Perhaps you’ve seen one of the news articles based on a massive study conducted by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) – “Nearly One in Three Americans Has History of Alcohol Problems.”

[See article.]

The study – the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). – was based on interviews with over 43,000 Americans in 2001-2002.

An article analyzing the study appears in the current issue of the Archives of General Psychiatry. It found that, over their lifetimes, 12.5 percent of Americans had incurred the most serious alcohol disorder, called alcohol dependence.

In addition, 18 percent had a less serious drinking problem, termed alcohol abuse.

Overall, for those with alcohol dependence, the Archives article revealed, 3.8 percent were alcoholic in the year prior to the study.

The study also found that only a quarter of alcoholics were treated for their alcoholism.

But this means that, although three-quarters of the most serious alcoholics are not treated, only 30 percent of those (3.8 divided by 12.5) are still alcoholic!

Obviously we believe that those who are treated succeed well, while those who don’t continue to suffer.

Not actually. There have already been a number of articles devoted to the NESARC results. One published in 2005 revealed that people treated for their alcohol dependence succeeded no better in overcoming their alcoholism than those who remained untreated.

The 2005 article examined the current status of people who succumbed to alcohol dependence prior to the past year.

Among this group, a higher percentage of those who were treated were still alcoholic in the past year (28 percent) than those who were untreated (24 percent).

Government publicity accompanying the study calls for greater and more rapid treatment,

“Today’s report signals the need for intensive efforts to educate professionals and the public to identify and address AUDs early in their course,” according to NIAAA director Dr. Ting-Kai Li.

But the study results showing treatment isn’t especially effective – or at least any more effective than going untreated – certainly would make us cautious about this conclusion. Indeed, the press release acknowledges this equivalence: “Although AUDs can recur, recovery is possible with or without treatment.”

The overall NESARC data convey an impression different than the message promulgated by the NIAAA, the AMA, and treatment programs that alcoholism is a progressive, irreversible, fatal disease.

Consider these two facts from the current NIAAA press release: “Risk for incurring AUDs is greatest at age 19 and diminishes thereafter. About 72 percent of persons with lifetime AUD experience a single episode.”

In other words, alcohol use disorders are a youthful phenomenon in the large majority of cases, and alcoholism dwindles with age – and maturity.

According to Dr. Li, “NESARC data can be used by researchers and health professionals to target preventive and treatment interventions for populations at greatest risk.”

But given that the vast majority recover without treatment, there can be dangers from Ti’s prescription to rush teenagers into alcoholism treatment.

One person who believes this is Koren Zailckas, author of the book, Smashed: Story of a Drunken Girlhood. Zailckas seems like the target case for Ti’s admonishments – she began a decade-long bout of alcoholism early in adolescence, the gory results of which she describes in her book.

Yet she never sought treatment, graduated college and began writing and formed a serious relationship, and ceased her dependence on alcohol.

Moreover, she continues – to the objections of alcoholism counselors – to reject the alcoholic label: “I don’t identify myself as an alcoholic. . . . In my mind, the whole point of Smashed is to say, you don’t have to be a quote-unquote alcoholic in order to examine the underlying reasons why you're drinking.”

She even thinks that by “branding” themselves alcoholics, young people can hinder their outgrowing abusive, even alcoholic, drinking. And the NESARC data back her up.

From Stanton Peele's blog
http://www.peele.net/blog/index.html