I think of substance use as self-prescribed medication for any of a range of un- or under-addressed root problems: depression, mental illness, social anxiety, trauma, etc. Substance use turns to substance abuse when it becomes destructive, debilitating, or self-perpetuating (drinking to cope with the consequences of drinking.) You can call that a disease if you need to, but I think that in America we tend to treat symptoms rather than causes. i.e., ibuprofen as a reflex instead of asking what caused the headache.
In the case of Terry McGovern, I suppose you can make a strong argument that sometimes you need the throbbing to stop before you can talk about why you have a headache. But I read her story more as a tragedy of abuse and subsequent self-destructive depression, not strictly one of alcohol. Calling it a disease or an allergy, to my eyes, clouds the issue.
I haven't read this in a few years, and probably by now my feeling on addictions has shifted slightly. But I really, really enjoyed reading Stanton Peele's
The Diseasing of America a few years ago. He has a few chapters up
free on his website. I recommend #6,
'What is addiction and how do people get it?'
He's often fairly aggressively anti-AA. I'm not sure I agree entirely. It works for some people, but our national reliance (and widespread belief that it's the only solution) seems unhealthy. I jived a lot with how AA is portrayed in David Wallace's
Infinite Jest -- necessarily flawed yet somehow brilliantly organic. Infinite Jest being another great book for anyone interested in a wide-ranging, slightly rambling study of addiction.