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Letters to the EditorFull Access

Observations Now Backed By Science

Published Online:https://doi.org/10.1176/appi.pn.2017.9b53

Observations Now Backed By Science

I am writing in response to the article “Negative Emotional States Help Drive Alcohol Use Disorder” in the July 7 issue.

That article reported on a lecture at APA’s 2017 Annual Meeting by Dr. George Koob, director of the National Institute on Drug Abuse, in which he discussed findings about the effect of addictive drugs as they increased sensitization in areas of the brain associated with negative emotional states, specifically dysphoria, anxiety, and irritability. He also pointed out that addicted individuals experience these negative emotional states when they do not have access to their substance.

I could not help but note that similar observations were reported 80 years before by Dr. William Silkworth in Alcoholics Anonymous, Fourth Edition: “They are restless, irritable, and discontented, unless they can again experience the ease and comfort which comes at once by taking a few drinks. …”

The scientific method continues to lead us to truth and understanding, and it is good to remember that the process begins with careful observation and recording. Dr. Silkworth’s work was a direct and important part of the creation of AA, and it is refreshing to hear that his observations remain reliable and of value.

The phrase “restless, irritable, and discontented” is frequently spoken at AA meetings, and it is quite likely that as members of APA listened to Dr. Koob, there were members of AA hearing it from a speaker or sponsor at an AA meeting in the same city. I’d like to remind my colleagues that they are welcome at any open AA meeting anytime, anyplace. Observation continues to have value. 

WILLIAM SULLIVAN, M.D. (Cape Elizabeth, Maine) ■