Myths, Labels of Alcoholism

We were outraged by the article (Editorial Pages, Aug. 11), “The Indulgence Epidemic” by Richard Vatz and Lee Weinberg. Their stated opinion was rife with illogical conclusions and shortsighted policy recommendations.

First they attack the labeling by the mental health profession of excessive behaviors as “diseases” on the grounds that this frees the sufferers of “moral, and sometimes legal, responsibility.”

Perhaps the authors have had unfortunate personal encounters in this area, but in clinical practice the application of such a label is crucial to providing the sufferer, as well as family and friends, a handle with which to cope with the problem. Far from being a release, the label is the beginning of responsibility.

The authors miss the point when they condemn the “lionization” of confessed celebrity alcoholics by the media. The use of such displays is not a glorification of alcoholism but rather a means of bringing about the public realization that alcoholism can affect even people who have reached an enviable position in society.

Another ridiculous assertion is that the “indulgences” are not diseases because the very successful “Anonymous” organizations that treat them use “persuasion, not medicine” (by which the authors appear to mean “drugs”). They are ignoring the fact that intangibles such as “bedside manner” and “doctor-patient relationship” have long been among the most effective tools in the medical bag of tricks.

It is in their focus on alcoholism that Vatz and Weinberg make their most egregious errors. As they acknowledge, there is a consensus among “experts” (a word they use disdainfully) that there is a genetic predisposition toward alcoholism in some people. Then they refute this with the testimony of a single “expert,” who is a lone voice, however qualified. The fact is that carefully controlled studies have found a hereditary liver-cell condition and enzymatic differences that appear more frequently in alcoholics and their children than in the rest of the population.

There are problem drinkers who do not have these predisposing conditions. But rather than encourage further research into this gray area, the authors seem bent on returning us to the days when alcoholism was seen only as a moral weakness, and the alcoholic was shunned by society. If alcoholism defies a precise definition, it is because there is not enough yet known about it.

The authors oppose use of insurance programs to “subsidize” treatment, again on the basis that the treatments aren’t “medical.” If a program has been proved successful in helping the alcoholic stay sober then it is in the public interest to see it applied. The side effects of alcoholism in death and damages run into billions annually. Shutting the door on the alcoholic, as well as on the only known treatments, will not make the problems vanish or diminish.

PAMELA DERNHAM RN

GREGORY LINDEN

Los Angeles