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Alcoholism: Is It Really a Disease? : Controversial Author Contends Drinking Is Modifiable Behavior

March 23, 1988|BEVERLY BEYETTE | Times Staff Writer

Herbert Fingarette, a mild-mannered professor of philosophy at UC Santa Barbara, has helped uncork a controversy of considerable proportions with his book, "Heavy Drinking: The Myth of Alcoholism as a Disease." In it, he challenges the long-accepted theory that alcoholism is a disease, states that chronic heavy drinkers can often return safely to moderate drinking--and stops just short of charging that alcoholism treatment providers are guilty of a money-grasping conspiracy.

Publication of the book this month by University of California Press dovetails with two events that have reignited media interest in the debate over alcoholism--is it a disease or a behavior?--and catapulted Fingarette into guest spots on radio and television.

One event was the perjury trial of Michael K. Deaver, former deputy White House chief of staff, whose lawyers argued, apparently without convincing jurors, that alcoholism had clouded Deaver's memory when he had been questioned earlier by a grand jury and a House subcommittee about illegal lobbying activities.

VA Rules Challenged

The other is a case argued in December before the U.S. Supreme Court and pending a decision, in which two veterans, both recovering alcoholics who have been sober since the early 1970s, are challenging the Veterans Administration for denying them an eligibility extension for using education benefits. They say their alcoholism prevented them from taking advantage of these benefits within the prescribed 10-year period after military discharge.

The Veterans Administration's position is that extensions are granted only to those with physical or mental problems, "not the result of their own willful misconduct." The plaintiffs contend that alcoholism is an affliction beyond the control of the drinker. The American Medical Assn. and the American Psychiatric Assn. agree, and joined in filing a friend-of-the-court brief.

The case could profoundly affect insurance payments for alcoholism treatment. (Last year 1.5 million Americans were in in- and out-patient programs, with private insurers paying most of the $1-billion bill.)

At the very least, it has heated up a debate between those who accept as gospel that a physiological/psychological predisposition in alcoholics eventually causes uncontrolled drinking for which there is no cure other than abstinence--and those who, like Fingarette, believe heavy drinking is a behavior, not an illness, that some people can moderate.

"The VA is actually saying what I'm saying," Fingarette says. "They based a lot of their case on my research (but) they're talking legalese and I'm talking English. 'Willful misconduct' makes it look as though these people chose to be drunkards." He makes an analogy: "You don't start out deciding to be a three-pack-a-day smoker. You just drift into it."

The idea that alcoholism is an illness is firmly entrenched in American society. Since 1957, the American Medical Assn. has recognized alcoholism as a disease characterized by preoccupation with alcohol and such loss of control over its consumption that one drink usually leads to intoxication. Recent research has focused on the degree to which children of alcoholics inherit the tendency.

Modern treatment programs emphasize family involvement and almost universally require patients to attend Alcoholics Anonymous meetings, while recommending Al-Anon for spouses of alcoholics, and Alateen and other support groups for children.

Nearly 90% of Americans, according to a 1987 Gallup Poll, agree that alcoholism is a disease. But Fingarette--whose interest in alcoholic behavior was piqued 40 years ago with his research on mental disabilities and criminal responsibility--states right off, on Page One: "Almost everything that the American public believes to be the scientific truth about alcoholism is false."

One recent afternoon in his Santa Barbara home, Fingarette, who at 67 is in "phased retirement" after 40 years on the UC Santa Barbara faculty, discussed his convictions and motivation for putting them before a public that, he believes, has been hoodwinked by a fraternity of evangelistic care providers and a cadre of gullible doctors.

In his book, Fingarette takes care to stick to the term heavy drinkers, explaining that anyone attempting to define an alcoholic is "faking it," as are those who say there are 10 million alcoholics in the United States. "All phony statistics," he says.

He acknowledges that he has done no experimental or clinical research on alcoholism but has, rather, analyzed and interpreted existing scientific literature. That, he believes, is "a strength I have," as "people involved in the (research) are all institutionally committed in some way. I have no personal or institutional or other commitments."

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