U.S.

Alcoholism Treatment Debate Reignited

By CBSNews.com staff CBSNews.com staff

August 11, 2000 / 3:19 PM EDT / CBS

The debate between two opposing movements in how to help problem alcohol drinkers reached another boiling point Friday, when the founder of a national organization that promotes moderate drinking was sentenced on two counts of vehicular homicide.

Audrey Kishline, who started a national self-help group Moderation Management, drove the wrong way on Interstate 90 in Washington state on March 25, crashing into a 2-door Dodge driven by Richard Davis.

The impact killed Davis, 38, and his 12-year-old daughter, LaShell. A half-empty bottle of 80 proof Vodka lay in the passenger seat of Kishline's car, and her blood alcohol level was registered as .26 - more than three times the legal limit.

As the sentencing in Yakima, Wash., took place, once again leaders of Alcoholics Anonymous and Kishline's Moderation Management were pitted against each other, with both groups claiming to practice the best treatment for treating heavy drinkers and blaming each other for what resulted in her tragic accident.

"She was alcoholic and didn't want to accept it. There is a stigma attached to the disease of alcoholism and these people who have the problem try to reject the idea that they have the problem by coming up with Moderation Management," said Dr. Nicholas Pace, a board member of the National Council on Alcoholism. "Most alcoholics I know have tried Moderation Management. It doesn't work."

Moderation Management claims it is a free nine-step program for problem drinkers who want to learn to control their drinking habits. Founders claim that alcoholism is not a biological disease, but learned behavior.

"Our program is a self-help group. It's a stepping stone to either abstinence or for someone who really can moderate," Marc Kern, a board member of Moderation Management, told CBS News Friday. "It is designed for what we call early stage problem drinkers … Because they are afraid of making that leap into abstinence, Moderation Management offers them a small step before they take the next step."

They also draw the distinction between the "chronic drinker," who is severely dependent on alcohol and has severe withdrawal symptoms, and the "problem drinker," who is not alcohol dependent but drinks excessively and suffers from one or more alcohol related problems, including DUI and hangovers.

Audrey, a poster child for the controlled drinking movement, left her organization shortly before the accident and sought help from Alcoholics Anonymous, an abstinence-based group.

"If you have a problem with alcohol, you shouldn't drink. I saw a man last week who had four DWI's. He's trying Moderation Management. He is failing," Pace said. "I don't turn people away. I try to help them. But in medicine, we say, 'do no harm.' If you know the drug alcohol is harming someone, you don't use it."

Abstinence advocates said Kishline's tragedy illustrates her long denial of alcoholism and serves as the best testimny for abstinence. Moderation Management supporters, however, say it was only after her failure at the abstinence program AA, that the crash occurred.

Kern said that his program offers people seeking treatment more than the only option of giving up drinking alcohol completely.

"I think they can get good education, good guidelines within moderation management and come to the determination themselves that they have a problem with alcohol and should go on to an abstinence group," he said. "We must offer a variety of services for more people to get into treatment."

In 1994, Kishline wrote the book Moderate Drinking that argued problem drinkers can control their consumption rather than abstain altogether. She now believes alcoholics use that argument to cover up their problems.

Kishline, who was sentenced Friday afternoon to four-and-a-half years in prison, apologized to the family, saying she'll carry the guilt for causing their grief for the rest of her life.