to be honest with yourself and with others about it.

Create a plan of action

Once you complete your evaluation, if you determined that you have an alcohol problem, it is time take responsibility for your choices, behavior and actions. Again, be honest. Own up to your situation and create a plan of action how you are going to improve it. Be realistic, but do not restrict your goals based on your past behavior, allow yourself to dream. This is the best way to change your self-image and improve your chances of success to stick to the plan.

Accept reinforcements

This is not mandatory, but you might find yourself in a situation where it is difficult to change your choices alone. There is nothing wrong in seeking help to fulfill your goals. Would that be your family, friends, educational program or else, it is entirely up to you. Whatever feels right for you and aligns with your views and philosophy is the right choice.

Stick to the plan

Change is never easy; however, it is entirely possible. If you want it strong enough and you truly believe that is the right choice for you, you can accomplish the goals you set in your plan. You just have to follow through, not because of anything or anyone else, but because you know it is your responsibility and your choice.

Move on

Sometimes when people deal with alcohol problem and they are taking action to change their situation, it is easy to go down the road of blame and shame. That is why it is important to learn how to move on. Take responsibility for your actions, behavior and choices, but once you do, let go. That is the first thing to do so you can begin rebuilding your life and make healthier choices- to realize that you can’t change the past, but you can for sure change the future.

In conclusion, there are many things a person can do to overcome your alcohol problem and the listed above are just a general overview. The most important thing that you have to do if you consider yourself having an alcohol use problem, is to make the choice to change your situation. Once you make the rational decision to make better choices, everything else will fall into place. Because after all, “addiction” is nothing but a choice, and it’s never too late to make the right one.


Heyman, G.M( 2013) Addiction: An Emergent Consequence of Elementary Choice Principles. Inquiry: An Interdisciplinary Journal of Philosophy. Addiction and Agency. Vol.56 (5)

Schaller, J. (2009) Addiction is a choice. Open Court (Carus Publishing Company), Chicago and La Salle. Seventh Edition