'Loss of Control' in Alcoholics

Self-estimation of blood alcohol concentration: A review

“…In the first (Ludwig, Bendfeldt, Wikler, & Cain, 1978), subjects were instructed to titrate to and maintain socially acceptable BACs in the range of approximately 0.046% to 0.059% based on internal cues, but were unable to do so. The authors posited a neurophysiological feedback dysfunction in alcoholics that contributes to alcoholics’ loss of control over consumption.…”

Network therapy for substance abuse: A clinical trial.

“…They are substance-dependent patients who, upon initiating consumption of their addictive agent, be it alcohol, cocaine, opiates, or depressant drugs, frequently cannot limit that consumption to a reasonable and predictable level. This phenomenon has been termed "loss of control" by clinicians who treat alcohol-or drug-dependent persons ( Ludwig et al, 1978; Galanter, 1983). Also included are patients who consistently demonstrate relapse to the agent of abuse, that is, they have attempted to stop using the drug for varying periods of time, but return to it, despite a specific intent to avoid it.…”

"Loss of control" in alcoholism and drug addiction: A neuroscientific interpretation.

“…For example, Marlatt et al reported that alcohol consumption by men with alcohol problems was increased by instructions telling them that the beverage they drank contained alcohol but not by the actual alcohol content of the beverage they consumed, supporting an instructional set or expectancy interpretation of loss of control rather than a pharmacological interpretation. Subsequent studies have indicated, however, that actual alcohol ingestion does increase alcohol consumption independent of expectancy in severely dependent alcoholics (Ludwig, Bendfeldt, Wikler, & Cain, 1978;Stockwell, 1991;StockweU, Hodgson, Rankin, & Taylor, 1982), supporting a pharmacological basis of loss of control in those with the most serious alcohol problems. Further, Maltzman (1994) questioned the relevance of Marlatt et al's findings to Jellinek's loss of control concept because Marlatt et al's participant sample may have consisted primarily of "problem drinkers" or "alcohol abusers" rather than Jellinek's truly alcohol-dependent "gamma alcoholics"; according to Jellinek (1960), only the latter group would be expected to exhibit loss of control in response to alcohol ingestion.…”