Despite the way the Third Report was released, it garnered widespread 
coverage in both print and broadcast media, including network television. 
[Robin, perhaps because of the large number of AA members in the media.]

And the report indicated that research was needed to test the effects on 
drinking behavior of modifying the content, distribution, and availability of 
alcohol.  Testing might involve adjusting pricing policies, taxes and zoning 
regulations as well as reducing the alcohol content of beverages and raising 
the minimum drinking age.

Not too surprising, the report was immediately attacked by the Distilled 
Spirits Council of the U.S. (DISCUS).  In a six page statement, DISCUS 
President Sam D. Chilcote, Jr., said the report "contains inherent 
contradictions, fails to cite substantial examples of progress, and 
disparages the value of education as a means to reducing alcohol abuse."  He 
said the report overlooked the "worth of prevention concepts such as 
responsible decision-making and building self-esteem."

"Instead, the HEW document is saturated with specious case-building for the 
neo-prohibitionist theory, which would manipulate public policy on taxes, 
prices, advertising, and retail outlets under the cloak of concern over 
alcohol abuse."

He charged that the report "voices alarming national statistics on alcohol's
relation to suicide, homicides and violence"  He said  "the lack of cited 
sources, studies and references in this version of the Report suggests it was 
designed for publicity purposes rather than careful scrutiny.  It may already 
be too late to reverse misconceptions that have been aroused.

Chilcote also challenged what he called the report's "sweeping judgment about 
alcohol being 'indisputably involved' in the causation of cancer," charging 
that it was "misleading, creates a false impression of certainty and is not 
supported by the text of the document itself."  He quoted Arthur Upton, 
Director of the National Cancer Institute, as telling a Senate committee the 
previous June that alcohol ingestion by itself does not appear to be 
carcinogenic."

Chilcote said it was obvious that "the leadership of NIAAA had been drifting 
toward an attack on normal, social drinking and manipulation of the 
individual's freedom of choice.  This approach failed to work in Scandinavia 
and Russia.  Totally overlooked is the reality that alcoholics and chronic 
problem drinkers are undeterred by high prices or hard-to-get supplies of 
beverage alcohol."

It was more disturbing to me that the American Council on Alcoholism (ACA), 
which had been formed when the Baltimore council had broken away from the 
National Council on Alcoholism, similarly attacked the Third Report.  It 
issued a lengthy statement on October 19.1978, expressing "dismay and 
disbelief' about its contents.

Thomas Walker, the Executive Director of ACA said the report referred to the 
use of alcohol as "the basic source of the problems," an approach he said 
which "seriously threatens the disease concept of alcoholism."

ACA President Lauren Lydic said that in a "drinking society, we must exercise 
utmost caution that the consumption of alcohol not be blamed for all the 
problems of our society," adding:

"To recreate a new prohibitionist era by the utilization of partial 
information in any study or research effort can be nationally disastrous."

Jay Cross, Director of the ACA's American Institute of Alcoholism Studies, 
took issue with the report's findings on alcohol's relationship with cancer, 
heart disease, and the fetal alcohol syndrome.  "As a source of data for 
uninformed people concerned with beverage alcohol-related problems, the 
document is very disappointing," he commented.

Cross termed the report "very questionable in that it almost totally excludes
citation of research scientists, research papers, sources of data, research 
settings and group studies."  He said that although conclusions of research 
findings are presented, there are "no references to provide legitimation of 
the authors' conclusions."

Soon the National Coalition for Adequate Alcoholism Programs (NCAAP), 
organized by NCA, added its voice to the attacks on the report.  I was not 
too surprised, as I knew that the coalition included representatives of the 
alcoholic beverage industry, and some of the other members of the coalition 
received funding from the industry.

At a November 14 meeting of the coalition David Keyes of the Wine Institute
urged the coalition to take immediate action to counter the report.   "I am 
wondering if you want to allow this kind of shoddy misrepresentation to stand 
from this point on without something in the way of an official comment," he 
said.  He described the report as bordering on McCarthyism.  He said he had 
seen some of the earlier technical documents upon which the report was based, 
and added "Unless they got the authors to rewrite these, and came to 
different conclusions, this report has misrepresented - grossly, seriously 
misrepresented - the research."

Reaction of some of the members of the coalition can only be described as
"hysterical."

Describing the Report as a "highly controversial document," Coalition 
Chairman Leo Perlis, Director of Community Services for the AFL-CIO, said he 
had the "impression that HEW was shooting from the hip on a great many items 
... not based on scientific evidence."  He said that the report was issued 
without adequate consultation with the field.  "They simply went ahead and 
issued it, and that was it," he commented.  [Meaning, Robin, that they didn't 
ask him -- and the liquor industry.]

He also distributed reprints from an article in the November issue of Human
Nature entitled "The Benefits of Drink" by William J. Darby, which he said 
contained a number of conclusions which were contrary to those contained in 
the Third Report.  The article's sub-head stated that "alcohol in moderation 
not only makes life pleasant but also reduces the threat of heart attacks and 
may promote healthy social attitudes."

George Dimas, Executive Director of the National Council on Alcoholism, said 
his organization would be appointing a panel to review the report.

J. Anthony Carpenter, Director of the Rutger's Center of Alcohol Studies, 
said that because the report was by HEW, he had initially felt it was "none 
of our business," but added that "it becomes our business when it is 
inaccurately written... not so much inaccurate as slanted."

Gus Hewlett, Executive Director of the Alcohol and Drug Problems Assn.
claimed that "a lot of damage" had already been done as a result of the 
initial publicity accompanying the release of the report and "the public is 
not aware that this report is based on erroneous assumptions"  He stressed 
the need to "do something to try to correct the damage that has been done."  
[Gus had always been, and as of 1988 at least, still was supported by the 
industry.  A fascinating hearing on warning labels in 1988 shows this.  He 
was testifying at the suggestion of the industry -- which refused to testify. 
 This was the Commerce Committee and Al Gore, who was chairing, really raked 
Gus over the coals.  I'm been a Gore admirer since.]

The coalition voted to draft a letter to Secretary Califano conveying the 
concerns of the Coalition and requesting him to designate an HEW official to 
work with the coalition's evaluation panel.

A three-member committee was appointed to evaluate the document and produce a 
report by January with plans for widespread dissemination and media coverage.

Carpenter was named chairman of the coalition's evaluation committee which 
would also consist of Gus Hewlett and John Wolfe, Executive Director of the 
National Council of Community Mental Health Centers.

In a November 21 letter addressed to Califano, Perlis informed the Secretary 
of the action taken by the Coalition at its November 14 meeting to establish 
a committee to evaluate the report, and asked Califano to designate an HEW 
representative to work with the Coalition's evaluation panel.

Loran Archer responded to the letter saying: "I do not consider the 
information in the Third Special Report describing the terrible toll that the 
excessive consumption of alcohol takes on the health, safety, and happiness 
of millions of Americans as controversial.  If I had, I would not have 
recommended to the Secretary, even though this is a tight budget year, that 
additional funds are needed for alcoholism and alcohol abuse programs."  He 
said he would provide the Coalition's evaluation committee a computer 
printout copy of the technical document which contained the backup material 
and references on which the report was based, and would be willing to meet 
with the panel "at any time to assist in the clarification of this issue."
[My memory is that Loren was then "acting director" after Ernie had been 
fired.]

On January 23, 1979, the Coalition released its evaluation of the Third 
Special Report on Alcohol and Health. *

It listed a series of specific criticisms and concerns, but judged the 
document overall as "more comprehensive" than the previous Alcohol and Health 
reports issued in 1972 and 1974.  Moreover, it said several of the chapters 
"appeared to be quite well done."  Its specific criticisms included that: 
Although the chapter on Prevention was progressive in that it recognized the 
host, agent and environment relationship for further study, it inadequately 
represented the bulk of current prevention activities in the field.

"Emphasis was placed on the availability of alcohol in the Prevention chapter 
with relatively less attention on other more frequently used means toward 
prevention.

"The chapter on Interaction of Alcohol and Other Drugs is another example of 
progress but the chapter is weak in that it does not cover some current, 
well-known important theoretical basics.

"The authors appear to rely on secondary rather than primary research 
information in some chapters of the report.

"The highlights did not always represent the conclusions and/or contents of 
the chapters."  Among recommendations, the Coalition urged that future 
reports “focus on reduction of morbidity and mortality due to alcoholism and 
alcohol abuse."  It also recommended that future reports be released only in 
conjunction with technical backup, and that the format of the next report be 
changed to consist of scientific monographs reflecting the state of the art.

The views had been shared with Loran Archer at a January 17 meeting, and the 
Coalition said his participation was "informative and helpful."  It said 
Archer's "reactions to the shortcomings of the report were positive and, upon 
recommendation of the Evaluation Committee advised us that NIAAA would 
consider these concerns in the preparation of the Fourth Report."

At a meeting of the NIAAA Advisory Council on January 15, 1979, Leland Towle, 
Managing Editor of the Third Report, said that a number of topics had already 
been identified for possible inclusion in the next report, including 
consumption and other areas where additional knowledge was needed and studies 
were already underway.

He listed these as: trends in consumption; further insight into the 
relationship of demographic statistics to alcohol abuse and alcoholism; 
identifying target populations at most risk; better information on women and 
youth; the relationship between alcohol consumption, particularly excessive 
consumption, and nutrition; further information development on diagnostic 
tests for early identification; effects of excessive alcohol use on the 
fetus; more data on treatment outcome over a period of four years after 
treatment; and additional information on the efficacy of employee-based HMO 
programs in reducing medical care utilization.

Robin if you think this was bad you should have seen what happened when I 
authored a staff report on warning labels, which commented on the industry's 
support of the alcoholism groups.

(I have some info in my book about why Ernie was fired.  I was
very involved in that at the time, but I think Brink Smithers may have
put his finger on it when he said it was because the industry pushed for
his firing.  There were many other theories, too.  One is that Peter
Bourne told Klerman he would never get control of the Institutes until
he fired the three directors.  All three were fired within a short time, but 
the timing of Ernie’s firing coincided with William's opposing Klerman’s 
attempt to take the peer review of research away from the three Institutes 
and put
in ADAMHA.)  Califano and Klerman met with Williams and me and
agreed that they would not do this because of our objection.  As we left 
William's office, Califano asked Williams to step back inside for a moment 
because he had something to tell him.  He told him he was going to fire Ernie 
- and gave a variety of excuses = and the next day the dirty deed was done.)