Heavy Drinking

...As he puts it: goes well beyond its specific subject...

...book is Heavy Drinking: The Myth of By wrapping the disease theory of Alcoholism as a Disease...

...THE AMERICAN SPECTATOR DECEMBER 1988 50...

...action...

...Indeed, AA would seem to em-doubt and guilt long enough to sum- body—in practice, if not in theorymon the courage to deal with their much that he advocates for treatment problems...

...On most social-policy quesquor would reduce liver cirrhosis mor- tions—welfare, crime, homelessnesstality by 1.9 percent—about 600 deaths experts typically offer analyses that each year...

...Signing a contract does not get the job done, but neither do For example, he calls attention to the we think that contracts are pointless, "inconsistency" between AA's rhetoric meaningless statements...

...Indeed, while estimates of the Mothers Against Drunk Driving number of alcoholics in the United (MADD), which have led to stiffer legal States range as high as 10 million, penalties, as well as increases in the Fingarette notes that "approximately legal drinking age from 18 to 21...

...They are necessary about alcoholics having no control over and important elements within a sequence their disease, and the reality that of events that may or may not result recovery begins when the individual ex- in the fulfillment of the intended trans- ercises control-by refusing to drink...

...many treatments, he fails to square this Fingarette takes an eclectic ap- with AA's explicit rejection of experts proach, advocating a variety of in- and its exclusive reliance on the counsel dividual treatments...

...He argues as though the disease view were so pervasive that alcoholics are routine-EI ingarette doesn't address this in- ly exonerated from all individual 1.1 triguing question, but perhaps responsibility for the consequences of the answer has something to do with their behavior...

...stress...

...And the an- alcoholism in the mystique of medical saver to my question is in that subtitle...

...His reasons...

...and countless other alcohol treatment More to the point, such expenditures programs are premised: that alcoholism focus on one type of alcohol abuser, is a biologically rooted disease over and neglect the millions of problem which its victims have no control and drinkers---i`the heavy drinkers" in the title—who may not fit the classic proPeter Skerry is a research fellow at the file of "the alcoholic," but whose lives American Enterprise Institute...

...Fingarette acknowledges this programs...

...points out that state and federal liquor Fingarette may exaggerate the extent taxes have not kept up with inflation to which the public at large has ac-since the 1950s...

...Most social-policy in spite of their best efforts individuals debates inevitably get tangled in the will slip and fail—in other words, that thorny problem of drawing lines betheir free will is not without limits...

...expertise, its proponents have little Although not directed exclusively at trouble extracting more than $1 billion Alcoholics Anonymous, Fingarette's annually from public and private brief work argues persuasively against sources for treatments that Fingarette the "enlightened" view on which AA reveals to be of dubious effectiveness...

...necessary balance in his laudatory ac- But in spite of his polemical bender count of treatment programs that against AA, Fingarette has written a assume individuals do have the power useful guide through a thicket of questo choose whether or not, or how much, tions raised by our persistent problems they will drink...

...Carefully reviewing the sciresponsibility argument write a book entific evidence, Fingarette demon-that ends up dismissing one of strates that, while not without physioAmerica's best known self-help efforts...

...Or perhaps alcohol tic moralism, which taught that a sincere alcohol the and — programs resolve was enough, and the loss-of-contreatment trol hypothesis, which viewed each failure abusers and their families who resort of willpower as proof that the drinker's to them—rely on a more subtle blend will had been incapacitated by disease...

...population Fingarette's argument also leaves a drinks enough to be . . . at substantial number of loose ends...

...tween individual and social responsibiThus, Fingarette sets himself the ex- lity—between free will and determinplicit task of carving out a moderate ism...

...Lost sight of here are the prevalence of alcoholism in so the recent activities of groups like many social groups, making it much HEAVY DRINKING: THE MYTH OF ALCOHOLISM AS A DISEASE Herbert Fingarette/University of California Press/$16.95 Peter Skerry How does a philosopher advanc- for which the only "cure" is total ing a free-will, individual- abstinence...

...signing of a contract...

...frequently pushes his case too far...

...Having de-risk of having alcohol-related prob- bunked the value of medical expertise in lems...

...The self-help individuals learn for a variety of group is Alcoholics Anonymous...

...20 percent of the U.S...

...Citing the anti-smoking efforts of fact that AA charges nothing...

...He same methods and philosophy...

...Fingarette disease, but it is true that this perspeccalculates that moderate tax increases tive has been more widely accepted would save lives: based on 1981 prices, than many other "enlightened" opinsixteen cents tacked on to a fifth of li- ions...

...But what the author perceives to be an inconsistency in AA might just as In light of this, Fingarette's single-well be seen as the ambiguity inherent minded pursuit of AA seems misguidin most endeavors—certainly most ed...

...For that recent decades, Fingarette favors public matter, he neglects to explain why, with education campaigns, increased penal- AA costing nothing, millions are spent ties for drunk driving, and, in par- on programs that rely on essentially the ticular, increased taxes on alcohol...

...Hardly a liber- and fellowship of recovered alcoholics...

...What is it about alcoholism that Despite his convincing review of the causes the public to back away from scientific evidence and quite reasonable moralistic, free-will explanations and public policy prescriptions, Fingarette accept the deterministic view...

...tarian, he argues for government Nor does he reconcile his criticism of policies to reduce alcohol consump- the cost of treatment programs with the tion...

...but that also teach that with alcohol abuse...

...Doubling the federal liquor underplay or completely ignore moral tax, he reckons, would decrease cir- choice and individual responsibility, rhosis mortality by about 6,000 cases which are precisely the factors laymen annually...

...By cutting a neat swath through free-will perspective that avoids both some of the thicket, at least, Heavy heavy-handed moralism and mindless Drinking demonstrates a relevance that determinism...

...logical and genetic aspects, alcoholism The philosopher is Herbert Fingarette, is much more accurately described as a professor at the University of Califor- a range of maladaptive behavior that nia at Santa Barbara...

...are nevertheless affected by alcohol THE AMERICAN SPECTATOR DECEMBER 1988 49 more difficult to dismiss as someone . . . we must put aside both the simpliselse's moral failing...

...As a result, the real cepted the view of alcoholism as a cost of liquor has declined...

...of moral toughness and therapeutic Let us instead view willpower as we do the compassion than Fingarette recognizes...

...For although his scientific argutherapeutic or pedagogical endeavors— ment against the disease theory pop-that call for a balance between zealous- ularized by AA is surely valid, his ly holding individuals responsible for criticisms of the program itself are less their plight, and freeing them from self- so...