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drinkers were frequent binge drinkers. Among the latter group, 70% of
the men and 55% of the women were intoxicated 3 or more times in
the last month. They drank to get drunk. Few think they have a
drinking problem. As a consequence, college students are experiencing
more blackouts, arrests, loss of friends, assaults, sexual harassment,
and so on. Among frequent binge drinkers, 62% of the men and 49%
of the women had driven after drinking.
One doesn't have to be an alcoholic, however, to have serious
problems with alcohol. 80% of drunk drivers in fatal accidents and
67% of persons arrested for drunk driving are not alcoholics. One
doesn't have to be poor to have an alcohol problem, among women
over 55 who make more than $40,000 a year, 23% have an alcohol
problem. Only 8% of women this age, who make less than $40,000 a
year, have alcohol problems.
Alcoholism remains very resistive to treatment. Peele describes the
effectiveness of treatment this way: Most American alcoholics don't
seek treatment; most of those that do enter treatment don't respond
to it favorably; most of those who complete treatment relapse later!
As mentioned above, there has been a heated controversy between (a)
"alcoholism is a disease" (AA groups) which supposedly can only be
controlled by total abstinence and (b) "alcoholism is a learned
behavior" which can, in less severe cases, be unlearned, controlled,
and done in moderation (Miller & Berg, 1995; Miller & Munoz, 1976;
Miller, 1978; Marlatt & Parks, 1982; Vogler & Bartz, 1985; Peele &
Brodsky, 1991; Peele, 1998). Current evidence suggests both views
may be partly right. For instance, there are very few ex-smokers who
can occasionally light up and not get addicted to cigarettes again. This
supports AA's position that total abstinence from an extreme addiction
is required (although the cigarette habit is different from the drinking
habit). Most psychologists would probably suggest that persons with
serious, long-term drinking problems are not good candidates for
controlled drinking experiments; it is believed that they need to
abstain and probably get intensive professional treatment for
alcoholism and any underlying emotional-personality problems.
There are many treatment programs, some very expensive and
with national reputations, but only 1 in 7 clients complete these
programs. After a few weeks of treatment (depending on the insurance
available), typically the clients are urged to attend AA. On the other
hand, there are many millions of people who have been moderate to
heavy drinkers and want to continue drinking moderately and
reasonably; they are often able to get and keep the habit under
control. All drinkers are not doomed to life-long AA meetings and total
abstinence may not be necessary, but all potential addictions are a
serious concern. Since controlled drinking is a new approach, we know
little and there is much to be learned. Certainly there is a flood of new
books and programs being offered for sale (see below).
Cooper (1994) explains alcohol use in terms of reinforcement:
internal positive reinforcement (feeling more relaxed, more assured,
