HAMS: Harm Reduction for Alcohol

Lowering the Bar for Alcoholics:
How America's Recreational Drinkers Got Branded with the Scarlet "A" for Alcoholism

Back in 1935 when Bill Wilson and Bob Smith founded AA the term "alcoholic" was only used to refer to people who went through major alcohol withdrawal whenever they drank. Major alcohol withdrawal is more than just shakes or sweats which some people these days erroneously call the DTs. Major alcohol withdrawal also involves delirium, hallucinations, disrupted heartbeat, blood pressure spikes, and seizures. Untreated major alcohol withdrawal can often result in death from stroke or heart failure. Only about three people in a thousand go through this sort of major alcohol withdrawal. Bill Wilson was a typical example of this sort of drinker and AA was initially created to deal only with this sort of drinker.

Today, however, the AMA says that any man who has more than four beers in one day per month period has an Alcohol Use Disorder--which is the modern word for alcoholism. For women the limit is even stricter--three beers. This is over thirteen percent of the US population. By this standard there are about forty times as many alcoholics today as there were in 1935.

A recent proposal by the NIAAA says that any man who drinks more than four beers in a day ever in a lifetime should be classified as having an Alcohol Use Disorder. Three beers for a woman. In other words a full third of the US population are alcoholics in need of AA or treatment. This is one hundred times as many alcoholics today as there were in 1935. Do we really have such an increase in alcoholism since 1935? Or have we merely lowered the bar to an extreme and actually harmful extent? Since there has been no really significant change in the amount of alcohol consumed per capita in the US between 1935 and the present, I am going to propose that the latter is the case.

I propose that we call these men who have chosen at some point in their lives to drink more than four beers at one sitting (and women who have gone past three) "recreational drinkers". Research shows us that 99 out of 100 recreational drinkers DO NOT progress into major alcohol withdrawal syndrome. Rather the research shows us that the majority of recreational drinkers tend to drink less and to drink more safely as they get older. Only one recreational drinker in one hundred progresses to major withdrawal syndrome.

The idea of alcoholism as a progressive disease based on the logical fallacy of "post hoc, ergo propter hoc". Bill Wilson observed that all the alcoholics suffering from major withdrawal syndrome had at one point been recreational drinkers. He therefore falsely assumed that recreational intoxication inexorably led to major withdrawal syndrome. The research tells is that this is the exception rather than the norm.

One might as well conclude that since all heroin addicts are born of woman, this means that all persons born of woman will become heroin addicts. This is the fallacy of reasoning from effect to cause which mistakes temporal sequence for causation--in other words the fallacy of "post hoc, ergo propter hoc".

The chemical dependency treatment industry has managed to majorly lower the bar and to coerce a lot of recreational drinkers into participating against their will into twelve step treatment programs. Is there anything wrong with this?

There are several things wrong with this. My personal experience is that people who have been coerced against their will into participating in AA tending to wind up drinking more and many of them committed suicide. Research shows us that people show increased binge drinking and increased drunk driving compared to a control group.

I think that AA is perfectly fine for those people who choose it of their own free will. I have several friends who have done very well with AA who have chosen it of their own free will. I have also seen AA and 12 step treatment cause great harms to recreational drinkers and to those who were forced into it against their own free will.

Moreover, coercion into 12 step programs violates the First Amendment Of The Constitution Of The United States which guarantees freedom of religion. Attempts to stop recreational intoxication which harm no others should be considered a fundamental violation of the rights of man.

Puritanism has been always thus. It is the worst addiction of them all.

REFERENCES:

Regier DA, Farmer ME,; Rae DS, Locke BZ, Keith SJ, Judd LL, Goodwin FK. (1990). Comorbidity of Mental Disorders With Alcohol and Other Drug Abuse: Results From the Epidemiologic Catchment Area (ECA) Study JAMA. 264(19):2511-2518.
http://www.ncbi.nlm.nih.gov/pubmed/2232018

NIAAA Newsletter WINTER 2004 Number 3
http://pubs.niaaa.nih.gov/publications/Newsletter/winter2004/Newsletter_Number3.pdf

Health Behaviors of Adults: United States, 19992001
http://www.cdc.gov/nchs/data/series/sr_10/sr10_219.pdf

Peele, Stanton (1999, 1995). Diseasing of America : how we allowed recovery zealots and the treatment industry to convince us we are out of control. San Francisco : Jossey-Bass,.

Resisting 12-Step Coercion: How to Fight Forced Participation in AA, NA, or 12-Step Treatment by Stanton Peele, Ph.D, J.D. And Charles Bufe With Archie Brodsky

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