the Jellinek Curve. Return

"It's not my Curve!"

Researcher pioneer Jellinek coined the expression "the disease concept of alcoholism" and significantly accelerated the movement towards the medicalization of drunkenness and alcohol habituation.

In his 1960 book, The Disease Concept of Alcoholism, Hillhouse, (New Haven), he identified five different types of alcoholism, and defined them in terms of their abnormal physiological processes.

The "Jellinek Curve" is derived from this classification of Jellinek, and it was named out of respect for Jellinek’s work. Jellinek later completely dissociated himself from this chart's representations; however it is still known as the "Jellinek Curve".

Read more about Jellinek .

Talking Points
Sandy B.: J-Curve his story

Download copy of J-Curve

Click on yellow dots for more information.

Talking Points.

  • Historically: Jellinek was a pioneer for the disease concept and seeing addiction on a continuum.
  • TASC client is a only a 3 month blip on their/your screen of life.
  • J-Curve provides a big picture, personal visualization of their addiction.
  • Disclaimer: there is no "one way", Curve is a guide, which supports the idea there is no one size fits all treatment model.
  • Client awareness of the Curve is just as important as the health care provider's awareness.
  • J-Curve is the form, client’s fill in their own personal stories, examples.
  • Disclaimer: a person can get off either side at any point, at any time, but where one lands is unpredictable & it’s getting back on which can prove difficult.
  • Curve accentuates the concept of time in addiction.
  • Metaphors: chutes, sliding down slippery slope, a ladder, climbing the sequential steps.
  • Client activity: present the J-Curve as a clinical activity, client circling symptoms they have experienced.

Going Down

  • The odds: there are many more people on the DOWN side vs. the UP side.
  • The Beginning Box: 10% are “addicted”. But take this into consideration: take all the people in the US who drink/drug, then whittle this down by those who abuse their usage, more whittling to those who get help for their usage, i.e. treatment, all those, 50% “success”, which leads to the hard question, what is success? 3 months of sobriety? 1 year? 5? Is abstinence success? Or not having any new related usage problems? How is this determined?
  • Disclaimer: a person can die from one's first usage, or have a life changing experience, i.e. killing your friend who's in your car when you’re driving under the influence, date rape, alcohol poisoning, etc.

The "Bottom"

  • No one can define another person's "Bottom".
  • A “Bottom” which will motivates a user to make a change, has to be user driven. All users have a line drawn in the sand, doesn’t mean they are conscious of that line, though.
  • User does not have to go to the end of the DOWN side to get to the UP side.
  • The intersection between the DOWN and UP, how does one define this area?
    Living in hell? “Living but wishing I was dead.”
  • Suicide Alert: thoughts, attempts, actual. Potential is always there, but a “Bottom” increases the odds.
  • There is another option at the Bottom besides going UP, continuing downwards: The “Tail”.
  • The Big Question: Why do some people start the UP side while others don’t?
    “Miracle”? Bill Wilson’s “White Light”? Luck?

Going Up

  • UP side is the least known, misunderstood side.
  • Recovery is more than a matter of just not drinking and/or using drugs, a family, public perception problem.
  • The odds: UP side is very challenging with the statistics against the user.
  • Relapse Disclaimer: if one “relapses” (slips) off the Up side, it's reported they don't get to start at the beginning of the Down side,
    instead they pick up where they left off, immediately, or in a very short time.
  • Disease of Relapse: yes, people relapse, but do they have to and is the danger element of relapsing ever emphasized enough for the client?
  • Recovery Alert: semantic vs. active recovery. “Talking the Talking, rather than Walking the Walk.”


Sandy B: J-Curve his story.

One of the best ways to learn about addiction is to listen with awareness to recovering people’s stories.

If you aren’t recovering yourself, attend open AA speaker meetings. And/or you can listen to AA speaker tapes on YouTube.

A Suggestion: listen to an AA speaker following along looking at the J-Curve. Can you identify some of the items on the Curve in their stories? When did they hit their “bottom”? And most importantly, what was it for that individual that turned on the “white light” allowing them to live in recovery?

Here's Sandy B's story.

Listen to other AA stories