What does AA mean by an allergy to alcohol?

Answered by Bill Hernandez

AA, or Alcoholics Anonymous, defines an allergy to as a physical reaction that occurs in certain individuals after they consume alcohol. This reaction is different from the typical response that non-alcoholics experience. In the context of AA, the term “allergy” is used metaphorically rather than in its strict medical sense.

The concept of alcoholism as an allergy was introduced in “The Doctor's Opinion” section of the Big Book, written by Dr. William Silkworth. Silkworth explains that for some people, alcohol sets off a phenomenon of craving, which leads to an inability to control or limit their drinking. This phenomenon is believed to be a result of an abnormal reaction to alcohol in the body.

To understand this concept, it is important to differentiate between an allergy and an intolerance. In a traditional sense, an allergy is an immune response triggered by a specific substance, whereas an intolerance is a non-immune reaction to a substance. However, in the context of AA, the term “allergy” is used more broadly to describe a physical and psychological response to alcohol that is beyond the individual's control.

The analogy of an allergy helps to explain why some individuals cannot consume alcohol in moderation, while others can. Just as someone with a food allergy may have a severe reaction to even small amounts of the allergenic food, individuals with an alcohol allergy (in the AA sense) experience an intense craving for more alcohol once they start drinking. This craving makes it extremely difficult for them to stop drinking or to drink in moderation.

It is important to note that the concept of an alcohol allergy in AA is not recognized or supported by the medical community as a true allergy. The medical definition of an allergy involves an immune response, which is not the case with alcoholism. However, AA's use of the term “allergy” is meant to convey the idea that for some individuals, the effects of alcohol are different and more problematic than for others.

In my personal experience as a sommelier and brewer, I have come across individuals who exhibit symptoms similar to what AA describes as an alcohol allergy. These individuals may have a history of excessive drinking, an inability to control their consumption, and a strong craving for alcohol once they start drinking. They often find it easier to abstain from alcohol completely rather than attempting to drink in moderation.

It is important to remember that AA's understanding of alcoholism as an allergy is just one perspective among many. There are other theories and models of addiction that focus on genetics, brain chemistry, psychological factors, and social influences. Each individual's experience with alcohol addiction is unique, and what works for one person may not work for another.