Drug Addiction as an Allergy

The Doctor’s Opinion: Addiction as an Allergy

Due to the vast number of ways that addiction affects the individual—bodily, psychologically, emotionally, behaviorally, developmentally, spiritually, socially, and so on—there have been numerous systems of thought regarding the factors that contribute to the development of addiction, how one suffers from the disease of addiction, and how or whether addiction can be treated.

As a result of the extensive studies on addiction, the general consensus is that addiction is a chronic, progressive, relapsing disease of structural and functional brain abnormalities, resulting in obsessive, compulsive behavior regarding the addictive behaviors. This system of thought—called the disease model of addiction—has allowed us to develop more effective recovery treatments for individuals suffering from substance abuse, behavioral and chemical dependency, and addiction.

One of the treatments that are available for alcohol and drug addiction is the participation in recovery fellowships such as Alcoholics Anonymous and its derivative recovery fellowships. Dating back to 1935, Alcoholics Anonymous was initiated by the efforts of Bill Wilson, an alcoholic who had had some success in creating his own recovery method in order to help Dr. Bob Smith, another addict and co-founder of the group.

As Wilson and Smith’s fellowship continued to grow, they published what group members colloquially call “The Big Book,” or Alcoholics Anonymous: The Story of How More Than One Hundred Men Have Recovered from Alcoholism. An opening section called “The Doctor’s Opinion” was written for the Big Book by Dr. William Silkworth, who was a New York physician specializing in the treatment alcoholic addiction.

In this opening section, Silkworth had several very interesting and unique observations to share regarding addiction to alcohol and its effects. Since the publication of the Big Book, Silkworth’s observations have been studied and scientifically tested in the hope of proving and elaborating on them to no avail; however, his words remain pertinent and rather illuminating 80 years later. The following is an excerpt from “The Doctor’s Opinion”:

“We believe, and so suggested a few years ago, that the action of alcohol on these chronic alcoholics is a manifestation of an allergy; that the phenomenon of craving is limited to this class and never occurs in the average temperate drinker. These allergic types can never safely use alcohol in any form at all; and once having formed the habit and found they cannot break it, once having lost their self-confidence, their reliance upon things human, their problems pile up on them and become astonishingly difficult to solve.”
—Alcoholics Anonymous, p. xxviii

A Scientific Explanation for Addiction as an Allergy

It was Dr. Silkworth’s opinion that chronic alcohol addiction was, in its own way, a type of allergic reaction, a phenomenon that is present only in certain people and can be attributed to the cravings that addicts experience for alcohol or other substances. This was an idea he developed over the course of his practice as he noticed the differences in how individuals responded to the compulsion to drink alcohol, or more specifically the result of treating their compulsions.

Silkworth noticed two distinct types of alcoholic addiction: With the first type, the patients responded well to treatment and would return home to either drink “like gentlemen” or not drink at all. However, the second type of patient likewise seemed to respond in a positive manner to his treatments, but would still lose all control over their drinking if they tried to consume alcohol again. In order to explain why one alcohol addict could regain control of his drinking while another couldn’t, Silkworth posited that there must be some sort of allergic reaction present in the latter type of alcohol addict that make their alcohol consumption and uncontrollable behavior.

The scientific rationale that led Silkworth to his concept of alcoholic addiction as an allergy is actually quite sound. In addition to being psychologically powerless to alcohol, those who suffer from alcoholic addiction also have a physical powerlessness, or an “allergy,” to alcohol that occurs as a result of the body’s inhibited processing of alcohol. Vital organs in the body fail to produce particular enzymes of sufficient quantity or quality, which is required to complete the decomposition of alcohol, or more accurately ethanol.

In the non-alcoholic individual who consumes an alcoholic beverage, their bodily functioning and production of enzymes are normal, which allows them to have a beverage without the risk of uncontrollable drinking. The alcoholic’s body processes alcohol in the same way as the non-alcoholic until it reaches a particular acetate compound with the liver and pancreas failing to produce the enzymes necessary to complete decomposition, which results in a strong “craving” that prevents those addicted to alcohol from being able to control the amount they drink.

Although his explanation was incorrect, Silkworth was on the right track in his deducing that addicts cannot regain control of the addictive behavior, but rather must remain abstinent in order to prevent the addictive behavior from overcoming them once again.

Despite the error of the concept, Silkworth made a number of concise, astute observations while trying to identify the root of individuals’ struggle with addiction. In particular, he described the obsession that individuals suffering from addiction have toward the object of their addiction. In “The Doctor’s Opinion,” Silkworth noted that addicts are “restless, irritable and discontented unless they can experience the sense of ease and comfort that comes from a few drinks.”

This passage describes the psychological dependency that individual develop along with a chemical dependency while addicted to alcohol and drugs, using the substance of their choosing in order to cope with stress, sadness, anger, anxiety, and so on. They require the object of their addiction and obsession in order to feel any semblance of peace and to placate their obsession.

Start Recovering from Addiction to Alcohol and Drugs Today

Although addiction is not technically an allergy, Silkworth’s concept of addiction as an allergy has been particularly enlightening and helped us to develop a mode of treatment that’s effective in helping individuals to abstain from addictive behaviors. If you or someone you love is addicted to alcohol or drugs, Drug Treatment Center Finder can help. Our recovery specialists have matched countless individuals to the recovery programs they need to be healthy, sober individuals living productive, fulfilled lived. Don’t wait—call us today.

  1. Testing has confirmed not only a ‘hypersensitivity’ but a different (than normal) neurological reaction to alcohol in alcoholics, so I think allergy is accurate.
    Subjectively, I think the allergic/abnormal reaction to alcohol is one of profound perceptual change – an existential shift – rather than the normal effect of simple sedation.

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