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A new flash of lightning theory.

"I can quit drinking anytime I want to--I've done it hundreds of times."

That old comic one-liner illustrates the all-or-nothing nature of alcoholism described in a new study of problem drinkers. John E. Helzer and his co-workers at Washington University in St. Louis report that less than 2 percent of 1,065 alcoholics were controlled, "social" drinkers five to seven years after receiving treatment for their problem.

"This study suggests that there is little cause for optimism about the likelihood of an evolution to long-term, stable, moderate drinking among treated alcoholics," say the researchers in the June 27 NEW ENGLAND JOURNAL OF MEDICINE.

A previous research project indicated that alcoholics could be taught with behavior therapy to become moderate drinkers, but its methods and results were criticized by several investigators (SN: 10/11/82, p. 168).

Helzer and his colleagues conducted personal interviews, reviewed records, or both, for alcoholics treated at any of four St. Louis-area medical and psychiatric facilities between 1973 and 1975. Nearly 79 percent were still drinking heavily, while 15 percent never drank alcohol, 4.6 percent alternated between moderate drinking and abstinence and only 1.6 percent were regular moderate or controlled drinkers.

The scientists used a three-pronged definition of moderate drinking:some drinking in at least 30 of the previous 36 months, no excessive consumption (seven or more drinks per day on four or more days in a month) and no social, medical or legal problems due to alcohol in the preceding three years.

The subjects most likely to become controlled drinkers were female and had a history of less severe drinking problems.

Alcoholics who do not seek medical attention may do better over the long haul than those who require treatment at some point, say the researchers. But the results suggest, add Helzer, that the "vast majority" of alcoholics receiving treatment should aim for total abstinence.

Treatments for alcoholism have a tremendous potential impact on society, note the investigators. An ongoing national survey, which has so far covered three major urban areas, recently found that 19 to 30 percent of all men had met psychiatric criteria for alcohol abuse or dependence at some time in their lives (SN: 10/6/84, p. 212).
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Publication:Science News
Date:Jul 13, 1985
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