Review of Under the Influence: A Guide to the Myths and Realities of Alcoholism (Mass Market Paperback)

I find the comments that the book is out of date sad, because the vast majority of alcoholism treatment programs as well as public opinion have not yet caught up to this book.
Milam advances several important concepts:
1. Alcoholism is a disease like diabetes. Psychology and morality play no role, except in the alcoholic's reaction emotionally to the consequences of the disease [hiding it, seeking help, etc.] If you think this view of alcoholism is completely accepted now, try telling your boss you are an alcoholic.
2. Milam then explains HOW alcoholism is a disease in fascinating detail. Alcoholics are not addicted to alcohol, but to a complex physical process that happens when they drink. Basically, the alcoholic's body reacts to the presence of alcohol in the body differently from that of a "normal" person, and no amount of counseling/threats/religious conversions can change that.
3. Alcoholics may not know when to save themselves, and may need help [he shoots down the "hitting bottom" myth]. Do you wait for a diabetic to go into a coma before you help them?
4. Treatment for the alcoholic must address the poor state of the alcoholic's health and nutrition. Alcoholic tremors, shaking, illusions, paranoia, etc. are caused by alcoholic malnutrition. Alcohol strips the body of water soluble vitamins, particularly the crucial B vitamins, and prevents the liver and other organs from repairing the body.
The one section of the book I don't agree with concerns the role of government/public agencies in alcoholism treatment. Milam expects too much of them. But that does not affect the brilliance of this book.
In the reviews here, there are some criticisms that Milam describes only "worst case" scenarios. That is not correct. He clearly describes all the stages of alcoholism, from the "I just want to have fun" stage to the lying in the gutter stage, and he recognizes that the disease progresses differently in people.
As an alcoholic who has been sober for twenty years, I can't recommend this book enough. It provides hard information, not moralizing.



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