Rating: 
Summary: An excellent overview of the physiology of alcoholism.
Review: This book is a real eye-opener, dispelling the myth that alcoholism is simply "moral weakness". As a member of AA I found the information to be an excellent supplement to the AA program. The explanation of the physiological impact of alcohol is clear and easily understood. I would recommend this book to anyone who wonders why alcoholics keep drinking.
Rating: 
Summary: Clearly written but out of date
Review: 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.
Rating: 
Summary: Propogates Myths of Domestic Violence -- AVOID!
Review: This book is of low quality and is not based on any scientific knowledge or research. In the first chapter, the author refers to an alcoholic man "slapping his wife around" but then states that the man did not "seriously" harm his wife. (???). ALL forms of domestic violence are serious. A slap in the wrong place can cause serious damage to the human body. Slapping leads to more damaging forms of abuse 100 percent of the time. Finally, a "mere" slap causes extremely harmful psychological damage to the abused partner.Then the author goes on to state that it was the husband's alcoholism that caused the violence. WRONG!!! Anyone with any knowledge at all of the subject of domestic violence knows that alcoholism does not CAUSE the abuse. Removing the addiction to alcohol cannot, and does not, stop the abuse. Anyone who wants proof of my statements can call their local domestic violence shelter for free information.
Rating:
Summary: Outdated and Does Not Tell the Whole Story
Review: 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.
Rating:
Summary: Outdated and Does Not Tell the Whole Story
Review: 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.
Rating: 
Summary: A clinical approach
Review: This is a book that is very hard to put down once started. It is a clinical approach to the problems associated with alcohol abuse. No finger pointing, just an explanation of what the disease, not a supposedly defective personality, is all about. A must read for professional counselors as well as those living with the problem or suffering from it.
Rating:
Summary: A trail-blazing classic of informative literature
Review: 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.
Rating:
Summary: Under the Influence: A Guide to the Myths and Realities of A
Review: 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.
Rating:
Summary: Under the Influence: A Guide to the Myths and Realities of A
Review: 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.
Rating:
Summary: One of Only a Few "Essential" Books on Alcoholism
Review: 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. 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. 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. 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.
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