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Why Is Alcoholism Considered a Chronic Disease?

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It wasn’t that long ago that society perceived people with alcoholism as immoral rather than sufferers of a chronic disease requiring intensive, long-term treatment. It was widely believed that people with addictions had moral or spiritual deficiencies and were self-indulgent, indolent, and reckless. As a result, these individuals were subjected to punitive remedies such as institutionalization rather than being provided mental health care. 

In recent years, medical providers, mental health experts, and much of the general public have begun to consider addiction a chronic, relapsing disease and not just a matter of free will. Regarding potential remedies, this suggests sufferers need effective, comprehensive medical care like those with other chronic health conditions, such as cancer. 

According to the National Institute of Drug Abuse (NIDA), “most patients need long-term or repeated care” to recover from addiction precisely because it is a chronic disease. (1)

If you or a loved one are struggling with an alcohol use disorder, contact Guardian Recovery today to speak with an experienced Treatment Advisor. We will provide you with a free assessment and no-obligation benefits check and help you determine what level of care is appropriate for you. Then, we’ll design an evidence-based treatment plan customized to meet your unique needs and goals and prepare you for your new life in recovery.

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What Is a Chronic Disease?

Chronic diseases are incurable, long-term, relapsing conditions. People with chronic illness may experience persistent, unwanted symptoms that affect their overall quality of life. In addition, they may experience acute health issues and complications that can reduce their life expectancy. Heart disease, high blood pressure, and lung cancer are among the most common chronic medical conditions. (2)

Alcoholism tends to be chronic because active avoidance doesn’t cure it. That is, long-term sobriety doesn’t make the addiction go away—it’s only in remission. It’s a form of disease management meant to minimize symptoms and improve one’s health and long-term prognosis. Alcoholism can be medically managed with medication, lifestyle changes, and various therapies, just like other chronic diseases, such as hypertension and diabetes.

What Is Alcohol Use Disorder (Alcoholism)?

Alcohol use disorder (AUD) is a condition hallmarked by an inability to discontinue or control alcohol use despite incurring several adverse consequences. (3) It is an all-encompassing term that includes what others refer to as alcohol abuse, alcohol dependence, or alcoholism. AUD is an effect of lasting changes in the brain caused and perpetuated by alcohol misuse, making those who suffer vulnerable to relapse.

What Causes Alcohol Use Disorder (Alcoholism)?

Medical and mental health experts believe alcoholism has multiple causes and develops in response to genetic, social, physiological, and psychological factors. For example, genetics can make an individual more vulnerable to alcohol misuse and dependence. This is demonstrated in families where multiple generations have experienced addiction. 

Certain psychological traits, such as impulsivity or susceptibility to peer pressure, are commonly found among alcohol misusers. Indeed, many alcoholics drink to self-medicate pain or emotional distress caused by anxiety, depression, or trauma. (4) Social and environmental risk factors include ease of access to alcohol and whether drinking in the childhood home was perceived as normal, encouraged, or despised. 

Once a person has developed an alcohol misuse problem, the various causes as to why this occurred may have less bearing on the condition than alcohol’s addictive properties. Moreover, repeated, excessive drinking episodes can produce physiological dependence that requires additional alcohol use to maintain. Abrupt abstinence will therefore result in withdrawal symptoms, and the only way to avoid discomfort is to recommence drinking.

Alcoholism & the Disease Model

As noted, most medical and mental health experts and organizations believe alcohol and drug addiction have complex etiologies underpinned by many factors. Alcoholism was declared a disease by the American Medical Association in 1954. (5) Since then, scientific and public perceptions about addiction have gradually shifted toward the disease model.

More recently, neuroscientists have “determined physiological mechanisms of addiction and how addiction specifically impacts brain function.” Their findings have “led many to conclude that addiction is a disease of the brain.” (6) Furthermore, many geneticists now believe that addiction may be “genetically predetermined” and carries a “hereditary risk.” (7)

Substance use disorders, like diabetes or cancer, are abnormal and persistent medical conditions that tend to wax and wane over time. Also, like these diseases, failure to address substance use disorders can lead to severe health complications, long-term dysfunction, permanent disability, and pain and suffering. Finally, addiction is associated with a genetic or inherited predisposition that individual and lifestyle factors can fuel—just like other chronic illnesses.

It’s important to note that treating alcoholism as a brain disease does not absolve individuals from being accountable for their behavior and the choices they make now and in the future.

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The Role of Choice & Accountability

The purpose of the brain disease model is to explain behaviors associated with substance misuse but not to excuse them. If there were no ability to choose, no one would be able to curb active alcoholism once addiction’s physiological processes had hijacked their brain. Framing addiction as a difficult-to-control disease doesn’t mean people with an alcohol use disorder are unaccountable for managing their condition and its far-reaching repercussions. 

Addiction has a unique ability to undermine a person’s integrity and authentic identity, as they are forced to make decisions that infringe upon their own values or those of others. If this is true of yourself, these violations may have led you to experience a profound sense of shame, self-condemnation, and self-hatred.

However, the truth is that the alcoholic suffers from an illness caused by changes in the brain’s reward system that encourages and perpetuates unhealthy and harmful behavior. (8) Rather than being deeply embedded character flaws, many of an alcoholic’s most unseemly actions are defense maneuvers, such as deceit and denial. (9) These tactics are not intended to be malicious but rather to thwart those unlucky enough to stand between them and alcohol. 

Ultimately, the disease model of addiction is not intended to justify bad behavior by disregarding free will as a contributing factor. It may, however, help reduce the harsh and self-destructive judgments sufferers inflict upon themselves by shedding light on the many factors alcoholics experience beyond their control.

Overcoming Alcohol Use Disorder

Because alcoholism is chronic, relentless, and a product of altered brain functioning, many people find they need a combination of long-term intensive medical and mental health treatment to treat it effectively. While no single approach works best for everyone, several methods have proven helpful for many, especially when used simultaneously. Examples include behavioral therapy, counseling, medication, holistic activities, and group support.

A full continuum of care for addiction might include an inpatient program followed by intensive outpatient treatment, aftercare planning, and ongoing individual therapy. Formal treatment is often accompanied by free support groups such as Alcoholics Anonymous or SMART Recovery, which can be used to promote accountability indefinitely.

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Comprehensive Treatment for Alcohol or Drug Addiction

Full recovery from addiction takes more than just willpower. It requires individuals to enact changes in nearly every area of their lives and actively maintain sobriety using effective coping skills and relapse prevention techniques. Comprehensive treatment is often necessary to address the underlying physical, emotional, and environmental factors that facilitate addiction and prevent individuals from being their best selves in recovery.

If you or a loved one are struggling with addiction, we urge you to reach out to Guardian Recovery today. We employ highly-skilled medical and mental health experts who provide individuals with the education, tools, and support they need to be successful in recovery indefinitely. We are prepared to help you conquer addiction and begin experiencing the healthy, happy, and substance-free life you deserve!


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Disclaimer: Does not guarantee specific treatment outcomes, as individual results may vary. Our services are not a substitute for professional medical advice or diagnosis; please consult a qualified healthcare provider for such matters.

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Reviewed professionally for accuracy by:

Ryan Soave


Ryan Soave brings deep experience as a Licensed Mental Health Counselor, certified trauma therapist, program developer, and research consultant for Huberman Lab at Stanford University Department of Neurobiology. Post-graduation from Wake Forest University, Ryan quickly discovered his acumen for the business world. After almost a decade of successful entrepreneurship and world traveling, he encountered a wave of personal and spiritual challenges; he felt a calling for something more. Ryan returned to school and completed his Master’s Degree in Mental Health Counseling. When he started working with those suffering from addiction and PTSD, he found his passion. He has never looked back.

Written by:

Cayla Clark

Cayla Clark

Cayla Clark grew up in Santa Barbara, CA and graduated from UCLA with a degree in playwriting. Since then she has been writing on addiction recovery and psychology full-time, and has found a home as part of the Guardian Recovery team.

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