By Kenneth Anderson, MA Alcohol treatment wasn't always divorced from alcohol science; the divorce between the two can be largely laid at the feet of Hazelden CEO Daniel John "Dan" Anderson, PhD (Mar 30, 1921 - Feb 19, 2003). Anderson's attitude towards science was one of hubris and arrogance. The History of Alcohol Treatment in the United States Treatment for alcohol problems in the United States occurred in two major waves: The first was prior to Prohibition (January 17, 1920), and the second followed Repeal (December 5, 1933). Demand for alcohol treatment dried up almost completely during the period from 1915 to 1920 due to state and local prohibition laws, the so-called Wartime Prohibition Act, and other factors, and all but a handful of alcohol treatment facilities had shut do...

By John de Miranda Innovation does not come quickly or easily to the addiction treatment sector. For example, harm reduction strategies had been employed in the public health sector for decades before their recent adoption by the federal government as a latecomer to fighting our nation’s opioid epidemic. Similarly, the Minnesota Model of addiction treatment, which emerged in the 1950s, still accounts for the model preferred by the majority of treatment programs. At its core, this approach draws heavily from 12-step ideology and requires a commitment to abstinence as the key focus of treatment goals. “If you have had enough and are ready to quit, then we can help you,” is the metamessage sent to potential clients by most addiction treatment programs. The problem with this approa...

By Tom Horvath, PhD Stanton Peele suggested this idea in one of his recent blogs. As we await Super Bowl Sunday (2/11/24) the question seems worth re-visiting. It would require a careful analysis of outcomes from pro football and substance use to provide an accurate comparison. The data about substance problems is easy to find. Pro football’s data is harder to find, but generally we know that playing football can result in concussions, broken bones, chronic traumatic encephalopathy (CTE), and other injuries. For further details search for the NFL concussion settlement. However, it seems unlikely than an accurate comparison between pro football and substance use will occur because professional football is popular, and substance use seems to be unpopular. We often condemn substance ...

By Tom Horvath, PhD How well can I calm myself or energize myself using my own abilities? How much do I need to use a substance for help? Although at times a mild sedative (one drink) or mild stimulant (a cup of coffee) can be a helpful tool, the more we rely on such tools the more our internal abilities diminish (atrophy). Daily low doses of sedatives or stimulants can be helpful. As the doses get higher, problems can emerge. In cases of substantial addictive problems, it is common to see someone bouncing between “downers” and “uppers,” sometimes even multiple times per day. At that level of substance use we can lose all sense that self-regulation can be accomplished by ourselves. None of us may reach the ideal of regulating ourselves entirely from our own resources. However, ...

By Kenneth Anderson, MA The history of alcohol treatment since the 1960s has been a history of practitioners ignoring science and the scientific method and forming conclusions based on observations of clinical populations without testing hypotheses, then self-publishing these hypotheses or publishing them in the popular press rather than in peer-reviewed scientific journals. Some of the most notorious examples of this are Hazelden and the Johnson Institute, which will be discussed in later blog posts. Another notorious example is Lakeside Milam, founded by James Robert Milam (Mar 3, 1922 - May 6, 2016). This is a far cry from Shadel Sanitarium, which meticulously published its data in peer-reviewed journals in the 1940s and 50s. James Robert Milam Milam was born in the state of Was...

By Kenneth Anderson, MA The Wegscheider-Cruse Family Roles Theory is one example of how “chemical dependency” treatment does not have the firm scientific foundation that it is suggested to have. Despite this lack of foundation, to become a certified addiction counselor today one must study Wegscheider-Cruse's theory. Below I present the history of the development of this theory, and some of the specific problems with it. Sharon Wegscheider-Cruse Behind the Wegscheider-Cruse Family Roles Theory was Sharon Wegscheider-Cruse (Nov 16, 1938 - living), born Sharon Rae Roelandt in Jasper, Minnesota, the daughter of Emil Leonard Roelandt (Jan 19, 1915 - Dec 24, 1961) and Marjorie Annadell Roelandt nee Olson (Aug 7, 1919 - Aug 11, 1986). The Roelandts were Catholic, and Sharon attended Cath...

By Tom Horvath, PhD Although you can embark on a new habit at any time of year, the New Year remains a popular starting time! Here are some suggestions on how to maximize your project. Decide whether to start small or start “big.” Even though your end point may evolve over time, decide at the beginning what your endpoint is (and write it down). If you start small, build over time. What is the smallest step you are confident you can consistently take? Then wait until that pattern is well established and add another step. This approach may be more realistic and comfortable than starting big. If you start big you will definitely need to prepare in advance. Do you have the items you need (e.g., exercise clothes, a new shopping list, a well-practiced breathing technique that you ...

By Tom Horvath, PhD This month the Substance Abuse and Mental Health Services Administration (SAMHSA) of the federal government released a 15-page document entitled Advisory: Low Barrier Models of Care for Substance Use Disorders. The document summarizes the difficulties associated with reaching and providing care for individuals with substance use disorders. Less than 10% of individuals who might benefit from treatment participate in it. A “low barrier” approach to treatment attempts to reduce the difficulties that might reduce treatment attendance. Although not primarily intended as a list of the shortcomings of the current US addiction treatment system, the document can be understood that way. What’s wrong with US addiction treatment? Too many requirements for entry. The insu...

By Tom Horvath, PhD Boredom is the perception of being under-stimulated. We all have optimal levels of stimulation (some generally want more, some generally less). Whatever your level, when you are not getting enough, you are bored (and when over-stimulated, you may be stressed). Boredom is often considered an undesirable state. However, let’s start with its advantages. If not much is going on in your immediate world, you have time to consider the larger context of your life. It is easy to lose track of what is more important than day-to-day and moment-to-moment issues. If bored you have a moment to consider what is important, rather than just immediate or urgent. When feeling bored you might say, “I’m glad nothing is pressing on me at the moment; I can think about the bigger p...

by Kenneth Anderson, M.A. THIQ is an acronym which stands for tetrahydroisoquinoline, a chemical which is formed in the brain when a metabolite of alcohol combines with dopamine. The THIQ theory of "alcoholism" became very popular in the 1970s and 1980s, when it was erroneously believed that THIQs were formed in the brains of "alcoholics," but not in the brains of normal drinkers. The theory became so popular that it was regularly taught to clients at Hazelden, both in a document riddled with historical errors and in a videotape which I recall seeing in the 1990s. THIQ theory is discussed in more detail below. Although THIQ theory was debunked in the 1990s when it was found that THIQs were formed equally well in the brains of both normal drinkers and "alcoholics," recent research sug...