A Guide to the Myths and Realities of Alcoholism - Under the Influence

This is an extremely insightful book for anyone that is in recovery from addiction/alcoholism AND for anyone that works in the field of chemical dependency. The book explains very complex scientific information in a way that makes it accessible and understandable for the layman.

I really enjoyed reading this book. But joy is not really a word to use for this book. As a nurse this book had a great impact on my thinking about alcoholism. As a member of a family with alcoholism it is most helpful.

I was introduced to this book about 30 years ago, when I was unknowingly involved with an alcoholic. It really opened my eyes to the influences of alcohol. At that time, I gave a copy to another friend who was exhibiting the early signs of alcoholism. Several years later he called me to say that he'd found the book I'd given him and wanted me to know that he'd completed 6 months in AA. He was amazed that I knew where he was headed way back when I gave this book to him. I am now a substance abuse counselor and have repurchased this book to help my clients. I recommend it to all of those involved with those challenged by alcohol.

I appreciated the unbiased information presented in this book...It was quite eye-opening and really changed the way I view alcoholism. The description of the physiological process of an alcoholic was amazing, completely different than I would have expected. A good read, A MUST read for anyone learning about the disease.

As a non-alcoholic, it was very helpful to understand the myths and the truth about alcoholism, the phases of addiction and the most effective, holistic rehabilitation. But the overly strong emphasis on heredity is misleading as more recent data indicate the environment is what causes the genes to be switched on (Biology of Belief by Dr. Bruce Lipton)

This book needs to be updated. Much as been discovered since the late 70s and early 80s pertaining to alchoholism.
For one thing, there are many types of alchoholics. Most of them do not drink a fifth of whiskey or more a day. When describing the withdrawal symtoms of an alchoholic, the book paints, for the most part, a "one size fits all" scenario: shaking hands, irritability, nausea being among the most common symtoms and - in the worst cases- DTs and convulsions. What the book does not address, however, is that there are many alcoholics, and/or problem drinkers, that NEED to stop drinking and SHOULD stop drinking, but would not go through any of these symtoms of withdrawal to the degree described in the book.
In addition, AA has evolved their position regarding antidepressants and similar drugs. They realize that many people do indeed need to take their medication(s) as prescribed, and this does not put them at risk of relapse. (AA publishes a pamphlet addressing this very issue.) Pharmacuetical science has become far more sophiscticated and targeted in the more than 20 years that have elapsed since the writing of this book.
However, I give this book three stars because it does contain some valuable information and does not stigmatize the alchoholic. However, that is another reason why the book must be updated: alcoholism does not carry the stigma that it did even in the early 80s.

The book is filled with good information, but the book is outdated. At lot more current information on the subject of alcoholism is available and Milarm should followup with a new version with updated information.

Although much of what was presented in this book was valid, I found the tone of the book to be extremely one-sided. I was hoping for more of a "whole-istic" book that presented a more complete picture of alcoholism. Yes, alcoholism IS a physical malady; however, the author's insistence that it is ONLY a physical illness weakens his presentation. Clearly alcoholism is a very complex problem and one that is multifaceted. But while the physical aspect is of unmistakable significance, genetics and psychology are of equally significance factors in alcoholism as well. By refusing to even address the validity of other factors, the author becomes just as guilty of the narrow-mindedness of which he accuses others who fail to recognize the importance of the physical influence.

As a fairly intelligent person in recovery, I find the ideas promoted in this book to be out-of-date. They do not hold up under the scrutiny of the latest scientific and psychological research. The book is full of simplistic, gross generalizations that are misleading. For example: alcoholism is a disease like diabetes and proper nutrition can combat alcoholism. As with almost any book, yes, there is some accurate and helpful information here. However, overall, this book should be avoided by those seeking current, accurate information. My advice to those seeking answers to the causes and treatment of addiction is to look elsewhere. I recommend In the Realm of Hungry Ghosts: Close Encounters with Addiction

This book was published in 1981. Aside from being out of date, it's out of sync with the truth about how to free yourself from all the hand-ringing imbedded in the literature about the so called "myths and realities of alcoholism". Please! Spare me! 203 pages, including 6 pages about diet! And, while it might educate you about the history of the problem, blah, blah, blah but there’s nothing about the practical, sensible, immediate action plan you can start using tomorrow to break the chain of events that physiologically and neurologically take place in your brain when you drink. If you're an alcoholic or think you might be, THE book you want to read is, "The Cure For Alcoholism". The subtitle says it all: 'The Medically Proven Way To Eliminate Alcohol Addiction'. This book outlines a medically and scientifically proven pathway to what you are seeking - a simple pharmacological means to regaining control of your use of alcohol. This "Under the Influence..." is a bunch of rehashed, tired old retreads of 'facts' no longer operant or helpful in getting you out of this problem. Disease? Nuts! But, who cares what you call it? AA? If you're looking for a friend or you want to talk to someone, get a dog or a therapist! The way out? Buy the book and take your meds. BUT, you must follow the precise directions. They're easy to follow. Yet, still today, many doctors who'll gladly write you the script have no clue as to how to direct your use of this drug properly and successfully. I'm a weak-willed procrastinator with a severe drinking problem who constantly felt sorry for myself . This science worked for me. I wish you clarity, control and freedom.

For many alcoholics and those who live with them, it's not enough to know that this disease is a mysterious "allergy." Under the Influence explains the physical aspects of alcoholism in a matter-of-fact, easily readable form. The authors follow the progressive stages of alcoholism with clear descriptions of what the disease does to the way the liver, the brain, and the emotions respond to alcohol at each stage.

This book explains how the bodies of alcoholics metabolize liquor differently from those of non-alcoholics, and the changes in the brain that take place over years of continued drinking. (It confirms, for example, the observation that many late-stage alcoholics' function deteriorates as they go without liquor for a number of hours). After a complete description of the stages of alcoholism, it provides some insight on intervention and treatment, and some valuable information about treating the physical aspects of the disease in sobriety, with proper diet and rest in addition to AA attendance.

Nothing in Under the Influence will replace the role of the experience, strength and hope of other alcoholics in helping alcoholics recover. Yet this book provides valuable information, especially about the often-overlooked physical aspects of the three-fold disease of alcoholism.

I train counselors and counsel families of alcoholics, and when a family member is having a very difficult time (even though she is trying hard) to understand that this is a disease----I refer her to this book. This helps her to see so well, that his rage is because alcohol excites the rage-centers of the brain. And because she now understands this, she knows, then, that the crazymaking coming out his mouth is the disease talking. Does not mean that she is not in pain from his behavior---but this book does help to take the edge off it. And this book helps her to spot the alcoholism in her children, too, because she now knows how very genetic this disease is.
I see that one of the inside-cover endorsements for this book is by Toby Rice Drews---the author of the "Getting Them Sober, you CAN help" book. Her book is my 'sister book' to Milam's book! Together, these two books are lifesavers in my home. My counseling clients tell me that when they read "Getting Them Sober", their family lives change for the better within three days! I feel that these two books are 'sister' books because Milam (in "Under the Influence") explains the entire physiological body/brain effects from alcoholism----and Drews (in "Getting Them Sober, you CAN help") explains in detail, exactly how to make changes in one's relationship with the alcoholic (whether or not you live with him)------ so that the alcoholic has an 80% better chance to get sober. (The cover-endorsements for the book are by 'dear Abby', Dr. Norman Vincent Peale, and Melody Beattie, author of 'Codependent No More', who says that "Getting Them Sober is the BEST book for the family of the still-drinking alcoholic".) Getting Them Sober: You Can Help! (Getting Them Sober)

This is a hard-hitting exposé of the institutionalized and moralist cant surrounding alcoholism and its treatment. This is a classic of informative literature, partly a fine bit of muckraking journalism, partly a public service report on the scientific findings, and partly a "how to" program to address the epidemic. Although written almost twenty years ago, this little paperback still packs a punch against an enemy that is still all too much with us. Milan and Ketcham employ a straight-forward, fact-filled, uncluttered prose style to make it clear to any but the brain dead that alcoholism is a physiological disease and NOT a psychological problem based on a character flaw and/or lack of will power. Read this and you will no longer put down the alcoholic as some kind of moral degenerate, but will recognize that if your body chemistry were a little altered, you do might well be a victim.
I can say this because both my mother and father were alcoholics, and I know the only thing that kept me from joining them was the fact that I couldn't stand the headaches and nausea that came with "overindulgence." I apparently inherited the physiologic trait common to, e.g., Italian, Jewish and Asian peoples (there's a chart on p. 45 showing susceptibility by ethnicity) protecting me from alcoholism. It wasn't due to any superior morality or advanced character development on my part that I avoided the horror of alcoholism. It's more like having black skin that protects against skin cancer. Is black skin morally superior to white skin? Or, are sickle blood cells evidence of an elevated will to resist malaria? I don't think so. Thanks to this book I can see that I was lucky: I am not an alcoholic because my internal chemistry is not disrupted by alcohol as it is with alcoholics. That's it. Pure and simple.
Unfortunately many people, including--as this book points out--doctors, psychiatrists, members of the clergy, government officials and others in a position to help or hinder, still think of alcoholism in moralist and psychological terms. As Milan and Ketcham make clear this ignorant and prejudiced attitude not only doesn't help the alcoholic and his long-suffering family, it hinders treatment. The authors are vehement on this point. On page 195, for example, they write (citing Joseph Pursch): "...physician ignorance about alcoholism and prejudice toward alcoholics are the major obstacles to effective treatment." Strong words indeed, but not surprising. Most doctors were too busy in medical school to get an education, and too busy with patients (and I must say, climbing up the hill of worldly success) afterwards to catch up. This includes psychiatrists. As the authors point out these "professionals" routinely prescribed tranquilizers and other drugs pharmacologically similar to alcohol to alcoholics, drugs to which alcoholics have a cross-tolerance, a situation that not only led to a double addiction, but was, in some cases, life-threatening.
Professionals who offer counseling and psychotherapy to alcoholics are also taken to task by the authors: "Psychotherapy diverts attention from the physical causes of the disease, compounds the alcoholic's guilt and shame, and aggravates rather than alleviates his problems" (p. 14). "A[lcoholics] A[nonymous] members are all too aware of the condescension and judgmental attitudes about alcoholism which pervade the conventional health agencies. They have been drugged with tranquilizers and sedatives, have spent expensive and fruitless years in psychotherapy, and have endured indifferent and even hostile professional attitudes toward them and their disease" (p. 132).
So-called moral leaders of public opinion are also rightly chastised for their ignorance and lofty (and phony) moral tone. Ex-California Congressman Robert K. Dornan, who is quoted as seeing alcoholism as "an absence of self-discipline," and columnist Jack Anderson, who sees alcoholism as "a personal problem" are examples cited on page 7, although if the authors had wanted to, they could have filled volumes with such inanities. Government agencies are also in the thick of the stupidity. Particularly interesting (and telling) is this bit of sly of hand reported on pages 187-188: In the government-funded Rand Report of 1976 the term "recovery" was replaced with the broader term "remission" so that it would appear that some alcoholics were in "remission" although they were still swilling down something less than three ounces of pure alcohol per day. (Three ounces of alcohol is about what you'd get in 21 ounces of table wine or more than four cans of beer!) This allowed "treatment centers which embraced this definition of remission to claim up to 80 percent success rates--even though most of the alcoholics so labeled were still drinking."
Even Alcoholics Anonymous which the authors acknowledge several times as the best recovery program in existence, could use some updating based on the reality of the disease nature of alcoholism. Step four, for example, of the12-step program ("Made a searching and fearless moral inventory") could be modified to refer to the alcoholic's conduct AFTER detoxification and the recovery process. That way a clear distinction is made between behavior caused by alcoholism and behavior over which the alcoholic now has control.
One question: Now that the new millennium is upon us, have things gotten any better? Have the medical and counseling professions gotten the word on the true nature of alcoholism, and is the disease being treated as a disease? Not being in the field, I don't know; but I suspect that Katherine Ketcham's new book (which I am going to read next) Beyond the Influence: Understanding and Defeating Alcoholism (2000) will provide the answer.

a disease that shows no mercy. When my husband committed suicide because of alcoholism I felt the only way I would survive was to find every book I could on it and learn why this had happened. This book was the first to explain his disease to me in a way that felt like this had been written while the author looked in our window. I literally went through and underlined whole passages that was like reading about our lives those last few years. This book helped to save me and gave me the foundation of understanding this insidious disease and how it takes control and destroys everything in its wake. If you are looking for a book to explain the mysteries and the impossible to understand character of the disease, this is it.

The information about Adaptation and Tolerance are excellent for both addiction professionals and recovering addicts. For the person who thinks they have learned their lesson about drinking too much, or DUI, and that they can drink just a few at home on Saturday night instead of abstaining completely, this book explains that slippery slope of tolerance and why your body will lead you to return to your previous, untenable, levels. However, it also says it's a "myth" that "psychotherapy can help many alcoholics achieve sobriety through self-understanding" and that the reality is that psychtherapy "diverts attention from the physical causes of the disease." So untrue! Therapy can help the client learn coping skills as alternative to drinking, self care, learn how tolerance affects your ability to "cut back" on your drinking, improve family functioning that deteriorated due to drinking, resolve issues such as a history of childhood abuse that creates the anger that triggers binge drinking, address PAWS symptoms (early recovery physical symptoms). Therapy can also help the client create a relapse prevention plan. It's a disservice to recoverying alcoholics to dissuade them from therapy.

I've authored four books on alcoholism, including Drunks, Drugs & Debits: How to Recognize Addicts and Avoid Financial Abuse and Alcoholism Myths and Realities: Removing the Stigma of Society's most Destructive Disease. This was one of perhaps at most a dozen books that were instrumental in helping me develop my ideas.

Under the Influence is a magnificent book. It thoroughly debunks the "mental health model" of addiction that misinforms so many. That alcoholism is biological is supported by the authors' detailed and thorough explanation of brain poisoning and adaptation to the drug we call alcohol. It is clear that this poisoning causes the alcohol addict to engage in destructive behaviors, both during and in-between drinking episodes.

The stages of alcoholism are beautifully described. The fact that there is an early stage vastly different from latter stages, makes sense of what seems a paradox: the high-functioning alcoholic. As few as one in a thousand observers ever identify these as such. This is terribly unfortunate, since the behaviors of the early stage addict can be so destructive and adversely affect so many.

There is a superb explanation of the nutritional damage that all alcoholics experience, along with the now well-known sugar connection. Under the Influence contains an excellent summary of diseases found in latter-stage alcoholics, including cancer and heart disease. At the same time, it has one of the best summaries that can be found of the behavioral signs and symptoms of addiction, including those that can be observed in early-stage alcohol addicts (which I describe in far greater detail in How to Spot Hidden Alcoholics: Using Behavioral Clues to Recognize Addiction in Its Early Stages. The fact that medical doctors often feed the addiction with other drugs is addressed, a clue to the idea that identification of alcoholics is, perhaps, best done at the grassroots level, by those who live with it (which I explain in great depth in Drunks, Drugs & Debits: How to Recognize Addicts and Avoid Financial Abuse.

This wonderful book has an excellent discussion of intervention and the reasons we don't need to wait for the addict's life to completely fall apart (and why it may be dangerous to the non-addict observer to delay). A proper professionally-aided intervention could include the employer and/or criminal justice system, and may be the more successful because of such involvement.

Finally, there is an illuminating discussion of the disease concept and the fact that the alcoholic must be held responsible. He must be counseled that he has a disease that causes him to process the drug differently than do non-addicts, and this differential processing results in the destructive behaviors that the rest of us bear the brunt of. One may reasonably conclude that he must be required to experience consequences for his drinking, which I dub "uncompromising disenabling" in Drunks, Drugs & Debits: How to Recognize Addicts and Avoid Financial Abuse.

Under the Influence may be 20 years old. However, its message and the vast majority of the research that went into it is timeless. I have read over 100 books on the subject. This is one of, perhaps, only seven or eight absolutely essential books on alcoholism. Because alcohol addiction affects everyone, it should be owned by all.

This book was written for anyone and everyone! Are you an alcoholic? Is your friend, son, or daughter an alcoholic? Have you ever considered working in the medical or social work field? This book is packed full of modern, practical information and yet does NOT read like a medical text. My father is an alcoholic. I am college educated in the field of psychology. I am married to an alcoholic. I thought I had an idea about alcoholism, but I was wrong. This book opened my eyes and heart and will yours too. I believe it is important to the future of our society on a financial, spiritual, and health level to understand this book.

This small book is still the most helpful tool for those who wish accurate information about the physical and psychological aspects of alcoholism. The disease of alcoholism is still misunderstood and to many people remains a moral problem or a failure of will power. While there has been progress in the treatment of many diseases over the past 20 years, there has been little change in the outlook for a cure for alcoholism. This book explains the physical and psychological disease in a way that can be easily understood. I have used this book for 22 years and have provided it to persons who wish to recover from the disease, always to good effect. And I am so grateful that it continues to be in print.

This is an excellent book whether you are an addict or know one. I have alcoholics in my immediate family and worked in the addiction field for a number of years. It is easy to read and understand. I highly recommend this book.

I myself am a recovering alcoholic. I never realized how harmful this disease is on ourselves and our families and friends. And the worst is that IT IS A PROGRESSIVE DISEASE. Alcoholism was pronounced a disease by the AMA in 1957. The disease sneaks up on you and then you get to the point where you start having serious symptoms, like delirious thoughts, paranoia, loss of appitite, and the shakes. No one should have to live like this. And this book points all of this out. And it also discusses different types of recovery. All which are helpful, from daily AA meetings, alternative recovery groups, and a helpful medicine called Disulfiram. I highly recommend this book for everyone, both alcoholics and the family and friends of the alcoholic.

This is an excellent book offering the best explanation of alcoholism. My daughter is an alcoholic and this is THE book that helped us understand what we needed to do; it set us free of guilt; it helped us focus on the problem. She is in a center that uses this philosophy for treatment and we are hopeful that this time treatment will be successful.

This book is a very clear presentation that makes the non-moralistic argument that genetic predisposition of some people causes them to become alcoholics when they drink. This leads to psychological and medical problems. The contrasting view is that psychological issues (or stress) leads to alcoholism which then leads to more psychological and medical problems. I'm neither an alcoholic, nor an expert in this area, and I found it difficult to judge the validity of the author's thesis on the basis of the age of the information presented -- all of it prior to the publication date of this book in 1981. Nevertheless, many other aspects of the underlying physiology, nutritional complications, treatment and recovery are presented in ways that I found to be very informative and interesting. Further, even though this is a book for a non-technical audience, I appreciated the authors'scholarship and referencing. Unfortunately, the cover of the paperback edition (still) proclaims this is a "new approach to alcoholism". Certainly, the physiological and psychological information on alcoholism must have advanced considerably since 1981. Given that alcoholism is such an important health problem to millions of people, the publisher should update the work or change its marketing claims. Because of this, I downgraded my evaluation of it.

I would reccomend this book to anyone who knows they, or someone they care about is an alcholic. I had to read this for my boyfriend who is currently going through his Divirsion classes. (AA) It helped both of us realize the seriousness of this disease. THUMBS UP!!