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February 19, 1968

The District of Columbia And the Alcoholic

JAMA. 1968;203(8):606-607. doi:10.1001/jama.1968.03140080066027

To the Editor:—  I am responding to the article, "The District of Columbia's Experiences With the Alcoholic," by Grant and Tatham and the accompanying editorial (202:931, 980, 1967). The medical model implicit in these pieces distorts the problem of alcoholism in a subtile and destructive way.Let me illustrate with the following example: When an alcoholic stumbles home inebriated, he must be cared for. It would be mean and useless to abuse him; he is senseless and uncomprehending. So his wife must nurse him back to health. Often this is a tremendous source of gratification to the oraldependent alcoholic. He drinks precisely to reach a state of infantilism requiring such care be given him. If the wife silently condones this behavior by staying with her husband and caring for his needs, she invites further regression, and he repeatedly drinks himself happily into her arms and sweet oblivion. The ultimate