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Beyond the Influence: Understanding and Defeating Alcoholism
By Katherine Ketcham and William Asbury. New York, New York: Bantam Books, 2000, 354 pages, $14.95 (paper).
- It is the most abused drug in the United States
- Each year it costs the economy $166 billion mostly in lost productivity and decreased earnings
- 15% – 20% of emergency room patients are there due to problems related to it
- Approximately 40% of traffic fatalities are caused by it
- And it’s legal to anyone over the age of 21
It’s alcohol. Each year Americans buy over $100 billion worth of alcohol. With a drug that is so prevalent in society, there is still so much that is unknown. Beyond the Influence: Understanding and Defeating Alcoholism (2000) tries to fill in the gaps in our knowledge. It discusses our current theory of alcoholism, which is that it is a disease not a weakness of willpower. Co-author, Katherine Ketcham has co-authored eleven books and was the co-author of the groundbreaking book about alcoholism Under the Influence: A Guide to the Myths and Realities of Alcoholism (1983). William Ashbury is a journalist and former editor in chief of the Seattle Post Intelligencer and a recovering alcoholic with 25 years sobriety.
The book is divided into three main sections. The first section (The Problem) describes what alcohol is and what it does to the body. It goes into detail about the three mechanisms used in the metabolism of alcohol. It describes our current knowledge on each mechanism and how each affects the brain as well as the body. Next it goes into the “addicted” brain of an alcoholic and how it has changed from the excessive use of alcohol. This sections talks about everything from brain damage in an alcoholic to the brain’s dependence on alcohol for normal operation. Then it talks about the three stages of alcoholism (early, middle and late) and the condition of the body during each stage. Each stage is marked by certain physical as well as mental symptoms. This book places clear emphasis on alcoholism being a disease that can be inherited and not a weakness of willpower. This is evidenced by the genetic marker said to be linked to alcoholism that was discovered in 1990.
The second section (The Solution) describes what can be done to help an alcoholic. It talks about diagnosing an alcoholic through the use of several self-surveys given in the book. Then there are intervention and treatment options. The book gives criteria for a successful alcohol treatment facility as well as a facility that is right for you. It goes into detail about the Sundown M Ranch in Selah, Washington. The Sundown M is a treatment facility that has helped over 30,000 alcoholics. The book describes why the Sundown M is so successful at a low price, offering everything from group therapy to education about the disease. Sundown M even stresses involvement of the families of alcoholics by bringing them in for three days and teaching them about the disease. Then it focuses on relapse prevention, counseling and spirituality. The last part talks about how diet and nutrition can affect sobriety.
The third section (The Future) discusses how society can change to reduce the effect of alcohol on it. It goes into a lengthy discussion about the alcohol industry and the steps it is taking to increase their business; everything from advertising geared to teenagers and young adults to lobbying to lower the drinking age to 18. It mentions the fact that 10% of the drinkers consume 50% of the alcohol and their slogan, “drink responsibility,” if followed would dramatically cut their profit margin. Then it discusses how alcohol’s effect can be changed; through higher liquor taxes, stiffer penalties for drunk driving, and more aggressive and informative education programs for children from elementary up though college. The book discusses MADD (Mothers Against Drunk Driving) which shares personal stories of the devastating impact alcohol impact has had on their lives in the hope of altering drinking and driving behaviors. Then managed health care, workplace programs, and prisons are targeted as decreasing the money they are allowing for alcohol treatment programs and the long term effect that has on treating alcoholism.
This book is well written, straightforward and not very wordy. While the discussion on the metabolism and cellular interactions might be too difficult for most readers, the rest of the book is well suited for all adults and most teenagers. The book has a very elementary reading style, anyone with any high school education can understand this book. It goes into detail about the metabolism of alcohol, how it transforms in the body and all of the chemicals it turns into. With the psychotherapist’s help the reader can understand this passage. The firsthand accounts by famous and well-off alcoholics bring the message home and helps relate the problem to the reader. The forward is by former senator George McGovern whose daughter died from alcoholism in the 1980’s. The book has various resources and a full bibliography listed in the back in case the reader needs more information.
This book would be most helpful to those individuals who have a drinking problem and are not sure if they are an alcoholic and to those individuals close to an alcoholic. This book can also be useful to beginning drinkers to deter excessive drinking which leads to alcoholism. This is a very informative book. If as the client reads the book and they have questions, the clinician can explain in more detail. It sets right many myths about the disease and offers helpful suggestions on treating it. The client can read the book and discuss it with the clinician. Points of discussion could be: Am I an alcoholic? What stage of alcoholism am I in? What treatment program should I go into? What is the rate of relapse? How severe are the withdrawal effects? How can I lessen the effects of withdrawal? What signs can I notice in others to identify alcoholism? What kind of support can I give to someone who is an alcoholic? What are the signs of relapse? All of these topics and many more can be springboards to discussions. Or therapy can be organized around each section. Each section can be read, then discussed to see how it is related to the client. There are 18 sections, and several sections can be skipped if they don’t apply to the client. The clinician can integrate other outside information to supplement the book, such as nutritional information and local support groups. This book is a great introduction to our current knowledge about alcoholism, it clears up any misconceptions about the disease as well as describes what can be done about it.