Science Digest. June 1944

Yale to Rehabilitate Alcoholics Condensed from The American Weekly

Howard W. Haggard

Director, Laboratory of Applied Physiology, Yale University

RECURRENT trips to jail for the poverty-stricken means for controlling the consequences of inebriate, recriminations and preaching at the diabetes. well-heeled drunkard wiil soon be replaced in There can be no cure for alcoholism. The New Haven and Hartford by a trip to the clinic. treatment must be fitted to the cause. ln each city, a diagnostic and guidance There are however, various ways and clinic will be opened in the near future, to be means by which the problem drinker can be known as the Yale Flan Clinic, under the helped to overcome his habit, provided always sponsorship of the Laboratory of Applied that he wants to be helped. Physiology of Yale University and the The ways and means used are as many Connecticut State Prison Association, where as there are kinds of problem drinkers; there is alcoholics, rich and poor alike, will be offered no “medicine” which will cure the craving for scientific help. alcohol, nor is there some standard method No new “cure” for inebriety has been which can be used in the treatment of any discovered; the clinics will approach the problem problem drinker. from the point of view that the alcoholic is a sick Today there are probably 600,000 men man and should be treated as such. and women in this country who need medical aid The alcoholic is either led to his because of their excessive drinking. excessive drinking by a sickness of his While this seems like a large number, it personality or his personality has become is nevertheless true that only a small percent of disordered in the course of many years of heavy those who drink become alcoholics, and there drinking. are some 45 million people in this country who Unless the alcoholic realizes that he is use alcoholic beverages. Out of every 1,000 sick, and unless his friends and relatives, and users about 13 eventually become problem the general public, realize that excessive drinkers -that is, no more than 1.3 percent. drinking is a disease and not just “weakness” or Between one and a half and two million “pure meanness,” there is little hope for the people drink heavily enough to be in danger of rehabilitation of the alcoholic. becoming problem drinkers. Wide dissemination Threats and punishment, scandal and of the scientific facts about the excessive use of divorce do not cure the alcoholic; they may even alcohol and the reasons behind excessive drive him deeper into his habit. What he needs drinking may help to prevent at least some of is help – physical and mental help in solving the these people from continuing on their dangerous problems which have given him his disease. paths to alcoholic doom. Unfodunately, the popular belief that the The 600,000 problem drinkers should not alcoholic merely lacks strength of character is be thought of as a group of like people. They are much the same as was the attitude toward the no more alike in their temperaments and mentally ill a century ago, when the insane were personalities than a group of people who put in prisons, orwhiPPed. contracted typhoid fever would be. And, unlike From time to time the public hears that typhoid fever, in alcoholism it is not the “germ” some “cure” has been found for excessive which must be treated but the man himself. drinking. This is never true, for there is no Just as all kinds of personalities are specific remedy for helpless dependence upon represented among problem drinkers, so are all alcohol, in the sense that there is a cure for social, economic and educational levels. The diphtheria, or in the sense that there are definite fact that most of the “”common drunks” we see

on the streets are from the lower economic have to drink themselves into a stupor before levels does not mean that such people are more they can tolerate existence. liable to become heavy drinkers; there are The great Edgar Allan Poe was one of simply more people on this level. these. Such people, despite their genius, suffer The well{o-do produce an even greater from an inner lack of self-confidence which bars proportion of inebriates, on a basis of them from productive work. Only when the population. We know, for instance, that about 20 barrier is removed by alcohol can they shed the percent of those admitted to hospitals and fetters of self-critique and, feeling “On top of the sanitariums for mental disorders are able to world,” produce the literature or art or music afford the relatively high costs of private which was locked up inside themselves. institutions, which means that they come from Alcohol does not create this things; it the upper income brackets. merely releases them, possibly in a less perfect The most familiar alcoholic is the “bum” form that some means of release other than on the dreary treadmill: he gets drunk, is alcohol might have given them. Alcohol does not arrested, sentenced to a few days in jail, slimulate genius. lt puts to sleep the forces released, gets drunk, is arrested –and so it which have held it down. goes. After a time, the sentences may grow Most people are not geniuses; they are longer, perhaps a few months. led to excessive drinking by boredom, by But no matter how long he is in jail, he frustration, by social problems, by economic resumes his career of drunkenness as soon as difficulties and family troubles. But all the he is freed. The jail sentence is definitely not a excessive drinkers, sooner or later, develop a remedy for inebriety. common characteristic that of damaged The “bums” clog up the jails and are a physical and mental health. burden on the courts, the police, and the Deficiency diseases develop from taxpayers. A solution to their problem is improper nutrition: and all excessive drinkers fall imperative. victims to other ills because their bodies have Less well known to the general public are lost their normal resistance. Their moral stamina the inebriate playboy and the glamour girl, who is undermined. do their too heavy drinking in the comparative They become unreliable, an increasing privacy of nightclubs, from which they are burden to their friends and relatives and to the regularly carried home in taxis or in their own community. They disrupt their families and limousines, or their maids and valets may know expose their children to misery as well as to the of their disease. example of intemperance. Even less exposed to the public eye is When the alcoholic finally realizes that the business executive who drinks either in his he cannot continue his injurious course of life, exclusive club or at his private bar. His he seeks for ways and means by which he can associates anxiously guard his secret and drink without doing harm, or by which he can squelch whatever rumors get out. drink less and still satisfy his longing. There is no single reason why people There are no such ways and means. For seek intoxication; alcohol can fulfill so many the inebriate there is only one way out, and that conditions that it can be taken for many reasons. is never to drink again. It may be baffled ambition, with As a rule, it takes him long to realize this. consequence disgust for the world and a desire And it takes even longer before he will admit to to escape from it. A man may be a square peg in himself that he can not achieve this without help a round hole – and drink to escape himself. from the outside. Drunkenness seems to be a rather When the inebriate enters the clinics (he coarse and bestial pastime, but there are many must be sober, for these are not sobering up highly sensitive souls among the excessive stations or hangover cures) he will be drinkers – people whose ideals are so much in interviewed by a psychiatrist who will endeavor conflict with the hard necessities of life that they to discover those deeply hidden conflicts, disappointments, anxieties, disaffection’s or

boredom which led him to his craving for The psychiatrist may find in some intoxication. individuals a certain readiness for religious Then social workers will endeavor to experience. lf such readiness is developed into reconstruct the life history of the patient from its full possibilities the religious experience may records and sources including the family. offer a solution. Psychologists will determine the picture ln a case of this sort, the patient may be of his abilities and limitations. A physician will referred to a minister. give him a thorough physical examination. Occasionally a patient with a The psychiatrist will then combine the readiness for religious experience may be results of all these examinations, which would referred to that courageous group of men and give him a picture of the type of man or woman women known as Alcoholics Anonymous. he has before him, the influences which Those who have contracted the disease contributed toward the excessive drinking, and of inebriety through compliance with the the psychological resources and liabilities of the customs of a hard drinking social set, rather than patient. through inner difficulties, may be referred to a According to the total picture thus physician skilled in what is known as the presented, he will determine the kind of “aversion” or conditioned reflex treatment. treatment which promises the best prospects ln this type of treatment, an aversion to and successful results. alcoholic beverages is created in the patient by The treatment, of course, will depend on means of certain drugs, and when the aversion the temperament, personality, family, and social is well established, psychological pressure is situation of the patient. lt will not be given by the applied to reinforce the newly acquired habit of clinics; the psychiatrist will recommend what abstinence. treatment the patient should receive. There may be cases in which it appears There may be some among those to the psychiatrist that all the patient needs is to referred to the clinics who are found to have be given a chance to use certain unemployment mental disorders in which heavy drinking is quite abilities or ambitions. incidental. ln such cases, treatment for the ln such cases the patient will be put in mental disorder in a state mental hospital is the touch with agencies which can offer the only possible recommendation. They cannot be opportunities. ln some cases the clinics may treated for drinking, since this is merely a help to establish contact with an appropriate symptom of the disease. employer.

Source; Science Digest, June 1944

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