Disease Model

imageMany may not know that addiction is classified in the DSM, the handbook used to diagnose psychiatric disorders by the APA (American Psych. Association).  In DSM-IV, “the distinction between abuse and dependence was based on the concept of abuse as a mild or early phase and dependence as the more severe manifestation. In practice, the abuse criteria were sometimes quite severe. The revised substance use disorder, a single diagnosis, will better match the symptoms that patients experience. Additionally, the diagnosis of dependence caused much confusion. Most people link dependence with ‘addiction’ when in fact dependence can be a normal body response to a substance. ” This is a nice way of saying that one hit and I’m hooked. Dependence can’t be created without use, and therein lies the argument from the naysayers that if you just don’t start, then you can’t become dependent. But what about those of us who’ve already stepped over the line? Chances are, Dr. Silkworth, the author of the chapter entitled, ‘The Doctor’s Opinion’, knew what he was talking about in the 1930’s when he states that alcoholism is a disease that centers in the mind and creates the phenomena of craving not experienced by the average, temperate drinker. He was qualified, having worked with countless drunks in hospitals and insane asylums, with very little positive results….. let’s suppose a friend has never picked up a drink. Maybe they had drunks in their family and never wanted to be like them. Then after years of not drinking,  he decides a glass of wine would be good at dinner. Rapidly, without fail, an alcoholic will begin to experience the change in the brain that says more, more, more. It’s progressive, fatal, and over time, that one glass turns into a handle of liquor, and we bury our friend in shock and awe. The “disease model” works for me. I had to grasp the idea that I am bodily and mentally different than my fellows. The biggest qualifier is that I can’t put it down once I start. I begin to obsess over it, always wondering if I have enough. It’s the insanity of a disease where the only option once was to chain a man’s leg to his bed. We’ve progressed in the “recovery model” as well, and thanks be to God and a few men who dedicated their lives to helping other alcoholics get on the water wagon for good. 86 years later, its results are sobering and unparalleled….good day!…b

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