Abstract
This article describes the phenomenon of the social construction of alcoholism as a disease in North America. The goal of this study is to explicate the persistence of the view of alcoholism as a permanent disease, despite that for the past three decades opposite scientific evidence has been accumulating. Initially, scientific studies are reviewed that support the dominant paradigm of alcoholism as a disease. To do so, studies are explored that reveal the genetic theories and various significant studies concerning twins, genetic markers, and adoption. Further, this review includes the neuro-biological and neuro-behavioral theories. It concludes with the major ideological role of AA (Alcoholic Anonymous). This review illustrates how the dissemination and socialization of the disease discourse passes through the 12-Step philosophy of AA; specifically the first step that underlies the acceptance of lack of power and control over alcohol. Then, we raise an opposing view of the dominant disease discourse with a discussion on how the addiction process is understood as a multifactorial phenomenon. By questioning these major scientific bases that consider alcoholism a disease, this review succeeds, through significant and concluding studies, to demonstrate that the disease model is, in fact, a medicalization process of alcoholic behaviors. Through a critical analysis that includes philosophy, epistemology, sociology, anthropology, and psychology, the author succeeds in demonstrating the emergence of an alternative paradigm to the disease of alcoholism. This alternative paradigm praises a vision where the individual suffering from addiction is not an object, as in the disease discourse (loss of control on a permanent basis; once an alcoholic always an alcoholic), but instead is a responsible social subject, able to decide to reduce, stop, or continue drinking according to one's own personal and social choices. This study is concluded by noting the importance of questioning ourselves on present and future issues related to the growing social and general medicalization of behaviors, particularly concerning alcohol and other drug addictions.