The Stanton Peele Addiction Website, September 16, 1997.
R. Brinkley Smithers
The Financier of the Modern Alcoholism Movement
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.
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?"
1. 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.