Anchorage Mayor Dan Sullivan wants the city to send a handful of severe alcoholics living at Karluk Manor to Seattle for a 10-day, $22,000 aversion therapy treatment that involves induced vomiting or electric shocks and is touted as a cure "nothing short of miraculous."
Schick Shadel Hospital says its method of treating alcoholism is time-tested and startlingly effective, boasting a 70 percent cure rate.
Detractors say Schick Shadel Hospital's claims of success have never been proven by independent research, and that the method may not be appropriate for the severe alcoholics Sullivan would like to see treated there.
'We're willing to try something new'
Sullivan says he first read about Schick Shadel Hospital in Alaska Airlines Magazine. He was impressed by the program's claimed 70 percent success rate.
It's time for a new approach to the stubborn problem of chronic alcoholics who cycle through services that cost the city millions of dollars while doing little to mend the addiction at the heart of the problem, he said.
"We're spending an inordinate amount of money on folks we're trying to help and treat," he said. "This is different than the 12-step programs we usually see and, quite frankly, we're willing to try something new."
Representatives from Schick Shadel traveled to Alaska to make a presentation to city officials about the hospital's offerings, he said.
Details of the proposed pilot program are being worked out by the Department of Health & Human Services, Sullivan said. A draft is expected in the next few weeks.
"We'll know in the next few weeks whether the Assembly is willing to fund a pilot program" he said.
Details of exactly how much it would cost weren't available Tuesday, but Sullivan said an initial group of eight to 10 Karluk Manor residents might go.
One idea being discussed is that residents might move back into a section of Karluk Manor that would be designated "non-drinking," Sullivan said.
Corrine O'Neill, the director of Supportive Housing for RurAL CAP, which manages Karluk Manor, could not immediately be reached Tuesday.
If Schick Shadel could really get pilot program participants sober for good, it would be a bargain for the city, Sullivan said.
"If you consider what we're paying to pick up people constantly on streets if they are passed out, and the cost of maintaining various programs, it actually might be a pretty efficient way of getting people out of their addiction and into a new lifestyle."
'Counter conditioning'
Founded in 1935, Burien, Washington-based Schick Shadel calls itself the oldest hospital exclusively devoted to treating substance abuse in the country. In 2011 it was purchased by Texas-based health care provider Ascend Health.
In advertisements on TV and radio, it claims to cure cravings for alcohol or drugs within 10 days. It also provides alcohol and drug detox services.
Schick Shadel uses what it calls a "counter conditioning" method, in which patients are exposed to alcohol in combination with medications that induce vomiting, in order to make the sight, smell, taste and thought of alcohol repellant.
Some patients who have health problems that make "emetic," or vomit-inducing, treatment unsuitable may instead choose "faradic," or shock, treatment.
In addition to the aversion therapy sessions, the patient undergoes interviews after taking sodium pentothal, nicknamed the "truth serum" drug.
On blogs, people documenting their experiences at Schick Shadel write vividly about their aversion therapy sessions, or "duffys."
"Florence then hands me a glass of my favorite Single Malt Whiskey and tells me to smell and drink," one anonymous blogger wrote in 2013. "As I'm looking at the bottle, I smell and drink; then immediately the flood gates hope (sic) and I puke violently into the bowl. This is how the rest of the Duffy goes: Drink then puke, 16 times. I never thought it would be over."
Many former patients, including the blogger, credit Schick Shadel for helping them overcome alcoholism and even saving their lives.
Twice, former patients have bought the company.
Hard to find neutral research
On its website, the hospital points to voluminous research conducted by its own medical staff pointing toward the program's efficacy.
But neutral outside research on aversion therapy is harder to find.
A Providence Alaska Medical Center addiction doctor declined to be interviewed about aversion therapy for substance abuse treatment.
Regence, a major health insurance company in Washington and Oregon, released guidance in January saying that aversion therapy offered by Schick Shadel should be considered "investigational" for insurance purposes.
"Although short-term findings from the published literature (short-term reductions in rate of relapse) appear promising, the evidence is limited in quality and quantity," the guidance said. "In addition, long-term evidence on efficacy and safety is not available."
Rosalie Nadeau, the head of Akeela Inc., an Anchorage drug addiction treatment center, said aversion therapy could be effective for highly motivated people -- for example, a professional whose employer has demanded they address an alcohol problem or face losing a job.
"That's somebody who is willing to spend $22,000 to go to a place and endure what amounts to torture in order to get over it."
The question, Nadeau says, is whether "the group of people we're talking about taking down there is ready to quit."
The lack of outside research demonstrating the efficacy of aversion therapy in treating substance abuse is a red flag for her.
"Schick Shadel says they have about a 70 percent cure record. We can find no evidence that they have any external reviews. That's their own number. They may have. I can't say they don't because there are no records."