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Addiction Center's Director Quits in Treatment Debate

New York Times.  Tuesday, July 11, 2000 - Metropolitan Desk 

The director of the Smithers Addiction Treatment and Research Center of St. Luke's-Roosevelt Hospital Center in Manhattan resigned yesterday, as a feud erupted over the center's decision to include so-called moderation management, which limits, rather than bans, the use of alcohol or drugs by patients.

The center and the Christopher D. Smithers Foundation, whose benefactor, R. Brinkley Smithers, created the treatment program 30 years ago, are no longer directly linked. The debate over the moderation method deepened a rift between the hospital and the foundation, which has long advocated abstinence.

The moderation approach has been heavily criticized by other rehabilitation clinics, including the Betty Ford Center. More recently, the founder of the method, Audrey Kishline, pleaded guilty in March to two counts of vehicular homicide after she killed a 38-year-old electrician and his 12-year-old daughter after a drinking episode that left Ms. Kishline's blood-alcohol level three times the legal limit, prosecutors in Washington State say.

The Smithers center was started in 1970 with a $10 million donation from Mr. Smithers, a philanthropist and recovering alcoholic who believed strongly in the 12-step approach used by Alcoholics Anonymous. The approach encourages alcoholics to give up drinking entirely and to rely on a group support system of other alcoholics.

But the center's director, Dr. Alex DeLuca, recently decided to steer the clinic, a 44-bed center within Roosevelt Hospital, toward an approach that advocates controlled drinking. The new direction for the center, where Medicaid patients and famous baseball players alike have sought treatment over the years, was first disclosed in the July 10 issue of New York magazine.

Dr. DeLuca denied yesterday that Smithers had abandoned its emphasis on abstinence. ''Our treatment programs never changed,'' he said. ''We are an abstinence-oriented treatment program, and our treatments are geared to have people maintain sobriety. I was only suggesting that you could engage people in a kinder, gentler manner rather than telling them that they had to sign up for a goal of achieving abstinence from the beginning.''

Immediately after the report in the magazine, dozens of calls began flowing into the offices of the Christopher D. Smithers Foundation, named for Mr. Smithers's father. Although Mr. Smithers, who died in 1994, made the original gift to the center from private funds rather than the foundation, the foundation has given smaller gifts in recent years.

On Sunday, the foundation placed a full-page advertisement in The New York Times denouncing the moderation management approach and stressing that the foundation no longer has a direct connection to the center. The advertisement, which also appeared in The New York Post yesterday, read in part: ''The Christopher D. Smithers Foundation's philosophy and mission is rooted in the conviction of R. Brinkley Smithers, our founder and benefactor of the program at St. Luke's-Roosevelt, that alcoholism is a disease that requires abstinence-based treatment, and that controlled drinking, under any name, whether it be ''moderation management'' or ''harm reduction,'' is not possible where the disease of alcoholism exists.''

Yesterday, the hospital released a terse statement that said that the Smithers center had a ''long and proud tradition of treating alcoholism by advocating total abstinence. Since Dr. Alex DeLuca does not support the program philosophy, we have accepted his resignation.'' Any changes to the program away from that philosophy would be immediately reversed, a spokeswoman said. It was not clear why the hospital permitted the doctor to promote that course to begin with.

This is not the first dispute between the foundation and the hospital. Mr. Smithers's widow, Adele Smithers-Fornaci, recently sued over the hospital's decision to sell the Upper East Side Art Deco town house that housed the program for years. The hospital, which has been heaving under a pile of debt for several years, got $15.9 million for the home, which the hospital acquired in 1973 for $1 million. The Supreme Court of New York dismissed the case this spring, and her lawyer has appealed.

Correction: July 12, 2000, Wednesday

Because of an editing error, an article yesterday about the Smithers Addiction Treatment and Research Center of St. Luke's-Roosevelt Hospital Center referred incorrectly in some copies to the publication date of an article in New York magazine. The article, reporting that the clinic was being steered toward treatment using controlled drinking rather than abstinence, appeared in the issue dated July 10, not June 10.


Organizations mentioned in this article:
St Luke's-Roosevelt Hospital Center (NYC); Smithers, Christopher D, Foundation

Related Terms:
Alcohol Abuse; Suspensions, Dismissals and Resignations

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