* Alcoholism basics

(A message I sent family on 26 April 2006.)

Disease, or sin?

To the best of my knowledge, the “disease theory of alcoholism” began with Dr. Robert Silkworth, at the time of St. Thomas Hospital in Akron, Ohio, coincident with the beginnings of A.A. “Dr. Bob” referred to the condition as an “allergy”; for whatever reason, these folks’ bodies respond to this substance differently than others’ do.

This theory and its ramifications are, today, largely taken for granted throughout the scientific world. Whatever the disease’s cause, behavioral strategies are needed, too, if the subject is to manage the disease and live a normal life. The same is just as true of diabetes or near-sightedness or hay fever.

The competing view, that drinking problems reflect sin or some kind of moral deficiency, still has its grip on the popular mind. The predicaments that problem drinkers create for themselves and for others, are bad enough in and of themselves without the added burden of this stigma. My late father insisted until his last lucid day, that it was all a question of “will power.” I remember visiting Mom at home sometime prior to 1990, and finding on the bookshelf different books by Hazen G. Werner, an Ohio Methodist bishop whom my father fervently admired, and finding certain passages that my father had marked wherein the author discounted the disease theory and blamed it all instead on, as it were, sin. I shook my head at the untold, needless damage such words do.

I now believe my father’s terms were correct, but his definitions of them were wrong. I now believe that alcoholism reflects a disease of the will — the will being the faculty that chooses what one wants, chooses what one feels. On the one hand, for 98% of people 98% of the time, this faculty is “asleep,” or completely subconscious; people have no awareness that it even exists; and so those interventions wherein it “wakes up” and acts, are experienced has having been done by a “Higher Power.” On the other hand, there are interrelations and connections between spirit and flesh, between what one may desire and the tools one has on hand, that remain a complete mystery.

Different forms of the disease

… have been identified, and different “classes” of stories one hears in A.A. have been substantiated in the laboratory. It’s a question of different genes that may be at work in different people, all with the same effect that these folks’ bodies don’t metabolize ethanol the same way those folks’ do.

For starters, for example, some folks drink “to get in” and others “to get out.” Some folks are problem drinkers from the moment they first ingest any ethanol at all (Birth? Age 4? Age 12?); others, like me, have no problem with the stuff at all until an abrupt change occurs, typically in middle age.

One gene has been identified that has different effects in men and women. In men, this gene results in continuous, chronic discomfort from which ethanol provides the only known relief. These are the guys who tell stories like this:

I was 14 years old, and a couple buddies and me had got this fifth of whisky, so we went out behind the barn to check it out. None of us had ever tasted any liquor before, ever. Bill took a swig and coughed real hard, and shook his head and gave Frank the bottle. Frank took a swig and coughed real hard, and shook his head and gave me the bottle. I drank the whole thing down as if it were iced tea. I didn’t cough at all. And for the first time in my life, I felt like a whole person.

When the same gene appears in women, the result is hypochondria. The same chronic discomfort is present; but ethanol provides no relief.

Progressive nature

It’s well known that alcoholism is a progressive disease: it gets worse over time. Less well known is that the disease itself continues to get worse regardless of whether one’s drinking or not.

It had been known for decades that a problem drinker who attains sobriety and then, perhaps years later, resumes drinking; will quickly to decay to the same point as if the person had never quit drinking at all.

The “organic” or biological basis for this was discovered circa 1990. There are certain structures, I suppose everyone has them, on the “brain stem,” which over time, in persons who possess the alcoholic genes, grow; they become “nodules,” and continue to grow throughout life. These appear to control the dysfunctional metabolism of ethanol, such that as they grow, so also grows the amount of ethanol one must consume to obtain a given effect; also the degree of impairment to the will; etc., etc.

Time travel. Another puzzling feature of the disease is that the “active” problem drinker is fundamentally a different person, somehow, from the same person in sobriety. At such time as the disease process becomes “active” — say, as happened with one of my students, at age 14 in 1982 — all development of the sober personality comes to a halt, and does not resume until sobriety is restored. If, for example, the student in question attained this in 1998, then he would have found himself a 14-year-old personality in a 30-year old body, and seeing the 1998 world through 1982 eyes. I’ve heard stories of how these guys seek to live on fast-forward until they catch up — progressing through 18-year-old impulses and interests, 24-year-old impulses, and so on.

It happened to me

As happens with some forms of the disease, I was a “normal” drinker all my adult life until, quite abruptly, sometime in 1993, something changed. My alcohol intake skyrocketed, and other symptoms of the disease began to appear.

Dehydration. The first change that I managed to actually notice, was that enigmatically, drinking made me thirsty. Well, immediately, the easiest response to that is to drink more. Of the same stuff, that is. The fastest way for me to sober up, on any given occasion, was to merely switch from drinking beer or whatever, to drinking water. THIS WAS NEW.

Drying out. I drank pretty steadily from 1993 to 1995. Once I began attending A.A., it was still six months before I quit drinking completely. In other words, I was still drinking at that time.

H.A.L.T. A.A. equips a person with many, many tools to help obtain and maintain sobriety. I mention now just one. They have a slogan, “H.A.L.T.: don’t let yourself become hungry, angry, lonely or tired.” Any one of those conditions can produce an impulse to drink; if the condition presents, fix it. Hungry? Eat. Angry? Deal with it. Lonely? Go find some people. Tired? Take a nap. Fix it.

In those days when I was first seeking to stop drinking, I found it necessary to take a snack to work with me every day, and eat the snack just before day’s end. For if I was hungry on the commute home, I discovered, I would not get off the bus and go straight home. Instead, I would swing past the liquor store en route. The daily snack at quitting time, fixed that.

Today. Since 1995, I have had several occasions of heavy drinking, that might last up to six months at a time. As I write this now, an impulse to get drunk is rare for me, and is usually easily overcome by recalling that drinking was, for me, a complete waste of money and of time (I typically drank at home at night, when I could have been doing housework or working on hobbies. But you can’t get anything done, really, while you’re blitzed or passed out.) In contrast to many people, however, complete abstinence is not a feature of “my program.” I still let myself get s*it-faced two or three times a year, specifically and only at family or church holiday parties. That’s it.


Common sense is useless. The turmoil that the disease of alcoholism inflicts upon a family is such that loved ones will wind up wanting to try anything, including prayer. There are ways to go about it — actually, a great deal is known and much research has been done on just this subject — but they prove to be beyond the scope of this writing. “First Things First,” another A.A. slogan: the processes that work are not at all what one might think from common sense. On the contrary, on this point, as on so many other points in dealing with this disease, common sense is useless.

Al-Anon is an organization designed for alcoholics’ loved ones,
and is the only place I know of that teaches what does work.
It’s available worldwide, 24/7, no farther from you than a phone call or mouse click.
The First Thing a loved one needs to do, to deal with the disease, is to
start attending Al-Anon meetings and learning what does work.

I do believe Jesus taught on these techniques and issues. I do believe he ministered daily to addicts and others. The Twelve themselves, however, and those for whom the Christian Scriptures were written, did not personally have these issues, and so for the most part those teachings have been lost. For the most part. Crucial vestiges of them have been preserved in the Synoptic Gospels. The best place to learn about them is from within the Twelve Steps movement, beginning by attending A.A. or Al-Anon.

(Reblogged 04/13/17.)
on air talent, talk show host, talk radio, the homeless blogger

4 thoughts on “* Alcoholism basics

  1. I tried to add these comments online but wasn’t able too. Too long, perhaps? Regardless, keep up the good work.

    Bill: Thanks for the insightful article. I specifically appreciated the example of how it helps fill a void using the example of kids behind a barn. While the science behind addiction escapes me, I am quick to believe that there is a genetic component that we have yet to fully understand.

    I always enjoy your comments and hope all is going well on your march from “homeless blogger” to simply “blogger”. I wonder if an update (monthly?, weekly?) about the job search is warranted for the curious audience like myself. For example, something brief like:

    Over the past 4 weeks, I have applied to ____ jobs. Of the jobs I’ve turned in resumes for, I found:
    ___% from online search engines that contacted me
    ___% from online search I did (I was only aware of it from additional work I did above and beyond existing emails I receive)
    ___% from manual search I did in person (example: I walked into Dunkin Donuts and asked for / turned in application)

    Of the resumes submitted in the past 4 weeks, I have been interviewed for ___%. Of the jobs I’ve been interviewed for, I found:
    ___% from online search engines that contacted me
    ___% from online search I did (I was only aware of it from additional work I did above and beyond existing emails I receive)
    ___% from manual search I did in person (example: I walked into Dunkin Donuts and asked for / turned in application)


    1. Good idea.

      It seems best to me to just collect a list of the positions I apply to, and post that once a month, probably on either the first day of the month or the first Monday of the month.

      The percentages are moot, because practically all my activity is based on the search engine results. I have three search engines at Indeed and one at University Hospital, which I’m very happy with; they send me a manageable number of realistic listings each week. Logistics preclude doing anything on foot.

      Separate from the search engines, I do need to re-apply at the various retailers — Target, Walgreens, etc.

  2. Interesting your idea that choice is latent, and then suddenly when someone comes upon this choice arising from the subconscious somehow, then they see it as a higher power. That is an interesting idea.

    I would counter that idea, though, with my experience. Whatever happened to me to apprehend my alcoholism, it had nothing to do with any sort of choice that I have. I don’t mean this just theoretically. I mean literally one day alcohol just became not interesting to me. The thought of having another drink simply vanished, it would be like reaching down and eating a bunch of mud. And I had been trying to stop for a good 10 years and not ever succeeding, in AAA orby myself or with therapy or anything. Literally I gave up trying to battle my alcoholism, came to believe that there must be some sort of power that can save my ass, as opposed to the conceptual power that I’ve been trying to implement through all these suggestions and AA, and once I got through the detox literally I had no compulsion to drink, nor have I in 12 years. Of course, I had to do some work on myself and my attitudes, but at no time, not the death of my child not arguments with my wife, not accidents in my car, not surgery I had to go through, nothing occurred that the thought of drinking even came up in my mind. Literally I reflected after the fact of these various events, events that alcoholics typically look for as like warning signs or worry about people when such events happen; N and that’s valid for sure considering the problems that alcohol I’ve given people in the past and myself. But in every sort of problem and crisis that I’ve had over the past 12 years, every time it was a few weeks later or after the crisis past that I recalled that at no time did having a drink or smoking a joint even enter my mind.

    And every time this comes up for me I have to say it’s not because I had any choice in the matter, but it’s because there is some power that somehow decided or was allowed into my life that simply removed the problem.

    so that’s something to think about in the estimation of choice.


    On another note, I thought I might fill you in on the disease concept of alcoholism. It was not Dr. Silkworth that came up with the disease concept; he was merely a doctor that was around in a series of events that had to do with two people who ended up getting sober and starting as. He was just a doctor like any other doctor, a scientist who was working in the field just like any other scientist at the time.

    The idea about what a disease was came up before Silkworth, and for scientists and doctors, I have learned they had criteria for what qualifies as a disease, it went like this:

    A disease:

    1) involves an organ.
    2) there is a defect of the organ.
    3) there are symptoms

    Every disease has these three components. And if it does not, then it is it a disease.

    The problem with alcoholism back then and up until recently, was that definitely there were symptoms, such as red skin, big noses, slurred speech maybe, water on the brain, relationship problems, etc …and definitely organs were being affected, such as the liver the Pancrease the stomach the esophagus the brain, but the problem was is they couldn’t figure out what was defective. They couldn’t pinpoint what Oregon was causing alcoholism, what defect in a particular Orgon was causing alcoholism.

    So for a long time it did not qualify as a disease. So, there are two ways to handle problems, through science, and through religion, generally speaking.

    So because science could not qualify alcoholism as a disease, it necessarily was a religious problem. Which is to say a moral problem, a problem of choice.

    But nowadays science has discovered the organ that is responsible for addiction, alcoholism etc. is the brain:

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