Slaying the Dragon The History of Addiction Treatment and Recovery in America. William L. White. Table of Contents

Transcription

1 Slaying the Dragon The History of Addiction Treatment and Recovery in America William L. White Table of Contents Dedication... iii Acknowledgments... iii Introduction...xi Prologue: The Problem of Language... xiii Section One The Rise of Addiction and Personal Recovery Movements in the Nineteenth Century 1. The Seeds of Addiction Medicine and Personal Recovery Movements...1 Early American Drinking...1 Benjamin Rush and the Birth of the American Disease Concept of Alcoholism...1 A New Republic on a Binge...4 The Rise and Evolution of the American Temperance Movement...4 Alcoholics and the Evolution in Temperance Philosophy...5 Early Involvement of Alcoholics in the Temperance Movement...6 From Individual Struggle to Shared Recovery...6 The Tortured Saga of Luther Benson The Washingtonian Revival...8 Founding and Growth of the Washingtonians...8 The Washingtonian Program...10 John Hawkins and John Gough...11 The Washingtonian Demise...12 The Washingtonian Legacy Fraternal Temperance Societies and Reform Clubs...14 The Reform Clubs...17 Osgood s Reformed Drinkers Club...17 Reynold s Red Ribbon Reform Clubs...17 Francis Murphy s Blue Ribbon Reform Clubs...18 Reform Clubs Operation and Spread...19 The Business Men s Moderation Society Section Two The Birth of Addiction Treatment in America 4. The Rise and Fall of Inebriate Homes and Asylums...21 Pre-Asylum Days: Knowledge of Addiction...21 Pre-Asylum Day: Care of the Addicted...22 The Earliest Institutions...23 Types of Institutions...23 Sponsorship and Financing...24 Relationship with Other Community Institutions...25 Early Professionalization: The American Association for the Cure of Inebriates...25 The Decline of the Inebriate Asylums...27 i

2 A Post-mortem of the Inebriate Asylum Movement...28 Legacy...30 Summary Inebriate Homes and Asylums: Treatment Philosophies, Methods, and Outcomes...31 The Staff...32 The Patients: Demographic Profile...33 The Patients: A Clinical Profile...33 Treatment Philosophies...34 Treatment Methods...37 The Family and the Inebriate Asylum...40 Aftercare...40 Reported Treatment Outcomes...41 The Treatment of Alcoholism and Other Addictions in Women Four Institutional Histories...45 The New York State Inebriate Asylum...46 The Boston Washingtonian Home...47 The Chicago Washingtonian Home...48 The San Francisco Home for the Care of the Inebriate Franchising Addiction Treatment: The Keeley Institutes...50 Humble Beginnings of a National Phenomenon...51 Keeley: On the Causes of Inebriety...52 The Keeley Patients...52 The Keeley Staff...52 The Keeley Treatment...53 The Mail-Order Business...55 The Keeley Leagues...56 Reported Treatment Outcomes...57 Other Gold Cures...57 Early Controversies and Critics...58 Turn-of-the-Century Decline...60 The Later Keeley Years: The Keeley Legacy Miracle Cures of Alcoholism and Other Addictions...64 The Context...64 The Products...64 Promotional Schemes...66 Exposés and Legislative Reform...67 Continued Presence of Fraudulent Cures...69 Fraud as a Theme in the Early History of Treatment Religious Conversions as a Remedy for Alcoholism...71 Religion and Recovery: Historical Roots...71 Skid Row, the Bowery and the Birth of the Rescue Mission...72 Jerry McAuley s Water Street Mission...72 The Salvation Army...74 America s Keswick Colony of Mercy...75 Early Professional Views on Religion and Recovery...76 Conversion and Recovery: The Ideas of William James...76 Later Professional Perspectives...77 Critics of Religious Approaches to Alcoholism Recovery...78 Section Three ii

3 Evolving Approaches to Alcoholism Treatment: Alcoholism Treatment Settings: The Inebriate Farm/Colony...79 Alcoholism and City Hospitals...80 Alcoholics in Local Psychopathic Hospitals and State Psychiatric Hospitals...81 Drying Out the Rich and Famous: A Continuing Story...82 The Saga of Willie Seabrook...83 The Charles B. Towns Hospital for the Treatment of Drug and Alcoholic Addictions Physical Methods of Treatment and Containment...87 Physical Treatments for Alcoholism Between 1840 and 1950: An Overview...87 Eugenics: Sterilization and Benign Neglect...88 Natural Therapeutics...90 The Water Cures...91 Drug Therapies: Convulsive Therapies...94 Psychosurgery and Addiction: The Lobotomy Era...94 Miscellaneous Treatments Psychological Approaches to Alcoholism and Addiction Treatment...96 The Psychoanalytic Approach...96 The Emmanuel Clinic and the Lay Therapy Movement Aversion Therapy: Early Efforts Section Four Treating Addictions to Narcotics and Other Drugs 13. The Treatment of Addiction to Narcotics and Other Drugs: The Use of Cocaine as an Addiction Cure and Freud s Retraction Cocaine, Morphine and the Father of American Surgery Opiate Addiction: A Hidden Disease Drug Treatments and Drug Cures Before the Harrison Act Drug Treatment, The Harrison Act, Drug Enforcement and The Supreme Court The Morphine Maintenance Clinics The Treatment of Addiction to Narcotics and Other Drugs: Voices of Protest : Medical Detoxification and Hidden Drug Maintenance Dr. Thomas Ratigan, Jr.: Villain or Hero? Phantastica and Narcotics Research The Federal Narcotic Farms The Addiction Research Center The World Outside Lexington and Ft. Worth Section Five A.A. and the Modern Alcoholism Movement 15. The Birth of Alcoholics Anonymous: A Brief History Carl Jung and Rowland H. s Failed Psychotherapy The Oxford Group The Oxford Groups, Ebby T. and Bill W. s Hot Flash Bill W. Meets Dr. Bob A.A. Identity and Early AA. Growth Grandiose Visions The Big Book Early Rituals iii

4 The Period of Explosive Growth A Maturing A.A Those Who Shaped the A.A. Treatment Relationship Bill Wilson Dr. Bob Smith Dr. William D. Silkworth Sister Ignatia Dr. Harry M. Tiebout The Program of Alcoholics Anonymous Defining the A.A. Program A.A. Steps and A.A. Practices A.A. Experience and A.A. Logic Identity Reconstruction Within A.A Reconstruction of Personal Relationships Reconstruction of Daily Lifestyle Within A.A Reframing: The Curse that Became a Blessing The Recovery Program of A.A. and Its Predecessors: Shared Characteristics Innovations in A.A. s Program of Recovery A.A. s Organizational Structure and Practices A.A. s Mission A.A. s Philosophy of Addiction A.A. s Prescription for Short- and Long-term Recovery Carrying the Message of A.A. Recovery Internal A.A. Relationships Defining A.A. Membership The Expected Duration of A.A. Participation Power and Decision-Making in A.A The Voice of A.A A.A. Relationships with Allied Fields and Related Causes Managing Member Growth Leader Development Managing the Issues of Money, Property and Personal Ambition Social Context and Organizational Endurance A.A. Critics and A.A. Legacy Stretching A.A. s Gateway of Entry: Women and People of Color in A.A Were the experiences of women and people of color instrumental in shaping the Twelve Steps and Twelve Traditions of A.A.? Has A.A. adapted its program to address the special needs of women and people of color? What is the degree of participation of women and people of color in A.A.? A.A. s Place in History A.A. and the Professional Care of Alcoholics: Visions of A.A. Hospitals The Knickerbocker Paradox: Actions of A.A. Versus Actions of A.A. Members St. Thomas: The Beginning of a Model Model Evolution: A.A. Involvement with Public and Private Hospitals Model Extension: A.A. and Private Hospitals, Sanitaria, and Psychiatric Institutions A.A. Members as Moral and Business Entrepreneurs The Boundary Between Treatment and A.A.: The Story of High Watch The Distinction Between A.A. and Treatment A.A. and Alcoholism Treatment: A Synopsis The Modern Alcoholism Movement : The Core The Context The Alcohol and Alcoholism Movements The Volatility of the Post-Repeal Period Research Council on Problems of Alcohol The Yale Center of Alcohol Studies iv

5 The National Committee for Education on Alcoholism The Modern Alcoholism Movement : The Periphery Changing Medical Opinion on Alcoholics and Alcoholism The Alcoholism Movement in the Workplace Alcoholism Movement in the Church Municipal, State and Federal Responses to Alcoholism R. Brinkley Smithers: Private Philanthropy and the Alcoholism Movement The Role of A.A. and Recovered Alcoholics in the Alcoholism Movement The Role of the Alcohol Beverage Industry in the Alcoholism Movement The Legacies of the Alcoholism Movement Origin of the Modern Disease Concept Section Six Mid-Century Addiction Treatment 21. The Birth and Spread of the Minnesota Model Pre-A.A. History The Story of Pat C Pioneer House Hazelden: The Early Years Willmar State Hospital Hazelden: The Continuing Story Further Minnesota Developments Defining the Minnesota Model Why Minnesota? The Spread of the Minnesota Model Further Contributions of the Minnesota Model Mid-Century Alcoholism Treatments Organizational Activity in the Alcoholism Field: Expanding Knowledge and Ideas About Alcoholism Mid-Century Alcoholism Treatment: An Overview A.A. and Mutual Aid: Other Mutual Aid Societies: Alcoholics Victorious and the Calix Society Mid-Century Alcoholism Treatment: Treatment Methods Hypnosis Revisited Physical Methods of Alcoholism Treatment: An Overview Nutrition, Alcoholism, and Vitamin Therapy ACTH: Alcoholism and Endocrine Dysfunction The Use of Tranquilizers, Anti-depressants, Mood Stabilizers, and Sedatives Benzedrine in the Treatment of Alcoholism Antabuse and Other Antidipsotropics in the Treatment of Alcoholism LSD and the Treatment of Alcoholism Miscellaneous and Multi Drug Therapies The Carbon Dioxide Treatment for Alcoholism Advances in Psychosocial Rehabilitation Technology The Halfway House Movement Mid-Century Addiction Treatment: The Rise of New Approaches The Legal Context Medical and Psychiatric Context Juvenile Addiction: The Story of Riverside Hospital Community-based Support of Institutionalized Addicts Religious Approaches to Addiction Recovery Narcotics Anonymous Synanon: The Birth of Ex-addict Directed Therapeutic Communities v

6 The Therapeutic Community Movement The Therapeutic Community: Treatment Methods Mid-Century Addiction Treatment: Part Two Civil Commitments Methadone and Modern Narcotic Maintenance The Methadone Critics Methadone, Watergate and Federal Narcotics Control Narcotics Antagonists Multimodality Treatment Systems: The Story of the Illinois Drug Abuse Program Lexington and Forth Worth: The Twilight Years Section Seven Addiction Treatment in the Late Twentieth Century 26. The Modern Evolution of Addiction Treatment Reaching Critical Mass The Cooperative Commission on the Study of Alcoholism The Deluge of Addiction Treatment Legislation Local Sponsorship and Organization Two Worlds: Alcoholism and Drug Abuse Early Programs: What it Was Like Alcoholism: An Insurable Illness Program Accreditation and Licensure Three Worlds: Public, Private and Military The Rebirth of Addiction Medicine An Evolving Workforce A Hidden Story: The Exploitation and Relapse of Recovering Alcoholics and Addicts Professionalization: Training, Credentialing and Worker Certification Explosive Growth Early Intervention Programs Recovery as a Cultural Phenomenon Expansion and Diversification of Mutual-Aid Societies Competition, Profit, and Profiteering Ethical Context and Breaches of Ethical Conduct The Financial Backlash The Ideological and Cultural Backlash The Crash A Panicked Field In Search of Its Soul and Its Future Modern Addiction Treatment: Seminal Ideas and Evolving Treatment Technology Eleven Seminal/Controversial Ideas The Concept of Inebriety Reborn From a Single to a Multiple Pathway Model of Addiction and Recovery The Biology of Addiction Toward a Developmental Model of Alcoholism Recovery Addiction as a Chronic Disease The Continuum-of-Care Concept vi

7 7. Rethinking Motivation: Pain versus Hope Needle Exchanges: A Harm-Reduction Case Study Natural Recovery, Spontaneous Remission and Maturing Out The Question of Controlled Drinking and Drug Use Codependency: Popularization and Backlash Treatment of Special Populations and Treatment in Special Settings The Public Inebriate Changing Responses to the Drunk Driver Gender-Specific Treatment Adolescent Treatment The Employed Alcoholic/Addict Treating Impaired Professionals Treatment in the Military Cultural-Specific and Culturally Competent Treatment The Addicted Offender Treating Addicts with HIV/AIDS The Multiple-Problem Client Modern Addiction Treatment Technologies Treatment Evaluation Research Parkside: A Rich Legacy and a Cautionary Tale The Birth Early Influences The Early Program Contrasts Between Lutheran General and Hazelden The Treatment Team The Role of the Alcoholism Counselor The A.A./Treatment Center Relationship Al-Anon and Family Programming Early Diversification Evaluation Research Model Dissemination Explosive Growth Later Diversification The Demise Lessons and Legacies A Lasting Legacy Some Closing Reflections on the Lessons of History Approaching History Recovery Addiction Science The Rise of Treatment Institutions and Mutual-Aid Societies Observations on the Treatment Field Treatment in Relationship to Community and Society The Fall of Treatment Institutions and Mutual Aid The Future of Treatment Final Words Endnotes Index / Names Index / Subject / Institution / Product About the Author/Chestnut Health Systems vii