Disease Theory of Alcoholism - History

History

Historians debate who has primacy in arguing that habitual drinking carried the characteristics of a disease. Some note that Scottish physician Thomas Trotter was the first to characterize excessive drinking as a disease, or medical condition.

Others point to American physician Benjamin Rush (1745–1813), a signatory to the United States Declaration of Independence — who understood drunkenness to be what we would now call a "loss of control" — as possibly the first to use the term "addiction" in this sort of meaning.

My observations authorize me to say, that persons who have been addicted to them, should abstain from them suddenly and entirely. 'Taste not, handle not, touch not' should be inscribed upon every vessel that contains spirits in the house of a man, who wishes to be cured of habits of intemperance.

Rush argued that "habitual drunkenness should be regarded not as a bad habit but as a disease", describing it as "a palsy of the will". His views are described by Valverde and by Levine:

Then there is Swedish physician Magus Huss who coined the term "alcoholism" in his book Alcoholismus chronicus. Some argue that he was the first to systematically describe the physical characteristics of habitual drinking and claim that it was a disease. However, this came decades after Rush and Trotter wrote their works, and some historians argue that the idea that habitual drinking was a diseased state emerged earlier.

Given all this controversy, the best one can say is that the idea that habitual alcohol drinking was a disease had become more acceptable by the middle of the nineteenth century, although many writers still argued it was a vice, a sin, and not the purview of medicine but of religion.

Between 1980 and 1991, medical organizations, including the AMA, worked together to establish policies regarding their positions on the disease theory. These policies were developed in 1987 in part because third-party reimbursement for treatment was difficult or impossible unless alcoholism were categorized as a disease. The policies of the AMA, formed through consensus of the federation of state and specialty medical societies within their House of Delegates, state, in part:

"The AMA endorses the proposition that drug dependencies, including alcoholism, are diseases and that their treatment is a legitimate part of medical practice."

In 1991, the AMA further endorsed the dual classification of alcoholism by the International Classification of Diseases under both psychiatric and medical sections.