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Throughout the ages and throughout the world alcoholism has been noted, among Jews, by its relative rarity, and this despite the virtual absence of teetotallers among them. On the other hand, misuse of other drugs has in recent years been described as not uncommon among Jews. In fact a London report in the early 1960s gave the proportion of nearly 20% Jews among the drug addicts seen by two general practitioners. Studies among our own patients, however, indicate that in the London area at present the proportion of Jews among alcoholics seems not as low as generally described - the proportion of Jewish drug addicts, on the other hand not as high as initially suspected. The common denominator amongst the great majority of these alcoholics and drug addicts was alienation from the background of their Judaism and their family - possibly thus leaving them without their former stabilizing anchorage. It is interesting to speculate, however, on the reasons for the usually-described relative rarity of alcoholism among Jews, and the relatively higher incidence of abuse of other drugs. In theory, it would seem that much useful information about the causation of alcoholism and drug dependence in general could be derived from studying, comparing, and contrasting, the factors at work in causing or preventing alcohol and (other) drug abuse, respectively, among Jews.

In the case of many alcoholics there is a risk of misuse of, and dependence on, sedative drugs, including clomethiazole. Used strictly in its proper indication and in the proper manner, the risk of dependence on clomethiazole is probably rather small. Proper indication and use in the case of alcoholics means treatment limited in time to the withdrawal period, i.e. as a rule not longer than six to seven days. Non-alcoholic/elderly patients suffering from cerebral sclerosis do not tend to misuse drugs; unlike alcoholics, there is therefore in the case of such elderly patients in general no risk of the development of dependence.

Alcoholics and (other) drug addicts show similar and different qualities. Differences affecting their "combined treatment" are based mainly on age and life style and much less on pharmacological nature of the drug concerned. Therapists and patients experience certain problems in "combined treatment" of addicts and alcoholics but also an extension of mental horizon-having to deal with such a heterogeneous population. Close, daily contact with older, more mature, experienced alcoholics offers young drug addicts an opportunity for a more rapid development of motivation, cooperation with treatment, and emotional maturation, than may be possible in a community formed by young addicts only. According to Wanke, in drug dependence the foundation of scientific understanding is even more insecure than in dependence on alcohol and medicaments. He quotes Lothar Schmidt's view that it is important to create a motivating framework for the patient (during his treatment) which determines motives for lifelong abstinence and maturation of personality. Possibly it is the close collaboration with older alcoholics which creates this motivating framework for certain young drug misusers.