Abstract
In Reply. — I appreciate Dr Atwood's comments on the pervasiveness of alcohol abuse and the great suffering it has caused American families. Yet I disagree that domestic violence is a sign of substance abuse, and I urge caution when assuming a causal relationship between these two behaviors. Each stems from different underlying factors, and although many families are dually affected by both behaviors, the strength of any correlation between the two is still debated. The tendency to alcoholize wife assault can lead to the erroneous conclusion that violent behavior will cease with abstinence from alcohol. Family violence literature clearly demonstrates that alcoholics who abuse their wives continue to do so after they have completed alcohol cessation programs. Physicians, therefore, must learn to recognize and ask about both problems, and recovery programs for dually affected families must address both behaviors to be effective. Unlike alcoholism, a disease with at least
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