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UNDERNEWS

Undernews is the online report of the Progressive Review, edited by Sam Smith, who covered Washington during all or part of one quarter of America's presidencies and edited alternative journals since 1964. The Review, which has been on the web since 1995, is now published from Freeport, Maine. See main page for full contents

November 17, 2009

RESEARCH CHALLENGES ASSUMPTION THAT ALCOHOLICS ARE HELPLESS TO CONTROL USE

LA Times - Seventy years ago, Bill Wilson -- the co-founder of Alcoholics Anonymous -- declared his powerlessness over alcohol in a book by the same name. The failed businessman contended that, as an alcoholic, he had to "hit bottom" before changing his life and that sobriety could only be achieved through complete abstention.

For generations, Americans took these tenets to be true for everyone. Top addiction experts are no longer sure.

They now say that many drinkers can evaluate their habits and -- using new knowledge about genetic and behavioral risks of addiction -- change those habits if necessary. Even some people who have what are now termed alcohol-use disorders, they add, can cut back on consumption before it disrupts education, ruins careers and damages health.

In short, say some of the nation's leading scientists studying substance abuse, humans travel a long road before they become powerless over alcohol -- and most never reach that point.

"We're on the cusp of some major advances in how we conceptualize alcoholism," says Dr. Mark Willenbring, director of treatment and recovery research at the National Institute on Alcohol Abuse and Alcoholism. The institute is the nation's leading authority on alcoholism and the major provider of funds for alcohol research. "The focus now is on the large group of people who are not yet dependent. But they are at risk for developing dependence."

Many of these people need not give up alcohol altogether. The concept of so-called controlled drinking -- that people with alcohol-use disorders could simply curb, or control, their drinking -- has existed for many years. Evidence now exists that such an approach is possible for some people, although abstinence is still considered necessary for those with the most severe disease.

The overall reassessment has been fueled by the groundbreaking National Epidemiologic Survey on Alcohol and Related Conditions, the largest and most comprehensive look at alcohol use in America. The project surveyed 43,000 people 18 and older in 2001 and 2002, and again in 2004 and 2005, with the results released in increments beginning in 2006. . .

Perhaps the most remarkable finding of the epidemiologic study was how many Americans experienced an alcohol-use disorder (either abuse or the more severe dependence) at some point -- and how many recovered on their own. About 30% of Americans had experienced a disorder, the research showed, but about 70% of those quit drinking or cut back to safe consumption patterns without treatment after four years or less.

Only 1% of those surveyed fit the stereotypical image of someone with severe, recurring alcohol addiction who has hit the skids.

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