The myth of alcoholism prevention

Abstract

Although practically every article about alcoholism contains at least one or two paragraphs that stress the importance and need for prevention programs, the “hows” and the “specifics” are rarely spelled out in any detail. The analysis of why this situation exists points to the existence of three central premises around which the present alcohol prevention model is constructed. Each of these premises has at its core the existence of some invalid statements, the perpetuation of which effectively blocks the establishment of more appropriate prevention models. Awareness of “facts” about alcohol leads to a change in drinking. The paper cites evidence from experimental and empirical sources, illustrating that the presentation of facts, although in some cases altering attitudes, does not result in changes in certain behaviors. An explanation and model are provided stating the conditions under which “facts” do and do not result in behavioral change and where “alcohol facts” fit into this paradigm. Prevention programs centered around “consequences” are an effective way to produce change in drinking. The common theme most alcohol prevention programs share today is that their “message” deals with the consequences of drinking. This approach is highly unsuccessful in appealing to alcoholics whose characterological style ties them to the present and not the distant consequences of their behavior. Applicability of a medical primary and secondary prevention model to alcohol education. This section of the paper deals with the misapplication of the medical primary and secondary prevention models to alcoholism. It discusses why the etiology of alcoholism must be understood prior to the establishment of a primary prevention program. It also questions the methodological premises around which the early warning signs of alcoholism are built and their validity in successfully predicting the later development of alcoholism. The need for more longitudinal studies is suggested.