Alcohol and Alcoholism Vol. 36, No. 6, pp. 609, 2001
© 2001 Medical Council on Alcohol
Book Review
Alcoholism: The Facts,
3rd edn. By D. W. Goodwin. Oxford University Press, Oxford. 2000, 176pp., £9.99. ISBN: 0-19-263061-X.
Now in its third edition, this is one of the best books available to the lay public. It is clearly written by someone with great experience in dealing with a group of clients/patients generally unpopular with all professional groups. It is excellent at demolishing myths, particularly by making us aware of the complexity of the actions of alcohol, and it is also non-polemical and clearly written. Goodwin shows that hard data in the field of alcoholism are difficult to come by, particularly in the areas of aetiology and treatment. In its attempt to define alcoholism (and it does not use any of the formal criteria used internationally for alcohol dependence), the book places emphasis on the compulsion to drink at least to a breakdown of the victim's ability to function, as illustrated by a quote from William James: ‘the craving for a drink involves dipsomaniacs is of a strength of which normal persons can form no conceptions, where a keg of rum in one corner of a room and where a cannon constantly discharging balls between me and it, I could not refrain from passing before that cannon in order to get the rum’.
The book is divided into three main sections: information about alcoholism; examining aetiological factors in alcoholism; and aspects of treatment. In the latter section the author stresses that supervised Antabuse is a regular treatment in the UK; this may surprise some specialists in the UK, who feel Antabuse never seems to have been developed to the extent it might have been, possibly by lack of information and poor promotion by pharmaceutical companies.
There is also nothing said about the important work on attitude to change, or rather stages of attitude to change, which seems a most useful concept recently developed in the field. In the section on treatment, considerable emphasis is given to Antabuse and Alcoholics Anonymous, although a clear account is also given of psychological approaches. It does not emphasize, however, the major differences between those clinicians who regard abstinence in itself as the treatment goal and others who regard treatment as having to produce major psychological change in the individual, if long-term sobriety is likely to be successful.
This is a valuable book for a lay audience, for patients, and perhaps also for medical students. Highly recommended.
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