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To the Editor.—
The Journal has repeatedly editorialized in favor of the disease conception of alcoholism and has praised the continuing efforts of those who would place this behavior problem within the purview of medicine. I do not quarrel with the fact that many excessive drinkers do require hospitalization for problems caused by alcohol, but I wonder if consideration of the many difficult problems caused by unqualified use of the disease conception of alcoholism has been adequate.At present, there is no agreement as to an acceptable definition of alcoholism, but the intention of those who sponsor the disease concept is to extend the definition so that anyone who chooses to diagnose himself may do so. As a practical matter, this is what regularly happens in alcoholism. All specialized treatment resources accept patients on their own diagnosis and in doing so they certify the diagnosis, with interesting legal and economic
Lew D. Alcoholism as Disease. JAMA. 1973;223(7):800. doi:10.1001/jama.1973.03220070054024