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One of the surprising things about alcoholism is how little most experts know. The main problem is that the definition they have agreed upon fails to describe the affliction in its early-stages. As a result, the current practice of identifying alcoholism is comparable to waiting until tumors become the size of basketballs before diagnosing cancer. Yet, almost every alcoholic shows signs of the disease years or even decades before it progresses into obvious latter-stage alcoholism. By acknowledging a difference in the processing of the drug between alcoholics and non-alcoholics, as well as between those in the early- and latter-stages of the disease, a definition can be shaped that remedies this problem. Simply put, the differential processing in the biochemistry leads to undesirable behavioral changes in those who inherit alcoholism. A definition that takes this into account allows the observer to identify the disease near its inception, increasing the odds of encouraging sobriety in the afflicted before tragedies occur.
The driving force behind the priest who molests a child, a parent who verbally or physically abuses his or her spouse and children, and the tyrant or terrorist who threatens civilization, is usually the same. This motivation is almost always egomania rooted in alcohol or other drug addiction. Journalists, biographers and historians cannot understand the compulsion that impels many of their subjects if they fail to grasp the idea of early-stage alcoholism, of which few have any knowledge.
These are bold statements. No doubt, many will wonder about my qualifications. I am not a therapist, doctor or psychiatrist. I’m not even an alcoholic. If I had been any of these, I couldn’t have written this book, especially from this perspective: I would have had too much to unlearn.
Instead, I became familiar with alcoholism as a result of an intimate involvement with an alcoholic. With the goal of protecting myself in future relationships, both personal and professional, I decided to study the subject. It soon became the most fascinating topic I’ve ever explored. In the process, I interviewed hundreds of recovering alcoholics and read almost as many books on the subject, finally writing the most controversial book on alcoholism ever, Drunks, Drugs & Debits: How to Recognize Addicts and Avoid Financial Abuse. In it, I challenged the idea that alcoholics can self-diagnose and that we should all patiently wait for the inevitable “bottom.” Only others can identify alcoholism in the early stages of the disease; even in the latter stages, the alcoholic must typically be coerced into sobriety. The surprising thing is that while most of this was implicit in other books on the subject, no one said it explicitly, perhaps out of fear of being seen as engaging in witchhunts. After all, many among us have alcoholism. Yet, we are reluctant to identify alcoholics as such, because of the stigma and ingrained belief that alcoholics are bad, immoral and/or weak.
Accepting the idea that personality defects do not lead to alcoholism and that, instead, addiction causes what appear to be character flaws, frees us from the shame, making it far easier to diagnose the disease in others. Alcoholics are, usually, intrinsically decent people. Since they are incapable of self-diagnosis, the rest of us must learn to do so. The most effective method is to consider seemingly insignificant behavioral cues that lead to more obvious ones, even though we may never see the use of a drug. It will become evident that for every tragedy that occurs in the life of an alcoholic, there were usually dozens if not hundreds of incidents, including relatively minor misbehaviors, for which close persons and/or the law could have intervened but didn’t.
We also hesitate to identify alcoholism for fear of excusing bad behaviors. Some suggest that a person afflicted through no fault of his own should not be held accountable for his or her actions. Yet, becoming clean and sober requires the imposition of responsibility and appropriate consequences. In fact, the earlier in the career of the alcoholic that private or legal sanctions are applied, the greater the chance of a return to normalcy.
This book begins by taking a look at the problems in identifying alcoholism, along with a simple explanation of its biochemistry, setting the stage for a revised definition of the disease and description of behavioral cues that inevitably follow. These are divided between early- and middle-to-latter-stage indicators and further subdivided into sets of clues within those stages. The least destructive ones, which are more numerous and less obvious as clues to alcoholism, are described in the beginning of each chapter. The more destructive indicators, generally presented towards the end of each chapter are, thankfully, rare and usually far more obvious. The general categories are divided between behaviors indicative of early-stage alcoholism in Part II and behaviors more suggestive of the middle-tolatter stages and polydrug use in Part III. Ironically, Part II behaviors tend to be other-destructive, while those in Part III are more self-destructive. The reasons for this can be found in the biochemistry, an explanation of which is therefore essential and for which I beg the reader’s indulgence.
The thrust of this book is that we can-and must-identify early-stage alcohol and other drug addiction if we are to prevent tragedies. These include the break-up of families, domestic violence, highway slaughter, and those destructive of financial and emotional health resulting from wayward employees, co-workers, debtors and tenants. They also include the ultimate tragedy, murder, whether committed by private people or at the direction of heads of state. The drug with which we are most concerned is alcohol, because it is legal, most used and rarely suspected as the source of problems. However, those using other drugs, though usually more obvious, are also of concern. The drug of choice is (relatively) unimportant. Misbehaviors are indicative of the disease of addiction, which is not particular to any one drug. However, because most people think they know an “alcoholic” or two but usually not an “addict,” the term “alcoholism” or “alcoholic” will generally be used to describe the overall affliction of drug addiction.
The reader should experiment with the ideas that follow. Until I began testing the hypothesis that poor conduct was usually a sign of alcoholism, I never dreamt that a few subtle clues might indicate a high probability of eventually proving the existence of the disease. I wouldn’t expect the casual reader to blindly accept this admittedly radical idea. However, if you test the concept with people in whom you can ultimately determine are or are not alcoholics, I am confident that you will not only become convinced that this system works, but also amazed that it works so well.
This book is for lay persons and medical professionals alike. It is meant to help the alcoholic’s next victim identify him before disaster strikes, as well as to assist the medical community in identifying the source of countless other diseases and life challenges. By identifying alcoholism in the early stages, proactively imposing consequences and intervening, we significantly increase the odds of stopping the inevitable progression of the disease before an all-too common tragic end.
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