[.ca] Under the Influence: A Guide to the Myths and Realities ... (ISBN 0553274872)

Still ahead of its time:
I find the comments that the book is out of date sad, because the vast majority of alcoholism treatment programs as well as public opinion have not yet caught up to this book. Milam advances several important concepts: 1. Alcoholism is a disease like diabetes. Psychology and morality play no role, except in the alcoholic's reaction emotionally to the consequences of the disease \ohiding it, seeking help, etc.\c If you think this view of alcoholism is completely accepted now, try telling your boss you are an alcoholic. 2. Milam then explains HOW alcoholism is a disease in fascinating detail. Alcoholics are not addicted to alcohol, but to a complex physical process that happens when they drink. Basically, the alcoholic's body reacts to the presence of alcohol in the body differently from that of a "normal" person, and no amount of counseling/threats/religious conversions can change that. 3. Alcoholics may not know when to save themselves, and may need help \ohe shoots down the "hitting bottom" myth\c. Do you wait for a diabetic to go into a coma before you help them? 4. Treatment for the alcoholic must address the poor state of the alcoholic's health and nutrition. Alcoholic tremors, shaking, illusions, paranoia, etc. are caused by alcoholic malnutrition. Alcohol strips the body of water soluble vitamins, particularly the crucial B vitamins, and prevents the liver and other organs from repairing the body. The one section of the book I don't agree with concerns the role of government/public agencies in alcoholism treatment. Milam expects too much of them. But that does not affect the brilliance of this book. In the reviews here, there are some criticisms that Milam describes only "worst case" scenarios. That is not correct. He clearly describes all the stages of alcoholism, from the "I just want to have fun" stage to the lying in the gutter stage, and he recognizes that the disease progresses differently in people. As an alcoholic who has been sober for twenty years, I can't recommend this book enough. It provides hard information, not moralizing.

Outdated and Does Not Tell the Whole Story:
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.

Under the Influence: A Guide to the Myths and Realities of A:
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.

Greatful introduction to physiological alchoholism but...:
The only problem with this book is that it ignores one important reason for alcoholism: psychologigal reasons. Millions of people have started their "career" as alcoholism because of psychological reasons: they have had psychologigal reasons that have started them to drink: divorece, loss of dear friend or job, depression, the list could go on and on. However there are fysiologically alcholized people and this book very well analyze their drinking career and its destructive power on his/her body and brain. One important point: these physiological vs psychological reasons for alcholism do NOT have to be reason for bitter fights. Just both sides of same coin so to speak. IMHO there are TWO kinds of alcholism: physiological and psychologocal and I really wonder why there should be just ONE proper explanation to such a complex problem as alcholism is. The most important thing is to try to help alcholized people, not to quarrel endlessly.

Clearly written but out of date:
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.