Disease Concept of Alcoholism and Drug Abuse
Throughout most of recorded history, excessive use of ALCOHOL was viewed as a willful act leading to intoxication and other sinful behaviors. The Bible warns against drunkenness; Islam bans alcohol use entirely. Since the early nineteenth century, the moral perspective has competed with a conceptualization of excessive use of alcohol as a disease or disorder, not necessarily a moral failing. The disease (or disorder) concept has, in turn, been evolving with considerable controversy since then, and has itself been challenged by other conceptual models. Because this article is concerned primarily with the disease concept, the other models will be mentioned only briefly.
Among the first to propose that excessive alcohol use might be a disorder, rather than willful or sinful behavior, were the physicians Benjamin Rush, in the United States, and Thomas Trotter, in Great Britain. Both Rush and Trotter believed that some individuals developed a pernicious "habit" of drinking and that it was necessary to undo the habit to restore those individuals to health. Words such as habit and disease were used to convey interwoven notions. Trotter saw "the habit of drunkenness" as "a disease of the will," while Rush saw drunkenness as a disease in which alcohol was the causal agent, loss of control over drinking behavior the characteristic symptom, and total abstinence the only effective cure.
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