Medicalisation of Alcoholism

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Medical Sociology
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* Medicalization of Alcoholism:
* Moral Issue or Disease of the Will?
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* Charmaine Tan Xin Yi
* A0085302N
* Discussion Group: E2
* Bachelor of Science (Nursing)
* AY2012/2013 Semester 2
* 25th March 2013
* This paper focuses on the medicalisation of alcoholism. Through the critique of the medical discourse of alcoholism, the paper seeks to understand better the social process in which alcoholism has changed from a moral issue of drinking to a disease of the will.

“ The will is at the root of human conduct. It is the basis of moral action. It is the foundation of wisdom. It is the controller of impulse. Without duty it cannot be done… It is the regulator of passion and desire. Without it in some strength no civilised, moral and permanent form of human society can exist. If it be true that this most authoriitative faculty of man is in any way lessened by alcohol, that substanc would seem to need no other condemnation.” (Sir Thomas Clouston, MD, 1914) * WHAT IS ALCOHOLISM?

* Alcoholism is a general term used to decribe excessive and uncontrolled consumption alcoholic beverages, to the point that this consumption detrimentally affects personal relationships and health of the alcoholic. * In 1979, an expert panel of the World Health Organisation recommended alcoholism to be replaced with the term alcohol dependence syndrome to remove some of the stigma attached. According the text-revised version of the Diagnostic and Statistical Manual of Mental Disorders (fourth edition), alcohol dependence is diagnosed as: * “…maladaptive alcohol use with clinically significant impairment as manifested by at least three of the following within any one-year period: tolerance; withdrawal; taken in greater amounts or over longer time course than intended; desire or unsuccessful attempts to cut down or control use; great deal of time spent obtaining, using, or recovering from use; social, occupational, or recreational activities given up or reduced; continued use despite knowledge of physical or psychological sequelae.”

HISTORY OF MEDICALISING ALCOHOLISM
* Habitual alcohol use was seen as socially acceptable in the 18th to 19th century. Alcohol and heavy drinking was prevalent at festivals, elections and many other social events. Liquor was easily available at taverns, inns and grocery stores (Adams, 1958) and affordable as many produced their own homemade alcohol and sold the rest for a profit (Hiebert, 1969; Smart & Ogborne, 1986). Rarely was alcohol use regulated by state controlled mechanisms. * However, towards the end of the 19th century, control of crime and deviance shifted from the church and family to the state as Cohen (1979) states, “ the state should be solely responsible for crime control.” Until that time, any deviant or criminal behavior was believed to have been a result of the exercise of the individual’s free will. As quoted from Levine (1978): “ A man never, in any instance, wills any thing contrary to his desire, or desires any thing contrary to his Will… His Will and Desire do not run counter at all: the thing which he wills, the very same he desires.” * Contrary to this school of thought, was the fact that many drinkers were poor people. This gave rise to the association of alcohol with negative behavioral qualities (such as idleness, ignorance, moral failure, poor work habits). Poor people were often heavy drinkers and hence thought that alcohol made them follow their “animal instincts” (Beattie, 1977) which ran contrary to the positive behavioral qualities of any rational “civilised” individual, such as hard work, discipline, and temperance (Beattie, 1977; Curtis, 1987; Graff, 1977). * From these causes of heavy drinking, two interrelated responses arose. The first response is that those who indulged in alcohol should be punished, and the second is...
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