Alcoholics are not only derelicts in old overcoats. They are the bosses and secretaries, preachers and parishioners, and teachers and children of Montgomery and Prince George's Counties.
With more than 45,000 problem drinkers in Montgomery, according to a recent health department study, and about 67,000 in Prince George's, booze affects nearly every aspect of working, family and social life, as it does in cities and countries all over the country.
Many doctors attribute alcoholism to emotional problems. Society views it as a moral weakness. Those directly involved blame their drinking on everything from naggng spouses to unhappy childhoods.
But current studies show that alcoholism, like diabetes or cancer, is a disease with both physical and emotional effects.
"Alcohol doesn't cause alcoholism," sates Buck Doyle, the Montgomery County's educator of alcholism and a recovering alcoholic himself. "It's a disease, a metabolic disorder. You have it your whole life and the only way to keep it under control is by complete abstinence."
He distinguishes it from alcohol abuse, the heavy drinking that might occur on weekends or payday afternoons.
"The abuser drinks to get drunk," Doyle says. "The alcoholic has no control over what he's doing. It's not a behavioral thing, like the abuse. It's a physical addiction."
Continued heavy drinking can damage the liver, the heart and the pancreas.
"We don't even know for sure what it's doing to the brain and the nervous system," said Herb Winstead, director of the Montgomery County alcoholism program. "Alcoholism is a terminal illness.
"We're not crusaders against all booze," he continued. "But those who have the disease must spend their whole life fighting it. And many who have the disease spend 24 hours a day denying it."
"The (state) health systems agency calls alcoholism a priority, and we do, too," noted Phyllis Baron, assistant director of the Prince George's drug and alcohol program.
Denial of the problem, alcoholics under treatment all agree, is the biggest obstacle to recovery.
"Once someone admits they have a drinking problem, we're 90 percent there," says Doyle.
Unfortunately, the family doctor, to whom one usually looks first for help, may just aggravate the problem, say many alcoholism counselors.
Although the American Medical Associate identifies alcoholism as a disease, many phyicians and psychiatrists, who never learned about it in medical school or who may be heavy drinkers themselves, don't see it that way.
"I thought maybe I had a drinking problem," said one alcoholic, who has stayed sober for several years. "My shrink said I didn't. That's all I needed to hear, and I drank heavily for two more years."
"My doctor never asked about drinking when I went to him depressed," said another. "He prescribed pills and pretty soon I was doubly addicted."
Private and county-run facilities treat alcoholics in both counties. Most incorporate Alcoholics Anonymous activities into the treatment.
Montgomery's Alcohol Program operates a crisis intervention program, out-patient counseling clinics and a 24-hour hotline (468-4594). It also runs two quarterway houses, where the physical withdrawal from alcohol, which can cause severe illness of death, is undertaken under careful supervision.
Four-week residential facilities are operated at Seneca House and at Melwood Farm in Olney.
Prince George's holds counseling and education sessions in College Park and sponsors two half way houses in Laurel (345-2000). Its "Driving While Intoxicated" courses, designed for motorists who are caught drunk while on the road, meet throughout the county. About 1,400 people are now participating.
The Washington Adventist, Montgomery General and Prince George's General Hospitals run detoxification units through their emergency rooms.
Alcoholics Anonymous holds more than 200 meetings a week in Montgomery and Prince George's Counties.
In some cases, employers and work supervisors can help an alcoholic when loved ones cannot.
"The threat of losing a job is sometimes more threatening than what's perceived as a nagging, nonalcoholic spouse," said Winstead. "One push now is to set up employes' assistance programs, where alcoholics are identified before they lose their jobs and treatment can be sought."
"Besides the alcoholic, at least four or five other people are adversely affected," said Marty Leyshon, a member of the Governor's Advisory Council on Alcoholism. "Spouses, children, siblings, co-workers: even if the alcoholic won't admit his probelm, these people still need to exist."
Al-Anon and Alateen are two A-A-oriented organizations for the "other victims" of alcoholism, the family members.
Concerned Persons, a private service in Rockville, counsels relatives and co-workers, who sometimes band together and confront the alcoholic with his or her problem.
"There's a domino effect on all of society," said Leyshon. "In the last analysis, all our institutions and all of use are affected by alcoholism."