Selected Papers of William L. White www.williamwhitepapers.com Collected papers, interviews, video presentations, photos, and archival documents on the history of addiction treatment and recovery in America. Citation: White, W. (2013). Fallen giants: The loss of addiction treatment and recovery pioneers in the United States. Alcoholism Treatment Quarterly, 31(4), 495-502. Posted at www.williamwhitepapers.com Commentary Fallen Giants: The Loss of Addiction Treatment and Recovery Pioneers in the United States William L. White Emeritus Senior Research Consultant Chestnut Health Systems [email protected] If I have seen further it is by standing on the The rise of addiction as a modern shoulders of giants. specialty field of knowledge and practice --Isaac Newton, 1675 over the course of the past half century was forged through intersecting social and The recent death of Griffith Edwards, professional movements. These movements MD (1928-2012), psychiatrist, addiction were led by pioneers in the arenas of mutual specialist, and long-standing editor of aid, public education and advocacy, social Addiction, forced me to pause to reflect on policy, scientific research, primary and the many modern pioneers of addiction secondary prevention, clinical practice, treatment who have died over the span of my professional education, and program career. Based in the UK, Griffith Edwards management and administration. It is fitting made innumerable contributions to the study that we pause as a field and acknowledge of addiction. His conceptualization of alcohol the contributions of such pioneers. This short dependence exerted a profound influence essay will focus on a few such pioneers from on modern diagnostic schemas for the United States. substance use disorders and he was a Anyone with substantial tenure in the commanding presence on the international modern addictions field has witnessed the drug policy front for more than four decades. passing of leaders whose lives exerted an But equally important was the mentoring that enormous influence on the evolution of he offered to many addiction specialists addiction treatment and recovery in the U.S. throughout the world, including this author. We have seen the passing of leaders from He and other giants of the addiction field are major addiction recovery mutual aid deeply missed. societies, including Alcoholics Anonymous williamwhitepapers.com 1 co-founder Bill Wilson, 1895-1971, Al-Anon 1966; and Dr. Marie Nyswander, 1919- co-founder Lois Wilson, 1891-1988, 1986). The field has also witnessed the loss Narcotics Anonymous co-founder Jimmy of modern addiction research pioneers (e.g., Kinnon, 1911-1985, and Women for Sobriety Dr. Sidney Cohen, 1911-1987; E.M. Jellinek, founder Jean Kirkpatrick, 1923-2000. There 1890-1963; Dr. Lawrence Kolb, 1881-1972). are the prominent celebrities, such as Lillian And we have witnessed the passing of iconic Roth, 1910-1980, and Jason Robards, 1922- drug enforcement figures (i.e., Harry 2000, who challenged prevailing stereotypes Anslinger, 1892-1975). about addiction and addiction recovery The pace at which we are losing the through public disclosure of their own modern pioneers of addiction treatment and recovery stories. There are the policy recovery in the U.S. has quickened in recent advocates who politically nurtured the birth years, particularly the leaders who shaped and evolution of modern addiction treatment the field’s coming of age in the 1960s and (e.g., Marty Mann, 1904-1980, Senator 1970s and went on to devote their lives to Harold Hughes, 1922-1996, Senator Paul this field. Here are brief profiles of some of Wellstone, 1944-2002). There are those the distinguished leaders we have lost in the whose philanthropy supported the drive for past decade. such policy changes (e.g., Brinkley Smithers, 1907-1994; Joan Kroc, 1928- Nathan Azrin, PhD (1931-2013), 2003). conducted landmark studies on the Those with long tenure in the field application of behavior principles to the have witnessed the passing of early treatment of alcoholism following his training pioneers of occupational alcoholism at Harvard under the tutelage of B.F. programming (Dr. John Norris, 1900-1985; Skinner. His studies at Anna State Hospital Dr. Luther Cloud, 1921-1991), those who in Illinois led to the development of the contributed to our understanding of the community reinforcement approach (CRA) sociology of addiction (e.g., Dr. Selden to the treatment of addiction. Bacon, 1908-1992; Dr. Alfred Lindesmith, LeClair Bissell, MD (1928-2008), 1905-1991; Don Cahalan, 1912-1992; Dr. was an influential leader in the rebirth of David Pittman, 1928-2002), and perhaps the addiction medicine in the United States. first modern addiction information specialist She was an early advocate of specialized (Mark Keller, 1907-1995). We have seen the treatment for women, conducted pioneering passing of early addiction medicine studies on alcoholism among professionals, specialists (e.g., Dr. Ruth Fox, 1896-1989; and co-authored the groundbreaking Ethics Dr. Marvin Block, 1903-1989; Dr. Frank for Addiction Professionals. For decades, Seixas, 1920-1992) and addiction she was a leading voice on alcoholism psychiatrists (e.g., Dr. Harry Tiebout, 1896- treatment policies and practices. 1966; Dr. Norman Zinberg, 1922-1989). We Alex Brumbaugh (1942-2013), was have lost the early generation of alcoholism director of Project Recovery and a prominent educators (e.g., Raymond McCarthy, 1901- recovery advocate. His recovery advocacy 1964; Father James Royce, S.J. 1915-1996; activities included participation in the history Reverend Joseph Kellerman, 1910-1933). making 2001 Recovery Summit that We have witnessed the passing of leaders launched the new addiction recovery who championed new intervention advocacy movement and authoring two techniques (e.g., Reverend Vernon notable books—Transformation and Johnson, 1920-1999) and led the Recovery and his about-to-be-released development and evolution of new treatment Praxis of Recovery. models, (e.g., Dr. Dan Anderson, 1921- Morris Chafetz, MD (1924-2011), 2003; Dr. Nelson Bradley, 1917-1983; was a vocal advocate in the late 1960s for Richard Caron, 1914-1975; Charles creating the National Institute on Alcohol Dederich, 1913-1997; Geraldine Delaney, Abuse and Alcoholism (NIAAA) and served 1907-1998; Sister Mary Ignatia Gavin, 1889- as NIAAA’s first Director. He was williamwhitepapers.com 2 responsible for forging the federal-state- sustained influences on the international local partnership through which local field of alcohol research. alcoholism programs rose across the Mrs. Betty Ford (1918-2011) and American landscape. Under his leadership, former President Gerald Ford announced to federal resources devoted to alcoholism the nation in April 1978 that Mrs. Ford had treatment grew exponentially, and the been treated and was recovering from foundation was laid for the modern era of addiction to alcohol and other drugs. Four alcoholism research. Dr. Chafetz authored years later, the Betty Ford Center opened more than 200 articles and 14 books on and went on to become an American cultural alcoholism, including The Alcoholic Patient: institution—a symbol of hope and healing for Diagnosis and Management. those seeking recovery from addiction. Mrs. John Chappel, MD (1931-2011), Ford’s openness about her addiction exerted was a notable figure within modern addiction a profound influence on the history of medicine. He crossed ideological divides recovery in the U.S., particularly the public within the field by simultaneously perception of women in recovery. championing methadone maintenance Avram Goldstein, MD (1919-2012), treatment and the role of spirituality and 12- through his work at Stanford University and Step participation in long-term addiction the Addiction Research Foundation, recovery. He was a strong advocate of conducted pioneering work on the addiction training for physicians and in the neurobiology of addiction. His research early 1980s led development of the first included collaborations that led to the certification exam for addiction medicine discovery of endogenous opioid peptides specialists. and opioid receptor sites. He was an early Herman Diesenhaus, PhD (1938- advocate of addiction as a brain disease that 2006), is best known for his role as a senior merited and warranted competent and public health analyst at the Center for compassionate treatment rather than Substance Abuse Treatment. While serving punishment. His landmark works include as the Associate Director of the Institute for Addiction: From Biology to Drug Policy. Medicine, Dr. Diesenhaus helped draft and Bill Iron Moccasin, Lakota (1921- edit the highly influential report, Broadening 2004), served as an honored member of the the Base of Treatment for Alcohol Problems. Council of Elders that guided the birth and Vincent Dole, MD (1913-2006), in development of the modern Native American collaboration with Drs. Marie Nyswander and Wellbriety Movement. His sage advice and Mary Jeanne Kreek, pioneered the use of teachings helped lay the foundation of a methadone maintenance in the treatment of vibrant movement that continues to promote opioid addiction. He also served as a non- and celebrate sobriety, health, wholeness, alcoholic trustee on the General Service and cultural revitalization within Indian Board of Alcoholics Anonymous. communities. Throughout his distinguished career, Dr. James Kemper, Jr. (1914-2002) Dole advocated treating addiction on par served as chief executive and chairman