Alexander DeLuca, M.D.
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Abstinence, Moderation, Harm Reduction and the Great Debate -
Journalism and Advocacy Collection
 
Compiled by Alexander DeLuca: 1998 - 2004.  Originally posted: 2004-10-24; Page modified: 2006-09-04.
New! - Most recent addition to this collection: 2006-08-22- New!

 

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New!
Road to Recovery - Interview with Audrey Kishline, founder of Moderation Management
Dennis Murphy; Dateline, NBC; Air date: 2006-09-01
--
"'I finally had a moment of clarity that said, 'You can’t live this lie anymore.' [Kishline] posted a message to MM members that said: 'I have made the decision recently to change my recovery goal to one of abstinence rather than moderation.' The creator of MM was admitting defeat. She checked herself into a detox facility followed up by AA meetings, but she couldn’t play by those rules either."   
 
See also:
What Audrey Kishline Told MM in January 2000
- Kishline; Moderation Management listServ; 2000-01-20
 
Why Controlled Drinking Never Dies - Peele; Stanton Peele Addiction website; 2000-08-08
 
The Controlled Drinking Debates: Four Decades of Acrimony - Brook Hersey, Psy.D., 2001
 
The Abstinence vs Harm Reduction Follies of Summer 2000 - Addiction Medicine Shoots Self in Foot, Again
 

 
Combined Pharmacotherapies and Behavioral Interventions for Alcohol Dependence:
COMBINE: A Randomized Controlled Trial
Anton, et al., JAMA 295(17), 2003-2017; 2006-05-03
--
"Patients receiving medical management with naltrexone, CBI, or both fared better on drinking outcomes, whereas acamprosate showed no evidence of efficacy, with or without CBI.
 
No combination produced better efficacy than naltrexone or CBI alone in the presence of medical management... "
   
 
See also:
Combined Behavioral Intervention for Alcohol Dependence - Miller et. al; CBI Therapist Manual; 2005
 
Disulfiram Acamprosate, and Naltrexone collections
 

 
A Cure for What Ails - [Vivitrol Revives a Controlled Drinking Controversy] - Chris Wright; Boston Magazine; July, 2006 -- "[Vivitrol] may allow alcoholics to drink moderately. To some, it represents the triumph of science over superstition. To others, it’s a heresy... According to moderation advocates, controlled drinking is actually more likely to help a patient achieve sobriety than the conventional all-or-nothing approach..."

See also:
Vivitrol for Alcohol Dependence - Randomized, Controlled Trial - Garbutt et al; JAMA; 293; 2005-04-06
 
The Controlled Drinking Debates: A Review of Four Decades of Acrimony - Brook Hersey, Psy.D., 2001.
 
The Naltrexone Collection archives
 
The Abstinence vs. Harm Reduction Follies of Summer 2000 - Addiction Medicine Shoots Self in Foot, Again
 

 
Flawed Basis for FDA Safety Decisions: Anti-Depressants and Children - Donald F Klein; Neuropsychopharmacology; 31(4):689-699; 2006
-- "The data necessary for objective evaluations of post-marketing harm cannot be gathered by the current process. Proper prospective surveillance by linked computerized medical records is a crucial issue that deserves major public and political attention and prompt action."

See also:
FDA Approves Selegiline Patch for Depression
- PRNewswire; 2006-02-28
Unhealthy Alcohol Use -
Richard Saitz, M.D., MPH; NEJM; 352(6): 596-607; 2005-02-10
Detox / Patient Engagement archives
  ; 
Abstinence / Harm Reduction Academic Literature archives
 

 
Evolution of the Moderation Management Network - Kosok and Cannon; Draft-Excerpt; 2006-09-04 -- "The Network (MM) now has 10 years of real experience. Subjective review suggests the practices of MM [remain] relatively true to the original design. [Experience and practice have brought about] several improvements in program policy that have been incorporated into the culture and literature of [modern] MM."

See also:
Symposium on Moderation Management - Kern, Rotgers, and DeLuca; 109th APA Conf.; 2001
 
A Research-Based Analysis of the Moderation Management Controversy - Humphreys; 2003
 
Characteristics and Motives of Problem Drinkers Seeking Help from MM Groups - Klaw et al.; 2003
 
The Controlled Drinking Debates: Four Decades of Acrimony - Brook Hersey, Psy.D., 2001
 
The Abstinence vs. Harm Reduction Wars of Summer 2000 - Addiction Medicine Shoots Self in Foot, Again
 

 
Alcoholics can Find Drinks and Help in 'Wet Shelter' - Sharon Boase, The Hamilton Spectator, 2006-02-07

Comment:
An article about a shelter that will serve chronically-alcoholic homeless people drinks throughout the day is opening in Hamilton. A study published in the Canadian Medical Association Journal (see below) showed that a similar program reduced the number of hospital admissions, ER visits and run-ins with police, while overall health improved, and all participants drank less in the program.

 
See also:
Shelter-Based Managed Alcohol Administration to Chronically Homeless People Addicted to Alcohol
Tiina Podymow et al., Canadian Medical Association Journal, 174(1): 45-49; 2006.
 

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."

See also:
Liver Cirrhosis Mortality Rates in Britain, 1950-2002
 Leon and McCambridge; The Lancet;
367(9504); 2006
 

Revised!
Tooting Smithers Horn! - Summary of JCAHO Audit of Smithers Addiction Treatment and Research Center, December 2000
Frederick Rotgers; Posted to ADD_MED@MAELSTROM.STJOHNS.EDU, Addiction Medicine listServ; 2000-12-29
--
"Here is how [JCAHO auditor Dr. Jack Burke] summarized his audit: 'Any one of your programs are head and shoulders above any other program in the country. When you put all your programs together, well; it's phenomenal. And what makes your program more memorable is that your patients are much more debilitated than the patients in other programs throughout the country.' The total score awarded by Dr. Burke to our programs was 98 out of a possible 100. The national average is 85."
 
Comment:
I discovered this original document, which was on the website but in an unreadable format, and have reformatted it appropriately. This document is, in one sense, the Epilogue to:
The Abstinence vs. Harm Reduction Follies of Summer 2000 - Addiction Medicine Shoots Itself in the Foot, Again - compiled by DeLuca; 2000-2001
 

 
Single Glass of Wine Immerses D.C. Driver in Legal Battle -
Brigid Schulte; The Washington Post; A01; 2005-10-12 

Comment:
A Washington Post article about woman charged with DUI after having 1 glass of red wine with dinner. Police quoted:
"If you get behind the wheel of a car with any measurable amount of alcohol, you will be dealt with in D.C. We have zero tolerance... Anything above .01, we can arrest."
 
The national 'legal limit' is a blood alcohol level of .08.

 
See also:
When Drunk Driving Deterrence Becomes Neo-Prohibition
Balko; FoxNews; 2005
 

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."

See also:
"
Back Door to Prohibition: The New War on Social Drinking"  R. Balko; Cato Policy Analysis #501; 2003
 

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."

See also:
Are Alcoholism Treatments Effective? The Project Match Data (PDF) by Robert Cutler & David Fishbain; BMC Public Health; 2005; 5:75
 

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:
US Drug Policy is clearly "outside the bounds of civilized nations" amounting to the state sanctioned killing of drug users in the US.
See also:
"Drugs are Bad. Compared to What?" by DeLuca, especially Figures 2 & 3.
 

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.'"
 
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."
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."
 
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."
 
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."
 
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]."
 
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."
 
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."
 
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..."

Comment:
Steve Bose gives us a very comprehensive look at this complex and interesting case. One can expect this attention to detail and honest questioning from Live.Sensibly.org. Highly recommended.
See also:
"'Fessing up to Doc Costs Drinker his License" and,
"Back Door to Prohibition: New War on Social Drinking"
 

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:
Major Session presentation to 5th National Harm Reduction Conference in New Orleans. See also:

5th National Harm Reduction Conference Agenda
 

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.'"

Comment:
This is a very good article about harm reduction approaches to alcohol problems in the U.S. Extensively interviews with Dr. Marlatt (a giant in the field of HR) and myself... the poor 'abstinence uber alles' spokesman sandwiched between us didn't stand a chance! <smile>

 

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.'"

Comment:
Do *NOT* underestimate these people.
See also:
"
Back Door to Prohibition: The New War on Social Drinking" by Radley Balko.
 

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."
 
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. "

Comment:
This is a fascinating and rare testimonial about the psychologically creative use of Antabuse by a leader of the MM movement.
   ..alex...
 

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. "
 
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."

Comment:
I do not know Dr. Westermeyer, but I usually enjoy his take on clinical addiction and drug policy issues. This essay is no exception.
..alex...
 

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. "

Comment:
Fred worked with me when I was Chief of the Smithers Addiction Treatment and Research Center, 1998 - 2000. He was fired shortly after I was, another victim of the "Abstinence vs. Harm Reduction Follies of Summer 2000!"   ...alex...

 

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]
 
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:
Brief, demystifying essay covering the principles of HR and also key HR attitudes and therapeutic techniques. Recommended.

 

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."
 
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. "
 
Treating Insomnia in Substance Users/Abusers by Maher Karam-Hage, M.D.; Psychiatric Times, 2004. --  

Comment: 
Pretty good review article covering Effect of Alcohol and Substances on Sleep Architecture, Consequences of Insomnia on Abstinence, and Treatment of Insomnia in Substance Users.   ..alex...

 

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
 
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).
 
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
 
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 **
 

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...
 

"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.
 

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...
 

[Top of Page]
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.
 
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:
The sick, sad tale of how a progressive treatment center (Smithers) was destroyed by corporate cowards and wealthy philanthropists in a moderation vs. abstinence brouhaha. This was my 15 minutes of fame.
 ..alex...  

 

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.
 
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!
 

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? "
 

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.
 
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?
 
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."
 
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.]
 

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."
 
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. "
 
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. **
 
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.
 
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.?"
 
Kicking the Habit (Sort Of) - Is Abstinence a Losing Battle? -  by Tara Parker-Pope, Wall Street Journal, 2002
 
[Top of Page]
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 **
 
Jeb Bush: Daughter Failed Treatment - by Associated Press, July 2002.
 
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...
 
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)
 
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."
 
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."
 
 

Dr. DeLuca's Addiction, Pain, and Public Health Website

Alexander DeLuca, M.D., FASAM

[Top of Page]

Originally posted: 2004-10-24

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