The Proof

William Mayer, M.D., former chief of the U.S. Alcohol, Drug Abuse, and Mental Health Administration, speaks of alcoholism as "a disease...genetically determined...clearly progressive. We can predict its course even though the speed of its course may vary from person to person. It is ultimately fatal. It leads to a predictable physical deterioration and often some mental impairment, and it occurs in people who have no discernable previous psychological or emotional disorders"

In 1982 the question of whether alcoholism is a physical or mental disorder was the subject of a major courtroom battle. The case pitted the federal government against Granville House, an alcoholism treatment center in Minneapolis that treats many uninsured clients who receive government disability funding. The government's position was that since alcoholism was classified officially as a mental disorder, Medicare could rightly refuse to reimburse Granville House for the treatment it provided.

The government's star witness was a psychiatrist, Dr. Robert Spitzer, who defended the view of alcoholism as a psychological disorder even though he recognized that "there exists no effective psychiatric treatment."

Two former presidents of the American Society of Addiction Medicine---LeClaire Bissel, M.D., and Maxwell Weisman, M.D.--testified in support of the concept of alcoholism as a physiological disease. In summing up their testimony, federal judge Miles Lord noted that they had described "the utter failure of treatment modalities based on defining, diagnosing and treating alcoholism as a mental disease."

In his descision, Judge Lord noted that the American Medical Association had classified alcoholism as a physical disease in 1957. Here is an excerpt from his opinion.

Alcoholism is the third leading cause of death in the United States. This Court is unaware of any mental illness that so directly and persistently results in death...Disease of the body, if severe and continuing, will in time effect the mind...The sole fact that a condition is accompanied by abnormal behavior does not justify its classification as mental. The great bulk of the testimony supports the conclusion that alcoholism is a diagnosis of a primary disease. It cannot be understood as a secondary effect of any other problems. The disease is predominantly physical as opposed to mental in nature...It is therefore the Court's conclusion that the Federal Government's classification of alcoholism and other forms of chemical dependency as mental disorders is arbitrary and capricious.