Theory and Practice in the Treatment of Alcoholism

Abstract

The American Medical Association in 1971 adopted a statement identifying alcoholism as “a complex disease with biological, psychological, and sociological components” (Todd, 1975). Like other conditions, it follows a more or less specific sequence. The susceptible individual is exposed to the causative agent and the early stages of the process begin. When that process contains self- perpetuating mechanisms which develop as a “consequence” of the condition, the syndrome is furthered. At this point the characteristics of the alcoholic have changed from their original status of “susceptibility to alcoholism” to those of alcoholism itself. This duality in which the factors perpetuating alcoholism may be not only “predisposing factors” which antedate its development but additionally mechanisms which are its “consequences” has led to much of the confusion surrounding the pathogenesis of alcoholism. A clear delineation of the interaction of these two different types of causative factors is essential to the understanding of the pathogenesis of the syndrome and to the elaboration of a rational plan of treatment.