Over the years we've branded the chemically dependent person (traditionally the alcoholic) as simply weak-willed: "If he really wanted to stop, he'd do it." In 1956, though, the American Medical Association recognized chemical dependence as a disease--a disease as much as diabetes or cancer is.

The alcoholic, for example, abuses alcohol because he's ill, not because he's bad. Understanding that fact will help clear away some of your confusion, frustration, anger. What do you do with a sick person who can't help himself? You learn how to help, or you get professional help.

Recognizing and accepting chemical dependence as a disease implies several important truths.

Like measles or the flu, chemical dependence shows certain symptoms by which we can recognize it. One of these is that the sick person has a compulsion, an irresistible urge, to use alcohol or other drugs. The compulsion is evident because this person uses those chemicals in a way that's inappropriate, excessive, and constant. His behavior is also unpredictable: his mood can swing from depression to euphoria in a short time and does so repeatedly. He may deny the compulsion with "I don't have to drink; I just decide to," but the decision is always ultimately the same: to drink.

Experts used to think of chemical dependence as only a symptom of emotional or psychological disorders. They's say, "Let's find out what's really wrong. Then she won't need to drink." But we now know that chemical dependence isn't the result of some deeper hidden problem; it's the cause of many mental, emotional, and physical ailments. For instance, alcohol might be involved in from 25 to 50 percent of all admissions to hospitals. Such diseases as cirrhosis of the liver, deterioration of blood vessels in the brain, impotence, and mental deterioration grow worse as the patient continues drinking.

A practical conclusion: We must treat the alcoholism before we can cure the other ailments.

To be blunt, once you have it, you have it for life. No one has measles over a lifetime, but a person who becomes chemically dependent remains so until death. For such a person, there's no moderate use; the only answer is total abstinence from all mood-altering drugs, including alcohol, cocaine, marijuana, "uppers", ""downers", minor tranquilizers, even cough syrups containing codeine or other mood-altering drugs.

The good news is that with outside help one can abstain, can arrest the disease, can be healthy and happy. Alcoholics Anonymous members have it right: "The best day drinking is not as good as the hardest day sober".

Like other diseases, chemical dependence runs a predictable course. But unlike many diseases that simply disappear after a while, this one always gets worse if not treated. For months or years there may be plateaus, with no seeing increase in the chemical use. There may even be occasional improvement. But without competent treatment the path leads inevitably downward, and deterioration can be physical, mental, emotional, spiritual. It's clear, then, that early treatment is the only sensible way--and the earlier the better. The old idea that the dependent person must "hit bottom" before being open to treatment makes as much sense as letting someone jump off a cliff and "hit bottom" before you offer to help.

Left unchecked, chemical dependence is 100 percent fatal. It it's not arrested, the victim will surely die from it, and die prematurely. For the alcoholic who continues to drink, death comes at least twelve years earlier than for the nonalcoholic. It's clear, too, that alcoholism is the real culprit in many premature deaths attributed to other causes: heart disease, liver ailments, bleeding ulcers, car crashes, on-the-job accidents, suicides. And, of course, we can way the same for other mood-changing drugs.