Previously in my series of posts I've noted the paucity of
OF-work in the sociology of the alcohol-problems field.
One of the consequences of that paucity is a remarkable
lack of knowledge--or even awareness, in some quarters--
regarding the on-going change in "popular paradigms" that
appears to be occurring in the addictions social arena,
both in the U.S. and internationally.  In other words,
because they have been on assignment as honest hod-carry
survey epidemiologists, our sociologists have had little
time to devote to comprehending the social changes going
on in this problem domain.  This listserv group may be an
infelicitious place to bring up those changes--I'm not
sure.  I've been struck, for example, by how many of the
topics discussed herein are in essence the classic and
enduring conundrums of the addiction treatment enterprise
--the limits of free will v determinism, nomothetic v
idiographic knowledge, diagnostic "lumpers" v "splitters",
voluntary v involuntary treatment, abstinence v
maintenance, etc.--and consequently cast less attention
outside the clinic door & to the wider society.  That's,
of course, all well and good for list comprised of
therapists.  The same topical focuses, however, may make
my comments on social change sound...well, like a waste of
time--in which case, I apologize in advance.///In my own
view, however, *something* historically significant has
been happening in this social arena--and I'm intrigued and
mystified by it.  Perhaps it will be just as well to start
with more backpeddling on my previous posts--namely, to
start with the confession that the recent ascendancy of
the "public health model" (PHM) (there are many names for
it) suggests the distinct aroma of a sociological perspec-
tive.  And, if that's true, then all these honest, hod-
carrying, mean-no-harm-to-anybody sociologists I've been
talking about just can't have been quite so *benign* as my
past descriptions have painted them!  Maybe gun-slinging
sociologists WERE shooting-up Alcoholismville after
all--after dark and with silencers!///Let me begin with
some historical fundamentals.  First, sociological
research was not the only--and certainly not the most
famous--source of troubles for the disease conception in
the post-Repeal American historical context.  The
troublemakers were many--& some have been at it since
virtually the beginnings of the new movement.  In an
earlier day, psychiatry had squared-off against the
classical disease concept (in the Krystal-Moore debate),
which marked the first big round in the dispute over
whether alcoholism was better regarded as a freestanding
disease entity or a mere symptom of underlying psycho-
pathology.  Oddly enough, and virtually from the get-go,
*alcohol science itself* became a major adversary and
detractor re significant aspects of the classical disease
conception.  For example, Howard Haggard, paterfamilias of
the Yale-based alcohol research effort, wasted little time
in testing and rejecting the good Dr. Silkworth's "allergy
theory" of alcoholism.  And Haggard was not the movement's
only major scientific & therapeutic hero who placed
relatively little importance upon, or denigrated outright,
disease thinking.  Psychiatrist, and movement hero, Harry
Tiebout--who did so much to articulate the genius of AA's
"surrender" ideology to the contemporary scientific
community--was genuinely impatient with overblown
disease-concept claims by the mid-1950s.  Behaviorist
psychology mounted the most notorious attack on disease
ideology--and drew the most famous counterattack in the
Pendery et al. (1982) assault on the Sobells' research in
prestigious *Science* magazine.  END OF PART V