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Source: 1985 Montreal International Convention – Multi Speakers – AA AND ALCOHOLISM AGENCIES – RS 06407.mp3 File: 1985-montreal-international-convention-multi-speakers-aa-and-alcoholism-agencies-rs-06407.mp3 Duration: 01:30:15
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I've been privileged to share this meeting and to visit with these three charming people up here. This is the meeting entitled AA and Alcoholism Agencies. And as I started to say, over here is the no smoking section for any of you that would like to sit over there. They'll start the meeting promptly and we have to finish promptly because all the taping is on automatic. And we'll open this meeting in the usual manner with a moment of silent meditation followed by the serenity prayer.
God grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference. For those of you who can't see this great big red thing here, that's my bleeding heart. I am now officially a bleeding deacon. I'm about to be a has-been trustee. We have some newspaper people here and I've been instructed to read our public relations announcement.
Our public relations policy is based on attraction rather than promotion. We need always maintain personal anonymity at the level of press, radio, TV, and films. Thus we respectfully ask that no A.A. speaker or indeed any A.A. member be identified by full name or photograph and published or broadcast reports of our meetings. The assurance of anonymity is essential in our effort to help other problem drinkers who may wish to share our recovery program with us.
And our tradition of anonymity reminds us to place A.A. principles before personalities. And that's about all the instructions that I have, so I guess we can get right along with the meeting. Our first presenter is Mr. Leonard Blumenthal, who is the assistant executive director of the Alberta Alcoholism and Drug Abuse Commission based in Edmonton, Alberta. And he's been in that position for 19 years.
His background before that was as a school teacher. Leonard? Thank you very much. Can you hear that? Is that on now? First of all, I would very much like to thank the organizing committee for extending their kind invitation to me to be here with you today and share with you some of my thoughts and experiences regarding my 19 years' involvement with the Fellowship of Alcoholics Anonymous. During that 19 years, I have been privileged to work in a variety of programs with the Alberta Alcoholism and Drug Abuse Commission and programs of a similar nature right across Canada.
I'd like to give you a brief description of what I saw happening during that time and bring it to the point that we are at today. In a book called A.A. Today, which was a special publication of the Grapevine commemorating the 25th anniversary of A.A., one of the articles written was by Premier Ernest Manning of Alberta. In that article, Mr. Manning made a short analysis of Alcoholics Anonymous and then went on to indicate what its influence had been in our province.
He described that a foundation with government support had been established and was operating two clinics and a special jail program for incarcerated alcoholics. One of the points he stressed is that the original organization in Alberta, and I quote from his article, quote, saw fit to take from the experience and traditions of Alcoholics Anonymous and to incorporate into their board and programming both friends, i.e. non-alcoholics, and recovering alcoholics as anonymous members in positions of service, end of quote.
Some 32 years later, that principle is still intact. When I first was presented with the idea of working for the Division of Alcoholism in the Department of Public Health in Alberta, I really didn't take it very seriously. I was a successful teacher, having a vice-principalship in an elementary school, and enjoyed my work thoroughly. I had absolutely no idea what an alcoholic was, although I knew there were people that I had come across, both while working in our family country store and in our own extended family who sometimes, and in some cases, often drank too much.
Their behavior, however, was simply dismissed as being exceptional or demonstrating a lack of willpower. I do remember my father extending virtually unlimited credit in the form of groceries and other necessities to a couple of families where the father usually drank up the money. He and the family would question my father's judgment, but he always won out, as fathers
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usually do. In later years, we found out that his stepfather also had a drinking problem, and my father identified very closely with the families of those who experienced the result of alcoholism. I thus came into the business relatively uninitiated and was amazed to find alcoholism referred to as a treatable illness. My first impression was that this was simply a good piece of propaganda for those who had experienced alcoholism to justify why they were doing what they did and acting the way they were.
However, it did also indicate that perhaps there was more to this whole thing than a lack of willpower or bad habits, and there was some sort of methodology for people actually to get better. I found out that the more I explored and investigated the whole area and tried to make some sort of logical sense out of it, the murkier it became. In fact, there seemed to be very little agreed upon factual information, and everyone you talked to seemed to be an expert and made a great deal of sense for the time you were talking to them.
I should also mention that I was greatly outnumbered insofar as most of the people working in the field of alcoholism at that time were recovered people, and as a result had their own particular theories and expertise as to how people contact the illness and then recover from it. However, after several months, it became apparent to me that the one consistent thread that seemed to be woven through all of the theories, experiences, and conversations that I had with people was the involvement in Alcoholics Anonymous.
It seemed that those individuals who had established and maintained a close relationship with Alcoholics Anonymous groups and or individual members were the ones who we didn't see in our clinics anymore. They just seemed to disappear. I decided to turn my investigation to Alcoholics Anonymous to determine why and how it works. I was directed and accompanied to several meetings originally by other staff members who themselves were recovering and were in the fellowship.
At first, they were somewhat skeptical of my being able to appreciate and understand what was happening because of the fact that I was not there for my own recovery, but rather to observe and learn. I found that the more meetings I went to, the more difficult it became to focus in on why AA seemed to work and how it seemed to work. There seemed to be no rhyme nor reason to why certain people got better while others didn't.
Also, there didn't seem to be any surefire formula that one could grab hold of and apply to someone else's situation. After about two years of going to meetings three or four times a week, a brilliant flash of insight hit me when I was once more trying to analyze why the program seemed to be as successful as it was. The insight that I came up with was that perhaps I should just simply accept that it does work, and once that acceptance has been made, do everything I can to assist those individuals who are searching for recovery and accessing as much of the AA program as is possible.
This has been my own personal philosophy ever since that time, and I found that it stood me in very good stead. While I was conducting all of this private research, I actually was employed to work as a counselor in an outpatient center. I would interview people who were experiencing problems with their alcohol use, their families, and in some cases, employers. I would also conduct information lectures, and being the newest and youngest on staff, I was to organize a recreation program such as outings, bowling, etc.
I should add that during this time, my father could not comprehend why he would give up a vice-principalship of his school to, as he put it, quote, go bowling with a bunch of drunkards. I assured him that it was probably just as interesting and made just as much sense as him giving away half the grocery store to the families of people who spent their money on alcohol. My father, however, really at that time did not think of what I was doing as being a real job at all.
He couldn't accept that. During these several years, I continued to attend AA meetings wherever and whenever I could and was privileged to work with alcoholics in a variety of settings such as general hospitals, mental hospitals, jails, and still in the outpatient clinic. During this time, I was continually amazed at the variety and dedication and enthusiasm of AA members and groups. Also as a non-alcoholic, I was coming to be more and more accepted and actually received invitations to attend private meetings, home groups, and members-only retreats.
The first major expansion in our provincial program occurred when we inherited a 64-bed
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minimum security jail to use as an inpatient rehab center. I was assigned the task of developing the program, hiring and training the staff, and beating the bushes for people to come into the place for treatment. This was when my involvement with Alcoholics Anonymous probably had its biggest payoff. I was given tremendous assistance and encouragement by the various groups and individual members I had come in contact with over the previous years and came to rely on them as significant referral sources and also as providers of the ongoing therapy for the individuals who came through the program.
I should add that I was also given a lot of advice from these same people, and I'm sure you'll appreciate that not all the advice was usable, and in fact, a lot of it was worth exactly what I had paid for it. However, we persevered with this new venture, and along with having a significant number of individuals on staff who had been through recovery programs and were active in AA, the outside groups assisted greatly in introducing our clients to the fellowship and also assisting them in establishing new groups when they came back into the community.
There are now many dozens of groups in our province that were organized and are still maintained by individuals who came through the Henwood program. Over the last ten years, the services available to alcoholics in Alberta have improved greatly. There are now treatment and rehabilitation services in some 70 locations, and the funding received from government to provide these services is approximately $10 per capita.
Throughout all of the treatment and rehab programs being offered, there is still the continual exposure and referral of participating clients to AA groups, and the feeling is that AA is still considered the ongoing therapy for all individuals who are coming through the treatment program. In a similar vein, it is important to maintain a core of strong and talented individuals who have firm roots in the fellowship of AA as workers in treatment programs.
We are proud that in our program we have members of AA at every level, ranging from our commissioned board of directors who set the policy and direction of our endeavors to those individuals working in the detox centers who come in daily face-to-face contact with the people still looking for recovery. Many of the individuals who are recovering and working in our commission are former clients, and I like to refer to them as the product we produce.
My feeling is that we must believe in our own product and demonstrate that belief if we are ever to expect anyone else to believe in it. Finally, I'd like to share with you the fact that my involvement with Alcoholics Anonymous has been of tremendous personal assistance in many of life's situations. You probably have often heard it said that the program is not one to combat alcoholism, but rather is a positive program for living.
I found this to be the case and feel that many of my attitudes and actions have been influenced and in fact molded by the principles and messages contained in the Twelve Steps and Twelve Traditions. For this, I as a non-member am grateful. I'm also very grateful for the assistance and instruction given me by various members of AA over the past 19 years that I have been involved in this line of work.
They have been inspirational, supportive, directive, and even critical, but most of all they have been very, very accepting and strive very hard to form a working cooperative venture dedicated toward assisting an individual to find recovery. Thank you for your attention. I began by indicating where we were at 25 years ago. We've made tremendous strides in the last 25 years. I very much appreciate being part of this very special golden anniversary celebration and know that if we continue to work with each other, the next half century will even show more advancement than we have experienced to this time.
Thank you very much. Thank you very much, Leonard. Our second presenter, and I'm not certain whether I remembered to say that we will be allowing time at the end for you to ask questions of the presenters as long as we finish by 11 o'clock. That was stressed quite strongly for me. Our second presenter is Laura Bass, who is the executive director of the Albuquerque area of the National Council on Alcoholism in Albuquerque, and she has her master's in public health, not in sociology, in public health.
Before she became director of the local chapter of the National Council, for which she has been director five years, she worked with adolescents for five years.
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I'm very pleased and honored to be here this morning, and on behalf of the National Council on Alcoholism, I would like to express to you our warmest and most sincere congratulations on your 50th anniversary. Did I happen to see Walter Murphy just walk in here? Hi Walter, you've made my day. Several months ago when I received the invitation by mail to speak here today, I was honored and thrilled. But I must admit that I have been full of anxiety and nervous about being here and what am I going to say to all of you wonderful people, what do I have to share with you, to offer to you, and I went through months saying I'm not going to be nervous, this is a wonderful group of people, I'm used to talking to people, but I must share with you something that just happened to me.
I told myself when I awakened this morning that I wouldn't be nervous, I was looking forward to this, and I said that all the way over here this morning, and so right before this I was standing in the restroom, combing my hair, looking in the mirror saying everything was going to be fine, until this gentleman came up behind me and he said, Madam, are you nervous? And I looked at him and said, why no, why? He said, then what are you doing in the men's room?
Now it's a true story, is he in here? So I hope I'm in the right place now. As I said, it's an honor and a privilege for me to be here today to join in celebration of this most joyous occasion. Speaking of joy, the other day I came across the word jubilee. There are two sources for this word. One is from the Latin word jubilar, which literally means to make sounds of joy. I've heard lots of sounds of joy.
The other word is from the ancient Hebrew word yobel, which refers to the trumpet that was sounded to call upon the people of Israel to celebrate every 50th year to proclaim liberty throughout the land and to all inhabitants thereof. And that is always the purpose of a jubilee, joy for all concerned, a time for celebrating. For what you are celebrating here today is not only a passage of time, not merely the very special birthday that a jubilee represents, but rather recognition of an example of the enduring worthiness of faith, hope, love, and fellowship.
I've been asked to speak about alcoholism agencies and how they work with AA in our communities. Are there any people in the audience today who serve on the board of directors of a local alcoholism council, National Council on Alcoholism, for instance? Good. We need to get more of you involved. I hope that all of you have one in your community. Let me quote Marty Mann. Is there anybody in the audience who knew Marty Mann? A wonderful woman.
When the day comes that alcoholism is accepted for what it is, one of our greatest scourges, but a disease which can be treated, and when we treat it with all of our resources as we do other illnesses, then AA will be able to function to its full potentiality. That day of deliverance is not so far away as it may seem. Public awareness is growing by leaps and bounds, and real understanding is not far behind.
I have to tell myself that every day when I go into work. More and more organizations are seeking information and advice on instituting action, and finally, more and more individuals are seeking information and guidance about a particular alcoholic, a loved one, or perhaps themselves. Where can people in our communities go for the information and help they seek? The National Council on Alcoholism Affiliates started 41 years ago when the National Council on Alcoholism was founded in 1944 by Marty Mann, a courageous woman who had recovered through AA.
Marty founded the NCA 41 years ago in an atmosphere of almost total darkness. The word alcoholism was a taboo word. The public attitude was compounded of ignorance, fear, prejudice, hostility,
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and this public attitude included most professionals. The drunkard was considered a helpless, hopeless proposition and wholly to blame for his or her own condition. Almost nothing was being done about alcoholism except by alcoholics themselves, meaning AA, and a few courageous scientists at Yale University. Obviously they were working against tremendous obstacles. The new organization, then called the National Committee for Education on Alcoholism, was dedicated to removing those obstacles and to creating an atmosphere of understanding and cooperation in which constructive work on alcoholism and for alcoholics could go forward.
The name was later changed to the National Council on Alcoholism, NCA, and was established as the only national voluntary public health agency in its field. The NCA now boasts over 200 affiliates nationwide whose primary purpose is to provide information and objective, unbiased referral and prevention and education services to the general public and special target groups. Dan stated that NCAs and other community alcoholism centers are the most advanced outposts in the fight against alcoholism.
They are much further out than the front-line troops of therapists, hospitals, clinics, and AA. They provide the headquarters for work, which must penetrate deep into hostile territory, infiltrating through combat lines of prejudice to establish a bridgehead of hope for the captive people behind the lines, alcoholics and their families. An alcoholism agency is not in itself the road to recovery. It is actually a bridge leading to that road and a very necessary bridge.
The bulk of our alcoholic population is still hidden, still sealed off from help by an impassable swamp, a no-man's land of ignorance, fear, superstition, and stigma. This swamp is a black morass with an unpleasant stench of contempt and hostility rising from it. It is a fearsome thing, and the average alcoholic in the earlier middle stages of his or her disease is quite unable to face it, much less to conquer it.
If these individuals and their families are to find a way out of their dilemma, and a way provided across the swamp, a bridge that will lift them right over it, this is the function of an alcoholism agency. For those of you not familiar with alcoholism agencies or NCA affiliates in your community, I want to just speak from my own experience. I was asked to share with you today the work of an alcoholism agency as the one that I work with way back there in Albuquerque, New Mexico, which is a part of the United States, is fairly typical of the alcohol agencies around the country.
The mission of the NCA is several. Their goals are referral and community services. If any of you have noticed in the past few years, looking through the yellow pages of the phone book, there's been a proliferation of alcoholism treatment programs and centers and individuals. It seems to be very popular and lucrative now for people to hang their shingle. And where do people who need help look? They open the yellow pages.
They see hundreds of different programs and names. That is one of the purposes of an alcoholism center, so that they can call into us, and we man our services 24 hours a day with recovered alcoholics, with members of Al-Anon, who can give clear, honest answers to these people and help them find a way. Education and training. Alcoholism agencies around the country provide a number of different kinds of programs.
Again, speaking from my own experience, we started with programs in the schools for children many years ago. We started at the junior high school level, mid-school level. Then we moved down to the third grade level, and there were so many people who said, how dare you talk about alcohol with third graders? Well, we were just amazed to find out that they knew more than some of our speakers knew, not only from their own experience in their homes, but certainly from the media.
Anytime you turn on a television set, you see alcohol being used and abused in so many different ways. So now we have started our educational programs at the kindergarten age level, and I am surprised at the response we get from kids that young. But they're ready for it, they're open to it,
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and it's an opportunity for us to identify children who are living in an alcoholic home and to provide services to those young children. All of our volunteers, like I mentioned before, are from AA or Al-Anon. They have a genuine interest in going out to the public and working with children and families. Our educational programs go from kindergarten all the way through the twelfth grade. Now, we know by the time kids are in high school, the majority of them have experimented with alcohol and other drugs, if not using it regularly.
The statistics are amazing. I don't feel that I need to share those today, but we've got a problem out there, and it's important for us to reach those kids constantly. We have to reach the kids at different levels with different kinds of programs. At the high school level, we go in talking about drinking and driving. If we just go in there and talk about drinking, they usually turn us right off and walk out of the room.
So that's the way that we bring it in. Besides many programs for children, we go all the way up to senior citizens. We have many programs for the elderly. We have programs for special target groups, for women, for minorities. And all of our programs, again, are conducted through speakers' bureaus with volunteers from the AA and Al-Anon communities. Medicine and health. Another mission of the NCA is to ensure that the resources of medicine and related health professions are organized for and directed toward the effective prevention, diagnosis, and treatment of alcohol abuse and alcoholism and to encourage maximum involvement of all health professionals in the alcoholism field.
We serve as advocates of research on a nationwide basis. We serve on many different commissions, governors' commissions, mayors' commissions, presidential commissions, in promoting that research be conducted and in promoting prevention and education nationwide. Labor management. I'm sure that a lot of you have heard of employee assistance programs. Again, there was a proliferation of employee assistance programs which seemed very lucrative to people.
Actually, the idea of working with labor management was introduced by the NCA in the 1950s in conjunction with the AFL-CIO. My particular office runs one of the largest DWI offender screening programs in the country. We screen almost 500 first offenders every month to see if they will be likely recidivists or if they have a problem. Now, I'll get into that a little later, but what I wanted to bring up here was that we found that the majority of them were working and the majority of them had been experiencing problems in the workplace prior to being arrested for their DWI.
Doesn't that seem like a logical place to start a prevention and education program, an outreach program? The NCA so many years ago went to labor management and said, Don't fire your alcoholic employees. Give them a chance and work with them. So we hope that that support will continue for many, many years, for always. The NCA's have gotten involved in many different and controversial issues. The NCA obviously started out of AA, but they can do things that AA is not meant to do by reaching many different community groups and working with them.
Besides labor management, another thing that we hear about constantly is drunk driving. And on so many drunk driving commissions around the country, we see representatives of MADD and we see representatives of the liquor industry sitting on there, but we have not seen very many representatives of the alcoholism field. We've not seen people who have been drunk drivers because of their alcoholism, and we need people to sit on those councils to support the need for screening and early intervention and rehabilitation of people suffering from alcoholism who have been convicted of drunk driving offenses.
Jail is no place for them to be. We have found that in our screening program of 400 to 500 people, first offenders every month, that at least 60 to 70 percent of those people are exhibiting severe problems with alcoholism, and we use that as a means for early intervention with the individual and the family. And so far our results have been very satisfying. Our number one obligation to the court, of course, is to keep drunk drivers off of the road.
But we go further than that. We hope that by intervening with people at this very early stage that we'll see a reduction in all sorts of alcohol-related incidents years down the line. All sorts of alcohol-related incidents years down the line, including cirrhosis, etc. So we feel that as an alcoholism agency, we're providing a very important service to the community
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that can only be done through an objective, unbiased agency such as ours. Consumer Representation. Another goal of the NCA is to represent the interests and concerns of private citizens with regard to policies and programs at the national, state, and local levels, to actively promote and support efforts aimed at the prevention and control of alcoholism by all levels and branches of government, and to clarify or reinforce the views and interests of the private voluntary movement in the alcoholism field.
Once again, we are able to sit on boards, we are able to sit on commissions, we are able to work with the policy makers in making sound decisions and leading the way to more services for alcoholics and their families. And public information. Another goal is to create nationwide public awareness of alcoholism and alcohol abuse as major health problems. We reach out to people in the community who support other major public health problems.
There is no reason why we should not have on our board of directors people, leaders in the community who serve on the board of directors of the Heart Association or Cancer Society. We need to reach out to those people and get them involved in all of our activities as a voice for alcoholics and their families. We are able to reach the community through public service announcements, through seminars for professionals and non-professionals and their families, and through various other activities.
Our involvement in public health fairs, for instance, is widespread. We also work very hard to create national, state, and community support for voluntary movements in the alcoholism field. While our board of directors at both the national level and our state levels consists primarily of recovered alcoholics and family members, as I said, we encourage everybody in the community to become involved. We encourage people to help us perform our puppet shows for children so that they can learn more about alcoholism and the problems associated with it.
I urge all of you out there to become involved with your local alcoholism agencies, to realize that they are understaffed, underfunded, and we need help, and we need your support. Alcoholism agencies serve a very important function in our communities, and we grew out of the needs of AA, we work closely with AA, and we always will, but we do need your support. In concluding, I wish to return to the meaning of this jubilee, to recognize how much went into the building of what is being celebrated today, to recognize what makes it work today, and to salute you and all of the people who made this possible.
I am grateful to have been privileged to be brought to this time and this happy occasion, and I thank you all. Applause Well, it took me 10 years in AA before I could say anonymity. It took me 18 years before I could say recidivism. I noticed Laura just reeled that off just like it was nothing. I'm still practicing it, as you can tell. Our third presenter is the director of the National Institute on Alcohol Abuse and Alcoholism, Dr. Robert Niven, who is a psychiatrist, spent 13 years at Mayo in practice before he became the executive director of the National Institute, where he has been the director for the past two years.
Dr. Bob? Applause Thank you, Buck. Ladies and gentlemen, it's indeed a pleasure and a privilege for me also to be here. When you're, in a sense, a bureaucrat, as I am now, you hear lots of, some not very nice jokes and comments about government and bureaucracy. One of the ones I heard recently that I would pass on to you involved the three greatest lies in the world today, which are, number one, it's only a cold sore.
Number two, my Mercedes is paid for. And number three, I'm here, I'm from Washington and I'm here to help you.
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I'm not here to help you today, but simply to express my thanks, both to Bob Pearson and the General Service Office for extending the invitation to me. I had the opportunity as director to visit the office last year, learned some new things, which I always do every time I interact with Alcoholics Anonymous, and the invitation to participate followed that meeting, and I'm indeed thankful for that. And I'd also want to congratulate AA on this anniversary.
I'd like to extend my congratulations to all of you personally for your personal anniversary, whatever that may be at this time. And I'd also like to thank and congratulate Al-Anon for its participation in this meeting and for its help to me as a physician. As director of the National Institute on Alcohol Abuse and Alcoholism, I oversee an agency that at this point in time has a somewhat different mission than it had when it was first created in 1971.
Its mission at this point is predominantly a mission of research. We're involved in funding research studies to generate new knowledge about alcohol, not just alcoholism, but really about any aspect of alcohol use in our society. A related mission is to get that information, whether it's new or even old information, out to people in this country and indeed even around the world because we are the largest agency in the world involved in doing research on alcohol and alcohol-related health problems.
And other missions, other parts of our mission include taking a leadership role in facilitating prevention, analyzing policies that have to do with alcohol use in the United States and even to some extent worldwide, and in treatment issues. When the institute was formed in 1971, and it was formed at that point in time as a separate institute, there had been in the National Institute on Mental Health a small center on alcohol research, but in 1971, largely due to the efforts of a small group of individuals, most of whom were recovering, most of whom were and still are members of Alcoholics Anonymous.
Separate legislation was formed that created the National Institute on Alcohol Abuse and Alcoholism. In the first decade of its existence, the institute was predominantly involved in developing and in actually funding and in some instances running alcoholism treatment programs around the country. And it really did very little research. It has always done a little bit of research, but early on in the first decade, the amount of research that the institute did was very minimal.
In supporting the treatment programs that it did, the institute always encouraged, philosophically supported and encouraged the integration of AA principles and concepts into treatment programs where that was appropriate to do so, and it almost universally was, and encouraged programs to utilize members of AA who were willing to help out in these programs in any way possible within the spirit of Alcoholics Anonymous principles and traditions.
I might note, and I'm not sure the reasons for this, but I believe that the growth in treatment programs around the country that the institute was largely responsible for stimulating has paralleled in many ways the growth in membership in Alcoholics Anonymous, and in my view, the treatment programs around the country and AA have functioned in a mutually reinforcing and supporting relationship, not always free of controversy, as many of us know, but I think on balance, the relationship has been productive for both.
I know it has been for the treatment community. I hope it has been for AA. I'd like to focus my relatively brief remarks on two aspects of Alcoholics Anonymous that I think tend to be somewhat overlooked, and these thoughts are purely personal ones, but they have to do with the contributions that AA as an organization has made, not deliberately, I don't believe, but I believe these contributions have been made to research and to the prevention of alcohol-related health problems,
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including but not limited to alcoholism. Firstly, the research contributions. I think that to the extent that AA members were involved in the creation of the institute and to the extent that AA members participated in treatment programs around the country, they really helped create and develop the institute as it exists today, and although our interaction with AA today is relatively limited and quite informal, in the earlier years that was not true, and I believe that the institute and research on alcoholism and alcohol-related health problems, of which the United States really is in a leadership position in the world today, would not exist were it not for two other organizations.
Firstly, AA, and secondly, the National Council on Alcoholism, both of which deserve tremendous credit for whatever contributions the National Institute on Alcohol Abuse and Alcoholism has made to our understanding of alcohol-related health problems. The institute was created at a time when there had been inroads made in combating the stigma that Laura so eloquently talked about. That stigma, as I think all of us can appreciate, still exists, but even in the 13, 14 years that I've been involved in this field, I've seen a remarkable decline, I think, in the stigma associated with being an alcoholic, and I think many people don't appreciate, but there also has been a stigma, still is to some extent, but it is also lessening, associated with being an alcohol researcher.
When I actually went to medical school at the University of Alberta, in Edmonton, Alberta, and while I don't recall ever meeting Leonard before, I may have, because my first formal exposure to alcoholics and to alcoholism treatment was at the Henwood facility, which was, and I presume still is, on the grounds of what was then a provincial mental hospital. My exposure was one day… Let me pause for a minute while that finishes.
My exposure at that point in time was limited to one day, and as, again, best I recall, that was all of the exposure I had to alcoholics, alcoholism, alcohol abuse, in four years of medical school. And that was more, that was in, I went to medical school from 1965 to 1969, and that was more exposure than most people had in medical school at that time, and frankly, more exposure than a few people still get.
My exposure, however, was not altogether positive. The predominant memory I have about visiting Henwood was that it was kind of nice, and I wondered why these people spent all this time playing basketball and had a very nice pool table. I didn't really learn much about alcoholism. But the memory of the facility and the atmosphere of the people in the facility who talked to us was a very positive one.
I came away with the feeling that they believed that they could do something to help people with alcoholism. That belief, fostered by AA, fostered by other people in the alcoholism treatment field, and has been growing as AA and alcoholism treatment has been growing. And the associated decline in the stigma associated with alcohol, again, I think has been a major factor that helped create the climate, which allowed and even facilitated the development of research into alcohol-related health problems.
When I was in medical school, my mother had great hopes that I would follow in the footsteps of one of my uncles, who was a plastic surgeon, or another one who was an internist. She was most dismayed. She was most dismayed when I, at the Mayo Clinic, after completing one year of a residency in internal medicine, decided to switch into psychiatry.
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My mother was, and she may still be, grieving. But I, Mr. Lynn tells me that she's come around to some extent, I think, because there's a conference this, actually next month, in Calgary, and he tells me that my mother's been phoning him, trying to find out things about the conference, so maybe I'm back in her good graces. A second contribution, besides helping create the research agency, the National Institute on Alcohol Abuse and Alcoholism, that AA has made, has been to philosophically support the need for research.
And I think that, and we're not talking about the kind of research that is the personal kind that many of you have previously done, but more formalized research. I think the recognition, including by the founders of AA, that AA did not have all the answers to all alcohol-related problems, and that there was a need for new knowledge and for research, has been a very important recognition. One that, frankly, is not understood by many people in the medical profession or by many scientists.
The success of AA itself, I think, has posed some interesting research questions. Scientists will not, as Lynn has, come around, I don't think. They will not come to the acceptance and to an unquestioning kind of posture, because they'll stop being scientists if they do. It's the nature of scientific injury to always be asking questions, to always try and understand why something works or doesn't work, and to try and generate new knowledge about a topic.
But the success of AA has posed numerous important research questions, some of which are somewhat controversial, and many of which remain unanswered. But I think in that very indirect, general sense, AA has made a major contribution to our knowledge about alcohol. Lastly, AA has done, in a sense, its own research. The surveys that AA periodically does of the membership are research, in the general sense of the term.
I frankly wish they would do more and more comprehensive research than they do, but I'm grateful for the understanding that comes from those surveys, and would thank all of you and encourage those of you who have to, again, and those of you who haven't, to participate in surveys, whether they're done by AA or, as occasionally happens, with local groups who agree to have their membership answer questionnaires or take part in other kinds of alcohol research endeavors.
Let me move on for just a minute to prevention, because I think that AA, at least in my view, again, these are personal views. I think that AA has made a couple of important contributions to prevention of alcohol-related health problems, again, not just alcoholism. Firstly, simply demonstrating, as AA has done literally millions of times, or at least over a million times, as I understand the membership is now well past one million, recovery from alcoholism is possible.
That has helped in prevention. It has helped in what we would call secondary and tertiary prevention, not primary prevention. It has not, at this point, I think, helped us so much in preventing alcoholism per se. I at least believe that we don't yet know how to do that. But it has helped in the prevention of some of the more serious complications, medical and psychiatric complications, of alcoholism.
The education that I have gotten and that many other physicians have gotten from AA and from individual AA members, and I personally at the Mayo Clinic received a lot of my knowledge and my education about alcoholism and recovery from two AA members who happen to work in the treatment program at Mayo Clinic. The formal relationships through the committee, the professional committee dealing with treatment organizations, I think has been a step in the right direction and has made a major, not easily documented,
[00:50:01]
but I think a major contribution to educating physicians around the country. Much needs to be done. Physicians still do not know anywhere near as much as they need to know, in my view, about alcoholism and other alcohol-related health problems and other drug problems. But they know a lot more than they did, and that's in large part due to the contributions of individual AA members. When I was running Mayo's medical school's teaching program on alcohol and drug abuse, which I did for several years prior to assuming my current position, I was fortunate to be able to get our medical students, the first year without any griping whatsoever, to attend an AA meeting as an elective on Thursday evening in Rochester, Minnesota.
The experiences that the first group of students had were so positive that in the second year I didn't even talk to the students about whether this was an elective or required. I just sort of put it in the schedule, and they all went. For the entire time I was there, and I believe to this day, they rate attending AA, and they also attend Al-Anon meetings, and the discussions with AA members as among the most positive experiences they have in medical school, not just in the alcohol or drug abuse part of the teaching program and not just in the psychiatry program, but they very much believe this is a positive experience for them as developing physicians.
A second contribution that this recovery understanding has made, the demonstration that recovery is possible, has been to help facilitate a decline in the health care costs associated with alcohol-related health problems, and these costs are of tremendous magnitude in our country. A recent study by the Research Triangle Institute demonstrated that the total health care costs of alcohol-related problems in our society in 1983 was in the vicinity of $115 billion a year.
Much of that, not all of it, but much of that related to treatment of alcoholism and treatment of alcohol-related health problems. We have now approximately 8 to 10 studies which document that alcoholics, and in a couple of these studies, document that the members of alcoholics' families are higher consumers of health care services than non-comparable populations of non-alcoholics or families of non-alcoholics.
And more importantly, that the health care costs associated with alcoholism decline following treatment. They, in one study, actually declined to a level below that of a control group of families. This was the Blue Cross Blue Shield study conducted in California where there were 90 alcoholics and their families contrasted to 90 non-alcoholic families. And in some aspects of health care costs following treatment, the alcoholics' health care costs actually fell to a level below that of the control group.
These studies, and we're doing more of these studies because they do demonstrate something that I believe to be true, namely that we can save health care dollars and spend those dollars on other aspects, on other health problems, by successfully treating alcoholism and its complications. Lastly, in the prevention area, I think that another important finding, another important fact that AA has demonstrated has important implications.
And that is that life without alcohol, or life without the consumption of alcohol, is not only possible, but can be a happy and productive life. That bit of information is important in countering the philosophy of some individuals that one needs to be a consumer of alcohol to enjoy life, and I think has, again, major prevention implications. There is, in our field right now, a continuing controversy, for example, about whether or not pregnant women should drink alcoholic beverages.
The position of our institute and the position of the Surgeon General and the Department of Health and Human Services in the United States government is that when we examine all the evidence,
[00:55:01]
the best advice we can give pregnant women is to not consume alcoholic beverages at all during pregnancy. That evidence, or that advice, rather, is given not because we know that a pregnant woman drinking one or two drinks on a few occasions during pregnancy will have a child affected by fetal alcohol syndrome, but because we do know that alcohol consumption by some women during pregnancy causes defects in the baby, and because we do know that it is quite possible to go through pregnancy with no ill effects whatsoever from abstinence.
And it is our belief… That sounds surprising, doesn't it? But many people don't believe that. In fact, there's a very natural inclination in pregnant women, which we don't fully understand, who get no advice, and women who have no knowledge even about the potential adverse effects of alcohol in pregnancy. Women just, by and large, tend to decrease or stop their drinking during pregnancy, presumably for physiological kinds of reasons.
But at any rate, the point is that many people don't believe that abstinence can be as happy and productive as I think most of you believe it can be, and getting that message out to the rest of the world can help all of us. I think that the same kind of message, and AA in more general terms, is able to serve as a model for the development of programs designed to help people cope with other health problems, and I'm sure you're all aware of the proliferation of self-help groups that are based on AA.
Frankly, I think some of them are a little ill-advised, and I know of none that has been as successful as AA, I think in part because they're not completely… Some of the principles of AA are adopted in a superficial sort of a level only, and in part because I think some of the problems that these programs have been applied to are perhaps not as amenable to the same kinds of programs that AA is directed to.
In closing, let me just finally express my own gratitude, both as a physician, because AA has helped me in helping patients that I have treated and will again be treating, and it has helped my patients because of their own personal involvement in AA, and the same goes for Al-Anon, to a lesser extent, Alateen. And I also express my gratitude because AA has helped me personally, I think, in following some of its principles, which I don't follow, I think, well enough, but to the extent that I do follow them, it has indeed helped me, but also because of its contribution in helping me find a very personally rewarding career in medicine and in psychiatry.
It has helped me with understanding the development of alcoholism and other forms of dependence on drugs and helped me in helping other people, and that's what I get a kick out of as a physician. I also would like to express my gratitude to AA in my role as director of the National Institute again, because it has played, in my view, a quiet, not heralded, but very important role in facilitating alcohol research, and I am grateful for that.
And I think that ultimately people in the United States, in Canada, and really around the world, whether they have alcohol-related problems or not, will come to the realization that we all owe Alcoholics Anonymous, its founders, and all of you who participate in it, a great debt for the contributions that you've made, not just to overcoming or to help individuals overcoming alcoholism, but to our understanding of all aspects of alcohol-related health problems.
Thank you very much. Thank you very much.
[01:00:00]
Before we get into the question and answer session, in order that I don't get thrown in jail, this is to have been read at 9.30. In accordance with the Municipal By-law, the Security Service of the Palais de Congress de Montréal would like to draw your attention to the evacuation procedures for this hall. Staircases marked with the word S.O.R.T.I.S. are located at the end of the corridors outside each conference hall.
Thank you for your attention. Okay. That keeps me out of jail for the rest of the weekend. For those of you who came in late, we have about 25 minutes allocated to question and answer session. Down on my far left is Leonard Blumenthal, who is the Assistant Executive Director of the Alberta Alcoholism and Drug Abuse Commission. Next to him, whom you just heard, is Dr. Robert Niven, a psychiatrist who heads up the National Council on Alcohol Abuse and Alcoholism.
And next to Dr. Niven is Laura Hart, who is the Executive Director of the Albuquerque, New Mexico National Council on Alcoholism Chapter. So with that, they have mics there, and don't be bashful. I'm sure that there are a number of questions. I think the presentations are excellent, thoroughly covered the area, but I'm sure that you'll all have some questions, so feel free to stand up and fire away.
Yes, sir. My name is Kit. I'm from Palm Beach, Florida. Hi, Kit. I would like to ask Dr. Niven what sort of progress has been made in the latest DPS. In other words, we go out and make a 12-step call, and some people say, simply they won't. Some people do this, some people say that, and then they go into the late DPS, and then they go into the DPS, and they just don't know what to do with it. And I'd just like to know what progress has been made toward that.
Well, I'm not sure that I really understand what you mean by delayed DTs, but in my view, DTs are delirium treatments. The true form of that, which we don't see very often in medicine anymore, the incidence or the prevalence of that has decreased markedly in the last 20 years. It is a very preventable, in my view, virtually 100% preventable condition, and as you know, it's a very serious condition because the mortality rate for people who do still get into the DTs is still significant, still in the area of 5 or 10% of people who get true delirium treatments die.
And my advice would be to not sit with anybody who you are worried is at risk of or who looks like they're going into alcohol withdrawal of any kind. The person who is shaky, sweaty, hasn't slept for a couple of nights, has nausea, can't eat, has a racing pulse, those are the kinds of symptoms seeing pink elephants, which are actually very rare. I mean, pink elephants are rare, and seeing them is also rare.
Any symptom which really makes you worried that somebody is at risk for having DTs or anybody who's had any history of having serious alcohol withdrawal problems, in my view, should be seen by a physician and thoroughly examined and probably admitted to the hospital and treated because delirium treatments is a preventable, serious problem, and I would not recommend sitting with it at all. Yes, sir?
Well, actually, we have so many directions that I don't have time to really list them all. There have been, in the last few years, numerous researchers from other areas of medicine and science that have been attracted to alcohol research for a variety of reasons, and there have been some new scientific technologies that have come along that have really opened up the door to our understanding of alcohol in some ways that we didn't even know existed five or ten years ago.
So we're doing all kinds of alcohol research funded by our agency, all the way from trying to understand the effects of alcohol, which is chemically a very simple molecule, on cell membranes
[01:05:05]
because alcohol has some effects very much like most anesthetics that are administered during surgery, and it is really as a tool helping us understand a lot about how membranes and cell membranes in the nervous system work, all the way to trying to understand alcoholism treatment outcome and virtually every kind of study in between. The way our institute funds alcohol research is that we have groups of scientists who are not employees of the institute who meet and who review all scientific proposals submitted to the institute requesting funding, and they review these for scientific methodologic soundness and for relevance to understanding alcohol-related health problems, and then we provide funding for those grants which are found to have the most merit.
I might note that we have a research budget that is in the area of $60 million a year, which is actually a remarkable growth in a very short period of time, but the attraction of alcohol research these days is indeed considerable, and we have many, many more good grants, grants that are research proposals that are methodologically sound and relevant, than we have money to devote to them. But that's a long-winded kind of answer to, I guess the bottom line is we fund research on all kinds of alcohol-related health problems.
I'd be glad to talk with you more specifically if you have a specific question after the meeting. With difficulty. We have a clearinghouse, a National Clearinghouse on Alcohol Information, the acronym for which is NCALI. If any of you are interested, let me give you an address. You can write post-office box 223. Post-office box 2345, Rockville, Maryland. The zip is 20857. That's NCALI, N-C-A-L-I, post-office box 2345, Rockville, Maryland, 20857.
And they will send you a list of all of the literature or the other resources of the clearinghouse and an application form for any of its publications. I might note that, and I have not been able to check to see if this got here, but in following my meeting at the General Service Office last year, I decided that we should try and do something by way of a small tribute to AA. And this Alcohol, Drug, and Mental Health newsletter, which is Adam Haw, Alcohol, Drug, and Mental Health Administration, is a part of the United States government that the Institute is located in, did a small supplement on AA and the 50th anniversary of AA.
And that was supposed to be 40,000 copies, which if my own grapevine tells me will be inadequate because I heard in the elevator last night that there were 45,000 pre-registrations and one person was speculating that there were 20,000 on-site registrations for this meeting. So even if these did get here, there won't be enough copies around, but you're welcome to write and get this or any of the other information that we have about alcohol, which is considerable.
I'm sure we'll have more than you will probably care to read, but we would very much encourage you to write. Can you please give us a breakdown of the $115 million cost associated with alcohol? You've given us a picture of it. Yes, I'm sorry, but off the top of my head, I can't give you much of a breakdown of that. That is a report that we did, again, by the Research Triangle Institute, a research organization in North Carolina, and if you would like a complete copy of that report, that is available through the clearinghouse or if after this meeting, if you'd like to leave me a card or an address, I'd be glad to personally make sure that you get a breakdown of it.
It included, that number included all kinds of alcoholism costs, insurance costs, treatment
[01:10:01]
costs, lost productivity from work, lots of kinds of costs. Dr. Niven, I think part of that survey was conducted by Blue Cross Blue Shield, and it's the increased health care costs for the entire family. It's not an increase in alcoholism costs per se. The entire family's health care costs rise that rapidly with untreated alcoholism, and then the survey went on to indicate that within two to three years after successful treatment of the alcoholism problem, that their health costs dropped down to where actually it was below the average.
I believe that's the same survey you're referring to, isn't it, Dr. Niven? I took it that his question was referring to a different survey. You're right about that Blue Cross Blue Shield study. Thank you. Well, I'll take a brief stab at that, and then perhaps Laura could, too. We have actually several research studies, usually do have several studies going on, examining the impact of alcohol on nutrition and the reverse, the impact of nutritional status on alcohol-related health problems.
And the bottom line from my standpoint is that while it's very clear that alcohol affects the body's ability to absorb and utilize a variety of nutrients, vitamins and some minerals, and while it's equally clear that a person who is malnourished in any one of a number of ways seems at more risk for certain alcohol-related health problems, that the interactions between alcohol and nutrition are exceedingly complex, and I don't believe that simple statements, and I believe statements like alcoholics are hypoglycemic or hyperglycemic or they should drink or shouldn't drink coffee or watch their sugar intake, are generally not warranted.
In my view, there is no one is, well, I would certainly support the advisability of everybody eating well, nutritiously and eating in a way that helps control their weight, et cetera. I personally don't believe at the present time, and I would even speculate that we won't in the future find that diet for the average alcoholic in this room makes a major contribution to their health or their sobriety, or the converse, that it poses a major risk factor for relapse.
That's not the same as saying it doesn't play any role, but so far I think simple kinds of statements or simple bits of advice about particular kinds of diets, including carbohydrate diets, don't provide any major answer to alcohol-related problems. Do we have anything to add to that? Sticky question. I'm interested in trying to understand that also. The best studies that we have, I and I think an increasing number of psychiatrists, believe that alcoholism is a primary disorder.
I think most of us also believe that it does develop in some persons seemingly, although in a distinct minority in my view, less than 10%. Or after the development of some other psychological problem. And the best example I can give you of what we call secondary alcoholism is retirement. We see people who have been either non-drinkers or clearly non-problematic drinkers their entire lives, who after retirement or the other common circumstances, drinking and who develop alcoholism and I'm not saying that the alcoholism is secondary but they begin to seem to use alcohol as a way of treating grief, boredom, other kinds
[01:15:03]
of things and that kind of alcoholism seems distinct or different in some important ways from the usual kind of primary alcoholism. It's clear that people who drink alcohol excessively for long periods of time develop a variety of secondary mental problems, depression being the most obvious and the most common and probably the most severe one, but those disorders almost always clear up by themselves without any primary psychiatric treatment once the alcoholism is treated and they don't clear up if you just provide antidepressant drugs, for example, to somebody who's an alcoholic.
You don't have to treat the primary disorder. That's a ballpark summary of my own personal view of the relationship. We are very interested in trying to understand whether or not there's some similarities in the inheritance of alcoholism and certain kinds of depression, both of which seem to run in some families, but so far we don't have much information on that relationship. It's still something that's being studied.
This gentleman here was next. You spoke about interventions in the families where alcoholism or alcoholism is not a problem. Have you run into a lot of resistance from the families themselves and if so, how do you deal with that? We run into more resistance from the alcoholic than from the family. We have found that interventions are certainly catching on all over the country. They're of course not always successful, but they have been known to be successful for many, many people, and it certainly does take a well-trained person to coordinate an intervention.
We have found that when the family is ready for an intervention, they are definitely ready and they are cooperative. We found that it's pretty easy to involve coworkers or friends or whomever else the family feels is necessary to carry off an intervention, but we're strongly promoting interventions. I think as everybody knows that for so long it was said that nothing can be done to help the alcoholic until the alcoholic's ready for it, and that's just not true anymore.
There are more people getting involved and trained and doing interventions. I believe this lady over here was next and then you, Tom. Weren't you? Oh, I'm sorry. Tom and you are next. I'm wondering about the reports I've read on the reported difference in brain wave patterns in young males of alcoholic fathers and what your opinion is on that. The question, if you couldn't hear it, was what is the relationship or what is the status of the reports that there is a differing brain wave pattern in the male children of male alcoholics.
This has been a finding of several researchers that a certain type of brain wave pattern is different in children of certain alcoholics than it is in the same kind of male children of non-alcoholics, that there's a difference if you come from a family with alcoholism. This has been an exciting kind of finding because it is what we would call a potential marker, a way that we might identify people at risk for alcoholism.
As it turns out, subsequent studies have demonstrated that this abnormality really is there, but it is not just in the children. A similar abnormality is present in some recovering alcoholics and in fact this abnormality can be brought out simply by exposing certain individuals to the idea that they might drink. This abnormality appears to be not something that is genetically inherited per se, but may still prove to be a marker of people at risk for developing alcoholism.
It's one of a series of kind of exciting findings which may allow us in the next five years or so to be able to precisely identify some people from families where there is alcoholism who are really at risk. Right now we know that in some families up to 40% of the children of certain alcoholics are at risk for developing alcoholism themselves, but that obviously means that 60% of those children may not be at risk.
It would be nice to be able to separate the two and to be certain and be able to say,
[01:20:03]
Johnny, you are going to get it, or Susie, you're not, with great certainty because you could then very clearly target prevention or early intervention efforts. There are some very exciting findings going on. I would actually predict that within the 1980s or certainly within a decade from now, we will be able to have that degree of precision. Not for everybody, not for the entire population, but for the children and families where there is multigenerational alcoholism.
We have about five minutes and we have about six hands up, so just kind of take your turns. I appreciate that these people had their hands up back here first, if you'll excuse me. So, Luke, we've got five minutes. I'd like to know how much the National Council is going about mandatory or some type of mandatory insurance coverage. Has somebody mentioned Rochelle or alcoholism? The National Council on Alcoholism certainly supports mandatory insurance coverage.
I can speak for my own state. I served on the Governor's Commission on Alcoholism and therefore was a spokesman for mandatory alcoholism coverage and insurance, which did pass. On a national level, maybe somebody else could speak to that, but I know how it's being handled at various state levels. I would just add that there was a recent challenge in the Supreme Court in Massachusetts to the whole concept of mandatory insurance coverage and that challenge was unsuccessful.
The Supreme Court upheld the right of states to mandate insurance coverage and that's been an important recent milestone in maintaining at least the ability of states to mandate insurance coverage. It's my understanding that the insurance companies involved in that suit, and it was several insurance companies sued the Commonwealth of Massachusetts to overturn the statute. It's my understanding that there may be an effort to go on a state-by-state basis to get mandatory insurance or mandatory options overturned, so I guess that's all I could say about the general status of it.
That decision is presently on appeal to the United States Supreme Court and should the U.S. Supreme Court uphold it, then it will give the states the right to mandate mandatory coverage. I've got about three minutes for whoever wants to get up first. Given AA's principle of cooperation with agencies and given your statement that there was a concern that AA might contribute more towards research, I'm wondering as a professional if you see a repository in the fellowship, if we cooperate more in research, is there some vague pool that we could afford, in your opinion, that might further that process of recovery and the process of research?
Well, I'm sure if I were an AA member, I'd be accused of analyzing instead of utilizing. I would answer your question positively. I think there's a tremendous amount that I would, as a scientist, would like to know about AA recovery, who makes it, when, why, how. What are the factors that make for a successful outcome versus a not-so-successful outcome? I asked Bob Pearson what turned out to be a naive question.
He'd obviously thought about it before when I was up there. I have the hypothesis that people who have long-term recoveries going and out of long-term AA involvement, 10 or more years, by and large engage in other beneficial health practices without going through formal treatment programs. I'd love to know whether or not that hypothesis is accurate. It'd be nice to be able to document that. It's my view that such persons probably pay more attention to a lot of health things than the general population does.
If that were true, and I see several people shaking their heads, I'm presuming that it is true, that would be very nice information to have. There's just dozens of other studies that we'd like to do. I realize, I think, some of the problems inherent in doing some of that kind of research. I'm not making a real pitch to turn AA into a research organization. I think that would be a mistake. But I think that there are lots of interesting things that could be bits of knowledge that would be nice to document.
I would just encourage you all to participate.
[01:25:00]
Another way you can participate that I didn't mention is to simply let us know. Let people like myself or other researchers around the country know of your thoughts about it. I mean, you may have ideas yourself about what helps an alcoholic recover, for example, that we've never thought of, and we need to know those kinds of things so we might generate our own studies. We'll have to stop the questions now.
I strongly emphasize that we stop promptly on time since the tapes are all on automatic. I'm sure that our participants will be available after we get finished with the formal part of the program. A copy of this meeting will be available in the tape sales booth in the convention center. And again, I'd like to thank Mr. Blumenthal and Ms. Bass and Dr. Niven for their participation. And for those of you who care to, join me in the Lord's Prayer.
Our Father, who art in heaven, hallowed be thy name. Thy kingdom come. Thy will be done on earth as it is in heaven. Give us this day our daily bread. And forgive us our trespasses, as we forgive those who trespass against us. And lead us not into temptation, but deliver us from evil. For thine is the kingdom, and the power, and the glory, forever and ever. Amen. I've had some very delightful conversations with Dr. Goodman.
And I was wondering, have you had conversations with your parents about Native Americans? Hello. Is that right? Are you a national network? Similarities. That's not on the public agenda. I will remember that. Thank you very much. Well, if there's any way, you know, it seems to me that our clearinghouse and, you know, regularly getting information from our clearinghouse would be of help. Thank you so much for your time.
Our council has set up a similar meeting in our community. And we found the same thing. How are you? Into our research unit that we have there? Good. Thank you. Thank you. Hi, Bob. Okay, well, I think we're finding some answers, so gradually. Thank you. Oh, yes, I was going to ask for you. Yes. Well, thank you. How nice to meet you. Yes. Oh, Harriet's a wonderful person. She said you were going to be here, so thank you for coming out.
I want to say to myself, I want to say that I think it's, uh, I think the new person I know is capable of handling emotional abuse. I met her a couple of years ago. She's very good. She's fantastic. And I work with her. Thank you. Thank you.
[01:30:00]
is probably going to make the difference. And clearly, I mean, there were about at least half of…