Every disease, e.g., alcoholism, has "economic, social, psychological, personal and cultural factors."  Once a person is infected with cholera, say, giving them a job isn't going do a bit of good; neither is a heavy duty dose of "talky-talk" psychological therapy.

There are differences, and I'm not even sure that alcoholism should be described as a disease.  For instance there are v. effective medical treatments for Cholera and the disease probably wouldn't exist now but for "economic, social, psychological, personal and cultural factors".

The major difference is that there has (up until now in any case) been almost no effective purely medical treatment for alcoholism - the medical model hasn't done a whole lot better than faith healing in that respect.

I don't doubt that there are genetic and other neurological/physical factors which influence the likelihood of addiction, and hopefully effective gene or other therapies will be discovered which will eliminate those.  Many children of alcoholics I know won't drink any alcohol for fear of addiction and having experienced the damage done at first hand.

I don't think we disagree all that much, I just think Sven's total denial of willpower/motivation as a factor is a bit strong and his faith in medical "cures" is not borne out by the evidence to date.  As things stand, the medical profession's attempt to characterise alcoholism as a disease and control its treatment (thus excluding many alternative treatments and professions) is a power play which has been relatively unsuccessful in terms of actual achievement.

The narrative framing of alcoholism as a disease requiring a medically managed cure diminishes both the patient and their prospects of recovery.

If the medical profession DO come up with an effective treatment I am more than happy that they should take control of the therapeutic process, but even successful medical interventions often require a great deal patient advocacy and motivation and my biggest problem with "the conventional medical model" is that it dis-empowers patients and often actually hinders their recovery.

Index of Frank's Diaries