Editor's Note
Breaking the Silence
In my high school, many kids drank. Some would nervously nurse a beer at parties. Others were drunk every weekend. Monday morning would bring elaborate tales told with braggadocio or amazement. Did you see how smashed Dan was and what crazy things he did when he was drunk? Did his parents find out?
Mired in adolescent experimentation, few of us questioned the bizarre admiration that was lavished on inebriates in our midst. Until we heard about Larry. Larry was one of the every-weekend variety of drinkers, and he eclipsed most everybody in terms of how often he drank and how much he consumed. If the sometime drinkers put away a six pack, Larry drank a case. If most drank only on Saturday night, Larry hit Friday and sometimes Sunday as well. The legends of Larry’s imbibing grew to mythological proportions. Then the rumors started. Something about a “liver problem.” Something about his mom and dad having the same problem. Something about Larry not going on to college like most of his classmates. A few years later, rumor evolved into fact when we heard that Larry had died in his early 20s from cirrhosis. Alcoholism was a quiet disease in the 1960s, the stuff of whispers, innuendo, and denial.
Whispers have become talk in 2006. Alcoholism and addiction are recognized as diseases requiring treatment. Centers such as Hazelden are known worldwide, and what they do has become common knowledge. Celebrities such as Mel Gibson publicly acknowledge their problem and some such as William Cope Moyers talk about their history to encourage others to seek help. Casual social conversation today is much more likely to include open talk about alcoholism than in the 1950s and ’60s, when drunks at cocktail parties were laughed at rather than worried about. Being the designated driver is a socially accepted assignment. And budding physicians now learn in medical training not just how to treat the DTs or esophageal varices but also how to spot addictions and what to do when they find them. My only exposure to drug treatment programs before I entered practice was the occasional general examination I performed in the alcohol treatment unit during residency. I suspect the first few patients in my practice who gave evasive answers to the question Do you drink? flew right under my radar.
Unfortunately, families still have their secrets, clandestinely calling the day before mom’s physical to tell about the hidden bottles and the frequent falls. Addiction’s stigma has not faded despite the medical profession’s declaration that it is a disease. And denial is now and maybe forever the mantra of addicts who haven’t acknowledged their problem and want to keep it to themselves.
Many years ago, when I participated with a family in an intervention on a fellow physician, I learned the power of not letting the addict keep to himself. The family and I intruded on this doctor’s secret world with honest talk about his problem, and we lovingly guided him into treatment.
Although the drugs of choice may change, clearly there is no perfect answer to addiction. What won’t change is the value of direct conversation about a medical problem that will only get fixed in the light of day.
Charles R. Meyer, M.D., editor in chief
Dr. Meyer can be reached at cmeyer1@fairview.org