Alcoholics Anonymous & the Disease Model of Addiction
At the Plymouth House we have carefully developed a comprehensive recovery program that is firmly rooted in the 12 Steps of Alcoholics Anonymous. There is an interesting connection between A.A. and the disease model — one that is undeniably present, but one that is also frequently overlooked. This is partially because A.A. subscribes to the idea that alcoholism and drug addiction are spiritual maladies, and that in order to fully recover, a person must come to believe in a power greater than themselves.
When the founder of A.A.,Bill Wilson, was asked to address the disease model, he replied:
“We have never called alcoholism a disease because, technically speaking, it is not a disease entity. For example, there is no such thing as heart disease. Instead there are many separate heart ailments, or combinations of them. It is something like that with alcoholism. Therefore, we did not wish to get in wrong with the medical profession by pronouncing alcoholism a disease entity. Therefore, we always called it an illness, or a malady – a far safer term for us to use.”
While alcoholism is not mentioned directly as a disease in the Big Book, this response indicates that A.A. had a handle on the nature of addiction before it was scientifically defined.
It is also repeatedly mentioned that in order for a person to truly recover, he or she must maintain complete abstinence because alcoholics a a “physical allergy to alcohol.” When the Big Book was first written in 1939, the phrase “Disease Model of Addiction” was not yet common. It was understood, however, that the body and mind of the alcoholic does respond differently to alcohol than in normal people. Even though there was not an outright cure, recovery could be maintained if all mood and mind altering substances were avoided completely.It was understood that alcoholism was a chronic and relapsing ailment.