Alcoholism: Disease or Vice?

Today's manager, faced with the problem of an alcoholic employee, is not expected to serve as a psychotherapist, a drug counselor or a member of the clergy for that person. But every manager is expected to have at least an understanding of the rudiments of alcoholism as they pertain to the workplace.

Columns From: 5/19/2002 Modern Machine Shop,

Today's manager, faced with the problem of an alcoholic employee, is not expected to serve as a psychotherapist, a drug counselor or a member of the clergy for that person. But every manager is expected to have at least an understanding of the rudiments of alcoholism as they pertain to the workplace.

Present studies about alcoholism center on one ongoing dispute: Is alcoholism a disease or a vice? As a manager, your answer to this question will color your perception and handling of alcoholism on the job.

On one side of the argument are those who insist that alcoholism, unlike a disease, is not physical. They view alcoholism as a social, economic and interpersonal problem, not a physical pathology. Current treatments of alcoholics turn them into victims by relieving them of responsibility to take charge of their lives. Alcoholics are failures who have made and continue to make bad choices every day they drink. Calling alcoholics "victims," shifts the onus of the problem from choice and personal control to the impersonal force called "disease."

On the other side, there is the position of Alcoholics Anonymous, which insists that alcoholism is a disease and that alcoholics are "powerless" before it. Alcoholism may not be like cancer, but it is certainly like high blood pressure—it's a disease with no known physical cause but with known physical consequences like cirrhosis of the liver and brain damage. As alcoholism worsens, voluntary control rapidly deteriorates. Calling alcoholism a disease exposes how little control its victims have. Choice matters at first, but in later phases, alcoholics have almost no choice.

Where does this leave the manager? Whether you believe alcoholism to be a vice or a disease will have a direct impact on your dealings with an alcoholic subordinate (or a boss). If you believe alcoholism is a (permanent, pervasive and personal) vice, you will treat the alcoholic as a person of bad character, a failed and flawed human being, or perhaps as a sinner who's likely to stay that way.

On the other hand, if you believe alcoholism is a (temporary, local and impersonal) disease, you will regard the alcoholic as a person physically addicted yet curable, a "treatable" subject deserving of care and compassion. "Disease" is a more optimistic description than "vice," and optimism has a lot to do with change.

Besides "disease," there are many other terms used by various groups to describe alcoholism. Some use terms such as "habit disorder" (clinicians), "behavioral problem" (psychologists) or "human frailty" (religious). All are attempts to render alcoholism as a condition that is treatable, curable and manageable.

Today's manager is often confronted by behaviors that are not welcome in the workplace. But, welcome or not, they somehow waddle their way into the best of places. To be aware of the genesis of alcoholism is to be less confused by its impact on the conduct of everyday business.

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