Magazine article Science News

Intoxicating Habits: Some Alcoholism Researchers Say They Are Studying a Learned Behavior, Not a Disease

Magazine article Science News

Intoxicating Habits: Some Alcoholism Researchers Say They Are Studying a Learned Behavior, Not a Disease

Article excerpt

Intoxicating Habits

Most alcoholism treatment programs in the United States operate on the assumption that people seeking their help have a disease characterized by physical dependency and a strong genetic predisposition. The goal of treatment, therefore, is total abstinence.

Herbert Fingarette, a philosophy professor at the University of California, Santa Barbara, pored over alcoholism and addition research and came up with a suggestion for the many proponents of this approach: Forget it.

In a controversial new book (Heavy Drinking: The Myth of Alcoholism as a Disease, University of California Press, 1988), Fingarette says alcoholism has no single cause and no medical cure, and is the result of a range of physical, personal and social characteristics that predispose a person to drink excessively.

"Let's view the persistent heavy drinking of the alcoholic not as a sin or disease but as a central activity of the individual's way of life," he contends. Seen in this context, alcoholism treatment must focus not just on the drinking problem, but on developing a satisfying way of life that does not revolve around heavy drinking. Total abstinence -- the goal of medical treatment centers as well as Alcoholics Anonymous -- is unrealistic for many heavy drinkers, holds Fingarette.

Disputes over the nature of alcoholism have a long and vitriolic history. But Fingarette's arguments reflect a growing field of research, populated mainly by psychologists, in which alcoholism and other addictions -- including those that do not involve drugs, such as compulsive gambling -- are viewed more as habits than as diseases. Addictive behavior, in this scheme, typically revolves around an immediate gratification followed by delayed, harmful effects. The habitual behavior nevertheless continues and is often experienced by the addict as uncontrollable.

"Addiction occurs in the environment, not in the liver, genes or synapses," says psychologist Timothy B. Baker of the University of Wisconsin in Madison. Biology may, in some cases, increase a person's risk of developing a dependency, but "an individual chooses to take drugs in the world. The likelihood of a person trying a drug or eventually becoming addicted is influenced by his or her friends, marital happiness, the variety and richness of alternative to drug use and so on," Baker contends.

Expectations and beliefs about alcohol's power to make one feel better shape the choices leading to alcohol addiction, according to one line of investigation. The most notable of these beliefs, says psychologist G. Alan Marlatt of the University of Washington in Seattle, is that alcohol acts as a magical elixir that enhances social and physical pleasure, increases sexual responsiveness and assertiveness, and reduces tension (SN: 10/3/87, p.218).

The initial physical arousal stimulated by low doses of alcohol pumps up positive expectations, explains Marlatt. But higher alcohol doses dampen arousal, sap energy and result in hangovers that, in turn, lead to a craving for alcohol's stimulating effects. As tolerance to the drug develops, a person requires more and more alcohol to get a short-term "lift" and a vicious cycle of abuse picks up speed.

Despite falling into this addictive trap, Marlatt says, some people drastically cut back their drinking or stop imbibing altogether without the help of formal treatment. In these cases, he maintains, external events often conspire to change an individual's attitude toward alcohol. Examples include an alcohol-related injury, the departure of a spouse, financial and legal problems stemming from drinking or the alcohol-related death of another person.

When treatment is sought out, Marlatt advises, the focus should be on teaching ways to handle stress without drinking and developing realistic expectations about alcohol's effects. Marlatt and his co-workers are now developing an "alcohol skills-training program" for college students, described more fully in Issues in Alcohol Use and Misuse by Young Adults (G. …

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