An Alcoholism Paper that 'Proved' Harm Reduction Was Wrong

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An Alcoholism Paper that 'Proved' Harm Reduction Was Wrong

By Stanton Peele 06/29/15

A 1982 study published in Science is an affront to science and the addiction field.

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Recently, in December 2014, graduate student Michael LaCour, at UCLA, and distinguished Columbia University professor Donald Green published a study showing that gay canvassers were highly effective in converting antagonistic voters to a pro-same-sex-marriage position. Their study in the prestigious journal Science was highly publicized in the New York Times, Washington Post, and Wall Street Journal.

It now appears, however, that LaCour made the study’s results up. Science seems likely to retract the study. Green—who says he never saw the actual data—has requested that the journal do so. This seems to be a case where people in a field wanted something to be true, and so they made it happen. Who knew that supposed scientific findings are subject to cultural fads and wish fulfillment?

The same players—UCLA and Science—were involved in perhaps the most harmfully erroneous study to ever appear in the addiction field. In 1982 Mary Pendery and UCLA professors Irving Maltzman and L. Jolyon West published an article in Science showing that alcoholics could never control their drinking. The Pendery et al. study “found” that psychologists Mark and Linda Sobell had misstated the results of research they had published showing that alcoholic subjects treated at a San Diego-area VA hospital with controlled drinking (CD) techniques fared better than subjects undergoing the standard abstinence, AA-oriented treatment at the VA.

The 1982 Science study was strange from the start. Pendery et al. sought to disprove the Sobells’ results by following up the 20 CD subjects during the eight years after the intervention, but not the subjects treated by the VA’s abstinence program. The “researchers’” supposed purpose was to detail relapse events. Of course, Pendery, Maltzman, and West were trying to show that alcoholics could never hope to modify their drinking. But the original study by the Sobells, which demonstrated what we now call relapse prevention, had reported that relapses did occur for CD subjects. Only these relapses were less likely than they were for the abstinence-treated subjects. So how could a follow-up study that only examined the one group disprove the original, comparative results?

Several subsequent neutral inquiries revealed that the Sobells had reported all of the relapses for CD subjects. These investigations questioned the purpose of Pendery et al.’s research—and of Science’s publishing its results—which I wrote about in Psychology Today in 1983. Why conduct a study that didn’t prove anything? But the Pendery et al. study had a major impact on the field of alcoholism and, by implication, addiction. It delayed the appearance of harm reduction in the United States for two decades.  

Ethan Nadelmann declared in The Fix

Where the 12-step thing has the most to own up to is its role in impeding harm reduction interventions to stem the spread of HIV/AIDS. Why was it that Australia and England and the Netherlands were able to stop the spread, and keep the number for injecting drug users under 5-10%, and the U.S. was not? It's that notion that abstinence is the only permissible approach, that we are not going to "enable" a junkie by giving him a clean needle. There has to be a kind of owning up to that role in hundreds of thousands of people dying unnecessarily.

This accountability also must occur in the case of alcoholism treatment. According to the Drug and Alcohol Findings Effectiveness Bank description of yet another study confirming the benefits of brief interventions aimed at reducing drinking for even diagnosed alcoholics, now called dependent drinkers: 

Commonly presumed unsuitable for dependent drinkers, the evidence is stacking up that brief advice after screening can lead even these drinkers to cut back. This study of heavy drinking Taiwanese hospital patients provides one of the most convincing demonstrations yet that brief intervention can work in this setting, and the drinking reductions were particularly steep among dependent patients.

In other words, it is possible—with relatively modest investments of time and effort—to assist alcoholics/dependent drinkers in moderating their drinking. This is not to say that all—or most—can become social drinkers. But, recall, HR is about how both drug addicts and alcoholics can make beneficial changes in their use and in their lives that may or may not culminate in full recovery, but which can currently save their lives. Yet, in the field of alcoholism in America, even more than with drug addiction, such HR approaches aren’t permitted. They are now declared impossible by the NIDA’s “chronic relapsing brain disease” theory that is being promoted by Science, as well as by the Drug Czar, Michael Botticelli, who is himself “in recovery.”

In Nadelmann's words, there must an “owning up to that role in hundreds of thousands of people dying unnecessarily" in alcohol as well as in drug treatment. In America, those who fail at AA and abstinence are simply left to experience their own negative consequences with no attempt to help them make incremental or life-preserving improvements. Remember George McGovern's daughter, Terry, who froze to death, drunk in the street, freshly out of a halfway house? Terry McGovern is an example of a human being who could be alive today if we concentrated on helping her even though she periodically relapsed. 

A first step towards practicing HR as national policy for drugs and alcohol in America would be the retraction of the ideological, useless, indeed harmful alcoholism treatment study Science published by Pendery et al. 33 years ago.

There is one last tragic result in the aftermath of the Pendery et al. study. Some time later, Pendery engaged in a relationship with a former patient at the San Diego VA. I described what followed:

On April 10, 1994, Mary Pendery was murdered by an alcoholic lover. Pendery left the alcoholism treatment program at the VA Hospital in San Diego which she headed to move to a VA hospital in Sheridan, Wyoming in 1992. In January 1994, Mary recontacted George Sie Rega, whom she had first known while he was being treated at the San Diego VA. Mary apparently was rekindling an old flame. By the time Sie Rega joined Mary in Wyoming in April 1994, he was deep in alcoholic relapse. Extremely intoxicated (his BAL was >.30), Sie Rega shot Mary dead and then turned his weapon on himself.

And, so, one more victim of the myths that alcoholism treatment is all about forcing people to never drink again, and that this approach is highly effective, was Mary Pendery.

Stanton Peele, Ph.D., is the author (with Ilse Thompson) of Recover! Stop Thinking Like an Addict. He is the recipient of career achievement awards from the Center for Alcohol Studies and the Drug Policy Alliance. His Life Process Program for treating addiction is available online. He last wrote about our dysfunctional national alcohol policy.

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