Nancy,

Accidental or not, thanks for posting this to the whole list!

I'd like to take issue with one element of your account, though.

There were, and there are, no epidemiological studies that did or could
confirm your 13+ million figure regarding the prevalence of alcoholism in
the U.S.  The central problem was that survey measures of "drinking
problems" resulted in continuous rather than bi-modal distributions on
their drinking problems measures.  Hence, the results did not lend
themselves to drawing an easy cutting point between alcoholic and
subalcoholic drinking and drinking problems.  (The problem was first
articulated in Walter Clark's classic paper -- "Operational Definitions of
Drinking Problems and Associated Prevalence Rates," Quart. J. Stud. Alcohol
27:648-668, 1966 -- and then echoed and ramified through countless
publications at the Alcohol Research Group in years following.)  A
secondary problem was that general population surveys would tend to miss
what's called the "nonhousehold population" of alcoholics -- i.e., residing
in one or another institutional or "group quarters" or even homeless
circumstances.

Of course, this did not stop the movement on behalf of the expansion of
alcoholism treatment in the U.S. from pressuring survey researchers to
produce alcoholism prevalence estimates regardless.  And the meeting of
these two forces -- survey researchers saying they couldn't do it and
political-social advocates saying "Give us a number anyhow!" -- produced
the sort of comedy and absurdity you described in your own experience in
Congress.  In due course the folly of the scientific situation was reported
to a wider scientific public -- see, Barnes, Deborah M., "Drugs: Running
the Numbers," Science 240:1729-1731, (24 June) 1988.  Robin Room has
somewhere recounted the situation surrounding prevalence estimation, too,
but at the moment I can't remember where.  Also see Hilton, M.E., "What I
would most like to know: How many alcoholics are there in the United
States?". British Journal of
Addiction, 84(5):459-460, 1989.

There may have been 13+ alcoholics in the U.S.; your guess was as good as
the epidemiologists'!