About Alcoholism - Alcoholism Information, Research and Treatment
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The possibility that a recovering alcoholic might return to controlled drinking, suggested in a survey issued by the Rand Corporation of California, has drawn a volatile response.
Frank Seixas, MD, medical director of the National Council on Alcoholism, cites "glaring" methodological deficiencies in the survey which prompted the authors to conclude that "alcoholics who were drinking socially were no more likely to relapse than those who were abstinent."
Though the study was based on a client pool of 30,000 individuals treated at 44 treatment centers, Dr. Seixas emphasizes that the conclusion supporting the possibility of a return to controlled drinking was based "not on 30,000 patients, nor 10,000, nor 1,000, but on a subsample of 161 patients.
"Furthermore," says Dr. Seixas, "the relapses upon which this conclusion of paramount importance was made, were eight in number: three cases out of 19 who claimed normal drinking at six months and five out of 31 who claimed abstinence at six months."
Much of the criticism focuses on the length of the Rand group's follow-up periods (six months and 18 months), the lack of a random sampling for the 18-month groups, the study's reliance on patient recall of their own drinking patterns, and the high numbers of clients lost to follow-up (9,000 of 11,500).
Another of the major criticisms concerns the alleged failure to include data from the work of other prominent scientists in the field, such as Dr. John Ewing of North Carolina, and Dr. Max Glatt of England, neither of whom has been able to establish any number of controlled drinkers over much longer periods of time.
Dr. Ewing says, "In my experimental attempts to inculcate controlled drinking in alcoholics, the results looked promising in the first 12 to 18 months. It was only when we did a long-term follow-up, ranging from 27 to 55 months since treatment ended, that we detected a universal failure to maintain controlled drinking."