Medicine: Out in the Open

Just before the Betty Ford Center opened in the affluent desert town of Rancho Mirage, Calif., in 1982, neighbors ventured out across their well- manicured lawns to ask the staff a few questions. "Will there be bars on the windows?" they wanted to know. "Will they get out and go drinking in the neighborhood?" The answer in each case was of course no, but the questions reveal a familiar attitude toward alcoholics: many people thought of them as hardly better than criminals or at the very least disturbed and bothersome people. But at the same time the fact that a sanatorium for alcoholics had been started by a former First Lady who openly admitted to a drinking problem signaled that a hopeful change was in the air. Since then, a stream of recovering alcoholics, among them such celebrities as Elizabeth Taylor, Jason Robards and Liza Minnelli, have stepped forward to tell their stories with bracing candor -- of being caught in the vortex of alcoholism, of taking the strenuous route to sobriety offered in therapy and of regaining their health and self-respect. The long process of recovering from alcohol abuse, which experts insist never ends, suddenly began to get favorable notices.

Today, in treatment centers nationwide, patients are getting a message of openness and hope. In his therapy sessions, John Wallace, director of treatment at Edgehill Newport, a center in Newport, R.I., explains that alcoholism is a disease with a genetic basis, and nothing to be ashamed of. "I ask how many had a close alcoholic relative," he says, "and 95% raise their hands. That astonishes them." He describes the latest theories about neurochemical imbalances that make an alcoholic incapable of drinking normally. "They are really fascinated," he says. "It takes away a lot of their guilt and makes them less defensive."

In ways unimagined ten years ago, the shadow that has obscured the truth about alcohol has begun to lift. There is encouraging news, and it is substantial. "Silence is each day giving way to courage," Otis Bowen, Secretary of Health and Human Services, said recently, "and shame to strength." Evident all around is a busy sense of awakening. Children are learning about the perils of alcohol in school through slogans like "Get Smart, Don't Start -- Just Say No." The accumulated scientific findings of the past decade are having a major impact on the public. Recently a Gallup poll found that a great majority of American adults are convinced that alcoholism is indeed an illness rather than a sign of moral backsliding. In that, they have the support of the American Medical Association, which 21 years ago formally declared alcoholism a disease. At that time, only a handful of programs, such as Hazelden in Minnesota, offered treatment for alcoholics. Since then medical centers and treatment programs have proliferated across the country. There are more than 7,000 treatment programs, a 65% increase in the past six years alone. Partly because of the new spotlight on the dangers of alcohol, Americans are beginning to moderate their drinking habits: consumption of alcohol peaked in 1981 and has since declined by 5%. In many social circles today, the big drinker stands out like W.C. Fields at a temperance meeting.