From: mccla_d@aethelbehrt.cs.odu.edu (dennis mcclain-furmanski)
Newsgroups: sci.psychology
Subject: Addictions
Date: 30 Jul 92 05:29:58 GMT
Distribution: sci.psychology
Organization: Old Dominion University, Norfolk, VA, USA

th@isr.harvard.edu (Todd Heatherton)  says:

>First of all, the Sobell's did not rely completely on aversion therapy.
>They used different behavior mod principles.  Their work all through
>the 70s anad 80s was focused on very different aspects of alcohol than
>on whether aversion therapy worked.

They are most well known, at least in therapy circles, for the aversion
therapy work.

>Second, they are at the Addiction Research Foundation, one of the world's
>leading addiction centers.

Research, not treatment. They're obviously two different things frequently.

>They went there before the controversy over controlled drinking (i.e.,
>your contention that they were chased out of the USA shows you know
>nothing about the history of alcohol treatment;

I've seen more than a few contentious responses to their work before they
moved. I suggest you're confusing the history of alcohol treatment with the
history of alcohol research publication. The Sobells (I could have sworn
there was an 'R' in there) were involved in research. Results in treatment
of addictions based on their work have not been considered suitable to the
field. As to the reasons given for their move, I've heard their story,
which had nothing to do with their research, and the stories of others in
the field, which included them having their funding cut as a result of
threatened lawsuits and government investigation.

>the Sobell's are still considered leading experts in issues related
>to alcoholism).

By some academic circles, possibly. But not in any facet of therapeutic
work which claims to follow the techniques considered to produce acceptable
results. As much as I find the concept distasteful, those who pay the bills
generally keep a close eye on results (government subsidies to indigent
treatment not withstanding). I don't think there's an insurance company in
the US that will pay for aversion therapy. This is strictly assumption from
observing tha the many that we work with refuse to consider it allowable
treatment.

>Third, the issue of controlled drinking has now been
>examined in well over 100 studies, with general support for the
>findings that some individuals can return to moderate drinking
>without abstinance.

And no solid proof that these individuals weren't merely abusing alcohol,
and not addicted. I know of many abusers who are not alcoholic. I typically
try to get them out of the treatement designed for addicts. They often seek
treatment (if they have the insurance coverage) to get out of some
associated trouble. They're extremely acquiescent in treatment and produce
good numbers when the results are looked at. They can and do return to
moderate drinking, sometimes. But addicted? They show little or no
cross-addiction tendencies to phenobarb, measured by rapid tolerence onset,
withdrawal symptoms and drug seeking behavior by requesting additional
dosage. This test, originally for estimation of current tolerance and
dosage, done in cases where immediate detox might be dangerous, is being
used to verify addiction as opposed to abuse. I am not very popular with
the marketoids and adminimonsters because I keep insisting on
differentiating between abuse and addiction. They don't care, as long as
the insurance companies pay, which they do. I care, because abusers who
seek treatment more for reasons besides getting 'cured' take valuable time
away from treatment of others with a greater need. (I have an extreme
distaste for the word 'cure' when discussing this topic. I don't believe
such a thing exists).

Does the literature on aversion differentiate between abusers and
addicts?

>I could easily believe that your treatment center is wrong...but,
>that's another matter.

Absolutely. You have no evidence *not* to believe that. I intend to produce
it. The marketoids in the head office keep all such numbers, and I've
requested them.

>I guess I am reluctant to get entered into a long drawn out debate
>on this topic.

I can understand that. I'm a long-drawn-out-debate type myself, but I don't
recommend it as a lifestyle. We'd likely recreate in microcosm for the
newsgroup the tendency for the academic to show that the therapeutic
neglects the science being done, and the therapeutic to claim the science
isn't responding to its needs. We're as likely to resolve that as we are to
resolve the argument over whether tomatoes should be sliced vertically or
horizontally.

>I am on the Board of Consulting Editors for Psychology of Addictive
>Behaviors, which is published by a division of APA, and I've review for
>many of the addictions journals.

Criminy, I've just pissed off a reviewer, a fatal flaw when your name is
hard to remember but easy to recognize. "OH YEAH!" At least there's still
the Journal of Polymorphous Perversity.   :)
Xref: sparky sci.psychology:3189 misc.education:2991 rec.org.mensa:5361