Published 1989, I`m still finding this book highly relevant – it`s available on Amazon from 1p + £ 2.80p&p.
It explores whether excess consumption of alcohol should be termed a disease or not, and whether total abstinence would be the way forward or too ambitious a goal. It asks a lot of difficult questions, which I`m finding highly inspiring.
Calling alcoholism a disease, rather than a behavior disorder, is a useful device both to persuade the alcoholic to admit his alcoholism and to provide a ticket for admission into the health care system.
The classic disease concept admirably suits the interests of the liqueur industry: by acknowledging that a small minority of the drinking population is susceptible to the disease of alcoholism, the industry can implicitly assure consumers that the vast majority of people who drink are not at risk.
If loss of control is triggered only after the first drink, why should the alcoholic have any special difficulty mustering the self-control to avoid the first drink? Why should abstinence pose a problem?
Or if we do recognize evidence of control, we decide the drinker in question cannot be a “true” alcoholic. We then minimize or discount that person`s drinking problems because the labels “alcoholic” and “disease” do not seem to apply.
Finally, the disease concept poses a frustrating paradox for drinkers who do seek treatment: They are told that they are unwilling victims of a disease that destroys their ability to manage their drinking and yet that they must strive to exert absolute self control and that only total abstinence can save them.
Instead of viewing heavy drinkers as the helpless victims of a disease, we come to see their drinking as a meaningful, however destructive, part of their struggle to live their lives.
Thus, he comes to see himself as the victim, even though it is his wive who has to endure his drunken outbursts.
Conversely, once a drinker`s overall quality of life is used as one of several measures of success, total abstinence is not necessarily a sign of success. Over time, the controlled drinking group on average reduced their drinking far more than the abstinence group. For heavy drinkers who are trying to address their problems the concept of controlled drinking can have the salutary effect of acknowledging human fallability.