Alcoholism Frontmatter 2/24/04 8:03 AM Page 1 Alcoholism Alcoholism Frontmatter 2/24/04 8:03 AM Page 2 Other Books in the Current Controversies Series: The Abortion Controversy Interventionism Assisted Suicide Iraq Capital Punishment Marriage and Divorce Computers and Society Medical Ethics Conserving the Environment Mental Health Crime Minorities The Disabled Nationalism and Ethnic Drug Trafficking Conflict Ethics Native American Rights Europe Police Brutality Family Violence Politicians and Ethics Free Speech Pollution Gambling Prisons Garbage and Waste Racism Gay Rights Reproductive Technologies Genetics and Intelligence The Rights of Animals Gun Control Sexual Harassment Guns and Violence Smoking Hate Crimes Teen Addiction Hunger Urban Terrorism Illegal Drugs Violence Against Women Illegal Immigration Violence in the Media The Information Highway Women in the Military Alcoholism Frontmatter 2/24/04 8:03 AM Page 3 Alcoholism James D. Torr, Book Editor David Bender, Publisher Bruno Leone,Executive Editor Bonnie Szumski, Editorial Director David M. Haugen, Managing Editor CURRENT CONTROVERSIES Alcoholism Frontmatter 2/24/04 8:03 AM Page 4 No part of this book may be reproduced or used in any form or by any means, electrical, mechanical, or otherwise, including, but not limited to, photocopy, recording, or any information storage and retrieval system, with- out prior written permission from the publisher. Cover photo: © Super Stock Library of Congress Cataloging-in-Publication Data Alcoholism / James D. Torr, book editor. p. cm. — (Current controversies) Includes bibliographical references and index. ISBN 0-7377-0139-0 (lib. : alk. paper). — ISBN 0-7377-0138-2 (pbk. : alk. paper) 1. Alcoholism—United States. I. Torr, James D., 1974– . II. Series. HV5292.A3855 2000 362.292—dc21 99-37265 CIP0 ©2000 by Greenhaven Press, Inc., PO Box 289009, San Diego, CA 92198-9009 Printed in the U.S.A. Every effort has been made to trace the owners of copyrighted material. Alcoholism Frontmatter 2/24/04 8:03 AM Page 5 Contents Foreword 12 Introduction 14 Chapter 1: How Serious Are the Problems of Alcoholism and Alcohol Abuse? Chapter Preface 18 Alcoholism and Alcohol Abuse Are Serious Problems Alcoholism Is a Serious Problem by Well-Connected 19 Alcoholism is a chronic, progressive disease that affects millions of Americans. It can cause a large number of medical problems and is associated with violence and child abuse. Alcoholism can be hard to detect because there is no clear point at which problem drinking be- comes alcohol dependence. Recovering alcoholics can learn absti- nence but must constantly guard against the possibility of relapse. Children of Alcoholics Face Many Problems by the American Academy of Child and Adolescent Psychiatry 30 The people harmed most by alcoholism are often not the alcoholics themselves, but their families. Children raised in alcoholic homes are more likely to abuse alcohol or other drugs later in life and often develop serious emotional problems as a means of coping with their parent’s drinking problem. Alcohol Abuse Is a Serious Problem for Teenagers by Center for Science in the Public Interest 32 Alcohol is the most widely abused drug among youth. Alcohol abuse among young people is associated with health problems, teen suicide, traffic accidents, crime, sexually transmitted diseases, and problems in school. In addition, underage drinking is often the first step toward other types of drug abuse. Binge Drinking on College Campuses Is a Serious Problem by J.J. Thompson 38 Most college administrators are not aware of the frequency with which college students abuse alcohol. Binge drinking is a wide- spread problem on college campuses, one that is associated with low grades, unsafe sexual practices, and violence. Colleges that restrict the use of alcohol on campus and provide students with nonalco- holic activities and events have lower rates of binge drinking. Alcoholism Frontmatter 2/24/04 8:03 AM Page 6 The Problems of Alcoholism and Alcohol Abuse Are Exaggerated The Dangers of Alcohol Are Exaggerated by Stanton Peele 44 For decades the temperance movement has exaggerated the dangers of alcohol and the risk of alcoholism. This has led to irrational alco- hol policies, such as raising the legal drinking age to 21, that have not helped to reduce alcohol-related problems. There are some indi- cations that the strong anti-alcohol sentiment in America is begin- ning to recede, in part because of the government’s admission that moderate drinking can help prevent heart disease. However, Ameri- cans still retain a very negatively biased view of alcohol. Alcohol Consumption Is Unfairly Condemned by Colman Andrews 50 Drinking can be a very pleasurable activity, and even drinking to the point of intoxication is not wrong if it is done responsibly and in the appropriate setting. However, it is becoming increasingly unaccept- able to drink alcohol at all, and those who do drink frequently or heavily are often erroneously regarded as alcoholics. This negative view of alcohol is unjustified; alcohol misuse, not alcohol itself, should be the target of public disapproval. The Extent of Binge Drinking Among Young People Is Exaggerated by David J. Hanson 59 The term “binge drinking” describes an extended period of heavy drinking in which the drinker gives up his or her usual obligations in order to become intoxicated. However, some researchers have de- fined bingeing simply as the consumption of five or more drinks in one day. This has led to deceptive statistics that make it seem as though most teenagers and college students are heavy drinkers. In reality, binge drinking among young people has been declining for years. Chapter 2: Is Alcoholism a Disease? Chapter Preface 64 Yes: Alcoholism Is a Disease Physicians Should Treat Alcoholism as a Disease by Thomas R. Hobbs 65 For decades the medical community has recognized that alcoholism is a progressive, often fatal disease that is influenced by genetic, psychosocial, and environmental factors. Yet studies indicate that many doctors still view alcoholism as merely a behavioral problem, and consequently often fail to detect or treat the disease. Hospitals and medical schools must help physicians understand that alco- holism is a preventable, treatable disease. Addiction Is a Disease by Greg Skipper 69 The medical concept of disease is often misunderstood by the gen- eral public. Many people think that diseases indiscriminately attack healthy bodies, whereas alcoholism or other drug addictions are brought on by substance abuse. In fact, many diseases, such as heart Alcoholism Frontmatter 2/24/04 8:03 AM Page 7 disease or lung cancer, are brought on by unhealthy behaviors. The disease model of addiction is compatible with the idea that addicts are responsible for their behavior. Alcoholism Has a Genetic Basis by Marc Alan Schuckit 73 Just as individuals have different genetic susceptibilities for heart disease or cancer, they also have different genetic risks for develop- ing alcoholism. Studies have shown that children of alcoholics are more likely to develop alcoholism, even when they are raised in adoptive families where alcohol is not prevalent. However, no one is predestined by their genes to become an alcoholic; individuals who are aware of a family history of alcoholism can always choose not to drink. Alcoholics Should Not Be Blamed for Their Disease by W. Waldo 76 Alcoholism is a brain disease that occurs in people who have a ge- netic susceptibility to this type of addiction. Alcoholism has a bio- logical basis, just like cancer or diabetes, and telling alcoholics that their disease is a result of weak character or insufficient willpower is just as wrong as telling cancer patients or diabetics that they are responsible for their diseases. When someone is diagnosed with al- coholism, they should receive treatment, not moral criticism. No: Alcoholism Is Not a Disease The Genetic Basis of Alcoholism Has Been Exaggerated by Stanton Peele 78 There is little evidence to support the idea that alcoholism is an in- herited disease. Studies purporting to show the link between alco- holism and genetics often have conflicting or ambiguous results. Moreover, even the scientists conducting such research acknowl- edge that genetics can explain only part of the problem, and that cul- tural and social factors play a large role in the development of alco- holism. Treating Alcoholism as a Disease Harms Alcoholics by Edward A. Dreyfus 83 Alcoholism was originally termed a disease in order to help people understand that it was a serious problem for which they should seek help. However, the disease metaphor is being overused and applied to all manner of individuals, from “workaholics” to smokers. As the use of the term “disease” increases, alcoholics and other emotion- ally disturbed people are coming to believe they are “sick,” and need medical rather than psychological help to overcome their addictions. Chapter 3: How Effective Is Alcoholics Anonymous? Chapter Preface 90 Alcoholics Anonymous Is Effective Alcoholics Anonymous Is Effective by Robert Zimmerman 91 Alcoholics Anonymous has over 2 million members worldwide, all Alcoholism Frontmatter 2/24/04 8:03 AM Page 8 of whom attend regular meetings where they help each other stay sober. The organization has helped thousands of alcoholics over- come their disease, and AA teachings have also been used to treat other types of addiction. Alcoholics Anonymous is over 60 years old, but its original twelve-step philosophy has not changed at all in that time. AA’s Emphasis on Spirituality Benefits Alcoholics by William W. May 95 In order to achieve long-term sobriety, alcoholics must undergo a “moment of clarity”—a spiritual awakening through which individ- uals are able to find the inner strength to overcome alcoholism. Alcoholics Anonymous works because it teaches people how to achieve this spiritual experience and use it to stay sober. Alcoholics Anonymous Is Ineffective Alcoholics Anonymous Is Ineffective by Michael J.