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AA makes alcoholics' problems 'worse' - Pro-moderation rival slams rigid approach
Zev Singer, The Ottawa Citizen, Friday 14 July 2000

The rigid abstinence preached by Alcoholics Anonymous makes the problem of alcoholism worse, according to rival group Moderation Management. "My belief is, actually, the abstinence world of AA has caused alcoholism to get worse," said Marc Kern, a California psychologist and board member of Moderation Management. "People are told in an AA meeting 'If you don't buy us 100 per cent, go out there and drink and when you hit bottom come back.' " Mr. Kern's comments escalate the war of words between the moderators and the abstainers, the two camps in the alcoholism treatment world.

According to Mr. Kern, the abstainer camp has been playing dirty, exploiting the tragedy involving the founder of the Moderation Management movement. Last month, Audrey Kishline, who started the movement in the mid 1990s, was charged with double manslaughter in Washington state after killing a father and daughter while driving drunk. Officially, Alcoholics Anonymous has said nothing about the case because, as a matter of policy, the organization never comments on outside issues. "And believe it or not, Moderation Management is an outside issue," said AA spokesman Bill A., who, as an anonymous alcoholic, asked that his surname not be published.

But the National Council on Alcoholism and Drug Dependence (NCADD), an organization with close though unofficial ties to AA, has commented. Its president, Stacia Murphy, said Ms. Kishline was in "denial," and "this tragedy might have been avoided if (she) had come to this realization earlier." Mr. Kern called Ms. Murphy's organization "nothing more than an extension of AA," and said her comments are an example of the way AA's powerful influence stifles dissent. "They have historically pounded on anybody who wants to speak against the gospel. It's like we're in the dark ages." AA has two million members -- an estimate made conservative by the anonymity of the program. Moderation Management has about 1,000 members.

The fact that AA won't speak directly to the issues, Mr. Kern said, is deceptive. "That's what's difficult about combatting this fundamentalist movement. They're designed in such a way as to be very slippery. You can't really press against it like you could a corporation or an individual."

Mr. Kern also sees the recent resignation of Dr. Alex DeLuca from his post as director of New York's Smithers Addiction Treatment and Research Centre as the outcome of AA pressure. Dr. DeLuca had come to accept the idea that moderation was appropriate in some cases. In apparent agreement with Mr. Kern on one point, Jeffrey Hon, spokesman for the NCADD, said of his own organization "Yes, in fact, (we) have a history of intolerance toward moderation programs." Philosophically, the abstainers believe that once people lose control of their drinking the only way to travel the road to recovery is on the wagon. Step one of their 12-step program is the admission that "we were powerless over alcohol -- that our lives had become unmanageable." Step five is the admission "to God, to ourselves and to another human being the exact nature of our wrongs."

The moderators agree that outright alcoholics should abstain completely, but contend that a far greater number of people with less advanced drinking problems can improve their lives greatly by learning to moderate. The moderators also say that their more attractive approach can also serve as a stepping stone for eventual abstainers who find quitting cold turkey too daunting a prospect. The abstainers counter that while it is possible for some individuals to moderate, it is too difficult to distinguish between problem drinkers and true alcoholics, and the safest course is to quit altogether.

In Ontario, services like the Alcohol and Drug Assessment Referral Service do offer a moderation program, the Guided Self-Change Program, to selected clients, in addition to its abstinence-based programs.


Alexander DeLuca, M.D., FASAM.
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Revised: March 21, 2001.