Medicine: Out in the Open

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The most exciting developments in the battle against alcoholism are taking place in the nation's laboratories, where scientists and medical researchers are probing its neurochemical roots and hunting for genes that may influence its development. Next month researchers from six national laboratories will meet in New York City to coordinate their search through human DNA for the genes that may underlie alcoholism. If they are successful, doctors may one day be able to test young people for certain genetic markers, the chromosomal quirks that predispose some individuals to alcoholism, and warn those who are at risk of developing the disease. Says Henri Begleiter, professor of psychiatry at the State University of New York Health Science Center and president of the Research Society on Alcoholism: "Never in the history of alcoholism have we made as much progress as we have in recent years."

For the 18 million Americans with serious drinking problems, life is a runaway roller coaster that, left untended, inevitably leads to disaster. "It ruins everything that matters to you," says New York Times Reporter Nan Robertson, a recovered alcoholic. "In the end, the bottle is your only friend. Alcoholics would rather do anything than stop drinking." For the vast majority of Americans, the occasional social drink is a harmless affair. For the afflicted, however, the most innocent gathering of family or friends -- a wedding at a suburban country club, a casual gathering on an urban sidewalk -- can turn into a nightmare of temptation, indulgence and worse. Recalls a youthful recovering alcoholic: "My biggest fear was getting through life without a drink. Today it is that I might pick up that one sucker drink."

The stakes are high. Alcoholism claims tens of thousands of lives each year, ruins untold numbers of families and costs $117 billion a year in everything from medical bills to lost workdays. The magnitude of the problem has been overshadowed in recent years by the national preoccupation with the new threat of AIDS and the widespread use of drugs such as heroin, cocaine, marijuana and crack. "Take the deaths from every other abused drug," says Loran Archer, deputy director of the National Institute on Alcohol Abuse and Alcoholism (NIAAA) in Washington. "Add them together, and they still don't equal the deaths or the cost to society of alcohol alone."

Alcoholism's toll is frightening. Cirrhosis of the liver kills at least 14,000 alcoholics a year. Drunk drivers were responsible for approximately half the 46,000 driving fatalities in the U.S. in 1986. Alcohol was implicated in up to 70% of the 4,000 drowning deaths last year and in about 30% of the nearly 30,000 suicides. A Department of Justice survey estimates that nearly a third of the nation's 523,000 state-prison inmates drank heavily before committing rapes, burglaries and assaults. As many as 45% of the country's more than 250,000 homeless are alcoholics.