Alcohol addiction; problems in treatment.

Of about five million problem drinkers in the United States, at least 750,000 are chronic alcoholics, a sixth of whom are in California. Seven phases of drinking patterns are described, from nondependent or "social" drinking, to the last two phases, when blackouts become more frequent and severe, "benders" fade into each other and serious organic diseases appear. General principles of treatment, after medical diagnosis and psychosocial evaluation, include hospitalization for acute episodes and physical disabilities, use of Antabuse (disulfiram) in suitable cases, psychotherapy, and the use of social aids such as Alcoholics Anonymous. The problem requires all resources available in the community, since chronic alcoholics are never cured and need support for long periods. A cooperative patient can finally readjust himself and get along without alcohol. Physicians must recognize the seriousness of alcohol addiction and help patients to accept treatment.