With regard to Ellen Goodman's piece on whether alcoholism is a sin or a disease {op-ed, Dec. 5}, extensive research findings have indicated that a biological predisposition to alcoholism exists in many individuals. Recent work has produced evidence that a number of abnormalities of behavior, ranging from Gilles de la Tourette's syndrome to manic-depressive illness, have genetic determinants. In addition, it is clear that alcohol changes neural function and that such changes are manifested as physical dependence on alcohol.

Ellen Goodman noted appropriately that the lines between sick behavior and bad behavior are not always clear. However, the comparison between alcoholism and brain tumors is far from rational if one is trying to decide whether alcoholism is "willful misconduct" or an illness. A better comparison would be with diabetes, in which the manifestations of the biological problem can, in many cases, be controlled by an individual's willingness to maintain the proper restricted diet. Society would not punish a diabetic for eating sugar -- society would attempt to treat him.

There is no question that the acceptance of alcoholism as an illness, and the treatment of alcoholism, should also be a major societal concern. Even if part of the treatment is to get the individual to take responsibility for his life, our society needs to realize that alcoholism is a treatable, biologically and environmentally linked behavioral disorder and that the treatment needs to be in the hands of professionals rather than in the "hands of the victim."


The writer is scientific director of the National Institute on Alcohol Abuse and Alcoholism.