A critical examination of some current assumptions in the treatment of alcoholism.

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Abstract
Recent research challenges a number of traditional assumptions in the treatment of alcoholism. Two major tenets, the disease conception of alcoholism and abstinence as a mandatory goal of treatment, are examined; there is insufficient evidence to support a dogmatic position for either. Among the basic assumptions of the disease conception of alcoholism are craving and loss of control. Studies in which drinking behavior of alcoholics was objectively measured and experiments specifically designed to test the question have not substantiated these assumptions. The therapeutic goal of mandatory abstinence has been called into question by studies showing spontaneous moderate drinking in former alcoholics and by numerous studies reporting success in teaching problem drinkers to moderate their drinking. Controlled drinking cannot be excluded as a possible goal of therapy for some alcoholics. An emphasis on empirical studies with objective measurement and greater tolerance and support for innovation is urged.

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