Further Reading

Can I abstain while still believing in your work?


I am an alcoholic. I read several books of your a few years ago and I thought that my drinking problem was voluntary. Therefore, I experimented with moderation drinking and failed miserably. I noticed that your case studies affect people who may have had problems drinking and therefore shouldn't necessarily abstain, but what about the "alcoholic?" Do you believe this word has any meaning? In your opinion is there any proof that addiction may in some cases, such as chronic alcoholism, have genetic roots? My father was an alcoholic (who unfortunately died from drinking), and sometimes I wonder whether my drinking was mostly learned behavior, or that perhaps alcohol affected me in a dramatically different way than most other people, such that, when I started I didn't stop. Perhaps it is a mixture of the two.

I did take some alcohol studies classes, but found the disease model dominant, and problematic to say the least. However, theorists such as Fingarette and you are certainly though provoking and challenging. I now abstain from alcohol, and have been sober for about six months after a relapse after two years of abstention. My descent into alcoholic drinking after my initial slip was dramatic and immediate. I really didn't think that I would drink alcoholically, but I did. Thank goodness I stopped in time. But I am still confused about the issue of recovery, support groups, 12 step programs and so on. Before I was involved with AA but felt alienated due to my atheism and free-thinking. Then I got involved with SOS, which was AA without steps, but strongly held that alcoholism was a physical disease (Kenneth Blum, et al.). After I relapsed, I went into a treatment center I found myself in the same situation as before. I need a support system, but I didn't necessarily want to be involved with AA. I know too if I don't use something, that I may be in danger of relapsing.

Sorry for the length, but I would appreciate your insight.


Dear John:

Thank for your thoughtful letter. I hope I have had some positive impact on your battle with drinking. Let me try to help sort out some of the issues you raise:

  1. No, I don't believe you inherit loss of control. That is, even genetically-oriented researchers have no evidence that genes pass along an inability to cease drinking once started. Genes can only affect metabolism, sensations, and capacity.
  2. But is that really the issue? You have learned that, for the time being and possibly forever, abstinence is best for you. This knowledge has been hard-earned, but now you have it. THIS knowledge is real and true — determining whether you inherited this or whether you are an alcoholic and only problem drinkers can resume moderate drinking are fairly irrelevant. It's like if some presents me with a resume, and I try to determine whether they are good employee; but say they've worked for me for a year, and I know what they can do and can't do. Why would I look back at their resume to determine whether they can do a specific job?
  3. Nonetheless, you strive for understanding, which I appreciate in a person. And you are entitled to find support for your views and approach to things. It appears that you don't react well to being told you have a disease over which you are powerless; yet you are not a candidate for resumption of drinking. There is nothing contradictory or derogatory in this information. It's you, and you want to work within this framework. SMART Recovery sounds like the organization most consistent with your approach.
  4. Let me just say, to the extent that you look to me for my opinions, more people come to me — uncomfortable with available treatment options — seeking to quit a drug or alcohol than to continue with it. I have no problem with this, and don't even bring it up with them (EXCEPT occasionally if they're quite young, and I think that ruling out alcohol is self-defeating and unjustified from their history). In nearly all cases, I'm happy that the individual has clearly identified a goal — at least we know what we're about.

So don't despair, or feel your are violating my precepts about addiction — I do not have an ironclad set of steps like AA. Every person who licks an addiction eventually develops their own strategy. No book lays out the true path for anyone, let alone everyone.