Some history behind Pendery 1982

Let me finish off 2018 by taking about how the seminal work refuting the notion that alcoholics can moderate their drinking again, Pendery 1982, came to be published.

Pendery 1982 (i.e. M.L. Pendery, I.M. Maltzman, and L.J. West. "Controlled Drinking by Alcoholics? New Findings and a Reevaluation of a Major Affirmative Study" Science 217) is a very key paper in the history of alcoholism studies; the release of the paper was the last nail in the coffin that alcoholics can engage in sustained controlled drinking again. It humiliated the controlled drinking for alcoholics proponents; the study undeniably shows that alcoholics who try moderate drinking end up either dead, drinking like an alcoholic, or abstaining from alcohol.

The paper has a very interesting history which can be seen in two articles from 1982, when this very important paper was published:

• Alcoholism study under new attack. This article shows how the 1970s Sobell studies resulted in alcoholism experts from that era believing that alcoholics could learn to drink in a responsible manner, and how Pendery 1982 refuted that notion.
• Showdown nears in feud over alcohol studies. This article shows how hard Pendery and Maltzman had to work to make their paper a reality: “At every step of the way the Sobells have tried to block the investigation by Dr. Pendery and Dr. Maltzman. [...] The Sobells refused to hand over their list of the participants [...] Undaunted by the Sobells' resistance, the Pendery group tracked down a list of the patients' names at a county alcoholism center [...] The Sobells retaliated with a suit to block the use of the names, but a Federal District court dismissed their action in April 1977 [...] It took Dr. Pendery, using thousands of dollars of her own money and whatever time she could squeeze in among her other obligations, several more years to track down patients”

However, despite all this resistance, the paper was published and the notion that alcoholics could control their drinking again was no longer mainstream addiction research. 60 Minutes broadcast a segment describing the Pendery paper; Al Gore, long before he became vice president, wanted to investigate the Sobells for fraud.

Ultimately, the addiction experts who supported Sobell’s point of view would appear to have never let go of Pendery 1982. As recently as 2015, in a poorly researched anti-AA polemic, Glaser inaccurately describes the Sobell study. The Sobell study was not accurate; while an initial 1982 panel felt the Sobells were reasonably accurate in their research, a later 1984 Federal investigation (you know, with subpoena powers) pointed out that the Sobells were “careless in preparing their manuscripts for publication”. Indeed, some of the “controlled drinking” subjects in the study sued the Sobells.

Since people who think alcoholics can drink moderately again bring this up: How the alcoholics given abstinence treatment fared is a red herring. The Sobell study was done in the early 70s, some four decades before we starting finding twelve step facilitation treatments which effectively got more people going to 12-step meetings and abstaining from alcohol.

The fact of the matter is this: With one exception, Pendery 1982 shows us that the supposedly moderately drinking alcoholics in the Sobell study were either dead, engaging in out of control drinking, or were abstaining from alcohol 10 years later.

AA has a higher success rate than 5%

There is a frequently quoted 5% success rate figure for AA's success. This is a popular figure which anti-steppers love to bring up in the comments sections of articles about AA, almost always without citation. This number comes from no less than three different sources, all of which use incorrect methods to derive the 5% number:

• The 1990 Triennial Survey which the anti-steppers love to bring out had, of the population of people in their first year, 5% in their 12th month. To say this shows a 5% success rate shows a profound ignorance of statistics, as a HindsFoot article clearly shows.
• Agent Orange started a rumor that Vallant in The Natural History of Alcoholism Revisited showed a 5% success rate. The old green-papers site refuted it quite nicely; I summarize those findings in the Wikipedia talk page for Valliant's book. The actual AA success figures in that book, for people who attended 300 or more meetings over a ten-year period, is on page 197. The "this many people who attended 300 or more meetings" numbers are not in that table, but easily enough determined with some simple math: 74% of the people who went to 300+ meetings had stable remission, 21% of the 300+ meetings attenders had intermittent alcoholism, and only 5% of people who went to 300 or more meetings were still chronic alcoholics -- numbers, that, interestingly enough, agree with the figures in the preface to the second edition of AA's own Big Book (50% got sober right away, 25% got sober after relapsing, and the rest showed improvement).
• Lance Dodes used some questionable math in The Sober Truth to come up with this same figure; Gabrielle Glaser, in her 2015 hit piece, parroted Dodes' figures. Thomas Beresford, writing for the National Council on Alcoholism and Drug Dependence, directly refutes Dodes' bogus 5% figure in one article and shows some actual success figures for AA in another article.

I am leaving this blog for a while

It's important to not completely ignore the anti-steppers. While the AA program and the 12 steps are a very effective way that keep countless alcoholics and drug addicts clean and sober one day at a time, they are not perfect. A good member of AA is open to criticism and complaint.

Yes, there is a lot of anger and hostility among a lot of anti-steppers, and, yes, it is toxic for an alcoholic in recovery to associate too much with people with the hateful world view many anti-steppers have (this is one of the big reasons I don't allow comments here: I'm not about to let the bitter resentful anti-steppers choose when they can try to poison my mind with their hatred), but there are nuggets of legitimate criticism which AA members should heed.

This is going to probably be my last blog post for a while; I have also decided to no longer post in that far too long flamewar which the comments section of Glaser's hit piece has become. I will conclude my discussion of Glaser's latest click bait piece with a couple of articles which discuss it:

https://www.thenationalcouncil.org/lindas-corner-office/2015/03/alcoholics-anonymous-irrational/  There are good comments in the comment section here; infinitely better signal to noise ratio than the mire that is the comments for Glaser's latest hit piece.

http://www.huffingtonpost.com/tommy-rosen/spirituality-versus-scien_b_6909290.html  Not as good of a rebuttal to Glaser's hit piece as the New York Magazine piece, but raises some interesting points. Also: http://highfunctioningalcoholics.com/content/critique-of-gabrielle-glasers-atlantic-article-irrationality-of-aa/

The science against AA is at best murky; it's not scientifically an open and shut case like evolution, vaccinations, or climate change.

One last thing: The opinions expressed in this blog are my own and do not represent the opinions of Alcoholics Anonymous as a whole. In fact, Alcoholics Anonymous has no opinion on outside issues.

Glaser got the Sobell story wrong

I am not about to read, much less point by point refute, all of Gabrielle Glaser's over 8000 word anti-AA screed published in The Atlantic this month.  However, the 300 or so words she writes about the Sobell study and its aftermath are inaccurate.  For me to properly comment on it, I need to give readers here the entire content of what Glaser wrote on that Sobell study:

To many, though, the idea of non-abstinent recovery is anathema.

No one knows that better than Mark and Linda Sobell, who are both psychologists. In the 1970s, the couple conducted a study with a group of 20 patients in Southern California who had been diagnosed with alcohol dependence. Over the course of 17 sessions, they taught the patients how to identify their triggers, how to refuse drinks, and other strategies to help them drink safely. In a follow-up study two years later, the patients had fewer days of heavy drinking, and more days of no drinking, than did a group of 20 alcohol-dependent patients who were told to abstain from drinking entirely. (Both groups were given a standard hospital treatment, which included group therapy, AA meetings, and medications.) The Sobells published their findings in peer-reviewed journals.

In 1980, the University of Toronto recruited the couple to conduct research at its prestigious Addiction Research Foundation. “We didn’t set out to challenge tradition,” Mark Sobell told me. “We just set out to do good research.” Not everyone saw it that way. In 1982, abstinence-only proponents attacked the Sobells in the journal Science; one of the writers, a UCLA psychologist named Irving Maltzman, later accused them of faking their results. The Science article received widespread attention, including a story in The New York Times and a segment on 60 Minutes.

Over the next several years, four panels of investigators in the United States and Canada cleared the couple of the accusations. Their studies were accurate. But the exonerations had scant impact, Mark Sobell said: “Maybe a paragraph on page 14” of the newspaper.

(Emphasis mine) 

I watched that 60 Minutes segment when it came out. It helped save my life. It is very telling that Glaser does not describe what that segment said. Glaser gives the false impression that the critics merely had issues with the Sobells’s honesty. What Glaser is not telling her readers is what happened to those 20 people who the Sobells tried controlled drinking with: Four died drunk. Eight – make that nine – were engaging in out of control drinking. Six were abstaining from alcohol altogether. Only one of those 20 people in the Sobell study was able to achieve long-term controlled drinking.

The panel who investigated the Sobells merely found that the Sobells did not commit fraud; the contemporary New York Times story describing the report points out that “The Federal panel found that the Sobells overstated their success in one passage of a 1978 book” and that
“The panel also found that the Sobells made incorrect statements about the number of times they contacted patients.”

That is a far cry from Glaser’s assertion that “[The Sobells’s] studies were accurate.” The panel made so such conclusion, and Glaser should not be implying that they did. There’s a world of difference between not deliberately lying and making an accurate survey.

This is not the first time I’ve seen Glaser give the wrong impression. In a previous hit piece attacking the 12-step programs, she implied that Joanne Fry was the sponsor for Karla Brada, who, like many alcoholics, died drunk. Joanne Fry has since flat out denied ever being Karla’s sponsor, and Glaser never directly stated that Joanne was her sponsor, but tried to imply it.

The press has been very hostile to AA this month

The press has been very hostile to AA and other 12-step programs this month.

First of all, numerous articles about that Moderation Management group have been hitting the mainstream press this week. Never mind that MM's founder died drinking, and killed two innocent people because of her drinking. There are undoubtedly heavy drinkers out there who can moderate their drinking, but I don't care. There are also active alcoholics who think they are merely heavy drinkers who can somehow moderate their drinking, and who will go to great lengths to believe that lie. Countless alcoholics have died thinking they could moderate their drinking; I pointed out a few examples in my posting yesterday.

Here is a post from over a year ago refuting the claims that serious alcoholics can moderate their drinking: https://elplatt.com/return-moderate-drinking-still-lie

Not only has Moderation Management been getting a lot of press this month, but also anti-stepper Gabrielle Glaser just got a long article with the same tired old anti-stepper talking points published in The Atlantic. The best refutation to her talking points published so far is the article "Why Alcoholics Anonymous Works" by Jesse Singal: http://nymag.com/scienceofus/2015/03/why-alcoholics-anonymous-works.html 

Back in the time before I started drinking and during my active drinking, the mainstream press was not this hostile towards Alcoholics Anonymous. Indeed, in my day, 60 Minutes aired a segment about how one controlled drinking program was a failure that killed no less than four alcoholics. The fact the press was so friendly to the 12-step program is one of the reasons I got clean and sober as quickly as I did.

I am worried about the bullshit active alcoholics are reading these days. Moderation Management's bullshit that a heavy alcoholic can drink normally again already killed its founder and two innocent people; I wonder how many other people MM and the positive press it is getting this month will kill. I wonder how many active alcoholics will read Glaser's article in The Atlantic and take the drink that kills them instead of getting to a meeting and getting better.

Alcoholics need help, not people cosigning their bullshit.

Did Karla have a sponsor?

Dr. Peele, in the comments to the his inaccurate hit piece published earlier this week claims that Karla (who I have now detailed in two previous blog entries) in fact had a sponsor.

His exact comment was as follows:

Gabrielle responds: "I happen to have notes in my possession that state Joanne Frye [sic -- it's spelled "Fry"] was Karla's sponsor -- in her own handwriting."

Now, it's very interesting that Dr. Peele uses Gabrielle Glaser as a source claiming that Mrs. Fry was Karla's sponsor. Because, when I read Gabrielle's own words, my conclusion was that Karla never had a sponsor. And, indeed, that piece written by Gabrielle never states that Karla had a sponsor.  To wit:

As a relative newcomer to AA, Suzanne said, Karla had not yet chosen a sponsor [...] Joanne Fry, Patrick’s wife and the woman she had asked to be her AA sponsor

Carefully observe that Gabrielle does not say that Fry became Karla's sponsor, but tries to imply that she might have been.

Now compare this to Joanne Fry's own account:

We were not, ever have been, nor intended to be or become sponsors for Earle or Brada; we simply knew them.

We have two different stories being told here. I choose to believe Joanne Fry never became Karla's sponsor because Glaser's own account of Karla Brada's death never directly claims Fry was Brada's sponsor, and because Joanne Fry out and out denies ever being her sponsor.

Karla Brada Mendez's tragic death

As someone who has been been in the rooms of Alcoholics Anonymous for decades, one of the most tragic things I have seen time and time again is the number of preventable deaths that occur. These deaths are preventable because, if the deceased people had followed the suggestions given to them and became clean and sober, they would not have had to die.

One recent example which has recently made the anti-AA blogosphere is one Karla Brada Mendez whose death has been detailed elsewhere. This death is especially tragic because, if Karla had made other decisions (such as, for example, following the suggestions most meetings give newcomers), she would still be alive today.

To wit:

• Most people in the fellowship suggest that men stick with men, and women stick with women. Many sponsors suggest that newcomers do not get in romantics relationships (classically, the suggestion is "no relationship in the first year"). Karla, instead, got in a relationship with another newcomer (one Eric Allen Earle).
• Most people in the fellowship suggest that newcomers get a sponsor. Karla chose not to do that.
• One common saying in the rooms is that "winners stick with the winners". Karla, for whatever reason, did not choose to associate with women with long-term sobriety. 
• There is not one oldtimer in the fellowships I have been to who would suggest that a newcomer drink or use drugs again. Karla starting drinking and using again with her boyfriend.
• When Karla's boyfriend was arrested for domestic violence, instead of going to a shelter and/or getting a restraining order against him, Karla instead chose to pay some $8,000 to bail him out.
• Finally, in another drunken fight between Karla and her boyfriend, she is killed from injuries consistent with a violent struggle.

The bottom line is this: In the rooms of AA, newcomers are given suggestions. Karla, for whatever reason, chose not to follow those suggestions. If she had, she would be alive today.

These events happened nearly three years ago. Karla's family felt the need to blame AA for their daughter's death -- despite the fact that she would be alive today if she had followed directions given to her in the meetings.

Don't get me wrong: I grieve very deeply for Karla's tragic death, just as I grieve for the countless other people who have gone through the rooms and died drunk. But I just can not see how AA is responsible for her death, since she was undoubtedly repeatedly given suggestions which would have saved her life.  But she chose, for whatever reason, to not follow those suggestions.

The suit was filed around September of 2012, but there is no information publicly available about how the lawsuit proceeded, whether it was dismissed, settled out of court, a settlement was reached, or the litigation is ongoing. Indeed, none of the articles about this lawsuit even have a docket number. Too bad; I am curious how the lawsuit went.