The disease concept of alcoholism Author:e.m. jellinek excerpt: "In order to differentiate alcoholism not just diachronically, along a time line but also synchronically across groups of people, thus distinguishing types of alcoholics in a way that ran quite counter to the AA emphasis on the unity of all alcoholics, Jellinek came up with the idea of grouping different drinking patterns and naming the... more »m by giving each a Greek letter. One might think that the purpose of such a classification is to expand the range of alcoholism and include as many people as possible under the "disease concept"; but, contrary to what the title suggests, Jellinek's 1960 magnum opus in fact tries to limit the scope of the "disease concept", stating that most of the types described might be alcoholics, but they are not diseased ? because they do not suffer from "loss of control".
Alpha alcoholism: the earliest stage of the disease, manifesting the purely psychological continual dependence on the effects of alcohol to relieve bodily or emotional pain. This is the "problem drinker", whose drinking creates social and personal problems. Whilst there are significant social and personal problems, these people can stop if they really want to; thus, argued Jellinek, they have not lost control, and as a consequence, do not have a "disease".
Beta alcoholism: polyneuropathy, or cirrhosis of the liver from alcohol without physical or psychological dependence. These are the heavy drinkers that drink a lot, almost every day. They do not have physical addiction and do not suffer withdrawal symptoms. This group do not have a "disease".
Gamma alcoholism: involving acquired tissue tolerance, physical dependence, and loss of control. This is the AA alcoholic, who is very much out of control, and does, by Jellinek's classification, have a "disease".
Delta alcoholism: as in Gamma alcoholism, but with inability to abstain, instead of loss of control.
Epsilon alcoholism: the most advanced stage of the disease, manifesting as dipsomania, or periodic alcoholism.
While Jellinek's classification draws a clear (if arbitrary) line between the garden-variety alcoholic and the truly diseased alcoholic, it does not draw such a clear boundary between alcoholism in general and normal drinking. This is Jellinek's Achilles' heel . . .
By relying on cultural norms to define several of his types, he implicitly gives up the project of providing a single, objective, universally valid clinical definition of alcoholism, and opens the door to anthropological nominalistic definitions along the lines of "whatever is normal drinking in that particular culture is normal drinking". "« less