Is Alcoholism a Disease?

Part One of Two in a Series on the Disease Debate

I remember my last visit to my sister.

She was lying in a makeshift bedroom — the old side porch turned TV room of her stately colonial — hooked to numerous tubes, empty Fiji water bottles scattered on the window sills, full bottles stacked in cartons along one wall.

She drank continuously like a camel coming off a month’s trek in the desert.

She was in the late stages of Stage 4 ovarian cancer, and I didn’t realize she’d be gone within the week. Her always-slender body was emaciated, and I painfully held in the gallon of tears that begged to flow as I hugged her frail, birdlike frame in a warm, long-forgotten embrace of earlier years.

She and I had finally reunited after almost twenty years apart. She told me she couldn’t remember why she had cut me out of her life. I remembered — but I didn’t tell her, as I once would have in an angry retort.

It didn’t matter anymore.

The Disease Everyone Agrees On

Cancer. That’s a disease.

Throw a stone in any direction today and you’ll hit someone who has it.

My husband has Stage 4 melanoma. A dozen years ago, a dermatologist (acting like a fortune teller, I thought) told me, “It’s inevitable you’ll get skin cancer.” Today I go for a biopsy on my face, so her crystal ball was right — along with the science. My Irish skin always fought the sun — and I didn’t listen. My sisters slathered on baby oil in the ‘70s. Back then, sunburn just meant summer.

Now we know:

• Sun exposure causes skin cancer.

• Smoking causes lung cancer.

• Daily use of talcum powder? A known link to ovarian cancer.

  
  

All of these were once brushed off. Normal. No big deal.

Then the connections were made.

We linked behavior to disease — and finally took it seriously.

So why is alcohol the exception?

We see the dots clearly now with other diseases. But with alcohol? Some still call it a moral failing. A lack of willpower. A bad choice.

I’ve even joked to people:

“Hey! Who knew that drinking a box of wine a day would lead to alcoholism?!”

Then I would laugh — but now I’m realizing it’s not a joke.

I’ve connected the dots. Excessive daily alcohol use can lead to alcoholism.

There.

I said it.

I believe alcoholism is a disease in the way I used to be a cucumber — now I’m a pickle. Just like with my husband’s cancer, it can go into remission, but it never goes away entirely.

Let’s look closer at this — because calling alcoholism a disease sparks about as much agreement as the Hatfields and the McCoys feud, and as much heat.

The “Yes” Side (Hatfields)— Why So Many Call It a Disease

If you’ve been to a 12 step recovery meeting, you’ve heard it: “Alcoholism is a disease.”

And the American Medical Association declared it so back in 1956 — a landmark shift in how addiction was understood. Since then, major medical institutions have followed suit. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) classifies Alcohol Use Disorder as a chronic brain disorder. The U.S. Surgeon General's Report, "Facing Addiction in America: The Surgeon General's Report on Alcohol, Drugs, and Health," released in 2016, highlights that addiction to alcohol or drugs is a chronic brain disease with the potential for recurrence and recovery, and "should be treated like other chronic illnesses."

Here’s why: alcohol changes the brain. It rewires the reward system, disrupts impulse control, and creates a cycle of craving and compulsion. According to research published in the New England Journal of Medicine, these changes are measurable and long-lasting — supporting the disease model neurologically, not just philosophically.

And like I wrote about last week in "Am I Doomed? The Truth About Alcoholism and Heredity" genetics matter, too. While not deterministic, studies show that genetic factors account for about 50% of the risk of developing an alcohol use disorder. The rest comes from environment, life experience, trauma, and learned behavior.

For many of us, hearing that for the first time felt like someone took a boulder off our chest.

It said: You’re not broken. You’re not weak. You’re sick — and you can heal.

But not everyone buys it.

The “No” Side (McCoys) — What the Critics Say

Some argue the disease model paints alcoholism as passive — like something you catch, rather than something that grows over time and can be unlearned. Others worry it encourages helplessness: “It’s not my fault, it’s my disease.”

Marc Lewis, PhD, a neuroscientist and former addict, argues that the brain changes seen in addiction resemble those of deep learning and habit formation — not a disease process. In his book The Biology of Desire, he suggests addiction is best understood as a developmental, goal-driven pattern that can be rewired.

Gene Heyman, PhD, of Harvard, offers another view. He calls addiction a “disorder of choice,” emphasizing that many people recover without treatment, especially by midlife. His point? That framing addiction as a disease might obscure the reality that change is possible — and often self-directed.

Even the DSM‑5 — the diagnostic bible of psychiatry — avoids the word disease. It uses the term Alcohol Use Disorder, defined on a spectrum with 11 clinical criteria. This diagnostic nuance shows that even within medicine, the language isn’t settled.

And then there’s Stanton Peele — a psychologist who’s spent decades criticizing the disease model and decrying AA and 12-step programs (founded by actual alcoholics and addicts), despite never having experienced alcoholism or addiction himself. Peele is not in recovery, and has never lived through addiction. That matters.

I include him here because he’s often cited in these debates — not because I agree with him.

For many of us who’ve actually walked this path, his views feel disconnected from a reality only those with lived experience can fully understand.

I know this firsthand. Early in my spiral — traumatized from therapy abuse and quietly unraveling in my drinking — I reached out to him for guidance and we spoke over the phone.

His advice? “Be busy.” He didn't think a 12 Step program would help and he gave me the number of a therapist (even though I told him I had just been traumatized by a therapist.)

Looking back it strikes me how little he understands the emotional, spiritual, and psychological weight of addiction.

For people like me — in crisis and desperate for help — his model didn’t just fall short. It delayed the help I truly needed. I didn’t need a motivational speech. I needed to stop drinking. And I needed a program built by people who understood addiction from the inside out.

So while views like his may be well-intentioned, they can genuinely harm those who are still sick and suffering like I was.

Where I Land

Yes it's a disease — but not just in the way medicine defines it.

It’s also emotional and spiritual.

And recovery has to heal all three.

But, when I first got sober, I needed to hear it was a disease.

It gave me something to hold onto. A name for the chaos.

A reason why I couldn’t just “snap out of it.”

But as I healed, that word started to feel… incomplete.

Most debates around alcoholism and disease focus on the physical — the brain, the body, the chemistry.

And yes, science matters. Alcoholism absolutely changes the brain.

But in recovery, I’ve learned something deeper:

In rehab, I first heard someone say:

“Alcoholism is a disease of the emotions.”

That hit me like lightning. I suddenly saw my drinking for what it was:

Not just a compulsion… but a way to survive my feelings.

The shame, the fear, the rage, the grief I never knew how to feel or express.

Alcohol helped me not feel. It kept the pain at bay.

Until it didn’t.

And then, through deeper recovery work, I discovered another layer — one no medical textbook can fully explain:

Spiritual disconnection.

Alcoholism had kept me estranged from my Higher Power — the God I had once known but drifted away from.

Drinking filled a void that wasn’t physical or emotional — it was spiritual.

It numbed my soul. It dimmed my light.

So now, when I talk about alcoholism, I don’t just mean a disease of the body.

For me, it’s:

• Part disease.

• Part emotional survival.

• Part spiritual disconnection.

• A trauma wound.

• A coping strategy.

• A cry for help wrapped in a bottle.

  
  

And now… I’m healing.

One layer at a time.

Looking Ahead

This is Part One of a two-part series.

In the next blog, I’ll take a deeper look at what it means to call alcoholism an emotional and spiritual disease — because that’s where the real healing begins.

The Truth That Matters Most

Whether you call it a disease, a disorder, a condition, or a habit — labels don’t heal, but work does. It’s the recovery work — the daily action, the healing process, the internal growth — that leads to transformation.

Language matters, but only to the degree that it opens a door to recovery.

The point is not to argue over the map — it’s to start the journey.

Your Turn

What do you think?

Have you heard the phrase “alcoholism is a disease” in your recovery — or in your family?Did it help you… or did it hurt?

Leave a comment below or share your story with me.

I’d love to know where you land.

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Take a breath. This is the moment you get to write a different story.

I created The RETURN (to Self) Method — to help strip away the stories, the shame, and the masks we’ve worn for too long, and bring you back to the you that’s still there.