Now that the three-martini lunch has gone the way of hula hoop, and Perrier with lime is the order of the day, does it mean that alcoholism, too, is on the wane?
The experts say no.
It is the moderate drinkers who are curbing their intake; a recent government report states that 10 percent of the population drinks 50 percent of the alcohol consumed. The nation's 10 million alcoholics are carrying on as usual.
Who are in that 10 percent? The disorder clusters in distinct patterns.
*Sex. Although alcoholism among females is on the rise, males are still more than twice as likely to become alcoholic, according to the National Institute on Alcohol Abuse and Alcoholism (NIAAA). Females have traditonally come to the problem later in life. They consume less alcohol than males do, and are likely to seek help for the problem sooner.
*Families. Alcoholism runs in families. About one quarter of the sons of alcoholics become alcoholic, says psychiatrist Robert Cloninger of the University of Washington at St. Louis. (There is a weaker, but still discernible, correlation between mothers and daughters.) Among first degree relatives of alcoholics, up to 60 percent of the males and 15 percent of the females are alcoholic. Alcoholism and depression also run together in families, says University of Iowa psychiatrist George Winokur. Cloninger has found a similar correlation with alcoholism and psychosomatic disorders.
*Emotional status. An alcoholic is, by definition, a person who has difficulty adapting to the reality shared by the majority. Rebelliousness, covert or otherwise, is a primary behavioral trait. Alcoholism and antisocial behavior often go together; hence, surveys by the Justice Department show that over half of prison populations are alcohol or drug abusers (usually both). Psychologists such as Ralph Tarter of the University of Pittsburgh have found that children whose social adjustment is distorted by learning impairments and hyperactivity are also at risk. People with depressive disorders (usually women) and antisocial personality disorders (usually men), and manic depressives are disproportionately represented in the alcoholic population, says Winokur.
Attempts to identify physiological factors that might underlie racial differences have met with failure except in the case of Orientals, who are rarely alcoholic. Researchers have found that 50 to 80 percent of Asian people have a enzyme deficiency that impedes the metabolism of acetaldehyde (which is what alcohol turns into in the body), according to Loran Archer of the NIAAA. These people have a built-in deterrent to drunkenness, since a few drinks will cause them to become violently ill.
*Nationalities. The highest mortality rate from cirrhosis of the liver (which is usually caused by alcoholism) is in Italy, according to figures compiled by the Addiction Research Foundation in Toronto, with 34.7 deaths per 100,000 in 1978. The comparable figure in the United States is 13.2.
Some experts theorize that in cultures with a long history of alcohol consumption (such as those around the Mediterranean), those genetically unfit to handle alcohol have been bred out, unlike, for example, societies that develop severe problems on exposure to modern civilization.
Occupations. Bartenders, longshoremen, newspaper executives and seamen were the occupations showing the highest mortality rate from cirrohosis in the years 1950 to 1974, according to a 1982 report by the NIAAA. Alcoholics tend to be in jobs predominantly held by males, jobs in which duties are periodic or irregular, or in which boredom and high tension alternate, according to sociologist Robin Room of the Medical Research Institute of San Francisco.
Writers, of course, are notorious for their drinking habits. Five of the six American Nobel Prize-winning novelists of this century were alcoholic or close to it. (The late Truman Capote, an alcoholic, once told a reporter: "I don't know a single writer, and I'm telling you the truth because all these people are great friends of mine . . . who isn't an alcoholic.")
The list can go on. Wherever young males congregate for purposes related to violence and aggression -- for instance, in the Army -- alcoholism is common. Alcohol and drug abuse is much higher in football teams than in symphony orchestras. The occupations most immune from alcoholism are probably those requiring a high degree of clearheadedness -- scientists and computer programmers, for example.
It is true that alcoholism ignores sex, race, age, social and economic status. But the fact is, you will invariably find more alcoholics in Hell's Angels than in Hadassah.
Constance Holden writes for Science magazine.