Criticism of the Disease Concept
The Disease Concept is perceived by some health professionals as too dichotomous, too all or nothing, too antithetical to the notion of addiction existing on a continuum. There is some movement towards seeing the notion of alcoholism as a disease as merely a useful metaphor that can provide a viable frame of reference for working with one’s client (White, 2001, p51).
Some common criticisms of the Disease Concept:
 Disease Concept is too simplistic, given that research increasingly indicates addiction to be “a cluster of disorders that spring from multiple, interacting, etiological influences, that vary considerably in their onset, course, and outcome”
(White, 2001, p50).
 The “disease model is inadequate to explain or resolve the wide spectrum of alcohol-related problems” (Miller, W., cited in White, W., 2001, p48).
 The Disease Model is too binary: “one either is an alcoholic
(and needs treatment) or a non-alcoholic (and needs no treatment)” (Miller and Kurtz, 1994, p163).
 There is no specific medical diagnosis for the disease of alcoholism: thus, there may be no disease.
 Disease model discounts possibility of spontaneous remission from alcoholism, although some evidence suggests otherwise:
A meta-analysis by the US Institute of Medicine (1990) found that:
1.Among young problem drinkers, 50-60% of men, and 70% of women, experience improvement without formal treatment 2. For middle-aged drinkers with an alcohol use problem, 30-40% of men, and 30% of women, will improve without formal treatment3. In

older drinkers, 60-80% of men, and 50-60% of women, will improve without formal treatment.
 Disease Model blurs different populations of users, and often confuses “problem use” with “addictive use”
 Notion of loss of control has been challenged: some view this as a product of expectancy or psychological factors, rather than as a product of the biological effects of the alcohol.
In a 1996 US experiment, when subjects were led to expect nonalcoholic drinks, they drank only a little. When they expected vodka, they drank a lot whether the vodka was present or not
(Marlatt and Gorski, 1996, pp4-5).