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R. Brinkley SmithersThe Financier of the Modern Alcoholism MovementStanton Peele
The dominance of the disease view in America is due in good part to one man — R. Brinkley Smithers. Through his personal contributions and those of the Christopher D. Smithers Foundation he commanded, Smithers influenced the course of the major national groups concerned with alcohol problems in the United States. Smithers provided the principal funding for the Rutgers Center of Alcohol Studies at pivotal points in its history. He was also the principal benefactor and a major officer of the National Council on Alcoholism ("and Drug Dependence" was added to the title in 1990) — the NCA(DD). Smithers and the NCA in turn helped to create the National Institute on Alcohol Abuse and Alcoholism (NIAAA), the Research Society on Alcoholism, and the American Society of Addiction Medicine. Smithers donated over $40 million to alcoholism programs, $13.5 million through the Smithers Foundation and $28 million of his personal funds (1, p. 9; 1a). He was heir to Christopher D. Smithers, a founder of IBM. At age 47, in 1954, after a hard-drinking career, Smithers quit drinking at a private hospital in New York (2, p. 15). At the same time, the NCA, the brainchild of Marty Mann, was encountering severe economic problems (3, p. 10). Smithers immediately became a benefactor and officer of the NCA, to which the Foundation ultimately gave $3.5 million and Smithers personally gave $5.2 million (1, p. 9). Smithers was president or chairman of the NCA from 1958-1965, and a board member from 1954 until his death in 1994 (3, pp. 29, 37). The NCA expanded dramatically in size and influence under Smithers's guidance and beneficence: "With Brink 'on board,' NCADD added a dozen staff members and expanded the board of directors to 60 volunteers...." (4, p. 10). The NIAAA was created in 1970 by the Hughes Act, named for Senator Harold Hughes, an NCA board member and Smithers associate (5, p. 143). Smithers played a critical personal role in this process, "including making some well timed phone calls to get then-President Richard Nixon to change his mind and sign the original legislation creating the NIAAA" (6, p. 1). The NIAAA "began contracting with the NCA for assistance. As a result, in 1976 NCADD's budget peaked at $3.4 million, nearly five times what it had been before the passage of the Hughes Act. Government funds accounted for more than 75% of it" (4, p. 14). However, "in 1977, the board voted to rely on private funds in the future and once again Brink was there to ease the transition" (4, p. 16). Although separated from the chief federal agency dealing with alcohol problems, the NCA maintained an important role in federal government decision-making about alcoholism, at one point "assuring the surviving [sic] of the Alcoholism Study Section of the Alcohol and Drug Abuse and Mental Health Administration when it was threatened with demise through integration with other study sections" (4, p. 28). The NCA was also central in the creation of American Society of Addiction Medicine, the key America medical group concerned with alcoholism and addiction, which was initially a component of the NCA (4, p. 9). Likewise, the Research Society on Alcoholism, a group committed to biological research on alcoholism, was "formed under NCA auspices" (4, p. 19). Enoch Gordis, currently director of the NIAAA, declared, "NIAAA, the American Society of Addiction Medicine, and the Research Society on Alcoholism, all owe their founding in whole or in part to the efforts of NCADD" (4, p. 25). Smithers rarely funded individual researchers. However, those he funded often figured significantly in American alcoholism developments, although not because of specific research they conducted. The first such grant to an individual occurred when "In 1957 he agreed to finance a major research project by Dr. E.M. Jellinek, later published under the title The Disease Concept of Alcoholism" (2, p. 16; see 1, p. 9). Another early grantee of the Foundation was Dr. Ernest P. Noble, funded in 1966 "to clarify, through genetic and behavioral measures, the inter-relationship of the biogenic amines and the alcohol metabolism" (1, p. 11). Noble became director of the NIAAA. During his tenure, the Rand Corporation — based on an NIAAA-funded study — concluded that many alcoholics eliminate alcohol dependence while continuing to drink. On the morning of the release of the Rand report, the NCA convened a press conference to attack Rand's results. Meanwhile, despite three strongly worded letters commissioned by the NIAAA from major figures in the mental health field (e.g., Dr. Gerald Klerman wrote Noble, "I would strongly urge you and the NIAAA and ADAMHA to stand firm wherever possible"), Noble issued a press release questioning the Rand results and strongly urging "that abstinence must continue as the appropriate goal in the treatment of alcoholism" (7, pp. 215-234; 8, pp. 1340-1341). Smithers' relationship with the Rutgers Center was crucial and long-lived. In 1962, grants from Smithers personally and from the Smithers foundation were used to match Department of Health Education and Welfare funds in order to move the Center from Yale to Rutgers (1, p. 11). At Rutgers, the Center was housed in Christopher Smithers Hall, named for Brinkley's father. However, some time after this, because of interest shown by the Center in controlled drinking therapy, Smithers "proceeded to cut the ... [Center] out of his will" (9, p, 193; 10, p. 57). But Peter Nathan, who became the Center's director in 1983, was able to re-establish the Smithers-Center link. In 1986, Smithers made a personal gift of $6.7 million addressing prevention and job impacts of alcoholism to Cornell and Rutgers Universities ($3.54 of which went to Rutgers) (1, p. 15; 10, p. 58). The Cornell grant established a Smithers institute for prevention and workplace problems, with Harrison Trice "the central figure in alcoholism research at Cornell" at the time (Cornell and Rutgers Universities press release, April 23, 1986). Rutgers and Cornell took this money knowing that Smithers could be a demanding donor. Smithers had a long-standing dispute with the St. Luke's-Roosevelt Hospital Center, to which he had originally pledged $10 million in 1971, and which used the funds to create the Smithers Alcoholism and Treatment Center. Smithers refused for some time to provide the second $5 million based on his dissatisfaction with the Roosevelt program. Smithers "disagreed with the way the center's program was run by Dr. LeClair Bissell, a psychiatrist and also a recovered alcoholic. Their dispute appeared focused on whom the center should treat, Mr. Smithers saying he was interested in helping people 'from my walk of life' and employed alcoholics. He also insisted that 'Rich people have more problems than poor people.' Dr. Bissell, however, argued that 'it was good for a variety of people to be in treatment together.'" (It is interesting that Smithers himself spent a good deal of time in sanataria for well-off drinkers prior to his recovery.) Bissell resigned in 1979 and eventually Smithers made good on the rest of his gift (1b). As for Rutgers, its link with Smithers was cemented, amplified, and frequently called upon. According to court papers provided to me, more than 100 letters concerning fundraising and donor issues were exchanged between Smithers (and the Smithers Foundation) and Rutgers and Center staff between 1984 and 1996. In 1988, Rutgers built an extension for the Center in Brinkley and Adele Smithers Hall (1, p. 16). Rutgers University president Dr. Edward J. Bloustein nominated Brinkley Smithers for the Nobel Peace Prize in 1989 (1, pp. 16-17; Harrison Trice wrote in support of the nomination; 1, pp. 17-18). However, trouble in this relationship re-emerged. Only three of these 100 Smithers-Rutgers letters occurred after 1992. No letters were exchanged from 1993-1995. During this period, the Center developed a brief intervention clinic which accepted controlled drinking treatment goals (1c). Smithers died in January 1994 at age 86. In 1996, Rutgers President Francis Lawrence wrote to Adele Smithers "fostering donor relations," even though Mrs. Smithers had strongly reiterated her disapproval of controlled drinking in an NCADD press release (July 20, 1995): "Millions of Americans have recently seen life-threatening stories in the media claiming that people with alcohol problems don't have to stop drinking completely to get better." Although little known to the public, or really to many in the alcoholism field, R. Brinkley Smithers quietly influenced — one might say directed — American alcoholism policy, theory, and treatment from the 1950s through the 1990s. The Smithers influence, now through Smithers' wife Adele, is still being felt today. Postscript: Following the posting of the above, I received a message from Eva Tongue, director of the influential International Council on Alcohol and Addictions (ICAA). "Last week we found on the Internet an interesting write-up, apparently done by you, on Brinkley Smithers. I have read this with great interest, especially as Mr. Smithers was a close personal friend of ours and [a] great supporter of ICAA as well.... Incidentally, did you know that Harold Hughes was the President of ICAA from 1972 to 1978?" References1. Smithers Foundation. (1992). The Christopher D. Smithers Foundation, Inc. 40th Anniversary Report, 1952-1992. Mill Neck, NY. 1a. Obituary: R. Brinkley Smithers. (1994; January 12). New York Times, p. B7. 1b. Teltesch, K. (1984, January 29). $4.3 million is given for alcoholism program. New York Times, p. 24. 1c. Foderaro, L.W. (1995, May 27). The Moderate Tack: Can Big Drinkers Just Cut Back? New York Times, p. 21. 2. Scott, Neil. (1988, October). R. Brinkley Smithers: 35 years of leadership. Alcoholism & Addiction, pp. 15-17. 3. National Council on Alcoholism. (1984). 40th Anniversary: Commemorative Journal. New York: NY. 4. National Council on Alcoholism and Drug Dependence, Inc. (1994). 50: 1944-1994. New York: NY. 5. Conversation with Senator Harold Hughes. (1997). Addiction, vol. 92, pp. 137-149. 6. Obituary: 'The last of the big ones.' Brinkley Smithers. (1994, January 17). Alcoholism & Drug Abuse Week, p. 1. 7. Armor, D.J., Polich, J.M., & Stambul, H.B. (1978). Alcoholism and Treatment. New York: Wiley. 8. Peele, S. (1984). The cultural context of psychological approaches to alcoholism. American Psychologist, vol. 39, pp. 1337-1351. 9. Lender, M.E., & Martin, J.K. (1982). Drinking in America. New York: Macmillan. 10. Peele, S. (1992). Alcoholism, politics, and bureaucracy: The consensus against controlled-drinking therapy in America. Addictive Behaviors, vol. 17, pp. 49-62. Links:
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October 23, 2003 Smithers Center Wins Legal Battle In a victory for the abstinence-base alcoholism treatment approach, the Smithers Foundation won a court settlement this week that will return control of The Smithers Alcoholism Treatment Center back to the foundation from the hospital that sold its mansion headquarters four year ago. In 1971, R. Brinkley Smithers donated $10 million to Roosevelt Hospital to establish the center. Two years after the St. Luke's-Roosevelt Hospital merged with Beth Israel Medical Center and shortly after the death of Mr. Smithers, the hospital decided to sell the Billy Rose mansion that housed the center. Patients were moved from the mansion to hospital wards on the other side of New York City. The hospital used funds from the $15.4 million sale of the mansion to help solve its financial problems, putting the money into its general fund. The Smithers Foundation claimed in court papers this was a violation of the terms of the charitable gift that placed the center under the hospital's control. Smithers Foundation President Adele Smithers-Fornaci said under a settlement of the four-year-old lawsuit, the hospital will give up any claim to the use of the Smithers name and will return $8 million to the foundation. "It's a big victory and finally we're hopeful we'll be able to reestablish the center," Smithers-Fornaci, whose late husband founded the clinic, told The Daily News. "My husband, R. Brinkley Smithers, was disgusted with what the hospital was doing and planning before he died in 1994, and after he died I had to do something about it.. We will find a new location." The battle over the Smithers Center heated up in 2000 when it was announced the center would change from an abstinence-based approach to a moderation management approach. In July 2000, Smithers-Fornaci wrote an open letter blasting the hospital for the change in philosophy, saying "lives will be destroyed and people will die in the process." ----------------------- Smithers History In the early 70's, my husband R. Brinkley Smithers, a grateful recovering alcoholic and the patriarch of the modern alcoholism movement, donated $10 million to Roosevelt Hospital to establish the Smithers Alcoholism Treatment and Training Center. It was the largest single grant ever made in the alcoholism field. The Smithers program became one of the leading treatment programs in the world, one on which many other programs have been modeled. Brink arranged for the purchase of the former Billy Rose Mansion on the upper east side to house the Smithers rehabilitation facility, largely because he felt that alcoholism should be treated as a respectable disease and that alcoholics deserved to be treated with dignity. This beautiful free-standing facility was very conducive to that philosophy. A few years ago, shortly after St. Luke's-Roosevelt hospital merged with Beth Israel Medical Center, and less than two months after Brink's death, the hospital decided to sell the mansion to raise money to resolve its financial difficulties, and move the patients from the serenity of the old Billy Rose mansion to one of the sterile wards at St. Luke's-Roosevelt on the other side of the city. Services and staff were cut and the quality of this once great treatment center plummeted. As you may be aware, I have filed suit against the hospital on behalf of my late husband's estate claiming that the hospital was not using the endowment in accordance with the original terms and intent of the $10 million gift, and also alleging misappropriation of funds and seeking to remove the Smithers program from that hospital. That suit is still in the New York courts. --------------------- Clouds Over Future of an Alcoholism Treatment Center January 28, 1999, Thursday - Metropolitan Desk - Copyright 2000 The New York Times Company By LYNDA RICHARDSON Amid a swirl of court papers and bitter feelings, the future of the Smithers Alcoholism Treatment and Training Center, a Manhattan institution with a celebrity-studded patient roster, is in doubt. Adele Smithers, the widow of the center's founder, said yesterday that she wanted her family's name removed from the stately mansion on East 93d Street if the current stewards of the program, Continuum Health Partners and St. Luke's-Roosevelt Hospital Center, relocate the program to a wing of the hospital in midtown Manhattan. ''Today, we discover it is often harder to take our name off a building than to put it on,'' said Mrs. Smithers, whose late husband, R. Brinkley Smithers, had donated $10 million to develop the center. Mrs. Smithers spoke to reporters outside the recovery center yesterday because she said she no longer feels welcome inside the wrought-iron-and-glass doors. With the prospect of the center shutting its doors, Mrs. Smithers said her lawyers were in discussion with officials at North Shore-Long Island Jewish Health System about opening an alcohol treatment and rehabilitation center on Long Island that would be similar to the current center. She also said representatives of the Betty Ford Center and Lenox Hill Hospital had expressed interest in the recovery program. For months now, Mrs. Smithers's family and St. Luke's-Roosevelt Hospital Center have been embroiled in a legal battle for control of the recovery program and the multimillion-dollar endowment left by the center's founder. ''An amicable divorce'' is what Mrs. Smithers said she would like. Citing financial pressures, hospital officials in early 1995 announced their plan to move the treatment program, which has a 44-patient capacity, from the Carnegie Hill neighborhood to the hospital's Roosevelt division, at 58th Street and 10th Avenue. ''We think this is the first step designed to ultimately get rid of the program,'' said Mrs. Smithers's lawyer, Paul R. Levenson. Mrs. Smithers said that the center was associated with a treatment philosophy that includes a freestanding, homey environment and that placing the program in a hospital setting would destroy its effectiveness. Among the celebrity patients, John Cheever once roomed with a ballet dancer, an insurance salesman, a deli owner and a tattooed sailor, according to his daughter, Susan, who wrote about this in a book about him. Other celebrities treated there have included Dwight Gooden, Joan Kennedy, Darryl Strawberry and Truman Capote. Patient stays are usually 28 days. In addition to her concerns about the center's environment, Mrs. Smithers has questioned whether St. Luke's-Roosevelt is trying to use the center's resources to balance its books. At yesterday's news conference, Mrs. Smithers's lawyer said the building was bought for $1 million in 1973 from Mr. Smithers's donation, and the hospital now has placed a $20 million price tag on the structure. According to an agreement with the State Attorney General's office, the hospital intends to use the proceeds from the sale to pay its debts, except for $1 million that would be put back into the program, Mr. Levenson, the lawyer, said. ''We don't believe Mr. Smithers gave $10 million to finance a real estate investment,'' the lawyer said. A spokesman for St. Luke's-Roosevelt Hospital Center, Brice Peyre, said yesterday that there would be no comment. ''We're not going to be offering any formal comment while the litigation is pending,'' he said. ''But I would like to stress that we are not closing the program but moving it to St. Luke's-Roosevelt Hospital.'' Last fall, Mrs. Smithers unsuccessfully sued in State Supreme Court in Manhattan to stop the relocation of the center and sale of the building. A judge had dismissed the suit, ruling that only the New York Attorney General could sue for breach of charitable gift conditions. Last week, Mrs. Smithers filed an appeal to that decision. It is unclear when the program would be relocated to the hospital. Mrs. Smithers's lawyer said the state has yet to physically inspect what would be the program's new home within the hospital. Mr. Levenson said he believed that the delay was because the replacement center did not comply with minimum codes for a substance-abuse center. The Smithers center has a training center and counseling services at the Roosevelt division, and it housed an inpatient detoxification unit there until November, when the unit was closed down. But the 93d Street house, once the mansion of Billy Rose, the Broadway impresario, always has been the centerpiece of the program. Within its secluded, tranquil environment, more than 10,000 people have been treated, with substance abusers sometimes forging incongruous alliances. Once at Smithers, patients are randomly assigned to dormitory-style rooms, with vaulted ceilings and french doors, and to therapy groups, which are the heart of the treatment. Counseling sessions are held in wood-paneled rooms. An outdoor stone terrace offers a place to relax. John Imhof, vice president of behavioral health services for North Shore-Long Island Jewish Health System, said yesterday that talks were under way with Mrs. Smithers about developing a treatment program that could operate somewhat like the center on the Upper East Side. ''We've always been planning to move ahead, regardless of what has been transpiring in the city,'' Mr. Imhof said. ''It would be an outstanding and exciting collaboration.'' -------------------------- Rehab center on mend with $8M settlement By WILLIAM SHERMAN DAILY NEWS STAFF WRITER An alcoholism clinic to the stars will be rehabilitated after a bruising legal battle with the hospital that ran the center, its president announced yesterday. The Smithers Alcoholism Treatment Center, where the likes of Truman Capote, Dwight Gooden and Joan Kennedy sought help, lost its luster when St. Luke's-Roosevelt Hospital sold its elegant E. 93rd St. mansion headquarters four years ago, pocketing $15.4 million. The clinic also lost more than $5 million when the financially ailing hospital diverted funds from alcoholism treatment - violating the terms of the charitable gift that put the clinic under the hospital's control in 1971, according to a suit against St. Luke's-Roosevelt. The money allegedly went to the hospital's general funds, the suit charged. Under a settlement announced yesterday by Smithers Foundation president Adele Smithers-Fornaci, the hospital will give up any claim to the renowned Smithers Center name, and will pay back some $8 million. "It's a big victory and finally we're hopeful we'll be able to reestablish the center," said Smithers-Fornaci, whose late husband founded the clinic. "My husband, R. Brinkley Smithers, was disgusted with what the hospital was doing and planning before he died in 1994, and after he died I had to do something about it," she said. "We will find a new location." Hospital spokesman James Mandler declined to comment on the alleged misappropriation but said, "We are delighted that we have been able to reach an agreement with the Smithers Foundation." The settlement followed a landmark decision by the Appellate Division of State Supreme Court granting Smithers and other charitable donors the "standing" to enforce the terms of gifts through litigation, a first in the trusts and estates law. The settlement also requires the hospital to use the rest of the mansion profits on alcoholism treatment. Originally published on October 22, 2003 |
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The
modern alcoholism movement is the dominant approach to drinking problems
in America, including the view that alcoholism is the essential drinking
problem and that it is a treatable disease. This view is not shared
worldwide, and has been questioned in the United States as well. For
example, a problems approach views drinking dysfunction in terms of the
negative behavioral and social consequences that stem from a variety of
types of excessive drinking.