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© 1989 Medical Council on Alcohol

research-article

IS ‘DISEASE MODEL’ AN APPROPRIATE TERM TO DESCRIBE THE ALCOHOL DEPENDENCE SYNDROME?

D. M. GORMAN*

Department of Sociology, University of Essex, Colchester, and Division of Clinical Cell Biology, Clinical Research Centre Harrow, Middlesex, U.K.

*Address for correspondence: Institute for Health, Health Care Policy and Aging Research, Rutgers University, 30 College Avenue, New Brunswick NJ 08903, U.S.A.

Received 21 November 1988; accepted 6 July 1989

Caetano (Concepts of alcohol dependence: the two worlds of research and treatment. Alcohol and Alcoholism 23, 225–227, 1988) has suggested that in the U.S.A. opposition from the disease model has been the main reason for the limited application of the alcohol dependence syndrome. In Britain, the charge that the syndrome is a poorly disguised version of the disease model has had a similar effect. This paper describes the main features of the crude biomedical disease model, which critics equate with the alcohol dependence syndrome. It is concluded that the alcohol dependence syndrome does not conform to this, in that it is not presented by its proponents as a discrete entity identified by a core psycho-biological pathology and carries no built-in assumptions about causal processes. It is argued that instead of setting-up and championing competing all-embracing conceptual models, both clinicians and researchers should be flexible and imaginative in their use of concepts.


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