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Fatal Illness. The patient goes through a similar process four more times during his stay at Schick's Shadel, at the end of which he will presumably associate nausea with liquor—and have a long-term aversion to the stuff. "Aversion conditioning is not fun at all," Schick's Shadel's Director Dr. James W. Smith tells incoming patients, "but you are dealing with a fatal illness. In other fatal illnesses, such as cancer, surgery is often called for if it gives the patient the best fighting chance for survival. At the moment this is the best we know of—the method that will do the best job in the shortest time."
Aversion therapy has been widely criticized. Says one social scientist: "I think doctors who emphasize aversion conditioning are misguided. They claim that they are curing alcoholics by giving them a shot in the behind, which makes them sick. But how long does that really last?" A program that draws even more fire is one in which doctors study alcoholism by offering drinks to alcoholics. Indeed, Dr. Edward Gottheil, who oversees such a research project at the Coatesville Veterans Administration Hospital in Pennsylvania, admits that his work is "extremely controversial." Still, he argues, traditional centers either study alcoholics without their alcohol or alcohol without the alcoholics—but not drinking itself. "The idea that complete abstinence is the only treatment interferes with research," he says.
At Coatesville, patients are not only given individual psychotherapy, group therapy, music therapy and antidrinking seminars but are also allowed one or two ounces of pure alcohol (ethanol) once an hour on the hour, from 9 a.m. to 9 p.m., simply by asking for it. If he drinks the allowable maximum every hour, a patient can achieve a considerable buzz by 9 p.m. More important, 13 times every day he must make a conscious decision: to drink or not to drink. In a follow-up study of their first group, Gottheil and his associates claim that, after six months, approximately half of the group members were either dry or drinking less than twice a week.
Almost everyone else who works with alcoholics regards this study as heresy against the almost universally accepted belief that a recovered alcoholic can never ever drink again. "Out of 3,000 alcoholics treated at this hospital and another 12,000 consulted, I have never seen one return safely to social drinking," says Richard Weedman, head of an alcoholic treatment center at Chicago's Grant Hospital. "One drink won't push him off the wagon, but if he takes another three weeks later, bang! He's gone."
Most of the methods owe a large debt to Alcoholics Anonymous, the oldest, the biggest (650,000 to 750,000 members) and still the most successful organization by far for helping alcoholics. "Until the researcher is able to demonstrate some better practical techniques, the A.A. approach continues to merit our admiration and endorsement," says Gottheil. And, write Sociologists Harrison Trice and Paul Roman: "Despite lay leadership, A.A. has apparently achieved a success rate that surpasses those of professional therapies."