What If Alcohol and Other Drug Dependencies Are Not Diagnoses?

This paper challenges the predominant conceptualization in the "chemical dependency" field: DSM-III-R categories of "alcohol and other drug dependencies" are not "diagnoses" and their use obscures vital differential diagnosis and results in the misguided and harmful treatment. Conversely, this paper does not dispute the concept that substance addiction is a disease, but rather proposes that "alcohol and other drug dependencies" are not synonymous with alcoholism and drug addiction and argues in favor of the definition advanced in Alcoholics Anonymous (1976); it does not dispute that alcoholism and drug addiction are treatable with specifiable methods, but rather argues that substance addicts must be distinguished from "functional" abusers and that treatments must be designed accordingly; and it does not dispute that a "recovery program" is an essential foundation for alcoholics and drug addicts, but rather proposes that a treatment designed for one disease is potentially harmful when a client suffers from another. Thus, instead of the misguided use of "alcohol and other drug dependencies" as criteria for admission to treatment, it is argued that assessments should identify the specific "functions" of substance use, which, in turn, should direct the administration of treatments that each correspond to their particular "functional diagnosis."