Let's see--Where was I?  Oh yes!  The emergence of the
survey-based critique of disease alcoholism in the
mid-1970s.  Let me backpeddle a little on what I was
saying in Part I.  Tho it's true that survey data--whether
in RAND's clinical follow-up or Cahalan's general pop.
samples--didn't seem to fit the clinical or
disease-concept mold, it is *not* entirely fair to say
that survey-research critique arose from a purely
empirical, inductivist, and unthinking exercise.  The
"problem drinker" (PD) perspective that emerged from
survey "epidemiology" (as the field was/is called) was
often regarded as focusing attention on the
not-quite-fully-addicted drinker--a sort of sub- or
potential alcoholic--thus perhaps leaving the "real"
alcoholic to continuing clinical jurisdiction.  But the
real difference between the "problem drinker" &
"alcoholic" conceptualizations lay not so much in the
*severity* or *degree* of putative dependence as in the
eye of the scientific beholder.  The PD perspective
brought an inherent philosophical *nominalism* and a
strong commitment to conceptual *operationalism* to
alcohol-problems research.  Both inclinations are in fact
more or less inevitable in survey research work--where the
enterprise itself tends to demand clear explication of
concepts, translation of concepts into askable questions,
and then analyses aimed at addressing the
"lumping-togetherability" and relational patterning (or
lacks thereof) of measured quantities.  But even in the
survey-research medium, the PD perspective can subtly
reconverge with clinical & disease-concept platonism.  All
the survey-data analyst need do, for example, is regard a
drinker's "problem-drinking score" as a *diagnostic*
(rather than essentially descriptive/operationalist)
exercise, and the trip back to an essentialism is
half-completed.  That sort of re-essentializing of the
topic is apparent to some degree in almost all survey
epidemiology of drinking problems but perhaps particularly
so in Cahalan's *Problem Drinkers* (1970)--though, and
ironically, that book contains one of the clearest
explications of the key differences between the survey and
clinical perspectives available in the alcohol
literature.///Survey research's cardinal finding that
alcohol-problems were not as "lumpy" as previously
thought--i.e., (1) they didn't clump together in
individual persons as much as clinical wisdom had led us
to expect, (2) inter-problem correlations were lower than
expected, and (3) (perhaps most importantly) even
cross-temporal problem correlations were lower than
expected--did not in turn create an "alcohol problems"
perspective *de novo* in the alcohol research scientific
community.  On the contrary, such a perspective--which
tended to foster a "disaggregated" view of
"alcohol-related problems" (splitting these into different
conceptual and policy domains rather than "lumping" them
together under a single disease denomination)--already had
a long history in post-Repeal American scientific thought.
An "alcohol problems perspective" (APP) was richly
evident, for example, in Thomas Plaut's (1967) report of
the Cooperative Commission and even as far back as the
early days of the Yale Center on Alcohol Studies (see
*Alcohol, Science, & Society* [1945]).  The emergent
survey research critique of the disease conception of the
mid-1970s, then, was of a piece with an older conceptual
motif in American alcohol science--and by no means a
wholly new thing under the sun.  END OF PART II