>Alcohol is a tricky one. What people who are not afflicted by it sometimes don't understand is that it isn't a weakness, it's a disease. It has been defined as such by the AMA since the 1960s.

I understand nothing I say on this subject is going to have any effect on you, but I say it in case it resonates with anyone else :

The way your body metabolizes alcohol is a disease and probably has some genetic component.

The decision you make when sober to buy alcohol ( since I know you are an at-home drunk ) or walk into a bar is a choice and cannot be blamed on that genetic component even though that bad choice is in fact related to a very real medical condition.

Depression is also a legitimate disorder that is chemical and very real and is probably the root of most substance abuse problems. It is treatable. Alcohol is probably the worst drug you can put in your body if your problem is depression.

I have what has been diagnosed as extremely high-functioning attention-deficit disorder. It is genetic, it is very real, and it simply means my brain works a little differently. Like depression and some other conditions it seems to run in families and depending on other factors it is often not understood.

I tried to self medicate that for years. I would find I metabolized and reacted to some drugs differently than did my peers. Amphetamine (not meth, talking Dexamyl etc ) does not make me speedy, it makes me focused. Ritalin is an amphetamine. If my wife takes it she flies around the room. I sit down a work or play piano or whatever and don't lose focus or get easily distracted.

Many people I have met in our profession exhibit signs of this condition.

If I had an ounce of cocaine in front of me right now I would have a real problem. So would anyone who likes cocaine meaning anyone who has ever done cocaine. That is why I do not buy cocaine and I do not associate with people who are likely to give it to me or encourage me to do it.

That is a choice. It is not the choice I would make with a gram of cocaine up my nose.

Is cocaine dependancy/addiction or whatever you want to call it a disease?

I have been fortunate to never have struggled with depression, though it is the centerpiece of my wife's existence. But my ADD has been the theme-song of a life that might have unrolled differently if the condition had been understood in the 50s or 60s.

If i were very very depressed or my life were off the rails because I was not managing (and in fact thriving on) my ADD, I would really be a lot more likely to make a bad decision about what kind of drugs I want to have around. That is a very good indication I would need to seek help for the condition. But the choice is still mine.

Many people who are wired like I am are the guys you knew in college who could graduate with honors without ever cracking a book but never really lived up to their potential and often developed substance abuse problems - probably not alcohol but definitely weed, coke and adrenaline - which resonate but are not the right treatment for the condition.

My biggest problem - before computers came along - was I got "bored" very easily so I spent 20 years (before computers came along) "looking for the card that was so high and wild he'd never need to deal another" Some of the choices I made were very bad ones, but I was lucky.

Cancer is a disease. Bad choices are just that - bad choices.

Depression is a very real condition, like ADD or Bipolar disorder or a number of other very real chemical imbalances.

Being susceptible to one degree or another to the wrong treatments and continuing to decide to attempt to treat one's condition that way is a bad choice.

We all have a genetic propensity to ruin our lives if we do coke, crack, meth, heroin etc. We also have a genetic propensity to die if we choose to step off of the top of a cliff.

The choice to go that way is usually made at a point where a different choice can be made - in your case buying alcohol when you are sober.

That is usually caused by an underlying problem like depression and that is the problem that should be addressed. Bad choices and spiraling bad behavior involving one's personal favorite incorrect self-medication are just a symptom.

( If anything I say about ADD or ADHD resonates with anyone and they want to discuss it further I am happy to do so privately and I recommend the books by Dr. Edward Hollowell who is not only a major authority on the subject but is a classic example of the high-functioning ADD that is one of the most under-diagnosed medical conditions.

http://www.drhallowell.com/add-adhd/ )