Where’s the War Against the Legal Killer, Alcohol?

Dr. Otis R. Bowen, secretary of health and human services, has finally lifted the lid on his long-simmering impatience with the Reagan Administration’s approach to the nation’s drug crisis. On April 28, after walking out of a meeting of the National Drug Policy Board, he made public a message that he had just delivered to the President and fellow Cabinet members. The gist of his message was this: We are losing the war on drugs, and he can no longer endorse the President’s optimistic pronouncements to the contrary.

Bowen, a “country doctor” and former two-term governor of Indiana, favors a public-health approach to addiction. He has become increasingly uncomfortable with Administration policy that focuses almost altogether on law enforcement. At his Secretary’s Conference on Alcoholism last November, he demonstrated his understanding of addiction as a problem with medical, social and psychological ramifications--a problem requiring broadened policies for prevention and treatment along with strict enforcement of the laws.

Ironically, America’s most widely used addictive drug is legal.

Alcohol figures in nearly half of America’s murders, suicides and accidental deaths, claiming at least 100,000 lives a year, 25 times as many as all illegal drugs combined. Alcoholism costs the country $117 billion, more than twice the $45 billion that we lose to drug abuse. Eighteen million Americans (5 million of them adolescents) have trouble with alcohol. While drug use has fallen to 33% among high-school students, drinking has risen to twice that. A public policy that separates alcohol and illegal drugs is further complicated by the fact that 80% of alcoholics abuse other drugs as well.

Don’t tell me that addiction is not a disease. Don’t tell me that a drug is not a drug just because it is legal.

Alcohol and drug abuse have riddled my family since long before the advent of international drug cartels. Mama, who never saw a drug-pusher, died at age 30 of an overdose of whiskey and morphine. Dad was an alcoholic, and both of my sisters have spent their lives in and out of treatment for alcoholism and mental illness; my brother was a heavy drinker who died from a stroke at age 40.

Recent research paints a tragic picture for the families of alcoholics. Even when they are adopted and raised by non-alcoholic parents, children of alcoholics are three to four times more likely to become alcoholics than other people are. Children who are born to parents with the most virulent form of the disease (one that strikes early and instantly, as it did with my mother and sisters) are nine times more likely to become alcoholics than members of the general population are.

With an uncanny instinct for self-destruction, in which both heredity and environment seem to play a part, children of alcoholics tend both to become alcoholics themselves and to marry alcoholics. Often they marry other children of alcoholics. Dr. Stephanie Brown of Stanford Medical Center estimates that up to 70% of children of alcoholics suffer from alcoholism or related compulsive disorders. Thus the psycho-social as well as the genetic effects of the disease accumulate, bringing trouble and suffering to the families of 56 million adult Americans.

When my father married my mother, generations of addiction and mental instability collided. Of their four children, three became alcoholics and two married alcoholics. The alcoholism was sometimes coupled with drug abuse, sometimes not. Although my father found a measure of recovery, he never stopped drinking altogether, and never faced the toll that the disease had taken on our family.

Whether we become addicted ourselves or not, none of us raised among addicts escape the damage. We learn to keep vigil when we should be learning to trust and play. We start too early looking after people who should be looking after us. The wounds go deep, and the scars last a lifetime.

Unless the cycle is stopped (and it is hard to stop), addiction is deadly. It seeps down through the generations, poisoning as it goes, wiping out families and threatening entire cultures, as ours is threatened now.

Yet progress is being made. Recent medical discoveries, improved clinical practices and heightened public awareness promise earlier identification of those at risk and more effective treatment for those already addicted. Insurance and employee benefits have begun to include treatment for families of addicts and alcoholics as well as the victims themselves.

Support groups for drug abusers and their families along with Alcoholics Anonymous, Al-Anon and ACOA (Adult Children of Alcoholics, a self-help movement growing rapidly among adults raised in alcoholic families) for people damaged by alcoholism teach millions of Americans not to repeat the past.

We can now hope that the time is coming when stricken families will find it easier than mine did to break the crippling cycle of addiction. Let’s hope, too, that Bowen will be able to prevail both on this Administration and on the contenders in the presidential election campaign to attack the complex problems of drug abuse and alcoholism with creativity and compassion as well as with determination.