Milam James Robert - Under the influence : a guide to the myths and realities of alcoholism

The physiology of the alcoholicnot psychological makeup or cultural backgroundis the chief determining factor, a conclusion that has had major impact on the way we perceive and understand alcoholics today.

Under the Influence removes the stigma of guilt from alcoholism. It explains how enzymes, hormones, genes and brain chemistry work together to create this abnormal, addictive reaction. Moreover, it suggests changes that can be made in our social programs, our research and our medical profession so that alcoholism can finally be recognized for what it really isa disease.

I give Under the Influence to my patients when I first make the diagnosis of alcoholism. Its been very effective. A tremendous teaching tool, and one of the best books on the subject I know.

Dr. Nicholas A. Pace, M. D.
Specialist, Internal Medicine

I find Dr. Milams concept absolutely extraordinary and very exciting.

Mrs. Marty Mann, Founder-Consultant,
National Council on Alcoholism

This is the one book to be left somewhere for the alcoholic to find and read.

Toby Rice Drews
Author, Getting Them Sober

This edition contains the complete text
of the original hardcover edition
NOT ONE WORD HAD BEEN OMITTED

UNDER THE INFLUENCE:
A GUIDE TO THE MYTHS AND REALITIES OF ALCOHOLISM
A Bantam Book / published by arrangement with
Madrona Publishers, Inc.

PUBLISHING HISTORY
Madrona Publishers edition published October 1981
Bantam edition / December 1983

All rights reserved
Copyright1981 by James R. Milam and Katherine Ketcham
No part of this book may be reproduced or transmitted
in any form or by any means, electronic or mechanical,
including photocopying recording or by any information
storage and retrieval system, without permission
in writing from the publisher.
For information address: Madrona Publishers, Inc.

eISBN: 978-0-307-80173-9

Bantam Books are published by Bantam Books, a division of Random House, Inc. Its trademark, consisting of the words Bantam Books and the portrayal of a rooster, is Registered in US Patent and Trademark Office and in other countries. Marca Registrada Bantam Books, New York, New York.

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I am thrilled with this book. It meets a great need. I know that it will be understood and utilized so that millions of lives can be saved.

Under the Influence clearly points out that the accumulated evidence from all the life sciences positively indicates that physiology, not psychology, determines whether a drinker will become addicted to alcohol or not. The alcoholics genes, enzymes, hormones, brain and other body chemistries work together to create his abnormal and unfortunate reaction to alcohol. This concept has not been and is not now understood or accepted even by the majority of alcoholism professionals, who seem committed to the misconception that alcoholism is, at least in part, caused by social, cultural, and psychological factors and is therefore treatable through mental health methods such as various psychotherapies and behavior modification techniques.

In 1970 James R. Milam wrote and self-published The Emergent Comprehensive Concept of Alcoholism. The book was enthusiastically welcomed by thousands of readers, both professionals and laypersons. Many of us said, Here for the first time is someone who really knows what alcoholism is all about and who has finally put it down on paper. Fifty thousand copies of Milams Concept, which was written in a relatively technical and clinical language, have been sold to date. This was accomplished without benefit of marketing, advertising, or the sponsorship of a publishing house. The demand for and acceptance of this new idea has indeed been phenomenal.

In Under the Influence, this original concept has been expanded, restated, and presented in a thoroughly understandable and fascinating explanation of alcoholism. It has been written with such clarity that many of the highly complex issues related to alcoholism become clear for the first time. Indeed, I feel this book is not only intended to be a textbook for professionals, clinicians, and academicians, but will also be welcomed and easily understood by the lay public. The authors have articulated ideas and truths which many of us have known or felt intuitively were underlying the disease alcoholism. For the first time, these ideas, concepts, and truths have been expressed with a validity based on research, documentation, and fifteen years of extensive clinical experience at Alcenas Hospital and elsewhere.

Thousands of alcoholics are seen every year by professionalspsychiatrists, psychologists, social workers, clergy, counselors, nurses, and doctorsyet, tragically, they are almost always misdiagnosed and often harmfully treated. It is my belief that alcoholism has suffered more malpractice out of ignorance than any other disease in recent times. Yet it is a disease that strikes our society so severely that, if unchecked, it could bring our nation to its knees.

It is my prayer and fervent hope that the concepts so clearly and boldly stated in Under the Influence have emerged at a time when they can be broadly recognized and accepted. They are truly ideas whose time has come. It is my further hope and prayer that the treatment approach described herein will be widely adopted as a basis for treatment of alcoholism in the future.

Under the Influence will aid and advance by light years the understanding of alcoholism and the recovery process. The labors of Milam and Ketcham in researching, documenting, and writing Under the Influence have placed us all in their debt. Let us hope that this book will spread light into darkness and bring us closer to a complete understanding of the disease alcoholism, and through this new understanding reach millions of our fellow men and women who today are sufferingand dyingbecause of societys ignorance.

M EL S CHULSTAD
Cofounder and past president of the
National Association of Alcoholism Counselors

We are especially grateful to Mrs. Dorris M. Hutchison, cofounder and for eleven years Executive Director of Alcenas Hospital. More than any other individual she is responsible for exploring and demonstrating the validity of this new approach to alcoholism treatment.

Special thanks go to Patrick Spencer, Fisher Howe, Elizabeth Howe, Kathe Monroe, and Bill Asbury for their advice and support.

Our greatest acknowledgment must always be a tribute to Alcoholics Anonymous, the inspiration and guiding force of the reform movement in alcoholism since 1935.

There are many anonymous human beings to whom this book refers only by pronouns. In the interest of stylistic simplicity, masculine pronouns generally have been used. The book, however, is dedicated to all who suffer from the disease of alcoholism, both men and women.

Every human soul is worth saving; but if a choice is to be made, drunkards are about the last class to be taken hold of.

From Drunkenness a Vice, Not a Disease,
by J. E. Todd, 1882

Bob is 26 years old and a talented song writer. He says he drinks heavily for any number of reasonswhen he is depressed because his work is not progressing well, elated because he finished a song, frightened about his future, or concerned about his financial problems.