From the Foreword by William L. White:
Not everyone will agree with the ideas and approaches set forth here, but for the past decade, individuals and families have used LifeRing Secular Recovery as an effective framework to initiate and maintain long-term recovery from life-impairing addictions. Those recoveries are cause for celebration, and this book details how they did it. Those seeking a solution to alcohol and other drug problems and professionals assisting people with such problems will find great value in these pages. — William L. White, Author, Slaying the Dragon: The History of Addiction Treatment and Recovery in America
One Saturday afternoon, my elder boy, then 10, came into the living room holding a chapter book they were reading in middle school. The Great Horned Spoon, it was; about the California gold rush days. One chapter features a brawl in a saloon. With the air of a boy looking for help with homework, wanting a vocabulary word explained, he spoke to me:
“Dad, you’re a ‘drunkard,’ aren’t you?”
I had no shields for that word, coming from him. The missile went straight into my heart. I was blowing the Daddy act. […]
Lots of good people have grown up without fathers. But I wanted my kids to have it better. Now I was blowing it. I pondered whether a kid who has a drunkard for a dad is worse off than a kid who has no dad at all. Instead of making a better life for my kids than I had, maybe I was making it worse.
That brief conversation with my eldest boy left me changed inside, at least temporarily. The balance between the “me” that wanted to get free of drinking, and the “me” that wanted to die drunk, had tipped.
Within a few days, while the impact of my son’s one-child, one-word intervention still burned inside of me, I telephoned the Alcohol and Drug Abuse Program of the Kaiser Permanente HMO, to which the family belonged. It seemed like hours before someone answered the ring. My hands shaking, voice straining to sound casual, I made an appointment.
The person in the grip of dependency on an addictive substance is a person in conflict. Their personality has split into two antagonistic camps. There is the old, original person, the person they used to be before addictive substances became a priority in their lives. And there is the more recent person, the addict, who lives in the person’s mind/body like a parasite, sucking up more and more resources, and driving the person toward a premature death.
The inner struggle between these two personalities inhabiting the same person is the central psychological reality of life as an addict. So typical is this inner split that “Dr. Jekyll and Mr. Hyde” is hands down the favorite modern metaphor for the condition.
In Robert Louis Stevenson’s Dr. Jekyll and Mr. Hyde, Hyde was the addict who committed unspeakable crimes while under the influence. Dr. Jekyll was the rational physician, a pillar of the community, always helping and doing good. The great hair-raising thrill of the story to this day is the audience’s gradual dawning that they were in fact one and the same person.
People who use addictive substances are notoriously hard on themselves. The reason is partly that the world is hard on people whose substance use has become too obvious, and we internalize those value judgments. There are elements in the traditional recovery protocol that reinforce these negative judgments, as we’ll see in later chapters of this book. But there’s an internally generated reason as well.
In the previous chapter, I showed how there’s an A and an S inside of the addicted person. The A is the voice that tells you to drink and use. It does more. It tries to keep you in the appropriate state of mind so that you will keep feeding it. That state of mind is miserable and stressed.
The A does not want you to feel good about yourself, to feel confident, to feel capable, except perhaps in an exaggerated, grandiose way that makes you seem foolish and that deepens your despair when your tall schemes come to nothing. If you begin to see your strengths realistically and to make small but real gains that give you confidence, you may no longer want or need to keep using the substances. So, when you “beat yourself up,” what’s really happening is that your A is beating up your S.
• Addiction is not a sin. People in LifeRing groups tend to have a matter-of-fact attitude about substance addiction. Chemical dependency is not a sin that you have to confess and atone for. It happens to people with all kinds of personalities, including people who are warm and caring, brilliant and generous. LifeRing meetings exist not to judge you or shame you or guilt you for your substance-influenced past, but to support you in building your substance-free present and future. The point is to make a fresh start.
• It stays positive. The LifeRing approach is thoroughly positive. LifeRing works by giving encouragement and support to your sober qualities and efforts. You are reinventing yourself as a person who has a life without drinking or using, and in that process you are supporting others in doing the same. What you are doing is worthwhile and important, not only for yourself, but for the group and for the whole community.
• You’re a grown-up. Although you may count your sober time as a rebirth and celebrate sober baby birthdays, you are an adult and need to understand some adult truths. The tooth fairy will not come in the night and take your problems away. Only you can get you sober. The group cannot get you sober. Its purpose is to support you in getting yourself sober. Your purpose as a group member is to give others the same support you would want for yourself.
One hallmark of a substance abuse treatment program that operates in a professional manner is its focus on building and carrying out a personalized treatment program for each patient.
It would be absurd if the individuals whose recovery it is were to set for themselves a lower standard than that which professionals have recognized as necessary. If a professional needs to respond to the needs of each individual, then the individual can do no less in his or her self-help work. If “one size fits all” does not work in professional treatment, it certainly has no place in self-treatment.
LifeRing embraces the modern, evidence-based principle of individualized treatment and applies it to self-treatment. Apart from the prime directive, not to put addictive substances into the body, which we all share, LifeRing dismisses the notion that any single program is appropriate for all our participants. Matching our program to our individual problems and needs is what each of us does and should do. Building a LifeRing Personal Recovery Program is what both science and common sense indicate.
In the fourth century AD, at the dawn of the Dark Ages, not long after Christianity became the official religion of the remnants of the Roman Empire, there lived two wandering teachers.
One was a Christian monk named Pelagius. Born in the remote provinces of the British Isles, he found his way to the imperial capital, and also visited and taught in Carthage and in Palestine. He led an exemplary life of poverty, modesty, and virtue. Even those who opposed his teachings respected his life style. He preached that God had endowed human beings with the power and the freedom to make moral choices, both for evil and for good.
The other teacher was, by his own public admission, a fornicator, a thief, a drinker, and the father of an illegitimate child, among other vices. He was a Manichean – a religion that holds that everything composed of matter, including all living beings, is dark, corrupt, and evil, but that the forces of light, which exist outside of material things, will eventually prevail. His sudden mid-life conversion to Christianity and his quick promotion to bishop of the North African city of Hippo aroused so much popular skepticism that he felt it politic to write a 160,000-word “Confessions” in his own defense. He preached, in opposition to Pelagius, that man was powerless to choose virtue, and could only choose sin; whatever human beings achieve that is good, they achieve exclusively through the power and grace of God, and God alone deserves the credit.
When my chemical dependency counselor on my Day One in 1992 held up for me the two schedules of the two kinds of recovery support group meetings – the groups that became LifeRing, and the 12-step groups — I had no inkling that I stood before a modern edition of the dispute between the virtuous monk Pelagius and the converted sinner, Augustine of Hippo.
In this chapter, I’ll tell the fascinating story of how the disease concept of alcoholism came to be part of AA’s teaching. You’ll see the psychological utility as well as the economic and political interests behind the disease concept. You’ll learn why the AA version of the disease model of alcoholism has failed to persuade many thoughtful people, including people within the medical and scientific communities. You’ll see that leading advocates of the disease model themselves undermine its credibility because their approach to treating alcoholism has little in common with accepted modern medical practice. Finally, I’ll present a brief summary of the pros and cons of the disease model and suggest a guideline for making up your mind whether to embrace it or not.
If you become part of LifeRing, you’ll have complete freedom of opinion on the disease issue. LifeRing as an organization does not take a position on it. Sometimes we have debates within the organization between partisans of different lines on it. Our experience is that people who love the disease model, people who hate it, and people who are on the fence about it can all stay clean and sober. And that’s what matters.
My friend Kevin comes from a mixed Native American and Irish background. On his father’s side, all the male ancestors as far back as anyone can remember died of alcoholism, directly or indirectly. Six of his mother’s sisters died of alcoholism, and so did both maternal grandparents. It is a safe bet that if alcoholism comes in the genes, Kevin has those genes. But Kevin doesn’t drink or do other drugs. He’s had a few nips now and then at ceremonial occasions but as a general rule he doesn’t touch the stuff. It just doesn’t appeal to him.
Sarah was Jewish. Nobody in her family tree, going back at least four generations, has ever had an issue with drinking or other addictions. Sarah started drinking in a college sorority, started doing pills not long after, and kept this up for almost three decades. When I met her, her friends said she was drinking two liters of vodka per day. Her skin was yellowing, a sign of liver failure. She refused to consider slowing down or stopping. She died at 49.
These examples touch only the surface of the problem of determining what role genetic factors play in the development of alcoholism and other addictions. Almost everyone knows a heavy drinker with a long family history of alcoholism who very probably inherited alcoholism in their genes. But almost everyone also knows people who break that stereotype, people like Kevin who should be alcoholics by family history but who don’t drink, and others like Sarah who have no sign of genetic background but drink and suffer with the worst of them.
Newspapers headlines occasionally announce that “the alcoholism gene” has been found. Headlines appear such as “Born to the Bottle” and “Gene and Tonic: Science Proves that Alcoholics Can’t Help it.” Popular excitement follows. But when the research is checked by other laboratories, the claims become smaller, and soon they evaporate.
There is, in sum, no rational cause to set addicted persons apart by their nature, character, or constitution from the rest of humanity, to view them as inferior, or to accord them less empathy and respect. To put it more personally, there is no reason for us, who know addiction from the inside, to view ourselves as different, inferior, or less worthy of empathy and respect.
To see the sober person inside the addict is not to flip from one absolute to its opposite, from contempt to admiration, but rather to see the person as a living contradiction, a person living two lives and balancing two personalities. To see addicted persons as living contradictions is to understand why liberation is the fitting metaphor for recovery.
Liberation as a metaphor points to the sober self imprisoned within the addicted brain and affirms its inherent dignity and value. Liberation conceives recovery as the empowerment of the sober self, bursting the shackles of chemical dependency, and emerging as the original sober person, newly freed and reborn.
Although this may sound revolutionary, it is in reality a restoration. Addiction has hijacked the person’s original self; it has stolen its energies, feelings, thoughts, and dreams, its very identity. Recovery gives them back. What we recover when we recover is our original self, the authentic us, the sober person we were meant to be and really are.
Ader, R, and N Cohen. “Conditioning of the immune response.” The Netherlands Journal of Medicine 39, no. 3-4 (October 1991): 263-73.
Alford, G S, E N Jouriles, and S C Jackson. “Differences and similarities in development of drinking behavior between alcoholic offspring of alcoholics and alcoholic offspring of non-alcoholics.” Addictive Behaviors 16, no. 5 (1991): 341-7.
Allen, Arthur. “The Disappointment Gene: Why genetics is so far a boondoggle. .” Slate, October 18, 2005. http://www.slate.com/id/2128292.
American Psychiatric Association. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, American Psychiatric Press, Washington, D C (1994).
Anthony, James C. “Epidemiology of Drug Dependency.” In The American Psychiatric Publishing Textbook of Substance Abuse Treatment, 52, 1999.
Ashcraft, Lori H., and William A. Anthony. “Breaking Down Barriers.” Behavioral Healthcare (April 2008).
Asyyed, Asma, Daniel Storm, and Ivan Diamond. “Ethanol activates cAMP response element-mediated gene expression in select regions of the mouse brain.” Brain Research 1106, no. 1 (August 23, 2006): 63-71.
“Atherosclerosis Risk Factors, Prevention and Wellness Tips.” Wellness Tips. http://www.recoverymedicine.com/atherosclerosis_wellness_tips.htm.
Augustine of Hippo. Confessions. Vol. 10. Pusey Translation. http://ccat.sas.upenn.edu/jod/augustine/Pusey/book10 .
B Rush, M Bass, M Stewart, E McCracken, M Labreque, and S Bondy. “Detecting, preventing, and managing patients’ alcohol problems.” Canadian Family Physician Médecin De Famille Canadien 40 (September 1994): 1557-66.
Ball, David. “Addiction science and its genetics.” Addiction (Abingdon, England) 103, no. 3 (March 2008): 360-7.
Bandura, Albert. Self-efficacy: The Exercise of Control. W.H. Freeman, 1997.
Barrett, Stephen, and Harriett Hall. “Dubious Genetic Testing.” Quackwatch, 2002. http://www.quackwatch.com/01QuackeryRelatedTopics/Tests/genomics.html.
Beeder, Ann B., and Robert Millman. “Patients with Psychopathology.” In Substance Abuse: A Comprehensive Textbook, 1997.
Begleiter, Henri. “What is inherited in the predisposition toward alcoholism? A proposed model.” Alcoholism: Clinical and Experimental Research 23, no. 7 (1999): 1125-1135.
Bischof, Gallus, Hans-Jürgen Rumpf, Christian Meyer, Ulfert Hapke, and Ulrich John. “Stability of subtypes of natural recovery from alcohol dependence after two years.” Addiction (Abingdon, England) 102, no. 6 (June 2007): 904-8.
Blum, Kenneth G. , John R. Cull, Eric E. Braverman, and David Comings. “Reward Deficiency Syndrome.” American Scientist 84 (March 1, 1996): 132-145.
Boettinger, Charlotte. “UCSF News Office – Brain imaging and genetic studies link thinking patterns to addiction.” http://pub.ucsf.edu/newsservices/releases/200712262.
“Book Review.” Journal of the American Medical Association 113, no. 16 (October 14, 1939). http://www.silkworth.net/bbreviews/01007.html.
Brown, Sally, and David Brown. A Biography of Mrs. Marty Mann: The First Lady of Alcoholics Anonymous. Hazelden, 2005.
—. “Marty Mann and the Evolution of Alcoholics Anonymous [Excerpts],” 2001. http://www.barefootsworld.net/aamartymann.html.
Burnham, John C. Bad Habits: Drinking, Smoking, Taking Drugs, Gambling, Sexual Misbehavior. NYU Press, 1994.
Carr, Allen. The easy way to stop smoking. [Rev. and updated]. New York: Sterling Pub. Co., 2004.
Cherpitel, Cheryl J. “Injury and the Role of Alcohol: County-Wide Emergency Room Data.” Alcoholism: Clinical and Experimental Research 18, no. 3 (June 1994): 679-684.
Ciccocioppo, ROBERTO, and PETRI Hyytia. “The genetic of alcoholism: learning from 50 years of research.” Addiction Biology 11, no. 3-4 (2006): 193-194.
Clarke, Toni-Kim, Jens Treutlein, Ulrich S. Zimmermann, Falk Kiefer, Markus H. Skowronek, Marcella Rietschel, et al. “HPA-axis activity in alcoholism: examples for a gene-environment interaction.” Addiction Biology 13, no. 1 (March 2008): 1-14.
Cohen, N, J A Moynihan, and R Ader. “Pavlovian conditioning of the immune system.” International Archives of Allergy and Immunology 105, no. 2 (October 1994): 101-6.
Cohen, Peter D. A. “Is the Addiction Doctor the Voodoo Priest of Western Man?.” Addiction Research & Theory 8, no. 6 (2000): 589.
Comings, D E, and K Blum. “Reward deficiency syndrome: genetic aspects of behavioral disorders.” Progress in brain research 126 (2000): 325-41.
Conrad, Peter. The Medicalization of Society: On the Transformation of Human Conditions. JHU Press, 2007.
Crabbe, John C. “Genetic contributions to addiction.” Annual review of psychology 53 (2002): 435-62.
Crabbe, John C., J. C. Crabbe, Jr, and R. Adron Harris. The Genetic Basis of Alcohol and Drug Actions. Springer, 1991.
Crabbe, John C., Tamara J. Phillips, R. Adron Harris, Michael A. Arends, and George F. Koob. “Alcohol-related genes: contributions from studies with genetically engineered mice.” Addiction Biology 11, no. 3-4 (2006): 195-269.
Dawson, Deborah A. “Correlates of Past-Year Status Among Treated and Untreated Persons with Former Alcohol Dependence: United States, 1992.” Alcoholism: Clinical and Experimental Research 20, no. 4 (1996): 771-779.
Deroche-Gamonet, Veronique, David Belin, and Pier Vincenzo Piazza. “Evidence for Addiction-like Behavior in the Rat.” Science 305, no. 5686 (August 13, 2004): 1014-1017.
“Diabetic Diet (Diabetes Diet) Information on MedicineNet.com.” Diabetic Diet (cont’d). http://www.medicinenet.com/diabetic_diet/page4.htm#toce.
Dick, Danielle M. “Identification of Genes Influencing a Spectrum of Externalizing Psychopathology.” Current Directions in Psychological Science 16, no. 6 (December 2007): 331-335.
“Diet and Hypertension.” http://www.ext.colostate.edu/pubs/foodnut/09318.html.
DiFranza, Joseph R. “Hooked from the first cigarette: New findings reveal that cigarette addiction can arise astonishingly fast. But the research could lead to therapies that make quitting easier..” Scientific American (May 2008): 82-87.
Dimeff, Linda, and Alan Marlatt. “Relapse Prevention.” In Handbook of Alcoholism Treatment Approaches, 176, 1995.
Dodes, Lance M. The Heart of Addiction. HarperCollins, 2002.
Doran, Neal, Mark G Myers, Susan E Luczak, Lucinda G Carr, and Tamara L Wall. “Stability of heavy episodic drinking in Chinese- and Korean-American college students: effects of ALDH2 gene status and behavioral undercontrol.” Journal of Studies on Alcohol and Drugs 68, no. 6 (November 2007): 789-97.
Doumas, Diana M, Christine M Blasey, and Cory L Thacker. “Attrition from Alcohol and Drug Outpatient Treatment Psychological Distress and Interpersonal Problems as Indicators .” Alcoholism Treatment Quarterly 23, no. 4 (June 9, 2005): 55-67.
Edenberg, Howard J. “The Collaborative Study on the Genetics of Alcoholism: an update,” September 22, 2002. http://findarticles.com/p/articles/mi_m0CXH/is_/ai_106731236.
Edenberg, Howard J., and Tatiana Foroud. “The genetics of alcoholism: identifying specific genes through family studies.” Addiction Biology 11, no. 3-4 (2006): 386-396.
Elliott, Victoria. “Addictive cocktail: Alcoholism and genetics … American Medical News.” American Medical News, February 5, 2001. http://www.ama-assn.org/amednews/2001/02/05/hlsa0205.htm.
Emrick, Chad. “Alcoholics Anonymous: Emerging Concepts. Overview.” In Galanter: Recent Developments in Alcoholism: Treatment Research, 7:, 1989.
Emrick, Chad, and J Scott Tonigan. “Alcoholics Anonymous and Other 12-Step Groups.” In Galanter: Recent Developments in Alcoholism: Treatment Research, 433, 2004.
Eng, Mimy Y, Susan E Luczak, and Tamara L Wall. “ALDH2, ADH1B, and ADH1C genotypes in Asians: a literature review.” Alcohol research & health : the journal of the National Institute on Alcohol Abuse and Alcoholism 30, no. 1 (2007): 22-7.
Eng, Mimy Y., Marc A. Schuckit, and Tom L. Smith. “The level of response to alcohol in daughters of alcoholics and controls.” Drug and Alcohol Dependence 79, no. 1 (July 1, 2005): 83-93.
Evans, Suzette M, and Frances R Levin. “Response to alcohol in females with a paternal history of alcoholism.” Psychopharmacology 169, no. 1 (August 2003): 10-20.
Fan, Li, Frederick Bellinger, Yong-Liang Ge, and Peter Wilce. “Genetic study of alcoholism and novel gene expression in the alcoholic brain.” Addiction Biology 9, no. 1 (March 2004): 11-18.
Farnsworth, Dorothy. “Quality Assurance Report.” CAADAC, November 6, 2007. http://www.capwiz.com/caadac/attachments/qa_final_report_12_07__fin.pdf.
Farren, Conor K., and Keith F. Tipton. “Trait Markers for Alcoholism: Clinical Utility.” Alcohol Alcohol. 34, no. 5 (September 1, 1999): 649-665.
Ferri, M, L Amato, and M Davoli. “Alcoholics Anonymous and other 12-step programmes for alcohol dependence.” Cochrane database of systematic reviews (Online) 2006, no. 3. http://www.mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD005032/frame.html.
Fields, Howard. “Alcoholism: Vice or Disease? A Conversation with Howard Fields, Part 3 of 3 – UCSF Science Café.” http://www.ucsf.edu/science-cafe/conversations/fields3/.
Finn, Deborah A., and John C Crabbe. “Exploring Alcohol Withdrawal Syndrome.” Alcohol Health and Research World 21, no. 2 (1997): 149.
Fischer, Monika, Leah Flury Wetherill, Lucinda G Carr, Min You, and David W Crabb. “Association of the aldehyde dehydrogenase 2 promoter polymorphism with alcohol consumption and reactions in an American Jewish population.” Alcoholism, Clinical and Experimental Research 31, no. 10 (October 2007): 1654-9.
Flatscher-Bader, Traute, Marcel van der Brug, John W Hwang, Peter A Gochee, Izuru Matsumoto, Shin-ichi Niwa, et al. “Alcohol-responsive genes in the frontal cortex and nucleus accumbens of human alcoholics.” Journal of Neurochemistry 93, no. 2 (April 2005): 359-370.
Fletcher, Anne M. Sober for Good: New Solutions for Drinking Problems–Advice from Those Who Have Succeeded. Houghton MifflinCookbooks, 2002.
Flynn, William R. “A Biography of Mrs. Marty Mann: The First Lady of Alcoholics Anonymous [Book Review].” Am J Psychiatry 159 (November 2002): 1950-1951.
Fuchs, Rita A., R. Kyle Branham, and Ronald E. See. “Different Neural Substrates Mediate Cocaine Seeking after Abstinence versus Extinction Training: A Critical Role for the Dorsolateral Caudate-Putamen.” J. Neurosci. 26, no. 13 (March 29, 2006): 3584-3588.
Gardner, Eliot. “Brain-Reward Mechanisms.” In Substance Abuse: A Comprehensive Textbook, 1997.
Geller, Anne. “Comprehensive Treatment Programs.” In Substance Abuse: A Comprehensive Textbook, 425-429, 1997.
Gill, K, M Eagle Elk, Y Liu, and R A Deitrich. “An examination of ALDH2 genotypes, alcohol metabolism and the flushing response in Native Americans.” Journal of Studies on Alcohol 60, no. 2 (March 1999): 149-58.
Gladwell, Malcolm. The Tipping Point: How Little Things Can Make a Big Difference. Back Bay, 2002.
Glantz, Stanton A., NetLibrary, Inc, and Inc NetLibrary. The Cigarette Papers. University of California Press, 1998.
Goedde, H W, D P Agarwal, S Harada, F Rothhammer, J O Whittaker, and R Lisker. “Aldehyde dehydrogenase polymorphism in North American, South American, and Mexican Indian populations.” American journal of human genetics 38, no. 3 (March 1986): 395-9.
Goldstein, Avram. Addiction: From Biology to Drug Policy. 2nd ed. Oxford University Press, 2001.
Gordis, E. “Accessible and affordable health care for alcoholism and related problems: strategy for cost containment.” Journal of studies on alcohol 48, no. 6 (November 1987): 579-85.
Granfield, Robert, and William Cloud. Coming Clean: Overcoming Addiction Without Treatment. NYU Press, 1999.
Hahn, Cheng-Yi, San-Yuan Huang, Huei-Chen Ko, Chau-Hsiang Hsieh, I-Hui Lee, Tzung-Lieh Yeh, et al. “Acetaldehyde involvement in positive and negative alcohol expectancies in Han Chinese persons with alcoholism.” Archives of general psychiatry 63, no. 7 (July 2006): 817-23.
Hall, Carl T. “Smokers, your addiction is all in your head, study finds.” San Francisco Chronicle, January 25, 2007. http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2007/01/25/BAG89NOCVN9.DTL&feed=rss.news.
Hartigan, Francis. Bill W.: A Biography of Alcoholics Anonymous Cofounder Bill Wilson. Macmillan, 2000.
Heberlein, Ulrike. “Research.” Ernest and Julio Gallo Research Center. http://www.galloresearch.org/site/HeberleinLab/section.php?id=187.
Heilig, Markus. “Imagen: implications for addiction science and science policy.” Addiction (Abingdon, England) 102, no. 11 (November 2007): 1699-700.
Helm, Jeffrey. “Myth of an ‘Addict Gene’.” The Tyee, July 28, 2006. http://thetyee.ca/News/2006/07/28/AddictGene/.
Herman, Judith Lewis. Trauma and Recovery: The Aftermath of Violence–From Domestic Abuse to. Basic Books, 1997.
Hester, Reid K., and William R. Miller. Handbook of Alcoholism Treatment Approaches: Effective Alternatives . 2nd ed. Allyn & Bacon, 1995.
Higgins, Stephen T. “Principles of Learning in the Study and Treatment of Substance Abuse.” In The American Psychiatric Publishing Textbook of Substance Abuse Treatment, 65, 2004.
Hiroi, N, and S Agatsuma. “Genetic susceptibility to substance dependence.” Mol Psychiatry 10, no. 4 (December 7, 2004): 336-344.
Holden, Constance. “Behavioral Genetics : New Clues to Alcoholism Risk.” Science 280, no. 5368 (May 29, 1998): 1348b-1349.
Horgan, Constance. Substance Abuse: A Comprehensive Factbook. Robert Wood Johnson Foundation, 2001.
Jellinek, Elvin Morton. The Disease Concept of Alcoholism. Hillhouse Press, 1960.
Jones, Douglas C, and Gary W Miller. “The effects of environmental neurotoxicants on the dopaminergic system: A possible role in drug addiction.” Biochemical Pharmacology (May 20, 2008).
Joseph, Jay. “Twin Studies in Psychiatry and Psychology: Science or Pseudoscience?.” Psychiatric Quarterly 73, no. 1 (March 1, 2002): 71-82.
Kalivas, Peter W., Jamie Peters, and Lori Knackstedt. “Animal Models and Brain Circuits in Drug Addiction.” Mol. Interv. 6, no. 6 (December 1, 2006): 339-344.
Kasl, Charlotte Davis, and Charlotte S. Kasl. Many Roads, One Journey: Moving Beyond the Twelve Steps. Harpercollins, 1992.
Kelly, John F. “Toward an Addiction-ary: A Proposal for More Precise Terminology.” Alcoholism Treatment Quarterly 22, no. 2 (June 21, 2004): 79-87.
Kessler, R C, K A McGonagle, S Zhao, C B Nelson, M Hughes, S Eshleman, et al. “Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Results from the National Comorbidity Survey.” Archives of general psychiatry 51, no. 1 (January 1994): 8-19.
Ketcham, Katherine, and William Asbury. Beyond the Influence: Understanding and Defeating Alcoholism. Bantam , 2000.
Khazaal, Y, E Frésard, and D Zullino. “[Exposure to addictogenic substances, conditioned response and treatment of the exposure with response prevention].” L’Encéphale 33, no. 3 Pt 1: 346-51.
Kiberstis, Paula, and Leslie Roberts. “It’s Not Just the Genes.” Science 296, no. 5568 (April 26, 2002): 685.
Kliesthernes, Christopher, and John Crabbe. “Genetic independence of mouse measures
of some aspects of novelty seeking.” PNAS 103, no. 13 (March 28, 2006): 5-18.
Koob, George, and Michel Le Moal. Neurobiology of Addiction. Academic Press, 2006.
Koob, GF, and FE Bloom. “Cellular and molecular mechanisms of drug dependence.” Science 242, no. 4879 (November 4, 1988): 715-723.
Kurtz, Ernest. “Alcoholics Anonymous and the Disease Concept of Alcoholism.” Alcoholism Treatment Quarterly 20, no. 3/4 (2002): 5-40.
—. Not-God: A History of Alcoholics Anonymous. Hazelden, 1991.
Layman with a Notebook, A. What Is The Oxford Group? Oxford University Press, 1933. http://www.stepstudy.org/downloads/what_is.pdf.
Le, Christine, Erik P. Ingvarson, and Richard C. Page. “Alcoholics Anonymous and the Counseling Profession: Philosophies in conflict.” Journal of Counseling and Development; http://unhooked.com/sep/aacouns.htm (July 1, 1995): 603.
Lester, David. “The Heritability of Alcoholism: Science and Social Policy.” In Gomberg, Current Issues in Alcohol/drug Studies, 1990.
Lin, Show W., and Robert Anthenelli. “Genetic Factors in the Risk for Substance Use Disorders.” In Substance Abuse: A Comprehensive Textbook, 2004.
Lincoln, Abraham. “Temperance Address .” Sangamo Journal, March 25, 1842. http://www.druglibrary.org/schaffer/History/ancient/TempAddr.htm.
Lobdell, Jared. This Strange Illness: Alcoholism and Bill W. Aldine Transaction, 2004.
Lovinger, David M., and John C Crabbe. “Laboratory models of alcoholism: treatment target identification and insight into mechanisms.” Nature Neuroscience 8, no. 11 (November 2005): 1471.
Lowinson, Joyce H. Substance Abuse: A Comprehensive Textbook. 3rd ed. Lippincott Williams& Wilkins, 1997.
Lu, Ru-Band, Huei-Chen Ko, Jia-Fu Lee, Wei-Wen Lin, San-Yuan Huang, Tso-Jen Wang, et al. “No alcoholism-protection effects of ADH1B*2 allele in antisocial alcoholics among Han Chinese in Taiwan.” Alcoholism, Clinical and Experimental Research 29, no. 12 (December 2005): 2101-7.
MacDonald, E B, and A R Patel. “Attitudes towards alcoholism.” British Medical Journal 2, no. 5968 (May 24, 1975): 430-1.
Malone, Stephen M., William G. Iacono, and Matt McGue. “Drinks of the Father: Father’s Maximum Number of Drinks Consumed Predicts Externalizing Disorders, Substance Use, and Substance Use Disorders in Preadolescent and Adolescent Offspring.” Alcoholism: Clinical and Experimental Research 26, no. 12 (December 2002): 1823-1832.
Marlatt, Alan, Kimberly Barrett, and Dennis Daley. “Relapse Prevention.” In The American Psychiatric Publishing Textbook of Substance Abuse Treatment, 357.
Matsushita, Sachio, and Susumu Higuchi. “[A review of the neuroimaging studies of alcoholism].” Nihon Arukoru Yakubutsu Igakkai Zasshi = Japanese Journal of Alcohol Studies & Drug Dependence 42, no. 6 (December 2007): 615-21.
McGue, Matt. “A Behavioral-Genetic Perspective on Children of Alcoholics.” Alcohol Health and Research World 21, no. 3 (1997): 210-217.
McIntire, Don. “How Well Does A.A. Work? An Analysis of Published A.A. surveys (1968 – 1996) and Related Analyses/Comments.” Alcoholism Treatment Quarterly 18, no. 4 (2000): 1-18.
McIntire, Steve. “Welcome to the McIntire Lab.” Ernest and Julio Gallo Research Center. http://www.galloresearch.org/site/McIntireLab/.
McLellan, A T, Deni Carise, and H D Kleber. “Can the national addiction treatment infrastructure support the public’s demand for quality care?.” Journal of Substance Abuse Treatment 25 (2003): 117-121.
McLellan, A T, D C Lewis, C P O’Brien, and H D Kleber. “Drug dependence, a chronic medical illness: implications for treatment, insurance, and outcomes evaluation.” JAMA: The Journal of the American Medical Association 284, no. 13 (October 4, 2000): 1689-95.
Mercadante, Linda A. Victims and Sinners: Spiritual Roots of Addiction and Recovery. Westminster John KnoxPress, 1996.
Merikangas, Kathleen Ries, and Neil Risch. “Genomic Priorities and Public Health.” Science 302, no. 5645 (October 24, 2003): 599-601.
Midanik, Lorraine T. Biomedicalization of Alcohol Studies: Ideological Shifts and Institutional. Aldine Transaction, 2006.
—. “What’s in a name? Proposed name changes of the US National Institute on Drug Abuse and the US National Institute on Alcohol Abuse and Alcoholism.” Addiction 103, no. 1 (January 1, 2008): 1-3.
Milam, James R. “The Alcoholism Revolution.” Professional Counselor, August 1992. http://www.lakesidemilam.com/TheAlcoholismRevolution.htm.
Milam, James R., and Katherine Ketcham. Under the Influence: A guide to the Myths and Realities of Alcoholism. Bantam , 1983.
Milgram, Gail Gleason. “The Need for Clarity of Terminology .” Alcoholism Treatment Quarterly 22, no. 2 (June 12, 2004): 89-95.
Miller, William R., and William White. “Confrontation in Addiction Treatment.” Counselor (October 4, 2007). http://www.counselormagazine.com/content/view/608/63.
Moos, Rudolf H. “Iatrogenic effects of psychosocial interventions for substance use disorders: prevalence, predictors, prevention.” Addiction 100, no. 5 (May 12, 2005): 595-604.
National Institute on Alcohol Abuse and Alcoholism. “Alcohol Alert #60,” July 2003. http://pubs.niaaa.nih.gov/publications/aa60.htm.
National Institute on Drug Abuse. Principles of Drug Abuse Treatment — A Research-Based Guide . NIDA, 1999.
Neumark, Y D, Y Friedlander, H R Thomasson, and T K Li. “Association of the ADH2*2 allele with reduced ethanol consumption in Jewish men in Israel: a pilot study.” Journal of Studies on Alcohol 59, no. 2 (March 1998): 133-9.
Nicolaus, Martin. How Was Your Week? Bringing People Together in Recovery the LifeRing Way. Oakland CA: LifeRing Press, 2003.
—. Recovery by Choice: Living and Enjoying Life Free of Alcohol and Drugs, a Workbook. 3rd ed. Oakland CA: LifeRing Press, 2006.
—. “The Role of Mirror Neurons in Addiction and Recovery.” Denver CO; Nashville TN, 2007. http://www.unhooked.com/discussion/index.htm#mirror.
Oakes, Edward T. “Original Sin: A Disputation.” First Things: The Journal of Religion, Culture, and Public Life (November 1998): 16-24.
Paz Filho, G J, L J Sato, M J Tuleski, S Y Takata, C C Ranzi, S Y Saruhashi, et al. “[Use of the CAGE questionnaire for detecting alcohol use disorders in the emergency room].” Revista Da Associação Médica Brasileira (1992) 47, no. 1: 65-9.
Pert, Candace B. Molecules Of Emotion: The Science Behind Mind-Body Medicine. 1st ed. Simon & Schuster, 1999.
Pfaff, Donald W., Wade H. Berrettini, and Tong H. Joh. Genetic Influences on Neural and Behavioral Functions. CRC Press, 1999.
Powell v. Texas, 392 U. S. 514 (1968). http://supreme.justia.com/us/392/514/case.html.
Powell, David J. “It’s time for a national approach on staff development.” Behavioral Healthcare (March 2006). http://www.behavioral.net/.
Rhodes, Justin S, and John C Crabbe. “Gene expression induced by drugs of abuse.” Current Opinion in Pharmacology 5, no. 1 (February 2005): 26-33.
Rhodes, Justin S., and John C. Crabbe. “Progress towards finding genes for alcoholism in mice.” Clinical Neuroscience Research 3, no. 4-5 (December 2003): 315-323.
Robins, L N. “The sixth Thomas James Okey Memorial Lecture. Vietnam veterans’ rapid recovery from heroin addiction: a fluke or normal expectation?.” Addiction (Abingdon, England) 88, no. 8 (August 1993): 1041-54.
Robins, L N, J E Helzer, and D H Davis. “Narcotic use in southeast Asia and afterward. An interview study of 898 Vietnam returnees.” Archives of General Psychiatry 32, no. 8 (August 1975): 955-61.
Robins, Lee N, and Sergey Slobodyan. “Post-Vietnam heroin use and injection by returning US veterans: clues to preventing injection today.” Addiction (Abingdon, England) 98, no. 8 (August 2003): 1053-60.
Roeber, Jim. “Excessive drinking, not alcoholism, may lead to most alcohol-related problems.” Eureka Alerts, January 25, 2007. http://www.eurekalert.org/pub_releases/2007-01/ace-edn011807.php.
Roizen, R. “Jellinek’s Phantom Doctorate,” 1997. http://www.roizen.com/ron/index.htm.
—. “Marty Mann: An Experiment that Failed.” Alcohol Sociology Home Page, 1997. http://www.roizen.com/ron/mann.htm.
—. The American Discovery of Alcoholism, 1933-1939. PhD. Dissertation, Sociology, University of California, Berkeley, 1991. http://www.roizen.com/ron/dissch8.htm.
—. “The Great Controlled Drinking Controversy.” Alcohol Sociology Home Page, 1987. http://www.roizen.com/ron/cont-dri.htm.
Room, Robin. “Alcohol.” In Detels: Oxford Textbook of Public Health. Oxford University Press, 2002. http://www.robinroom.net/alcohol.htm.
—. “Sociology and the Disease Concept of Alcoholism.” In Research Advances in Alcohol and Drug Problems, 7:47-91. New York and London: Plenum Press, 1983. http://www.robinroom.net/sociolog.pdf.
—. “What if we found the magic bullet? Ideological and ethical constraints on biological alcohol research and its application.” Robin Room, 2004. http://www.robinroom.net/magic.doc.
Schermer, Michael. “Adam’s Maxim and Spinoza’s Conjecture.” Scientific American, March 2008.
Schneekloth, T D, R M Morse, L M Herrick, V J Suman, K P Offord, and L J Davis. “Point prevalence of alcoholism in hospitalized patients: continuing challenges of detection, assessment, and diagnosis.” Mayo Clinic Proceedings. Mayo Clinic 76, no. 5 (May 2001): 460-6.
Schuckit, Marc. Drug and Alcohol Abuse: A Clinical Guide to Diagnosis and Treatment. Springer, 2000.
—. “Reactions to Alcohol in Sons of Alcoholics and Controls.” Alcoholism: Clinical and Experimental Research 12, no. 4 (1988): 465-470.
—. “Vulnerability Factors for Alcoholism.” In Neuropsychopharmacology: The fifth Generation of Progress, 1399-1411. American College of Neuropsychopharmacology, 2002. http://www.acnp.org/Docs/G5/CH98_1399-1412.pdf.
Schuckit, Marc, T L Smith, J Kalmijn, J Tsuang, V Hesselbrock, and K Bucholz. “Response to alcohol in daughters of alcoholics: a pilot study and a comparison with sons of alcoholics.” Alcohol and alcoholism (Oxford, Oxfordshire) 35, no. 3 (June 2000): 242-8.
Schuckit, Marc, Tom L Smith, Victor Hesselbrock, Kathleen K Bucholz, Laura Bierut, Howard Edenberg, et al. “Clinical implications of tolerance to alcohol in nondependent young drinkers.” The American Journal of Drug and Alcohol Abuse 34, no. 2 (2008): 133-49.
Schuckit, Marc, and Tom L. Smith. “The clinical course of alcohol dependence associated with a low level of response to alcohol.” Addiction 96, no. 6 (June 15, 2001): 903-910.
Schumann, Gunter. “Okey Lecture 2006: identifying the neurobiological mechanisms of addictive behaviour.” Addiction (Abingdon, England) 102, no. 11 (November 2007): 1689-95.
Senay, Edward C. “Diagnostic Interview and Mental Status Examination.” In Substance Abuse: A Comprehensive Textbook, 1997.
Shavelson, Lonny. Hooked: Five Addicts Challenge Our Misguided Drug Rehab System. New York: The New Press, 2001.
Siegel, Daniel J. The developing mind: toward a neurobiology of interpersonal experience. Guilford Press, 1999.
Singer, Emily. “Technology Review: More Effective Alcoholism Treatment.” Technology Review Published by MIT, October 27, 2006. http://www.technologyreview.com/read_article.aspx?id=17669&ch=biotech.
Sober, E., and D. Wilson. Unto Others: The Evolution and Psychology of Unselfish Behavior. Cambridge MA: Harvard University Press, 1998.
Sontag, Susan. Illness as Metaphor and AIDS and Its Metaphors: And, AIDS And Its Metaphors. Macmillan, 2001. http://www.susansontag.com/illnessasmetaphorexcrpt.htm.
Sparks, Robert D. “Watch Your Language! .” Alcoholism Treatment Quarterly 22, no. 2 (June 21, 2004): 97-100.
Stoltenberg, Scott F., and Margit Burmeister. “Recent progress in psychiatric genetics–some hope but no hype.” Hum. Mol. Genet. 9, no. 6 (April 1, 2000): 927-935.
Straus, R. “Medical Practice and the Alcoholic,.” Annals of the American Academy of Political and Social Science, 315, no. 1 (1958): 117-124 .
Substance Abuse and Mental Health Administration. “Overarching Principles To Address the Needs of Persons With Co-Occurring Disorders .” SAMHSA, 2006. http://www.coce.samhsa.gov/cod_resources/PDF/OverarchingPrinciples(OP3).pdf.
“Take Kids Away from Alcoholic Parents.” Daily Record (UK), February 19, 2007.
Takeshita, Tatsuya. “Gene-environmental interactions in alcohol-related health problems–contributions of molecular biology to behavior modifications.” Nippon eiseigaku zasshi. Japanese Journal of Hygiene 58, no. 2 (May 2003): 254-9.
Tarter, R E. “What is inherited in the predisposition to alcoholism: new model or more muddle?.” Alcoholism, Clinical and Experimental Research 24, no. 2 (February 2000): 246-50.
Traynor v. Turnage, 485 U. S. 535 (1988). http://supreme.justia.com/us/485/535/.
Trimpey, Jack. Rational Recovery: The New Cure for Substance Addiction. Pocket Books, 1996.
Tu, G C, and Y Israel. “Alcohol consumption by Orientals in North America is predicted largely by a single gene.” Behavior Genetics 25, no. 1 (January 1995): 59-65.
Vaillant, George E. “Interview: A Doctor Speaks.” The A.A. Grapevine, May 2001.
—. The Natural History of Alcoholism Revisited. Harvard University Press, 1995.
Vogel, Friedrich, and Arno G. Motulsky. Human genetics: problems and approaches.
Volkow, Nora D., Gene-Jack Wang, Henri Begleiter, Bernice Porjesz, Joanna S. Fowler, Frank Telang, et al. “High Levels of Dopamine D2 Receptors in Unaffected Members of Alcoholic Families: Possible Protective Factors.” Arch Gen Psychiatry 63, no. 9 (September 1, 2006): 999-1008.
Volpicelli, Joseph, and Maia Szalavitz. Recovery Options: The Complete Guide. John Wiley & Sons, 2000.
W, Bill, and Alcoholics Anonymous. Alcoholics Anonymous: the story of how many thousands of men and women have recovered from alcoholism . 3rd ed. Alcoholics Anonymous World Services, 1976.
Wall, T L, S H Shea, K K Chan, and L G Carr. “A genetic association with the development of alcohol and other substance use behavior in Asian Americans.” Journal of Abnormal Psychology 110, no. 1 (February 2001): 173-8.
Wall, Tamara L, Lucinda G Carr, and Cindy L Ehlers. “Protective association of genetic variation in alcohol dehydrogenase with alcohol dependence in Native American Mission Indians.” The American Journal of Psychiatry 160, no. 1 (January 2003): 41-6.
Walters, Glenn D. “The Heritability Of Alcohol Abuse And Dependence: A Meta-Analysis Of Behavior Genetic Research .” The American Journal of Drug and Alcohol Abuse 28, no. 3 (2002): 557.
Warren, Jazmin I, Judith A Stein, and Christine E Grella. “Role of social support and self-efficacy in treatment outcomes among clients with co-occurring disorders.” Drug and alcohol dependence 89, no. 2-3 (July 10, 2007): 267-74.
Washton, Arnold, and Richard Rawson. “Substance Abuse Treatment Under Managed Care: A Provider Perspective.” In The American Psychiatric Publishing Textbook of Substance Abuse Treatment, 2004.
“Wave–particle duality – Wikipedia, the free encyclopedia.” http://en.wikipedia.org/wiki/Wave%E2%80%93particle_duality.
White, William. “A Disease Concept for the 21st Century.” Counselor 2, no. 4 (April 2001). http://www.bhrm.org/papers/Counselor4.pdf.
—. “Addiction as a Disease: Birth of a Concept.” Counselor 1, no. 1 (2000). http://www.bhrm.org/papers/Counselor1.pdf.
—. “Addiction Disease Concept: Advocates and Critics.” Counselor 2, no. 2 (February 2001). http://www.bhrm.org/papers/Counselor3.pdf.
—. “The Rebirth of the Disease Concept of Alcoholism in the 20th Century..” Counselor 1, no. 2 (2000): 62-66.
White, William . “It’s time to stop kicking people out of addiction treatment.” Counselor (April 2005). http://www.bhrm.org/papers/AD-PDF.pdf.
—. Slaying the Dragon: The History of Addiction Treatment and Recovery in America. Chestnut Health Systems, 1998.
Wilbourne, Paula, and Ken Weingardt. “Therapeutic outcome research and dissemination of empirically based treatment for alcohol use disorders.” Translation of Addictions Science Into Practice (2007): 259-276.
Willett, Walter C. “Balancing Life-Style and Genomics Research for Disease Prevention.” Science 296, no. 5568 (April 26, 2002): 695-698.
Williams, Cecil, and Rebecca Laird. No Hiding Place: Empowerment and Recovery for Our Troubled Communities. HarperSanFrancisco, 1992.
Wilson, Bill. “Statement Before the U.S. Senate,” July 24, 1969. http://www.hopenetworks.org/bill_w.htm.
—. “What Happened to Those Who Left?,” 1965. http://www.silkworth.net/aahistory/billw2/gsc1965.html.
—. “Why Alcoholics Anonymous is Anonymous.” The A.A. Grapevine, January 1955. http://silkworth.net/grapevine/whyaaanonymous.html.
Wing, Nell. Grateful to Have Been There: My 42 Years with Bill and Lois, and the. Hazelden, 1998.
Winick, Charles. “Epidemiology.” In Substance Abuse: A Comprehensive Textbook, 10-16, 1997.
Wise, Roy A. “Addiction.” In Steven’s Handbook of Experimental Psychology, 801-839, 2002.
—. “Addiction Becomes a Brain Disease.” Neuron 26, no. 1 (April 2000): 27-33.
Woerle, Sandra, Jim Roeber, and Michael G Landen. “Prevalence of alcohol dependence among excessive drinkers in New Mexico.” Alcoholism, Clinical and Experimental Research 31, no. 2 (February 2007): 293-8.
World Health Organization. Neuroscience of Psychoactive Substance Use and Dependence. World Health Organization, 2004.
Wu, Da-Yu. “Decoding Drug Abuse in Noncoding RNA?.” The Scientific World Journal 7, no. S2 (2007): 142-145.
Yokoyama, Akira, and Tai Omori. “Genetic polymorphisms of alcohol and aldehyde dehydrogenases and risk for esophageal and head and neck cancers.” Japanese Journal of Clinical Oncology 33, no. 3 (March 2003): 111-21.