Under the Influence and Ending the Drug Addiction Pandemic by Dr. James Milam

Reviewed by John Lauritsen

Dr. James R. Milam has almost singlehandedly revolutionized alcoholism treatment.  He is creator and champion of the “biogenic model”, which holds that alcoholism is a physical addiction to the drug, ethyl alcohol.

The older “psychogenic” model placed the blame on alcoholics — on their moral weakness, sinfulness, or in AA language, “character defects”.  According to the psychogenic model, alcoholism is a symptom or consequence of underlying character defects, a destructive response to life problems, a bad habit.  Since alcoholism was considered a psychological disorder, psychiatrists were considered the experts, and they dominated the alcoholism field.

In contrast, Milam’s biogenic model blames the disease itself, the result of alcohol intake in a biologically susceptible body, with the susceptibility being largely inherited.  Alcoholism itself is the primary problem; it is not a merely a symptom of psychological problems — nor is alcoholism a sin or moral weakness, as the clergy-led temperance movement believed — nor is alcoholism just a bad habit, as some current therapists claim.  Rather, alcoholism is a progressive disease, which is fatal unless arrested through total abstinence.

There are forerunners to Dr. Milam’s biogenic model. I date the beginning of the alcoholism recovery movement from the founding of the Washingtonian Movement in 1840.  The Washingtonians not only believed that inebriates could be saved, they proved this, by restoring seemingly hopeless drunks to health and happiness.  And this they did by demanding total abstinence, staying away from the fatal first drink.

In 1970 Milam self-published The Emergent Comprehensive Concept of Alcoholism (ECCA), which attained an underground celebrity.  Then, in order to reach a larger audience, he collaborated with Katherine Ketcham, who helped him translate the technical ideas of ECCA into simpler language.  Their book, Under the Influence (UI), was published in hardback in 1981 and then as a mass market paperback, which has sold well over a quarter of a million copies.

In my opinion UI is the best book ever written on alcoholism.  This new book, Ending the Drug Addiction Pandemic: Discovering the Liberating Truth (EDAP), is complementary to UI.  Milam on his own is a fine writer, clear and concise.  Very little of EDAP is overly technical for a good reader.

Dr. Milam is now ninety-three years old, living in Seattle and recovering from lung cancer.  I’ve spoken to him several times in the past few months.  He describes himself as an agnostic, rejecting the dogmatism of either religionists or atheists.  His Higher Power is The Wisdom of the Body.  He believes in the power of positive thinking, in which sense religious faith can sometimes be beneficial.

Milam is strongly pro-AA, but not uncritically. Recovering alcoholics need the support of other people, and here AA is the best option.  On the other hand, he rejects AA’s (or Bill W.’s) insistence that alcoholism is a symptom of character defects:

Despite its moralistic foundation, however, A.A. worked as no other approach to alcoholism had before, and as a long-term sobriety maintenance program, there still is not even a distant rival.  Thus A.A. stands as a colossal paradox.  The fellowship has undoubtedly been the most powerful force in getting society to accept alcoholism as a treatable disease.  Yet at the same time, it has become a powerful obstacle to accepting the otherwise overwhelming evidence that biological factors, not psychological or emotional factors, usher in the disease. (UI p, 140)

In these two books Milam explains how psychological problems are the consequences, rather than the cause, of alcoholism.  According to Milam, alcoholism turns good people (Dr. Jekyll) into bad ones (Mr. Hyde), by injuring the brain and other organs:

Within the biogenic paradigm Jekyll is the real person, Hyde a neuropsychological distortion created by the addictive chemical.  Hyde exhibits the same kind of deterioration of personality and character as victims of such other progressive brain pathologies as brain syphilis or a brain tumor.  Body mind, and spirit (including willpower) are biologically compromised and subverted to serve the addiction.  Given time for healing, in alcoholism the brain syndrome is reversible.  The task of therapy is to restore Jekyll to sanity and selfhood, and to start him on a path that will preclude a return to the addictive, transforming chemical.  (EDAP p. 3)

Therapists treating alcoholism routinely confound the physical effects of alcohol damage with psychological problems:

One of the main semantic strategies for hiding the biological truth is to purport to be measuring psychological traits of the alcoholic person without mentioning which of the constantly changing biological states he is in at the time the measurement is made, e.g., whether in the acute or protracted withdrawal period, and whether in the early, middle, or late state of alcoholism.  The resulting potpourri of bogus descriptions in the alcoholism literature misrepresents the personality of the alcoholic as inconsistent, irrational and incomprehensible.  (EDAP p. 35)

For example, what is considered “anxiety”, a psychological term, may actually be physical “anguish” caused by injured and recovering nerve tissue.

With total abstinence and time the good personality (Dr. Jekyll) re-emerges. This does take time — sometimes years — and may need the help (experience, strength and hope) of other people — but it happens mainly from the healing of the body and all of its organs, including the brain.

In addition, Milam is critical of AA’s belief that an alcoholic must “hit bottom” and that it is good to eat sugar.  AA’s emphasis on “spirituality” goes along with a neglect of the physical aspects of recovery, especially nutrition.

Although Ending the Drug Addiction Pandemic is a short book, it has a wealth of information, much of it new.  To me one of the most important chapters is “Actions of Alcohol & Onset of Alcoholism”, in which Milam describes in detail what alcohol does, and the differences between alcoholics and nonalcoholics.  It is neither obvious nor easy to make distinctions between alcoholics who are at an early stage of alcoholism, or temporarily drinking within the limits of their tolerance, and nonalcoholics, who may drink too much on occasion or even for a long time.  But Milam does make the distinctions convincingly.

Aside from alcoholism, Milam discusses the pandemic of addiction to harmful prescription psychoactive drugs.  I was shocked to learn that in the United States ten million little boys have been put on Ritalin, a harmful drug closely related to “speed”, on the basis of a phony psychiatric diagnosis, “Attention Deficit Disorder” (ADD), “for which no organic causes have ever been found.”

Milam’s ideas went against powerful interests: psychiatrists, as well as the liquor, sugar, and pharmaceutical industries, which fought back covertly:

It was easy to reassert the psychogenic belief about alcoholism because it had always been the default position and it still appeared to the public as the obvious truth.  As the abundant scientific and clinical evidence that it is false began to appear psychiatrists simply became more proactive…. They provided the media and the public with steady flow of disinformation, bogus research claims and unfounded opinions.

Along with AA, Milam insists that recovery from alcoholism requires total abstinence from alcohol.  For this position, both AA and Milam have been attacked by therapists, who claim that alcoholics can learn to drink “in moderation” if, with therapeutic help, they resolve their psychological problems.  Such therapists are promoting death for alcoholics.  It has been known for two centuries that drinking “in moderation” is not an option for true alcoholics.  This I know not only from my own experience, but also from the untold hundreds of experiences I’ve heard shared in AA meetings, of those who tried to moderate their drinking.  The lucky ones made it back to AA, staying away from the first drink; the unlucky ones died.

UI was not directly confrontational regarding psychiatry.  In EDAP the gloves come off.  Milam not only demonstrates that the psychiatric influence on alcoholism treatment has been disastrously wrong, but that psychiatry itself is anti-scientific: “Psychiatry is not even a profession.  It is an exploitative, self-serving secular cult masquerading as a profession.”

Amazingly, Milam was unable to find a major publisher for EDAP.  Random House told him that they would not look at his manuscript unless he obtained an agent.  This is not the way that publishers should treat a best-selling author, but it happens when powerful interests are threatened.  As it was, Milam had to fall back on a small press, which offered little editorial help.  Nevertheless, EDAP is a worthy successor to UI.

I recommend both books highly.  Read UI first and then EDAP, which brilliantly complements it.

Dr. James R. Milam and Katherine Ketcham.
Under the Influence: A Guide to the Myths and Realities of Alcoholism.
Bantam Books, 1983 (First publication 1981).
ISBN: 0-553-23788-8 (paperback).
Also available in Kindle format.

James R. Milam, PhD.
Ending the Drug Addiction Pandemic: Discovering the Liberating Truth.
Strategic Book Publishing and Rights Co., 2013.
$11.50  ISBN: 978-1-62857-209-4 (paperback).
Also available in Kindle format.

About the Author

John Lauritsen. was born and raised in Nebraska.  He attended  Harvard College (AB 1963), majoring in Social Relations (Sociology, Anthropology and Psychology).  In New York City he worked as a market research executive, writing on the side.  He was in the antiwar movement since 1965 and the gay liberation movement since July 1969.  He founded Pagan Press in 1982.  For a decade, beginning in 1985, John was a leading writer for the New York Native, which was then the foremost gay paper.  He has twelve books to his credit.  John dates his alcoholism from his first bender in 1958 to his last drink in 1968.  He considers himself a loyal, but by no means uncritical, member of AA.  John now lives in Dorchester, Massachusetts.

Freethinker-AAJohn’s groundbreaking book, A Freethinker in Alcoholics Anonymous 

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  1. John the Drunkard March 5, 2019 at 8:45 pm - Reply

    I’ve just ordered the EDAP book. Searching for it, I notice that the publisher is essentially a vanity operation that solicits unvetted manuscripts. So I will anticipate and accept a level of editing and design that I might otherwise complain about. I’ve read Under the Influence, and the Ketchum-only followup Beyond the Influence.

    Sure the nutritional stuff is questionable. But I suspect it may have been driven by the really crazy promotion of sweets that flourishes in some circles of AA.

    I don’t think its possible to write about ‘moderation’ schemes, the Sobells, and Psychoanalysis honestly without unleashing outrage and scorn. The price alcoholics have paid for these has been collected in blood.

  2. Laurie A November 27, 2015 at 2:18 am - Reply

    So, ‘Psychiatry is an exploitative, self-serving, secular cult.’ Is that so? Dr Silkworth wrote in the Big Book ‘We doctors have realised for a long time (1939!) that some form of moral psychology was of urgent importance to alcoholics’ but was suitably modest about the efficacy of the psychological approach. And he added, ‘Though the aggregate of recoveries resulting from psychiatric effort is considerable … many types (of alcoholic) do not respond to the ordinary psychological approach.’

    The psychiatrist Max Glatt (a non-alcoholic) dedicated his professional career to helping problem drinkers, including hundreds of AA members.  And I am personally grateful for the immense support an encouragement – and professional advice – I received from his colleague at St Bernard’s hospital in London from his colleague Dr David Marjot. Let’s be friendly with our friends, not all doctors -or psychiatrists – are charlatans.

  3. Chris G. November 25, 2015 at 9:40 pm - Reply

    EDAP: What a load of rubbish. The review had me very hopeful for a really good new book shedding medical light on alcoholism, so I immediately bought it and read it. Spent all day on it. Definitely not what I was expecting.

    Whether or not he had an agent, he certainly needed an editor. The book is written in an appalling style, difficult to follow, and has so many diversions down rabbit holes that it is really tedious. It is even full of typos, in the Kindle version at least.

    Almost the entire book is simply a diatribe against psychiatrists and psychiatry. This quote will give you both a hint of the style and the entire raison d’etre of this book: (this is his summary in the Treatment chapter)

    “It was public trust in psychiatrists as the ultimate authorities on addictions that enabled them in 1988 to so easily abort the first move toward enlightenment by brushing scientific reality aside and snapping the public back into denial. Not this time. All respect for psychiatrists will disappear with the discovery of the irrefutable truth presented for the first time in this publication: Psychiatry is not even a profession. It is an exploitive, self serving secular cult masquerading as a profession.”


    As far as alcoholism itself is concerned, I learned not a single new medical or scientific fact; in fact his science is very out of date. The most recent publication in his references is 1992, and his scientific references are mostly from the 1940s through the 1960s. His most familiar drugs are Thorazine and Miltown, although he admits to later ones.

    Scientific medicine? How about this: “In the small to medium dosage range alcohol acts as a primary stimulant as it tends to liquefy the cytoplasm, or main substance of the cells. Then only in larger amounts it tends to coagulate the cytoplasm and act as a sedative.” Maybe a touch of the 1890s?

    And his cure for alcoholism? Don’t drink. Period. Pure abstinence. AA can do it, his old hospital (circa 1935 through the 1960s) can do it, and a few other poorly defined abstinence programs can do it – but stay away from those blasted psychiatrists! He does have an interesting few paragraphs on AA in chapter 7, but much more on his beloved Shadel Hospital.

    Curiously enough, in spite of all this, I personally agree with some of what he has to say. I agree that psychiatry, special moneyed interests, bad public policy, Big Pharma and so on have helped keep science out of the alcoholic treatment arena. If you have read Johann Hari’s excellent book Chasing the Scream: The First and Last Days of the War on Drugs, you will find a strong parallel. And, yeah, I have no use for psychiatry. I certainly agree that genetics plus alcohol is what creates an alcoholic, in the end. Everything in the mind is, at its root, chemistry.

    John, I’m sorry to disagree with your opinion that “Milam on his own is a fine writer, clear and concise.” I offer the following reasonably typical sentence in my defence: “By recognizing the more basic neurological augmentation it becomes clear why the added stress of an inappropriate traditional psychotherapy augments the stress of the neuropsychological symptoms while adding another layer of iatrogenic symptoms to the patient’s already overstressed psychic economy.” Could I read that at a meeting?

    I also bought UI – I will have to give that a try, when I recover from this one. Yes, I probably should have read it first!

    • John L. November 26, 2015 at 5:52 pm Reply

      Chris G. — I don’t know what to make of your comment. You may disagree with James R. Milam on some things (as I do) and you may be irritated by stylistic shortcomings, but these hardly justify starting out your comment with “What a load of rubbish.”.

      Re-reading much of Ending the Drug Addiction Pandemic (EDAP) in order to see if I’ve been promoting rubbish, I found a few misspelled words and a few paragraphs that were difficult to understand, but on the whole I was more impressed than ever by Milam’s courage and clarity. He doesn’t mince words or use euphemisms. Yes, he really is “a fine writer, clear and concise.” The paragraphs you quoted are not typical, and were taken out of context.

      In my review I said that Milam’s book, Under the Influence (UI), should be read first and then EDAP, which, as Milam himself states, is a complement to the former book. I came to EDAP as a great admirer of Milam’s, having read not only UI several times, but also Milam’s earlier writings. No doubt a few parts of EDAP may prove difficult for someone who hadn’t read UI.

      You say that Milam needed an editor, and I agree. Unfortunately, more and more new books show no signs of editing. Even books from major university presses (shame on you, Oxford!) can be filled with typos. Milam’s book would also have benefitted from an index and bibliography. But even with its shortcomings, EDAP is a good and important contribution to alcoholism recovery literature.

      You were disappointed that you “learned not a single new medical or scientific fact” and that Milam’s “cure” for alcoholism consisted solely of “Don’t drink. Period. Pure abstinence.” But there is and will never be a “cure” for alcoholism, which can only be arrested through abstinence. This is what I heard often in the first years of my sobriety, nearly half a century ago. As Milam puts it:

      “It is here that AA and the successful abstinence-based treatment programs have the scientific and ethical high ground. By painful trial and error they learned two critically important facts. One, an alcoholic can arrest the disease and fully recover from it only through continuous total abstinence. And two, an alcoholic can never safely take the first drink.” (EDAP p. 11)

      I disagree that “Almost the entire book is simply a diatribe against psychiatrists and psychiatry.” Much of EDAP consists of Milam’s well supported exposés of the villainous role psychiatrists have played in alcoholism treatment and in the promotion of harmful prescription drugs. His writing may be severe at times, but cannot fairly be called a “diatribe”.

      Milam is not a friend of drug use, whether prescription or “street”; he opposes prescribing psychoactive drugs to alcoholics. He disapprovingly quotes President Carter’s drug czar, psychiatrist Peter Bourne, who declared: “Don’t worry about cocaine. It is among the most benign of all drugs in widespread use.” I also disapprove of Bourne’s statement, since I’ve known too many people whose lives were ruined by cocaine; some of them died.

      You mention “Johann Hari’s excellent book, Chasing the Scream: The First and Last Days of the War on Drugs“. I’ll check this out. The Wikipedia entry on Hari is very negative — although I take Wikipedia with a grain of salt. There is a critical review of Hari’s book on The Fix:

      4 Things Johann Hari Gets Wrong About Addiction

      Based on this review, Hari is very much in the “psychogenic” camp, whereas Milam and I are in the “biogenic” camp — two competing paradigms. However, I expect to agree with Hari on the “War on Drugs”, which in my opinion is the worst possible approach to (in Milam’s words) “the drug addiction pandemic”.

  4. John S November 25, 2015 at 9:33 pm - Reply

    Thank you John for your contribution and for introducing me to these two books. I will make time to read them. I assumed that it was established that there’s a genetic component to alcoholism, that there were studies that actually isolated a gene. I guess the science isn’t as established as I had thought.

    It makes intuitive sense to me that my character didn’t cause my alcoholism, rather my alcoholism chipped away at my character.

    Again thank you. The talent we have in our community of heathen AA is really extraordinary.

  5. Joe C. (@Rebellion_Dogs) November 25, 2015 at 8:22 pm - Reply

    Totally enjoyed this (and the discussion that follows). I don’t agree with everything John says but I always love his candor and ability to support his thesis. Two thumbs up, John. UI was definitely a breath of fresh air in the 1980s. This new offering will be on my ‘to read’ list for sure.

  6. John S November 25, 2015 at 5:21 pm - Reply

    Hi Greg. I am working on it. This just started happening today. Our original comments box didn’t have editing capabilities so we installed this one, which was working pretty well until recently. Websites are odd in that things just go awry for whatever reason, but it keeps me on my toes.

    We’ll get it fixed.

  7. Greg H November 25, 2015 at 5:16 pm - Reply

    I do hope that the maintainers of this web site can figure out (perhaps learn from the maintainers of aaagnostica.org) how to prevent all the normally invisible formatting junk text inserted as a result of a cut and paste from a word processor or other text editor, along with other formatting changes such as the deletion of blank lines between paragraphs, from appearing in the posted comments. Those of us who do that cut-and-paste thing cannot see the ugly formatting changes until after the comment has been posted.

  8. Greg H November 25, 2015 at 5:03 pm - Reply

    Thank you, John, for bringing Milam’s new book to our attention. I’ll have to get a copy.

    I totally agree with you that “UI is the best book ever written on alcoholism.” We even have it on the literature table at both of the AA meetings I regularly attend. It is especially helpful for people like me who can read the first 164 pages of the Big Book and say to themselves, “Well, if that’s what it means to be an alcoholic, then obviously I must not be one!”

    Back when the first edition of the Big Book was written there was no section of personal stories called “They Stopped in Time” because virtually all of the early members of AA were low bottom drunks of the hopeless variety. As Bill said in the chapter More About Alcoholism (p. 32), “the difficulty is that few alcoholics have enough desire to stop while there is yet time.” In other words, any alcoholic who is both willing and able to quit drinking while they are still in what Milam calls the “early adaptive stage” isn’t actually an “alcoholic” at all. With that mentality, I have been told by mainstream AA culture members that I am not and never have a been real alcoholic precisely because I was able to quit drinking based on nothing more than “the warning of a doctor.” In the paragraph starting at the bottom of page 21, people like me who can do that are characterized as being merely “a certain type of hard drinker.” Then the very next paragraph begins, “But what about the real alcoholic?” And of course every right-thinking AA member knows that the first 164 pages of the Big Book are nothing short of holy scripture, inerrant in every word.

    One thing I have figured out for myself over the years is that the Twelve Steps (no matter how they are worded) are not actually a program for recovery from alcoholism per se (as Silkworth, Milam and I all understand it). They are an often-effective program for recovery from what the American Psychiatric Association has called a Cluster B personality disorder which can effectively block recovery from alcoholism. Cluster B includes the Antisocial, Histrionic, Borderline and (as was Bill W’s case) Narcissistic Personality Disorders, all of which involve some sort of compulsive “control-freakishness.” For those of us who are not at all like that, working the Steps–even a version that has been “sanitized” to remove all of the God stuff–can range anywhere from totally beside the point to disastrously counterproductive.

    There is one point where I do disagree with Milam and others who share my basic understanding of alcoholism as being caused primarily by a physiological predisposition. That is with the common use of the word “disease.” The simple fact of the matter is that alcohol is a toxin which poisons every cell in the body of anyone who drinks it, regardless of whether they happen to be an alcoholic or not. As is the case with many other toxins, the exact symptoms that manifest after exposure to it can vary considerably from one person to the next. So I prefer to say, not that we alcoholics have a “disease” that set us apart from non-alcoholics, but rather that we are simply differently poisoned by the universal toxin alcohol.

    I have more recently learned that in fact the precise manner in which we are differently poisoned can vary from one alcoholic to the next as much as our personalities can. The only things that we all have in common are that (1) especially while we are still in what Milam calls the early adaptive stage, alcohol makes us feel “better” in one way or another, and (2) we develop a tolerance for it over time such that we need increasingly larger quantities of it in order to achieve the desired effect until eventually, once we have progressed into Milam’s “middle stage,” we need to consume it on a regular basis just in order to feel okay.
    In any event, I’m looking forward to discovering in Milam’s new book what else we have collectively learned about the physiological underpinnings of alcoholism in the decades since UI was published.

    • John L. November 25, 2015 at 6:00 pm Reply

      Thanks for your extensive comments. My experience was different from yours in that I was physically a low-bottom alcoholic. I crossed the “invisible line” either with or shortly after my first bender. But if a knowledgeable person had explained my alcoholism to me early, I could and would have stopped drinking before reaching the bottom that almost killed me.

      I agree with Milam that the physical susceptibility to alcoholism is largely, although certainly not entirely, inherited. But social, cultural, and psychological factors also play their roles — and differently from one individual to another. For example, the alcoholism rate among gay men is many times higher than among the general population. I think this is due to real oppression and also to circumstances — that for many decades bars were the only places where gay men could safely meet each other. Even so, most gay men drank without becoming alcoholics.

      Your concept of “differently poisoned” is thought provoking. Probably the effects of alcohol in alcoholics differ by body build, metabolism, etc. I don’t know.

  9. life-j November 25, 2015 at 2:18 pm - Reply

    John, thanks for writing this review. I am not sure I have quite understood the main points of it, so I may missing the mark entirely here:

    It is easy to oversimplify such that there is only one cause of a problem, and I think I see some tendency toward that here. It is not only alcohol itself or only the environment or genetics or psychology or nutrition, or whatever, it is all of them to some extent.This almost sounds like there is supposed to be no psychological and no moralistic components to alcoholism, but only a physical one, both in its origin and its development.
    This must turn it into a mostly genetic issue?

    The moralism in AA is indeed a problem, and it is two-fold.There is the story about how alcohol turns good people into bad ones – alcohol undoubtedly does that. Once we have come to a place where drinking becomes the focus of our lives, and our primary need, then we are bound to follow a path of moral deterioration. This part of it does indeed tend to straighten itself out once we quit. Sounds like this is what Milam focuses on.
    The other – AA at its worst – is AA resorting to an original sin concept wherein it begins to trace the problem with alcoholism back to how we were self-willed long before we ever touched alcohol.
    We must thus have been self-willed from birth, and this neglects entirely issues with abuse, neglect, and trauma from the environment, and while AA has promoted the disease concept of this phenomenon it can’t quite help returning to moralizing over it, as in steps 4 to 7 especially. If alcoholism isn’t a moral issue – then why do we take a moral inventory?

    But this morass of original sin we only wound up with because psychology as a science was in its infancy. So there is one set of psychological problems resulting from alcoholism, one set that is causing it. These two do have some relations to each other, and the earlier ones keep feeding the later of course, but they are also two very distinct, and separate phenomena. I don’t buy the genetic theory almost at all. At any rate I know there is no overt alcoholism in my own family of origin, and I think most people who drink because their parents drank do so because they have the same pain to cover up, and alcohol works as well for them as it did for their parents, genetics is only a minor issue of being predisposed to a conglomerate of circumstances for which alcohol is as much a solution initially as it later becomes a problem.

    There is much effort to explain everything genetically these years. It relieves our horrid capitalist social structure of any responsibility for the mess we’re in. We’re a bunch of genetically defective people who live in the best of all possible worlds.

    • John L. November 25, 2015 at 6:47 pm Reply

      Life-j — Neither Milam nor I ever claimed that there is only a single cause of alcoholism. I differ slightly from Milam in placing more weight on social, cultural, circumstantial, and psychological factors — but still consider alcoholism largely based on a physical susceptibility.

      You state: “psychology as a science was in its infancy”. Here we need to make a distinction, between psychology and psychiatry. Milam devotes an entire chapter, “MDs and PhDs”, to distinguishing psychologists (with PhD degrees) from psychiatrists (with MD degrees plus Freud). As Milam well demonstrates, the discipline of psychology is scientific (evidence based); psychiatry is not scientific, but rather “an exploitative, self-serving secular cult masquerading as a profession.” The chapter, “Chafetz”, gives a devastating description of the unscrupulous Freudian psychiatrist, Morris Chafetz, who for decades dominated alcoholism recovery, to its detriment, as head of the National Institute on Alcohol Abuse and Alcoholism (NIAAA).

      At any rate, I urge you to read Under The Influence, if you haven’t already done so.

  10. Ian C November 25, 2015 at 11:13 am - Reply

    Nice review – I’ll be buying both books based on your recommendations. One niggle, though. You suggest the major publishers “…would not look at his manuscript unless he obtained an agent… it happens when powerful interests are threatened.” Mm. A quick browse of the self-help / popular science shelves in bookstores (in the uk, at least) indicates that challenging ‘powerful interests’ – eg big pharma, religions, energy co’s, political status quo, etc – is rather good for sales. What’s wrong with appointing an agent if they can get you a good deal? Lord knows books like these need international, mainstream distribution. UK AAers tend to respect new peer-reviewed research (as Bill W urged us to), so Milam’s work would be great counter-weights to the low-key, but insistent strictly roots movement over here.

    Many thanks

    • John L. November 25, 2015 at 6:18 pm Reply

      I don’t mind niggles. Perhaps Dr. Milam could have found an agent and a major publisher. At his advanced age (93) he may have been prematurely discouraged. So far as powerful interests are concerned, they and their public relations firms can jettison a threatening book even before publication. Examples are given in the book, Toxic Sludge Is Good For You: Lies, Damn Lies and the Public Relations Industry, by John Stauber and Sheldon Rampton. There is much censorship in the mainstream media, often hidden — but with the Internet there is a whole new ball game.

  11. Thomas B November 25, 2015 at 11:01 am - Reply

    Thanks so much  John L. for this exemplary review of Milam’s work — I’ve known about Under the Influence for a number of years, but now I have another book to add to my pile/cue of books to read, Ending the Drug Addiction Pandemic: Discovering the Liberating Truth.

    I was back in New York this past October and was most grateful to be able to attend and speak at two of the meetings that were crucial to my early recovery in the 1970s, Mustard Seed and the Midnight Meeting — unfortunately I was unable to get to a Perry Street Meeting, which was also essential to my early recovery, when I was hospitalized for congestive heart failure for a week at the Manhattan VA hospital. I remember you from early meetings I attended at Perry Street.

    Thanks for your activism in our secular recovery movement as well as for your activism in both the peace movement and the LGBT movement. I am privileged to have been re-acquainted with you in Santa Monica, and I look forward to seeing you again in Austin.

    • John L. November 26, 2015 at 6:03 pm Reply

      Get well, Thomas!  I’m afraid that these days Midnight meetings are well past my bedtime.  I haven’t been to a Mustard Seed meeting since leaving NYC 20 years ago, but have fond memories.

  12. John J. November 25, 2015 at 8:04 am - Reply

    I have read Under the Influence and found it quite informative.  The only issue I have is his assertion that alcoholics either are or become hypoglycemic as a relationship to alcohol abuse.  This seemed to be more of an opinion or educated guess than a conclusion based on scientific evidence.  My wife is diabetic and I have checked my blood sugar levels regularly both during my drinking career and in the year since I stopped and it has always been within the normal range.  It was recommended to me by a doctor/psychiatrist AA at an outpatient rehab back in 1992.  I’ll have to check out the new book as well.

    • John L. November 25, 2015 at 6:09 pm Reply

      The relationship between hypoglycemia and alcoholism is complicated, and I don’t think the medical establishment understands it even now. I myself suffered from severe “protracted withdrawal syndrome” even two months after my last drink. Hypoglycemia caused this, and my withdrawal symptoms went away less that three days after going on the hypoglycemia diet. The real test for hypoglycemia is the 5-hour glucose tolerance test, not a blood test. I’ve told my own story about this in my article, “Physical Recovery”, which is a chapter in my book and also on-line in AA Agnostica.

      Anyway, Milam in Under The Influence does present findings that most (not all) alcoholics suffer some degree of hypoglycemia. Perhaps you are an exception.

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