Alexander DeLuca, M.D.
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Comment: |
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British Livers and British Alcohol Policy - [Outline, References, and Link to Full Text PDF] - Robin Room; The Lancet; 367(9504); 10-11; 2006-01-07 -- "Great Britain has recorded the steepest rise in [cirrhosis mortality] rates in western Europe [and] there is no doubt that the cumulative amount of alcohol consumed has a primary role. But the UK Government has turned a determined blind eye to the problem and has failed to make the reduction of the population's alcohol intake a policy goal."
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Revised! |
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Comment:
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When Drunk Driving Deterrence Becomes Neo-Prohibition - Radley Balko (The Agitator); FoxNews.com; 2005-10-05 -- "MADD's biggest victory on [the neo-prohibition] front was a nationwide blood-alcohol threshold of .08, down from .10. But when two-thirds of alcohol-related traffic fatalities involve blood-alcohol levels of .14 and above, and the average fatal accident occurs at .17, this move doesn't make much sense."
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Study Questions
Effectiveness of Alcoholism Therapy -
Reuters
Health;
2005-07-22
--
"[The
authors] found that in the months following treatment, patients who
attended no therapy sessions did nearly as well as those who went to all
[and those] who
stuck with treatment made most of their improvement in the first week,
before they had received [much] therapy."
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German Drug
Deaths at 15-Year Low, Government Credits Harm Reduction -
Drug War Chronicle #387; 2005-05-20 --
"By
comparison, about 15,000 people die from illegal drugs each year in the
US... US citizens are dying of drug OD's at a rate roughly four times
that of Germans."
Comment: |
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Human
Rights Watch:
US Abstinence Calls Hurt Uganda AIDS Success
by Daniel Wallis;
Reuters; 3/30/2005 --
"HRW said abstinence schemes had
proved ineffective & harmful, 'a triumph of ideology over
public health.'" |
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Harm
Induction vs. Harm Reduction: Comparing American & British Approaches to
Drug Use by K. Van Wormer; J. Offender Rehab.; 1999. -- "This paper examines [the US disease model and the British harm reduction model] in light of historical/cultural differences related to Puritan zealotry and argues that with regard to illegal drugs, America's War on Drugs actually inflicts harm." |
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Moderation
on Campus Menu
by Jenna
Russell;
The Boston Globe; 3/4/2005 --
"Two schools of thought have collided in recent years, as
traditionalists continue to argue for discipline and dry campuses, while
[the] ''social norms" movement says alcohol problems are better combated
by pushing moderation over abstinence." |
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Spreading a
Culture of Moderation
Editorial;
New Zealand Herald; 12/15/2003
--
"Alcohol
is part of human life and has been produced in some form in most
cultures since time immemorial. It is best controlled by unwritten codes
of acceptable behaviour rather than laws that limit the rights of the
sensible as well as the abuser." |
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Air Force
Abuzz Over Moderation
USA Today; 1/27/2005 --
"[0-0-1-3] is drilled into
everyone... It stands for: zero underage drinking, zero drunken-driving,
1 drink an hour, up to 3 drinks in an evening." |
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Blair 'Fails to
Grasp Alcohol Problems'
by Anonymous reporter;
netdoctor.co.uk; 1/27/2005. --
"[B]lair's description of alcohol misuse by a "small minority" in the
Alcohol Harm Reduction Strategy for England published last year [was
criticized]." |
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German
Court Rejects "Zero Tolerance" Drugged Driving Law in Cannabis Case
by
Drug War Chronicle #371; DRC-Net; 1/21/2005. --
"[T]he highest [German]
court... has ruled that tiny traces of THC in a driver's bloodstream are
not sufficient to convict him of DWI... Until the ruling, any trace of
illegal drugs in one's system would have been sufficient for a
conviction... [The convict had] smoked hashish the previously night - 16
hours before [arrest and] had less than 0.5 nanograms of THC per ml of
blood." |
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Benefits
of Drinking Outweigh Harm from Abuse by Hanson, Ph. D.; Alcohol Problems & Solutions; 2004.
-- "The researchers
determined that if everyone abstained from alcohol, death rates would be
significantly higher. In the words of the lead author, "alcohol saves
more lives than it costs." |
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Joe
Six Pack in the News by Steve Bose; TownSquare;
LiveSensibly.org; 8/22/2004. -- "Keith Emerich's...
physician contacted the Pa. [DOT] to identify Emerich as having a
condition that could impair his ability to drive safely... The condition
which the
law requires the doctor to report is alcohol misuse — which
Pennsylvania legal code doesn’t define any further..."
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Towards a Coalition of People Oppressed by Prohibition DeLuca, Tartarsky, Cannon; 5th Nat. HR Conf.; 11/13/04. -- "Pain patients, drug users, their doctors, people with alcohol problems and the general population who might someday suffer chronic pain or mental illness, are in common persecuted and discriminated against. How might we go about forming a socially and politically powerful coalition of people oppressed by prohibition?"
Comment: |
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Harm
Reduction - Meeting Patients Where They Are
by
Kate Jackson, Social Work Today; 4(6); 2004. --
"Explains Marlatt, '[HR,
a] more motivational acceptance-based approach,
establishes a strong therapeutic alliance that lets
clients know you’re going to stick with them...'
'No approach does so well that any of us are justified in being
dogmatic,' DeLuca says. 'Patients are diverse, demanding that we...
provide a diversity of treatment approaches so we can better meet
patients where they are.'"
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The
Dry Party
by
Joel Warner, Boulder Weekly; 11/1/2004.
--
"'I think we are moving in the direction of
prohibition,' says Dodge. 'I don't think it will be an amendment like we
had before. I think it will gradually come about because people will
finally say it is a health hazard, and eventually I think the FDA will
regulate it, and then at some point, it will be voted out of
existence.'"
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Harm Reduction and Moderation
as an Alternative to Heavy Drinking
by Robert Westermeyer, Ph.D.; ?Date?
--
"It is truly shocking that the issue of
controlled drinking still evokes such violent debate.
Most people simply don’t know the facts regarding
controlled drinking as a viable alternative for some
problem drinkers...
The purpose of this article is to set the record
straight with regard to the controlled drinking debate."
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My
Experience with Antabuse
by Cannon;
Moderation Management Network, Inc; 2004.--
"Taking Antabuse
is a proactive way of achieving abstinence for whatever
timeframe the problem drinker seems appropriate. For me,
it was a useful tool. It removed the alcohol factor from
my emotional life. The results were useful and
unexpected. "
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Reflections
on Traumatic AA Experiences, AA-Bashing in MM, and
Effective Communication of Deeply Held Ideas...
by Alex DeLuca and 'Harry R.'; Excerpt
from MM listServ; 2004.
-- "What comes across to me is a person so enraged by a
particular topic that he can barely speak coherently
about it, or a person who can speak coherently but with
such intense and unpleasant emotional overlay that most
other people can't stand to listen to it. " |
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Addiction
Treatment: What on Earth are We Doing?
by Robert Westermeyer, ?original date?;
Originally posted: 8/26/2004 --
"Unfortunately (and quite
curiously) most of the advancements in this area have
not made it out of the Ivory tower. There are volumes of
research in this area, most of which are not applied in
clinical settings...
I
predict a paradigm shift, in which the discrepancy
between research and application will become clear to
those who are footing the bill. It will become
impossible to continue offering the spectrum of
individuals with alcohol related difficulties one
intensive, expensive and scientifically unsubstantiated
mode of treatment."
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Why
We Fail to Use Treatments that Work
by Fred Rotgers, Psy.D.; SUBABUSE
listServ, 1999. -- "We *know*
what treatments work--but it's not what we do!!! ...
[This] has to do with a hidebound, quasi-religious
ideology that has... been adopted by... [the] NCADD, and
pushed to the detriment of the very people they claim
they want to help. "
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Recovery
Movement Needs to Keep Distance from Treatment Field
by Anonymous, Join Together Online, 2000.
-- "I don't think the centerpiece of the recovery movement should
be 'treatment works' or 'alcoholism is a disease.' I think it should be that
recovery is a reality, that there are many pathways to recovery, and that
recovery is a voluntary process." -- [William L. White,
historian] |
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What
is Harm Reduction and How Do I Practice It?
by
Stanton
Peele, Smart Recovery News & Views, 2002. --
"What we consider
substance abuse therapy in the United States consists
largely of exhortation—"quit drug taking and drinking!"
Real therapists must know how to improve the conditions
of a range of clients, from those who are ahead of the
therapist in curing themselves, to those who merely need
encouragement, to those who need help to avoid falling
off the edge, to those who may have given up and who are
waiting —or helping themselves—to die."
Comment:
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Fessing
Up to Doctor Costs Drinker His License - A Lebanon
County man admitted that he drank a 6-pack a day. A Pennsylvania
law required PennDot to be alerted.
by Patrick Kerkstra, Philadelphia Inquirer, 8/6/04. --
"'What
I do in the privacy of my home is none of PennDot's
business,' said Emerich, who is appealing... Medical
ethicists said the case presents a serious
confidentiality issue, and a reason for patients to lie
to their doctors about any alcohol and drug use." |
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Harm
Reduction: A New Perspective on Substance Abuse Services
by S.A. MacMaster; Social Work, July 2004
--
"The author outlines abstinence and harm
reduction perspectives and the stages of change model
and discusses how these perspectives can be integrated
in social work practice. He proposes using harm
reduction strategies for individuals for whom the
abstinence perspective may not be appropriate. " |
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Treating
Insomnia in Substance Users/Abusers
by Maher Karam-Hage, M.D.; Psychiatric
Times, 2004. --
Comment:
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Symposium on MM - three Slide/Lectures
- Talks by Drs. Marc Kern, Fred
Rotgers, and Alex DeLuca presented at the 109th
Convention, American Psychological Association, August
25, 2001 in San Francisco |
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Experiences of Moderation Management members with
naltrexone (ReVia) as an aid to moderate drinking -
compiled by Alex DeLuca, circa 2001 from the
MM
listServ (the Moderation Management online
community). |
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MM
at the 4th National Harm Reduction Conference, Seattle,
12/2002 -
Reports from
Ana K. and
Cannon --
"I came away with the understanding that ...
American consciousness would be greatly elevated if [it]
included harm reduction solutions [which] are effective
and humane. Inexplicably, implementing them is resisted
with zealousness." -- Cannon |
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Some General Comments about Moderation Management
- by Alex DeLuca, 7/01 (Updated 10/02) --
"The system we have fails to engage the majority. The system we
have tends to push people away, to become potentially sicker. The
system we have does a poor job of engaging people early on the continuum
of
illness as is standard medical practice for any of the other
'chronic, relapsing, diseases.'"
**
July 21,
2004: Reformatted page to be much easier to read and
Print Version added
** |
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Over
the Limit
by Loretta Douris, Brisbane News,
6/16/2004.
-- "A tipple a day may keep the doctor away - but only
when it comes to some diseases... [Modest] consumption
of beer, wine and spirits is good for the heart...
[Alcohol] increases the risk of cancer... [of] the
mouth, pharynx, esophagus and liver [and breast]...
Even drinking small amounts of alcohol increases the
risks of these cancers and the more you drink, the
greater the risk." --
This is a pretty good article about
relationship between alcohol and heart disease, obesity,
and various cancers. More good reasons to stay within
moderate drinking limits. ..alex... |
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"Principles
of Harm Reduction" & "The Need for Harm Reduction" -
From the
Harm Reduction Coalition, 1/24/2001 --
"Harm
reduction is a set of practical strategies that reduce
negative consequences of drug use, incorporating a
spectrum of strategies from safer use, to managed use to
abstinence. Harm reduction strategies meet drug users
"where they're at," addressing conditions of use along
with the use itself. "
See also: "Abstinence
vs. Harm Reduction - A False Dichotomy" by Alex
DeLuca, 2000. |
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Abstinence vs. Harm Reduction: a False Dichotomy
- by Alex DeLuca, 2000.
--
"Only in addiction medicine is it insisted that patients and staff
hew to a ‘philosophy’ of ‘total abstinence’ rather than support
appropriately individualized treatment goals."
This 'op-ed'
length essay is one of the best I've ever written. ..alex... |
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The Abstinence vs. Harm Reduction Follies of Summer 2000!
(or Addiction Medicine Shoots Itself in the Foot, Again)
-
Compiled by Alex DeLuca, 2000. --
DeLuca's firing
from Smithers, Kishline's MVA, Corporate
Cowards!, Tyrannical Philanthropists!, and the rise
of Moderation Management in NYC. |
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12-Steps Back - by Maia Szalavitz, Brills Content, December
2000/January 2001 issue. - "Having
spent ten years as a health and science journalist in print and
television, I thought I'd be jubilant if a story I wrote won national
attention and changed an important institution. Unfortunately, in July
2000, when newspapers and television grabbed a short article I'd written
for New York magazine on the revamping of one of the nation's
most respected alcohol- and drug-rehabilitation centers, it was terribly
distorted. In the aftermath, the doctor who ran the clinic lost his job,
the reforms he made were reversed, and a complicated debate about the
treatment of alcoholism was reduced to a clash of anecdotes that shed
little light on the subject. Here's how my story went wrong."
Comment: |
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Spotlight On: The Smithers Evaluation Unit - by
Alex DeLuca - One
of the very few pages salvaged from what was the
Smithers website - A rational front-end for assessment
prior to treatment (another 'radical' idea <g>) - DeLuca,
Foote, Taylor, Wilkens, et al. |
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Growth
& Development of Smithers Treatment Center, 1990 - 1998
- by Alex DeLuca, M.D., 1998 --
Our strategy and what we actually accomplished.
This document was prepared for new incoming hospital
administration so they would know what we were about so as not to ruin us.
So, do you think it worked? <g> See also:
The Abstinence vs. Harm Reduction Follies of Summer 2000!
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When
is a Binge a Binge? - Prevention File, Vol. 11, No. 4, 1996
-- "
'Binge' has become a handy term to describe a level of
drinking that is the dividing line between harmless and
harmful – five drinks at a sitting for men, four drinks
at a time for women...What they mean and what readers
understand may differ, however. Is this an appropriate
use of “binge” when the word has a different meaning in
the popular mind? " |
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The
Surprising Truth About Addictions -
by Stanton Peele, Psychology Today,
May/June 2004
-- "More people quit addictions than maintain them, and
they do so on their own... People succeed when they
recognize that the addiction interferes with something
they value - and when they develop the confidence that
they can change." Also: I highly recommend the
Stanton
Peele Addiction Website. |
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Frequently Asked Questions (FAQs) About Naltrexone
by Alex DeLuca, 2000, 2001, 2002, 2003, 2004. Includes: ==> Dopey Doctors and Naltrexone Prescriptions ==> Simple Truths About Naltrexone ==> Naltrexone for Patients who Wish to Moderate or Control Their Drinking ==> See also: Naltrexone as an Aid to Controlled Drinking ==> Naltrexone References and Resources and Links ==> Why is there so little research on naltrexone as an aid to problem drinkers trying to moderate? ==> Problem drinkers, endorphins, naltrexone and testosterone - Part 1 ==> Naltrexone use rarely associated with liver damage (Medline references) ==> Are there medications that can help me reach my sobriety goals? ==> I've heard that sometimes taking naltrexone at a dose of 100 mg or 150 mg is effective where 50 mg was not. Can these larger doses be taken all at once, and what time of day should I take it? |
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Sudden Exit as Clinic Chief Sends Addiction Specialist
Reeling - by Robin Fine, Daily News, 7/26/2000
-- Did Dr. DeLuca deal
with substance abusers who weren't ready to embrace
abstinence? Guilty as charged. Done, he says, in the
spirit of early intervention: "Better you should come in
and talk to me and still drink than not come in at all."
Radical words, those. But irrational? They're a product,
he says, of research, not proof of antipathy toward the
benchmark approach: "My personal recovery was through
A.A.," he notes. "The whole nine yards." |
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Alcohol Abuse vs. Dependence and the Evolving Role of Naltrexone as
Adjunctive Pharmacotherapy - a HTML slide-show lecture by Alex
DeLuca, January 2002. Considers the following questions and issues:
* Are alcohol abuse and alcohol dependence part of the same continuum of illness or are they distinct disorders? * The problem with 'radical abstinence' as a universal treatment suggestion. *Abstinence vs Extinction theories of naltrexone and the very different medication regimens. [As of 3/18/02 - approximately 1/2
of the talk has lecture notes included.]
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New Drugs Promise Treatment for Addicts, Profits for
Firms - Peter Landers, Wall Street Journal,
2003
--
"[Dr.
DeLuca], who has has clashed with proponents of
abstinence -- recommends an alternative use of
naltrexone. The drug should be taken before craving
strikes, he says... Studies suggest the drug retards the
mild euphoria of a drink, helping alcoholics imbibe
moderately." |
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Breaking Out of the 12-Step Lockstep - by Maia Szalavitz, Washington Post, 2002
--
"Alex DeLuca [chief of Smithers] saw that options needed to be expanded
beyond AA... [and] began publishing studies funded by the NIAAA showing
that adding treatment options, including support for moderation rather
than abstinence, was effective. " |
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Problem drinking
- Alcohol's "neglected majority" need help reducing
intake - By Victor Greto, South Florida
Sun-Sentinel, 2002 --
"[Problem] drinkers have become the 'neglected majority' of alcohol abusers...
[They're] at the heart of the country's alcohol-related social and economic troubles, from drinking while driving to lost work productivity. 'For every alcoholic, there are four problem drinkers,' says Mark Sobell, a
[psychology] professor. He estimates there are 12 million problem drinkers in the United States. " ** July 1, 2004: Page reformatted / Print version added. ** |
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Slaying the Dragon, by William L. White -
An excellent and informative review of this 1988 history
of alcoholism treatment and the recovery movement, by
Marty N. |
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Abstinence as the Only Treatment Goal: New U.S.
Battles - by Robin Room, 2000.--
"Why does the idea that some alcoholics may be able
to learn controlled drinking generate so much heat in
the U.S., and uniquely in the U.S.?" |
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Kicking the Habit (Sort Of) - Is Abstinence a Losing
Battle? -
by Tara Parker-Pope, Wall Street Journal, 2002
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Getting a grip - Somewhere this side of a drinking
problem, imbibers learn to sip - Bob Connor, Chicago Tribune, 2002.--
Thoughtful article with good information about the
DrinkWise program and about
Moderation Management. ** July 1, 2004: Page reformatted & Print version added ** |
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Jeb Bush: Daughter Failed Treatment - by Associated Press, July
2002. |
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Abstinence... at all costs? - by Captain Tim H. M.--
"The real immorality of the whole picture is the fact that a
number of medical alternatives are possible with much, much greater chances
of patient survival; maybe no where near the quality of life as the 1 in 500
perfect abstainer, but at least an improved life. The sin is
the fact of the political repression of those alternatives, the medical
profession's apathy, ignorance, and justified fear of opiate addicts because
of eighty years of witch hunts on the physicians that have had the
compassion, courage, and / or greed, to work with them. " -- This
is a passionate rant - highly recommended. ..alex... |
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Old Battles - the Controlled Drinking Debate - Interview
with Linda and Mark Sobel -- A look back at 25 years of
controlled drinking research. "There's
nothing quite like a controlled drinking debate to arouse the passions of
even the mildest-mannered addiction professional. "
Addiction Research Foundation (ARF) |
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Can Alcoholics Cut Back? Abstinence camp blasts moderation - DeLuca
fired. - by Mary Jane Fine, Daily News, July 16, 2000 --
"To drink or not to drink? That is the question
that cost Dr. Alex DeLuca his job as chief of New York's prestigious
Smithers Addiction and Treatment Center of St. Luke's-Roosevelt Hospital —
and has reignited a furor over how best to treat problem drinking." |
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Myths and Facts about getting sober - 222 paths to sobriety - a review
of Anne Fletcher's book: "Sober for Good" by Brody, Science Times, 4/17/2001
-- "But the fact that hundreds of former abusers of
alcohol are now sober is not what makes this book special. What sets it
apart is her in-depth descriptions of the routes to sobriety taken by those
she questioned and the many myths about alcohol recovery that they expose.
In this book, there is a path to recovery for virtually everyone, including
those who have tried repeatedly to escape the yoke of alcohol and those who
believe they can never give up drinking." |
| Alexander DeLuca, M.D., FASAM |
Originally posted: 2004-10-24 |
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All Email to: adeluca@doctordeluca.com |
Most recently
revised: 2006-09-04 |
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This work is licensed under a
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