- Hardcover: 224 pages
- Publisher: Hatherleigh Press; First Edition edition (June 2001)
- Language: English
- ISBN-10: 1578260817
- ISBN-13: 978-1578260812
- Product Dimensions: 6.4 x 0.8 x 9.5 inches
- Shipping Weight: 1 pounds
- Average Customer Review: 4 customer reviews
- Amazon Best Sellers Rank: #4,899,419 in Books (See Top 100 in Books)
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Alternatives to Abstinence: A New Look at Alcoholism and the Choices in Treatment Hardcover – April 27, 2001
The Amazon Book Review
Author interviews, book reviews, editors picks, and more. Read it now
A readable, informative, and balanced overview of...how problem drinkers might go about getting effective help. -- Frederick Rotgers, Psy.D., Assistant Chief Psychologist, Smithers Alcoholism Treatment and Training Center, St. Luke's-Roosevelt Hospital Center, New York, NY
From the Back Cover
Over 50 Million Americans Struggle with Alcohol. Is Total Abstinence the Only Answer?
Chances are, you or someone you love has a drinking problem. Most of us think the only solution is the twelve-step program of Alcoholics Anonymous. We readily accept that alcoholism is a disease and that the only path leading to a lasting recovery is quitting cold turkey. But what if this conventional wisdom is wrong?
Now Heather Ogilvie shows that there really are Alternatives to Abstinence in this groundbreaking book. This balanced and unbiased look at our current methods for treating problem drinkers will open your eyes to a world of treatment options beyond AA.
Alternatives to Abstinence will show you:
Why current attitudes toward alcoholism stem more from "folk" theories than from scientific evidence.
How expanding treatment options will lead to greater overall recovery rates.
How decades of well-established research contradict popular beliefs about the nature of alcoholism as an irreversible disease.
and give you:
Descriptions of twelve alternative treatment options that are at least as effective as twelve-step programs.
A comprehensive listing of public and private organizations, as well as individual therapists, specializing in alternative or traditional treatments.
Finally, Americans will be able to discuss and treat problem drinking without the misinformation that has plagued us in the past. If AA has not worked for you, there are Alternatives to Abstinence.
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The book opens with a foreword by A. Thomas Hovath, PhD, a professional therapist and the President of SMART Recovery. SMART Recovery, an alternative to AA, is supposedly an abstinence program, but Hovath makes no secret of his personal and professional preferences for moderation. A decent man who believes strongly in his philosophy of behaviorism, Hovath declares: "Drinking problems do not occur as a result of a disease process. Drinking," he says, "is a learned behavior." Despite this assertion, Hovath's language is almost exclusively that of a healthcare provider. He speaks of "patients" in a "healthcare setting" giving "informed consent" to "providers" who must "honor the patient's rights." All these may all be good things, but his language undeniably shows that this problem, though it's "not a disease," is being thought of in terms that are very much like the medical establishment thinks of diseases and health issues. To the astute reader, Dr. Hovath's foreword reveals that the argument here is not really about "a disease" vs. "not a disease" but about who is going to treat this condition, by what methods, and measuring what outcome.
Following Hovath, a preface is offered by Frederick Rotgers, Psy.D. The tone of Rotgers' essay is much harsher and, some might say, reflective of feelings that are alive in many treatment providers today. In Rotgers' view, those who do not agree with him are members of the "cult of abstinence only." The tenets of which, he believes, are "deeply rooted in the heritage of religious fundamentalism." From his point of view: "To be a 'recovering alcoholic'" - something he apparently is not - "is to have a special status in our society - the status of one who has taken the Devil by the horns, battled, and emerged victorious." Here again, the singular view of the treatment provider should be apparent. To be a so-called "recovering alcoholic" may grant one a "special status" in the world of professional alcohologists, but in "society," in the real world of bankers, merchants, teachers, soldiers, firemen, homemakers, bricklayers and accountants (to name but a few) a "recovering alcoholic" usually has a certain stigma, a somewhat spoiled identity.
Ogilvie recites the traditional arguments of the moderationists. She revisits the nearly forty-year-old paper of D. L. Davis, purportedly revealing that a small number (seven out of 93 or about 7.5 percent) of so-called "alcohol addicts" who had been treated in a London hospital were found drinking "normally." She did not discuss a follow-up study by Griffith Edwards showing that those same "alcohol addicts," twenty years later, were mostly back in their cups. Two of the seven had engaged in "trouble free drinking" over the total period, but five had experienced continued problems with alcohol and other drugs. One had an enlarged liver, one was hospitalized for peptic ulcers, and one poor fellow fell victim to Wernicke-Korsakoff syndrom, the "wet-brain" caused by too much alcohol.
Ogilvie cites several other studies, a superficial reading of which gives the impression that moderate drinking is effortless and common. In fact, the studies only show that moderate drinking is sometimes possible. For thirteen studies between 1952 and 1972, where the number of participants was given, 1,879 "alcoholics" were studied and 228 (about 12 percent) showed some success in moderation. The lengths of the follow-ups ranged from one to eight years, with the most common follow-up period being only one year.
The only positive thing about these data is that the numbers for AA attendees are even worse. Ogilvie cites the generally accepted figure, based on AA's own membership surveys, that 90 to 95 percent of those who begin attending AA drop out within a year. She cites Nick Heather and Ian Robinson, no friends of AA, in estimating that 25 to 50 percent of regularly attending AA members stay sober for one year.
Still, it is not correct to say, as she does (quoting the Rand corporation report), that "some alcoholics can return to moderate drinking with no greater chance of relapse than if they had abstained." Here everyone's thinking has become confused, for if one abstains, one drinks no alcohol and that is that. To think otherwise is for the moderationists to take a page from the "powerless" disease theory they despise, and use it for their own benefit. What is really happening is that of the universe of "alcoholics" who are treated, only a small number chooses to abstain. A much larger number, unfortunately, chooses to try moderate or controlled drinking, and of that number a very large majority will re-experience problems associated with alcohol. Neither side, to the extent that there are sides, can take much pleasure from this phenomena.
Has this book any value? Yes, but mostly as a neutral vehicle that perhaps can be used as a starting point to begin a more productive, more useful, discourse on the whole problem.
Reviewed by L. Allen Ragels