Alexander DeLuca, M.D.
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References and Resources:
Abstinence, Moderation, Harm Reduction and the Great Debate -
Peer-reviewed and Academic-quality Literature, and Official Reports

Latest additions: New! 2006-02-13 New! (Harm Reduction series) This Collection is organized into the following SERIES:

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 The Great Debate over Controlled Drinking Strategies
Moderation Management / Harm Reduction Approaches
The Great Debate
The Controlled Drinking Debates: A Review of Four Decades of Acrimony - by Brook Hersey, Psy.M., 2001. 

A very thorough, thoughtful, scholarly-yet-readable consideration of the "Great Debate," from 1962 - 2001. If you are only going to read one paper about this topic and want a comprehensive, academic, well argued and well referenced review,  read this excellent review by my wife, Brook Hersey, Psy.D.

The Great Controlled-Drinking Controversy - by Ron Roizen. Chapter 9 from Galanter: "Recent Developments in Alcoholism, 1987. -- "Abstract: This chapter reviews the controlled-drinking controversy. It presents cameo descriptions of the controversy's three major episodes--those occasioned by D. L. Davies' 1962 report, the 1976 publication of the first Rand Report, and the 1982 publication in Science of a paper by Pendery, Maltzman, and West--as well as a cameo for the long "interepisode" period between Davies' paper and the Rand Report. I argue that the controversy has emerged out of the failure of the "new scientific approach" to alcoholism, initiated a half century ago, to advance alcoholism treatment significantly beyond the point from which it began."
Controversies in the Addiction's Field - by Ruth Engs, 1990. --

An entire book, now out of print, made available in electronic form,  free. Very interesting topics and authors. I highly recommend spending some time with this nicely produced work;  it's well written; interesting, and you'll enjoy it. Thank you, thank you, Dr. Engs!

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. "

Amen, Mark, amen.

Controlled Drinking: More than Just a Controversy by Saladin  et. al.; Current Opinion in Psychiatry, 2004. --

Good article reviewing developments in the controlled-drinking literature since 2000, including BSCT, MOCE, Harm Reduction, DCU, & Moderation Management. Makes an excellent companion piece to "The Controlled Drinking Debates: A Review of Four Decades of Acrimony" by Brook Hersey, which examines 'The Great Debate' 1962 - 2000. ..alex...

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.?"

Controlled Drinking as a Moral Achievement and a Social Program by Robin Room, 1998. -- "Behind the arguments for moderate... drinking can be discerned the outlines of a coherent worldview... In this modern and secularized version of the pilgrim's progress, it is drinking behaviour which becomes a daily test of character.  By drinking moderately or in a controlled fashion, the modern pilgrim exercises and demonstrates his or her self-control and rationality in a new trial every day."

Dr. Room is a sociologist whose work I always enjoy. He asks fascinating questions and is then rigorous and disciplined in his analysis. A pleasure!

Back Door to Prohibition: The New War on Social Drinking by Radley Balko, Cato Policy Analysis #501, 12/5/; 2003. -- "One would think that, given the failure of Prohibition, Americans wouldn't need to worry about its return. That may not be the case. A well-funded movement of neoprohibitionists is afoot, with advocates in media, academia, and government."

No Friends of Bill Wilson by Radley Balko, New Republic, 5/17/2004. -- "The same mindset that finds a symbolic victory over alcoholism more important than a deathbed drink for a sick man can see fit to justify a 25-year prison term for an oxycodone-using MS sufferer and handcuffing an elderly post-polio marijuana user to her bed at the point of a gun."

Well written article finds toxic similarities in the mindsets behind both the 'abstinence-uber-alles' mentality and drug war thinking. Recommended. 
See also:
"Back Door to Prohibition: The New War on Social Drinking" by Radley Balko.  ..alex...

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."

I highly recommend the Stanton Peele Addiction Website.

[END: Series - The Great Debate]

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Moderation Management / Harm Reduction

Harm Reduction Psychotherapy: Extending the Reach of Traditional Substance Use Treatment
A. Tartarsky, Ph.D.; J. Substance Abuse Treatment, 2003
HR is the recognition that treatment must start from the clientís needs and personal goals; that all change that reduces harm is valuable. The paper presents HRís rationale, principles, treatment implications, and application to psychotherapy.
See also:
Study Questions Effectiveness of Alcoholism Therapy - Reuters Health; 2005-07-22

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

Updated! (2005-12-30)
Does Naltrexone Cause Permanent Liver Disease? (No) - Can Naltrexone be Used in the Presence of Liver Disease (Carefully)
[References with Abstract from Medline Search for 'naltrexone' and 'hepatotoxicity'] -
Alex DeLuca, M.D.; 2001-06-16; Updated: 2005-12-30
"A review of the literature indicates that even when given at much higher doses than are needed for treating heroin or alcohol abusers, there is no evidence that naltrexone causes clinically significant liver disease or exacerbates, even at high doses, serious pre-existing liver disease." [Brewer et al.; Addiction .Biology; 2004]

Characteristics and Motives of Problem Drinkers Seeking Help from Moderation Management  (Also: PDF version) -  Klaw, Luft, Humphreys;  Cognitive & Behavioral  Practice, 2003 -- "[This] paper presents survey data on the characteristics and help-seeking motives of 467 individuals... Study participants, particularly women, typically experienced MM as a better 'fit'... than disease model, abstinence-based approaches." --
Also: I highly recommend the Moderation Management website  ..alex...
Can targeting nondependent problem drinkers and providing internet-based services expand access to assistance for alcohol problems? A study of Moderation Management - Keith Humphreys,  2001 -- "[This] paper presents survey data on the characteristics and help-seeking motives of 467 individuals... Study participants, particularly women, typically experienced MM as a better 'fit'... than disease model, abstinence-based approaches."
Prediction of Alcohol-related Harm from Controlled Drinking Strategies & Alcohol Consumption Trajectories
by Toumbourou et al.; Addiction 99(4); 498-508; 2004. -- "[T]he overall level of utilization of alcohol control strategies... were highest for 'low weekly drinkers' [who drank at recommended levels less than weekly]."

Very interesting prospective study of adolescents in Australia (has a national policy of harm reduction) which raises the question whether encouraging less than weekly drinking may be a way to reduce alcohol-related harm.

[END: Series - Moderation Management / Harm Reduction]

Addiction, Pain, and Public Health website

Alexander DeLuca, M.D.

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Originally posted:  2004-10-05

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