Good intentions and perhaps overreaching claims aside (""It is the purpose of this book to break this silence"" which camouflages the problem), Dr. Hoff restates definitely and well the variable and unpredictable problems alcoholism derives from and generates. Dr. Hoff is a clinician-teacher-therapist of many years of experience and he discusses the covert practices and malignant effects to which this ""unacknowledged drug"" leads. Perhaps he is most innovative where he claims no single etiology if alcoholism is viewed as an illness, nor any easy attribution of causes, nor a particular personality profile of the man or woman who succumbs to the ""lonely disease"" (cf. Elizabeth Whitney's Lonely Sickness). Many people are tense (""If you really need a drink, it is not good for you"") or bored -- all do not become drinkers. He charts with precision attitudes (whether stigmatizing or sanctioning) as well as the course of alcoholism from incipient to critical to chronic. Once you have hit the bottom of the bottle, motivation is not enough, while family intervention is ineffectual; he discusses at some length the ""planned and continuing"" program -- both inpatient and outpatient -- at Virginia Commonwealth University where he is now based. A sound, responsible book -- although one might question the market intake for yet another book on the subject.