Throughout most of recorded history, excessive use of ALCOHOL was viewed as a willful act leading to intoxication and other sinful behaviors. The Bible warns against drunkenness; Islam bans alcohol use entirely. Since the early nineteenth century, the moral perspective has competed with a conceptualization of excessive use of alcohol as a disease or disorder, not necessarily a moral failing. The disease (or disorder) concept has, in turn, been evolving with considerable controversy since then, and has itself been challenged by other conceptual models. Because this article is concerned primarily with the disease concept, the other models will be mentioned only briefly.

Among the first to propose that excessive alcohol use might be a disorder, rather than willful or sinful behavior, were the physicians Benjamin Rush, in the United States, and Thomas Trotter, in Great Britain...