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Is alcohol dependence best viewed as a chronic relapsing disorder?
Article first published online: 7 OCT 2011
© 2011 The Authors, Addiction © 2011 Society for the Study of Addiction
Volume 107, Issue 1, pages 6–12, January 2012
How to Cite
Cunningham, J. A. and McCambridge, J. (2012), Is alcohol dependence best viewed as a chronic relapsing disorder?. Addiction, 107: 6–12. doi: 10.1111/j.1360-0443.2011.03583.x
- Issue published online: 12 DEC 2011
- Article first published online: 7 OCT 2011
- Submitted 18 December 2010; initial review completed 7 March 2011; final version accepted 29 June 2011
- Alcohol dependence;
- brain disease;
- chronic relapsing disorder;
This ‘For Debate’ paper starts by recognizing the growing trend towards considering alcohol dependence as a chronic relapsing disorder. We argue that the adoption of this model results from focusing on those in treatment for alcohol dependence rather than considering the larger number of people in the general population who meet criteria for alcohol dependence at some point in their lives. The majority of the general population who ever experience alcohol dependence do not behave as though they have a chronic relapsing disorder: they do not seek treatment, resolve their dependence themselves and do not relapse repeatedly. We suggest that caution is therefore needed in using the chronic relapsing disorder label. Our primary concerns are that this formulation privileges biological aspects of dependence to the detriment of psychological and social contributions, it inhibits much-needed developments in understanding alcohol dependence and leads to inefficient distributions of public health and clinical care resources for alcohol dependence. We invite debate on this issue.