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name is Josh and I'm not an alcoholic. In the past a college
student with my drinking habits - a frequent beer or two,
a couple of times a year to excess - wouldn't feel compelled
to declare this. But when I got ill from drinking last spring
at Princeton and was taken to the infirmary, I was told
to meet with the school's full-time alcohol counselor. Opening
a folder in my name, he began the interview: Do you play
drinking games? Have you gotten sick on alcohol before?
Do you consume more than fourteen drinks a week? After fifteen
minutes of this, he told me that getting sick was "a
significant episode" in my "drinking history,"
that I was teetering on the brink of alcoholism.
Subjection to this type of inquisition is an increasing
part of the curriculum on America's campuses: 60 percent
of colleges have some sort of substance abuse program. And
the idea behind it - that a given level of consumption or
a major bender means you're a confirmed lush, or close enough
to being one to need treatment - now pervades the $2 billion
alcohol- treatment industry.
treatment theories reflect a far broader neo-temperance
trend, which first became evident around 1984, when Mothers
Against Drunk Driving succeeded in raising the drinking
age to 21. In 1988 then Surgeon General C. Everett Koop
called (unsuccessfully) for a ban on happy hours. Last January
an award-winning edition of Little Red Riding Hood was banned
for first-graders in the Empire, California, school district
because Grandma takes a glass of wine after escaping the
wolf. Today's puritans lobby for a whole range of prohibitions,
from banning alcohol industry sponsorship of sports events
and rock concerts to barring convenience stores, gas stations,
and supermarkets from selling booze.
The new public awareness about drinking has, of course,
helped to reduce the horrendous problems caused by alcohol
abuse. Consumption is down, particularly among the young.
In 1980, 58 percent of Americans between the ages of 18
and 24 said they drank beer, according to Simmons Market
Research. By 1989, only 47 percent did. The number of deaths
attributed to drunk driving has fallen, too, from 20,356
in 1982 to 17,849 in 1989 - a 12 percent decline in seven
think such a success might moderate the impulse for ever
more draconian correctives. But if anything the anti-alcohol
severity is increasing. Last summer the Supreme Court found
that "the measure of the intrusion on motorists stopped
briefly at sobriety checkpoints" is a small price to
pay in the effort to reduce the "death and mutilation"
caused by drunk drivers. Thirty-nine states now have "dram-shop"
liability and twenty-four states have "social host"
liability, in which bartenders and hosts can be held partially
responsible when someone they serve gets in an accident.
In the treatment industry, the tactics used to intimidate
heavy drinkers have become more coercive. An increasingly
popular method of alcoholism treatment these days is "intervention."
Invented by Dr. Vernon Johnson, a reformed alcoholic who
became famous when he pressured Betty Ford into treatment,
the method relies upon a team effort. Family, friends, and
co-workers "intervene: by confront-ing the offender
in public –sometimes at work, preferably when he is
hung over - with a list of grievances and a series of ultimatums.
Johnson's transcript of a typical intervention from his
recent book, Chemical Dependence, includes threats from
the victim's wife that she'll leave him if he doesn't seek
treatment, and from his
boss, who says he'll fire him. A car is supposed to wait
outside so the victim can be whisked directly to a treatment
Johnson Institute promotes intervention through travelling
workshops and a large mail-order business of books, cassettes,
and videos. One of Johnson's biggest clients is the national
network of Employee Assistance Programs, in-house and regional
counselors who specialize in alcohol problems and are currently
working with 12,000 corporate government offices across
the country. A supervisor, noticing lagging performance
or simply suspecting an alcohol problem, can order an employee
to meet with an EAP counselor. the counselor, who doesn't
have to meet any national training standards, will tell
these presumed alcoholics to go on the wagon. If the employee
is caught drinking again - whether or not the drinking is
affecting his job performance - his boss is encouraged to
send him back for more counseling or fire him.
treatment is essentially an extension of one of the main
precepts of Alcoholics Anonymous: alcoholism - a disease
over which the alcoholic has no control - starts with the
first drink and leads inexorably to death if the alcoholic
does not become perfectly abstinent. It is thus essential
to stop alcoholism in its early stages, no matter how scant
the evidence. In recent years, however, the disease theory
of alcoholism has come under attack. (See "alcohol
and Free Will" by Robert Wright, TNR, December 14,
1987.) Studies have shown that even many hard-core drinkers
are able to control their drinking. Yet virtually every
major alcohol treatment program in the country largely adheres
to the A.A. tenets, and now a growing number are using some
form of coercion.
drivers, understandably enough, have come under particularly
Court Judge Albert Kramer of Quincy Massachusetts sentences
about 470 drunk drivers a year to enroll in Right Turn,
a $725, twenty-six week, out-patient treatment program,
and to attend a series of A.A. meetings. "Everyone
is assumed to be having a problem by virtue of their DWI
conviction," explains Dr. Steve Valle, director of
the program. "Social drinkers are really high-risk
problem drinkers." As do most treatment programs, Right
Turn uses a questionnaire to determine if you're an alcoholic.
Right Turn's test is adapted from one by the National Highway
Traffic Safety Administration. Out of curiosity, I took
it myself. Sure enough, I scored a 30 out of 47, which meant
I was in "the final, deteriorative stage of alcoholism,
when most alcoholics outwardly appear to be alcoholic."
The test was designed in
such a way that each symptom on a night of overindulgence
was recorded separately, boosting my score.
the country convicted drunk drivers are ordered to begin
treatment, usually at an A.A. chapter, or are given a choice
Between treatment and prison, which is, I suppose, a choice
of sorts. But forcing someone to go to A.A. presents another
problem: six of A.A.'s "Twelve Steps" to counter
alcoholism allude to God. Last year a Maryland drunk driver,
John Norfolk, objected to his court-ordered A.A. meetings,
saying the government was forcing him to participate in
a religion. The state yielded - Norfolk was switched to
a non-religious program - before a judgment was rendered,
avoiding a precedent and letting Maryland continue with
court-ordered A.A. There are now, though, non-spiritual
groups for people with drinking problems, which judges are
beginning to use as A.A. alternatives in sentencing. In
contrast with A.A., one group, called Rational Recovery,
believes everyone has the power to overcome alcohol problems
– without undergoing lifelong treatment.
craze for compulsory treatment would make some sense if
there were proof that it worked. Yet a 1988 Bureau of Statistics
report found that nearly half of all inmates convicted of
driving while intoxicated had previously been involved with
an alcohol treatment program, and one in eleven was in treatment
at the time of arrest. A major report issued last spring
by the National Academy of Science's Institute of Medicine
cites a study in which sanctions (e.g., suspending licenses)
were shown to be more effective against recidivism than
course, all this might be an elaborate process of self-denial.
After several more sessions with my college alcohol adviser,
a couple of compulsory sessions with A.A., and an "intervention"
organized by TNR interns, maybe I would be forced to admit
that, yes, I am an alcoholic. The trouble is, by the time
that's all over, I probably will be.
The New Republic, April 22, 1991)