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What is an alcoholic?
Even the dictionary waffles. Alcoholism, Webster's says, is either "the habitual drinking of alcoholic liquor to excess" or "a diseased condition caused by" excessive drinking. Some help that is to people who worry they're drinking too much.
An estimated 10 million Americans are officially classified as alcoholics, and 8 million others as problem drinkers. Drunk drivers account for some 18,000 U.S. highway deaths a year. About 30,000 a year die of liver damage.
But beyond these measurable statistics, alcoholism is still a baffling subject to physicians and drinkers alike.
Certainly there are people who drink heavily and yet do not lose control of their lives. Some abuse alcohol at certain times -- when they are in college, for example -- and then are able to reduce their alcohol consumption. Others, after a single drink, cannot stop. Many slip slowly from social drinking to addiction. What causes these differences?
Recent research suggests that there is a significant genetic component in alcoholism. But more than 35 percent of alcoholics have no family history of alcohol abuse. What role do genes play? What other factors are involved?
People used to think that the alcoholic must hit bottom before getting help. But now families and colleagues are actively intervening and forcing heavy drinkers into treatment. What is the best method of treatment?
The legal system, too, is grappling with the issue. Today courts are called upon to decide whether former White House aide Michael Deaver can use alcoholism as a defense for perjury (he cannot), and whether the Veterans Administration must pay retroactive benefits to a recovered alcoholic (the Supreme Court will rule).
All this is taking place against a background of centuries filled with drinking and merriment -- and ruined lives. As Sir Walter Raleigh wrote in the 17th century, "The first draught serveth for health, the second for pleasure, the third for shame, the fourth for madness."
Now medical science is using its high-tech tools to sort out the biochemical clues to addiction. Meanwhile, recovering alcoholics and their families as well as mental health experts are charting psychological maps to help people find a way out of their addiction. Despite formidable odds, there's new optimism that alcoholism is a problem that can be overcome. W