Beyond the Influence

April 3, 2000
In the nearly 20 years since Ketcham coauthored Under the Influence, it has become a classic in identifying and treating alcohol addiction. Now, with new coauthor Asbury (an experienced journalist and "recovered" alcoholic), she restates much of her original material, with additional support from recent scientific research. The authors define alcoholism as "a genetically transmitted neurological disease," not the result of a character defect or moral weakness. They explain in exhaustive detail the effects of "the drug alcohol" on the human body and brain in both alcoholics and nonalcoholics. Clearly and concisely, they offer abundant information on such usually neglected topics as the importance of nutrition and identifying early to middle-stage symptoms of the disease. They also break with conventional wisdom in other ways, encouraging intervention rather than waiting for alcoholics to "hit bottom" and seek help on their own, and they label alcoholics with six years of sobriety as "recovered" rather than continually "recovering." The most surprising statistic here is the relatively small number of people who consume most of the alcohol sold; the authors level a stinging indictment of the "Big Alcohol" industry and its deceptive tactics. The glare of their harsh light also falls on the government (for failing to hold the alcohol industry accountable and for jailing alcoholics rather than getting them into treatment that works), and on doctors (for failing to identify the disease earlier and treat it as a hereditary biochemical disorder that requires medical and nutritional treatment). This book offers a plethora of timely information; a blow to old stigmas, myths and stereotypes; and hope for a future in which many senseless tragedies can be avoided and lives saved.

March 15, 2000
This informative, levelheaded book draws on pioneering scientific work during the past 10 years to make the case for alcoholism as a disease. It isn't, however, wedded to that concept and deals fairly with other views of alcoholism. Literary quotations lighten the science as the book conveys the expansion of knowledge about how alcohol affects body and mind that the new understanding of the brain and nervous system has spurred. Armed with such understanding, the book points out, for example, why the term "drinking and driving" is more accurate than "drunk driving": a driver doesn't have to be drunk to more easily get into an accident. Other intriguing new understandings include regarding the gene some associate with alcoholism as a disease as a "reward gene" rather than an "alcogene," and responding to the question "Is alcohol beneficial to your health?" with a resounding "in most circumstances, for most people, no." Much remains to be discovered; meanwhile, this valuable book reports current scientific knowledge. ((Reviewed March 15, 2000))(Reprinted with permission of Booklist, copyright 2000, American Library Association.)