If you are not an alcoholic, first accept my congratulations!

There are, according to recent estimates made by HEW’s National Institute on Alcohol Abuse and Alcoholism, about ten million alcoholics in the United States, or one in thirteen adults. (Alcoholics Anonymous places the percentage as high as one in ten.) But avoiding the disease requires only two things: decent enlightenment on the subject coupled with a self-interested desire to avoid the devastating troubles that alcoholism brings.

There are three other diseases whose toll is as great as that of alcoholism—heart and circulatory disease, mental disease, and cancer. We do not have the necessary knowledge to prevent these diseases, and a great deal of research must still be done to obtain it. But we already know how to prevent alcoholism; all that is needed is to put this knowledge into practice.

Much of our attention has been misdirected. There are many existing questions and controversies about alcoholism: can potential alcoholics be spotted in advance by psychological tests, or is the real source of the trouble physiological? Do some alcoholics have a fundamental character weakness which calls for alcohol, or if not alcohol then something else? Is malnutrition of the brain cells a result of alcoholism, or is it a contributing cause of alcoholism? But answering these questions is unimportant if prevention is our aim; we can realistically attack the problem without settling them.

There are some mysteries about alcoholism, of course. We do not know for certain why certain individuals become alcoholics. But people are not born alcoholics; all those who are now alcoholics were at one time non-alcoholics. Some are far more vulnerable to the disease than others; for example, Marty Mann, the founder of the National Council on Alcoholism, told me that as a very young woman she liked the taste of liquor tremendously the first time she tried it. She could and did drink quantities without showing signs of intoxication, and within a short time she was "hooked." Her case is not typical, however; while occasional alcoholics become addicted rapidly, for most it is a long, progressive process requiring several years.

Virtually no attention has been paid to heavy drinkers on the way to alcoholism but not yet addicted. Five hundred thousand new recruits will join the ranks of the alcoholic this year if the incidence of alcoholism continues to increase at its present rate. Unfortunately, in our society it has become established policy to wait until people break down and then try to patch them up. The policy of Alcoholics Anonymous, by far the most successful agency in our society for dealing with alcoholism, is to wait for the open confession, "I am an alcoholic," before offering assistance. Relying solely on this approach is like having a fire department which omits fire prevention, and only springs to life when flames can be seen pouring out of a building. Alcoholism needs to be dealt with when the very first signs of compulsive drinking appear, while the individual is still in control. Heavy drinking by itself, even before it has reached the alcoholic stage, is dangerous. Recently, evidence has accumulated indicating that heavy drinking is associated with throat cancers and heart disease: these dangers exist whether or not one ever becomes an alcoholic. Raymond Pearl, a famous Johns Hopkins biologist, found out about 35 years ago that heavy or even moderate use of tobacco decreased human life expectancy by several years; in the same study, he found that heavy drinking did the same (recent insurance company statistics cited by Alcoholics Anonymous indicate that the average life span of the alcoholic male is about 55 or 56 years, whereas life of the non-alcoholic male averages 66 or 67 years). However, there was no significant difference found by Pearl between the life spans of non-drinkers and moderate drinkers.

Following are the basic facts we have at hand which can be the basis for a successful attack on the alcoholism problem.

First, every person has a distinct biochemical makeup, and nowhere does this show up more prominently than in regard to alcohol consumption. Medical studies have shown that some people may appear intoxicated when the alcohol content of the blood is .05 per cent, while others may appear sober when the alcohol in their blood is eight times this high. Since people are by no means alike in their reactions to alcohol, each person needs to act for himself. So it is scientifically unsound to suppose that what one can do, another can duplicate, and for a person to assume that he is immune is completely unwarranted; actually if there are enough thorough practice sessions with alcohol, almost anyone can become an alcoholic.

Second, alcohol becomes a part of the environment of our brain cells. In low concentrations it may be burned up in the body without harm, but at higher levels it is definitely a poison and causes cellular damage. Indirectly, heavy consumption also spoils the environment of brain cells by crowding out many other substances that they need. There are about 40 different chemical substances that brain cells need all the time; these include minerals, amino acids (derived from proteins), and vitamins. Heavy alcohol consumption causes the supply of all these chemicals to be depleted. If one takes half one’s daily calorie intake (say 1250 out of 2500) in the form of alcohol (10-1/2 jiggers of whiskey yield 1250 calories), and only half of one’s calories in the form of food, this means that the healthy amount of minerals, amino acids, and vitamins that are supplied in addition to raw energy by one’s food is also cut in half. It has been found in medical schools that when alcoholics die their brains are of no use for dissection purposes because they have usually become partially disintegrated, and sometimes have virtually turned into mush.

Third, non-alcoholics need to appreciate that most alcoholics are not skid-row characters; they are, much of the time, respectable-acting businessmen, lawyers, educators, politicians, and housewives, who are struggling to maintain appearances as they lose control. It has been estimated by statistics which I cannot vouch for that the suicide rate is 58 times higher among alcoholics than among non-alcoholics.

We must make a great effort to cultivate moderation in alcohol consumption. Children need to be taught in school about the total environment and made to realize that what we put into our mouths and thence into the environment of our brain cells can make the difference between abundant life and sickliness. Presently, these studies are lacking in elementary schools, high schools, and colleges; even in medical schools, courses on nutrition are inadequate.

Watching one’s diet and using nutritional supplements when indicated can do a great deal to help immoderate drinkers. In addition to vitamin and mineral supplements, there is the nutritional supplement glutamine, a white crystalline food substance (not a drug) and the only amino acid which readily passes the blood-brain barrier. Improved nutrition will build up the health of brain cells and help them perform all their regulatory functions, including those involved in eating and drinking. That my opinion on these matters is not shared by more people is due, I feel, to the fact that very few have studied the matter from the standpoint of nutrition as I have. Throughout 25 years of research, I have persisted in the concept that better nutrition is a potent factor in preventing alcoholism. Many thousands of alcoholics and potential alcoholics have received help using megavitamin or glutamine nutritional supplements—some showing dramatic improvement; but statistically controlled studies, which are expensive, have lagged.

Two examples give an idea of the social climate in America regarding drinking. I was recently engaged in conversation with a university student about alcoholics. He assured me that he was not an alcoholic, without my suggesting or thinking that he might be. He told me proudly that he "didn’t get drunk very often," which he evidently thought was exemplary. I told him that in my opinion he was a prime candidate for becoming an alcoholic; a young person who drinks heavily has a most unpromising future. If, in spite of heavy drinking, he does not become an alcoholic early, he has many years ahead of him in which to reach this destination. If he does become an alcoholic, early or late, there is little hope for recovery. Recovery—defined, minimally, as at least one year of sobriety—is achieved by 25 per cent of Alcoholics Anonymous members on first try and by an additional 25 per cent after one relapse. Only one in ten patients released from the alcoholic ward of the state hospital achieves this record.

Turner Catledge, recently editor of the New York Times, has written an interesting book, My Life and the Times. He tells of an incident in San Francisco where he and another Times executive got acquainted by drinking the equivalent of twelve to fourteen martinis each before dinner. This was evidently regarded by the writer, and I fear by many of his readers, as a normal—or rather supernormal—performance and something to be proud of. To me such a performance is no more praiseworthy than taking and surviving sublethal doses of arsenic. It does, of course, demonstrate the fact that some individuals—who deserve no credit—are able to tolerate far more alcohol than others.

I have had many thousands of contacts with alcoholics and near-alcoholics, and I am not so naive as to expect that heavy drinking can be abolished with desirable speed. I do affirm, however, that unless heavy drinking can be curbed by education, by better nutrition, and by changing the climate of our thinking, alcoholism will continue to run rampant. The one hundred and thirty million non-alcoholics in this country must inform themselves and work toward preventing our most preventable national illness.