One Drunk to Another An Illness of This Sort
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discountdiscussdisdaindishdis·ease(di-ˈzēz)n. dis·ease ALCOHOLICS ANONYMOUS
Illustration · A reading desk at night: a dictionary open at “disease” under a reading glass, beside a blue book lettered “Alcoholics Anonymous.” Imagined; not drawn from a photograph.

An Illness of This Sort

Is it a disease?

For two hundred years doctors, judges, scientists and AA’s own members have argued over one word, and they still do.

“An illness of this sort—and we have come to believe it an illness—involves those about us in a way no other human sickness can.”

The Big Book, “There Is a Solution” · Alcoholics Anonymous, 1939

Many AA members speak of alcoholism as a disease. AA’s own book, in the sentence this piece is named for, called it an illness, and in 1960 Bill W. told a conference of clergy, by its printed record, that AA had never called it a disease. Whether it is one has been argued over since doctors first called drunkenness a disease, more than two hundred years ago, and it still is.

This piece follows the argument part by part: the doctors of the 1800s and the asylums and cures they built; AA’s own words; the Grapevine’s survey of AA members and the phases Jellinek drew from it; what the American Medical Association actually voted; the courts and the drunk tank; the researchers who said some alcoholics could drink normally again; and the manuals, two veterans and the Supreme Court. Legacy ends with today’s alcohol use disorder, the argument over the brain, and what AA’s pamphlets say now.

It’s built from AA’s own books, pamphlets and Grapevine, the doctors’ and the courts’ own records, the researchers’ papers and the replies to them, and the histories of William White, Ernest Kurtz and Mike Ashton. It takes no side: each side is given in its own words, in the order it was said, and where the sources disagree, these pages say so. Nothing here is medical advice.

Start with 1 · By that name

The argument, year by year

  1. 1780sIn Philadelphia, Dr. Benjamin Rush publishes a pamphlet on strong drink. Its later, enlarged editions call drunkenness a disease outright.
  2. 1864The New York State Inebriate Asylum at Binghamton takes its first patient.
  3. 1870Doctors meeting in New York declare that intemperance is a disease.
  4. 1879Dr. Leslie Keeley opens his first gold-cure institute at Dwight, Illinois.
  5. 1920By Prohibition, nearly all the asylums and cures are gone.
  6. 1939The Big Book calls alcoholism an illness and a malady. Its chapters use the word disease once, for a spiritual one.
  7. 1945The Grapevine prints a questionnaire for AA members. The next year E. M. Jellinek publishes phases of alcoholism drawn from 98 men’s answers.
  8. 1951AA receives a Lasker Award, which praises it for emphasizing alcoholism as an illness.
  9. 1956The American Medical Association adopts a statement on hospitalizing alcoholics. It says illness, not disease.
  10. 1960At a clergy conference in New York, Bill W. explains why AA has called it an illness or a malady.
  11. 1966Two federal appeals courts rule that a chronic alcoholic can’t be convicted for being drunk in public.
  12. 1968The Supreme Court upholds Leroy Powell’s conviction for public drunkenness, five votes to four.
  13. 1970The Hughes Act creates a national institute on alcoholism and pays for treatment in the states.
  14. 1976A RAND report counts normal drinkers among those in remission, and the National Council on Alcoholism calls it dangerous.
  15. 1980The psychiatrists’ manual drops the word alcoholism for alcohol abuse and alcohol dependence.
  16. 1988The Supreme Court upholds the VA’s rule that primary alcoholism is willful misconduct, keeping two veterans from more time to use the GI Bill. That November Congress changes the rule for those deadlines.
  17. 1992A joint committee of the National Council and the addiction doctors’ society defines alcoholism as a primary, chronic disease.
  18. 1997The director of the National Institute on Drug Abuse calls addiction a brain disease.
  19. 2013The fifth edition of the psychiatrists’ manual names one alcohol use disorder, mild, moderate or severe.
  20. 2026AA’s Conference approves a fifth edition of the Big Book, its first 164 pages unchanged but for one word.

Walk through the argument

Each part has a short story, a one-minute audio stop, and a closer look for anyone who wants to go deeper. Read them in order, or start anywhere.

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