By BENEDICT CAREY, The New York Times

A HUMILIATING accident. An apparent memory lapse. A sudden, emotional confession.

Representative Patrick Kennedy's car crash on Capitol Hill early Thursday and a news conference a day later had a familiar rhythm, especially for those who study addiction or know it firsthand.

Mr. Kennedy, a six-term Democrat from Rhode Island, said that his addiction was to prescription medication and that he planned to seek treatment at an addiction clinic, as he had done before.

"I struggle every day with this disease, as do millions of Americans," said Mr. Kennedy, who is 38.

But will a cure that apparently didn't take the first time be successful the second time around? Mr. Kennedy, for one, ruefully acknowledged how easy it was for him to backslide.

Mr. Kennedy is seeking treatment at a time when the entire field is undergoing a transformation. Once akin to exorcists, committed to casting out the demons altogether, those who work with addictive behavior of all kinds are now trying less dogmatic approaches — ones that allow for moderate use as a bridge to abstinence.

A government-financed study of alcoholism released last week, the largest to date, suggests how deeply this "moderate use" idea has taken hold.

The study found that the treatment produced "good clinical outcomes" in about three-quarters of the almost 1,400 heavy, chronic drinkers in the study. Some quit altogether; most, however, had moderated their drinking — to 14 drinks a week or fewer for men, 11 or fewer for women.

"The fact is that these moderate measures are becoming more and more accepted in judging treatments," said Dr. Edward Nunes, a professor of clinical psychiatry at Columbia University.

Millions of recovering addicts and their families as well as counselors working in the trenches consider this approach to be foolhardy and immoral.

Addicts are by definition unable to control or manage their addictions, they say, and leaving an opening for moderate use only encourages the experimentation that can lead to ruin or death.

Cases like that of Mr. Kennedy dramatically illustrate how close to breakdown many addicts live, they say. "Implying you can simply cut down does a tremendous disservice to those who have this addiction," said Stanley L., a recovering alcoholic in Pennsylvania who still attends group counseling sessions.

Yet the openness to moderate use is likely to increase, driven by changes in the science of addiction, like pharmaceutical treatments.

Continued in longer article in The New York Times
Published: May 7, 2006