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Under The Influence: Forward

A Guide to the Myths and Realities of Alcoholism

Dr. James R. Milam and Katherine Ketcham

Foreword by Mel Schulstad, Co-founder and past-president of the National Association of Alcoholism Counselors

I am thrilled with this book. It meets a great need. I know that it will be understood and utilized so that millions of lives can be saved.

Under The Influence clearly points out that the accumulated evidence from all the life sciences positively indicates that physiology, not psychology, determines whether a drinker will become addicted to alcohol or not. The alcoholic’s genes, enzymes, hormones, brain and other body chemistries work together to create his abnormal and unfortunate reaction to alcohol. This concept has not been and is not now understood or accepted even by the majority of alcoholism professionals, who seem committed to the misconception that alcoholism is, at least in part, caused by social, cultural, and psychological factors and is therefore treatable through mental health methods such as various psychotherapies and behavior modification techniques.

In 1970 James R. Milam wrote and self-published The Emergent Comprehensive Concept of Alcoholism. The book was enthusiastically welcomed by thousands of readers, both professionals and laypersons. Many of us said, "Here for the first time is someone who really knows what alcoholism is all about and who has finally put it down on paper." Fifty thousand copies of Milam’s Concept, which was written in a relatively technical and clinical language, have been sold to date. This was accomplished without benefit of marketing, advertising, or the sponsorship of a publishing house. The demand for and acceptance of this new idea has indeed been phenomenal.

In Under The Influence, this original concept has been expanded, re-tested, and presented in a thoroughly understandable and fascinating explanation of alcoholism. It has been written with such clarity that many of the highly complex issues related to alcoholism become clear for the first time. Indeed, I feel this book is not only intended to be a textbook for professionals, clinicians, and academicians, but will also be welcomed and easily understood by the lay public. The authors have articulated ideas and truths which many of us have "known" or felt intuitively were underlying the disease alcoholism. For the first time, these ideas, concepts, and truths have been expressed with a validity based on research, documentation, and fifteen years of extensive clinical experience at Alcenas Hospital and elsewhere.

Thousands of alcoholics are seen every year by professionals—psychiatrists, psychologists, social workers, clergy, counselors, nurses, and doctors—yet, tragically, they are almost always misdiagnosed and often harmfully treated. It is my belief that alcoholism has suffered more malpractice out of ignorance than any other disease in recent times. Yet it is a disease that strikes our society so severely that, if unchecked, it could bring our nation to it’s knees.

It is my prayer and fervent hope that the concepts so clearly and boldly stated in Under The Influence have emerged at a time when they can be broadly recognized and accepted. They are truly ideas whose time has come. It is my further hope and prayer that the treatment approach described herein will be widely adopted as a basis for treatment of alcoholism in the future.

Under The Influence will aid and advance by light years the understanding of alcoholism and the recovery process. The labors of Milam and Ketcham in researching, documenting, and writing Under The Influence have placed us all in their debt. Let us hope that this book will spread light into darkness and bring us closer to a complete understanding of the disease alcoholism, and through this new understanding reach millions of our fellow men and women who today are suffering—and dying—because of society’s ignorance.

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