I read an article on CNN’s website called “Where Alcoholics Can Drink Themselves to Death” about a “wet house” in Minnesota. Alcoholics are allowed to live there and drink, but their drinking is restricted to certain areas of the house. The people who run the program, like program manager Bill Hockenberger sees the house as a harm reduction model instead of treatment. While the staff would love the residents to get sober, there doesn’t seem to be any active treatment of the illness.
Meanwhile, the public advocacy executive director for Hazelden, William Cope Moyers, was quoted in the article as saying, “We feel that that it’s never too late, and that even if the alcoholic doesn’t want help, doesn’t mean that their drinking should be condoned or in any other way enabled or facilitated…I see the wet house model as a model that enables the addict in the alcoholic to continue those destructive patterns.”
So we’ve got two poles. One group will let them drink as long as they stay off the streets and don’t hurt themselves or others and the traditional treatment provider demands they stop drinking and take the treatment offered. There’s a line in Alcoholics Anonymous that is apropos, “Do you have a sufficient substitute?” Obviously, not for these guys.
They’d all tried traditional treatment and ended up in a wet house. Because the people that run the wet house believe the people who run treatment programs, they think they have nothing to offer except harm reduction. But the wonderful thing about addiction treatment is that addiction is a disease, and treatment works. You just have to give the treatment. The wet house seemed to have doctors and nurses for care of sequelae of alcoholism but no addiction medicine treatment for the underlying illness.
It’s a shame that between a place like Hazelden, which is on record as being generally against agonist substitution treatment, and a wet house there’s no middle ground. Since only a small percentage of people with addiction can just stop and wait to feel better and only a small percentage of people are actually hopeless to the point where no treatment will work, most addicts live in the middle. Those of us who treat addiction should meet them there.
© Howard C Wetsman MD FASAM