E. M. Jellinek (Elvin Morton Jellinek, 1890–1963) was an American physiologist and addiction researcher widely regarded as the founder of the disease model of alcohol dependence. His name is closely associated with the so-called “Jellinek Model,” which shaped the still-prevailing view that alcoholism is a chronic, progressive, and ultimately incurable disease.
Jellinek worked in alcoholism research from the 1930s onward, including on behalf of the World Health Organization and in collaboration with the Yale School of Alcohol Studies. In 1946, he published the paper Phases of Alcohol Addiction, in which he first attempted a systematic description of the course of dependence. His aim was to remove alcoholism from moral and religious interpretations and classify it scientifically.
Jellinek became particularly well-known for his 1960 book The Disease Concept of Alcoholism. In it, he distinguished five main types of alcoholism, which he labeled with the Greek letters Alpha to Epsilon. The Alpha type corresponded to psychological dependence without loss of control, the Beta type showed physical damage without addictive behavior, the Gamma type represented the classic progression with loss of control and increasing tolerance, the Delta type was unable to stop drinking but could keep consumption constant, and the Epsilon type described periodic, binge-like drinking.
Central to Jellinek’s concept was loss of control: once drinking began, the alcoholic could no longer stop. This idea shaped the understanding that alcohol dependence is a disease in its own right—not merely a symptom of psychological, social, or other medical problems. The model became the theoretical foundation for many treatment approaches and contributed significantly to the development of the 12-step movement, whose abstinence principle remains influential to this day.
For its time, Jellinek’s work was groundbreaking, but today many of its core elements are considered outdated. His typology was based on a very limited data set—primarily anonymous questionnaires filled out by members of Alcoholics Anonymous. Critics point out that this sample was not representative and contained significant bias.
Criticism of Jellinek’s Model #
More recent scientific findings challenge central assumptions of Jellinek’s model. Psychiatrist Mark Willenbring, long-time research director at the National Institute on Alcohol Abuse and Alcoholism (NIAAA), emphasizes that the idea of an incurable, chronically progressive disease is not empirically tenable. In his view, alcohol dependence is a spectrum of behavioral disorders with varying biological, psychological, and social causes. Many affected individuals are able to change or control their drinking behavior without having to abstain completely.
This perspective was clearly supported by the results of the NESARC study (National Epidemiologic Survey on Alcohol and Related Conditions), a large-scale NIAAA investigation. It showed that about 30 percent of the adult U.S. population met criteria for an alcohol use disorder at some point in their lives, but most experienced only a limited episode and subsequently remained stable long-term. Around 72 percent of those formerly dependent reported remission without relapse—often even without formal treatment.
The NESARC-III survey confirmed these findings and demonstrated that alcohol dependence is not a uniform disease picture but varies greatly in duration, course, and severity. The majority of those affected achieve lasting improvement—some through abstinence, others through controlled drinking.
The DSM-5 classification of “Alcohol Use Disorder” (American Psychiatric Association, 2013) also reflects this insight. It replaces the previous distinction between abuse and dependence with a continuum of severity levels: mild, moderate, and severe. An alcohol use disorder is diagnosed when at least two of eleven diagnostic criteria are met. This model no longer views alcohol problems as a separate disease but as a disorder with fluid transitions.
Taken together, these findings mean that Jellinek’s model is today regarded as historically significant but scientifically outdated. It marked the transition from moral judgment to a medical understanding, yet modern research sees alcohol dependence as a dynamic, multifactorial, and individually changeable process.
Frequently Asked Questions about E. M. Jellinek and his model
Elvin Morton Jellinek (1890–1963) was an American physiologist and addiction researcher. He is considered the founder of the modern disease model of alcohol dependence and shaped the idea that alcoholism is a chronically progressive disease.
Jellinek distinguished five main types of alcoholism (Alpha to Epsilon). The Gamma type, with loss of control and increasing tolerance, is regarded as the classic picture of dependence. His model became the theoretical basis for abstinence-oriented and 12-step programs.
Jellinek assumed that once dependent individuals take the first drink, they lose control over the amount consumed. This idea established alcohol dependence as an independent disease rather than merely moral failure or weakness of will.
Newer studies such as NESARC and NESARC-III show that alcohol dependence is usually not an irreversible progression. Many affected people achieve remission without relapse. Therefore, Jellinek’s model is regarded today as historically important but scientifically obsolete.
The DSM-5 replaces the former separation of abuse and dependence with the continuum of “Alcohol Use Disorder.” It is divided into three severity levels and covers the entire spectrum of alcohol-related disorders.
Bernd Guzek, MD, PhD #
Physician, author & co-founder of Bye-Bye-Booze
Specialized in biochemical mechanisms of addiction and brain metabolism.
