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Grammar detail: ~ずに(は)いられない

~ずに(は)いられない - cannot help but ...
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verb negative stem + ず
+
に(は)
+
いられない
means
cannot help but ~
The ず negative form of a verb is an archaic form which simply uses ず instead of the modern ない. In this construction, the ず negative is combined with the negative potential form of いる (to be / to exist), which means 'cannot be'. So the construction literally means 'without doing ~, I cannot exist' - in other words, 'I cannot help but do ~'.
アルコール
いぞん
依存
しょう
さけ
まず
いられない
びょうき
病気

Alcohol dependence is an illness with which one cannot help but drink alcohol.
Japanese contains several subtly different ways of expressing 'must do ~', 'have to do ~', 'feel obliged to do ~', 'cannot help but do ~' etc (as does English!).
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See also:
  • verb negative stem + ずに - without doing
  • verb potential form - ability to do
  • いけない, ならない etc - various ways to express obligation

Kanji used in this grammar

イ   エ    reliant   
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4
ソン   ゾン    suppose   
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3
ショウ    symptoms   
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5
シュ   さけ    さか- sake   
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3
イン   の to drink   
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2
ヘイ   ビョウ   やまい illness   や to fall ill   
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2
キ   ケ    spirit   
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1
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