Introduction

The view of alcoholism currently boasting wide acceptance is the disease model approach (Jellinek, 1960:8). This approach views alcohol as a disease of the individual. Juxtaposed with a view of alcoholism as moral degeneration or a personal weakness or failure, the disease perspective is a most desirable approach in that it provides both an impetus for treatment and sympathy of the alcoholic, and it removes or at least minimizes the guilt and reluctance to seek treatment which the alcoholic experiences.

Viewing alcoholism as a disease allows a professional group, namely the medical profession, to claim responsibility for its understanding and treatment and therefore affords the problem more exposure and respect (Jellinek, 1960:2). By labeling alcoholism a disease, it is put on par with other diseases and medical problems, thereby removing the stigma associated with the problem. We do not look down on people because they have diseases; in fact, we try to assist them in overcoming their problem by offering them such things as time off work, Medicare funding, and government or corporate funded rehabilitation programs. In the same way, defining alcoholism as a disease, should afford alcoholics this same degree of understanding, respect and sympathy. By giving the responsibility of research and study into alcoholism to the medical profession we effectively put the problem of alcohol addiction in a more favourable light than if it was considered the responsibility of psychologists, social workers, or clergypersons. A corollary of this observation is the fact that it is the medical profession which is expending the most effort and energy in supporting the disease model as the dominant way in viewing alcoholism (Milam & Ketcham, 1985).

Jellinek himself acknowledges the appropriation of alcoholism by the medical profession when he states that “a disease is what the medical profession recognizes as such” (1960:12). However, seeing alcoholism as a disease is not necessarily the only way to look at the problem; if the disease model were to lose its basis of consensus, many in the medical profession would be out of a job (Schneider, 1978). It can be argued that alcoholism is seen as a disease because it is profitable for the medical profession to see it as a disease.

Although the medical community has a vested interest in the disease perspective of alcoholism, this would be no reason to disregard the disease model if indeed the disease perspective is the best paradigm available. In this paper, a number of issues will be discussed. Initially a critique of the disease perspective will be offered. A more detailed and operational definition of alcoholism will be proposed and a new paradigm that incorporates the details and features of alcoholism ignored by the disease model will be suggested. This is an ambitious undertaking to be sure, but a necessary one.