August 14, 2000
ELLENSBURG, Wash. (Seattle Post-Intelligencer) - For years, Audrey Kishline thought she and other recovering alcoholics could learn to drink responsibly.
Her belief was so strong that she helped found a nationwide movement called Moderation Management, and became the movement's marquis speaker.
Friday, the Woodinville, Wash., woman is being sentenced on two counts of vehicular homicide - deaths resulting from her drunken driving.
Four months ago, the 43-year-old alcoholic drove down the wrong side of Interstate 90 near Cle Elum, Wash., plowing through traffic and crashing her pickup head-on into a car driven by Richard "Danny" Davis, 38, of Yakima County. In the car with Davis was his daughter LaSchell, 12. Both were killed.
More than an hour later, doctors found that Kishline had three times the legal limit of alcohol in her bloodstream. She was headed for Spokane, though she still cannot say why.
Detractors of the Moderation Management movement immediately began to criticize Kishline for what they called her moral failure - and for duping alcoholics into thinking they could drink again. For decades, Alcoholics Anonymous and other organizations have said only total abstinence would do.
Yet as their founder prepares to enter prison, Moderation Management followers are keeping the movement alive. While suffering the tragedy of Kishline's relapse, they say they continue to believe in her. In fact, they say they respect her for pleading guilty to her crimes, and note that accepting responsibility for their own actions is the first rule of their organization.
The fourth rule is never to drink before driving. Moderation Management, commonly called MM, was ushered into the mainstream media five years ago as "a common sense" solution to heavy drinking.
With individual meetings in 15 states, the organization is spreading quickly through support groups on the Internet. There are no reliable membership numbers, however.
Kishline declined comment for this story, citing an agreement between prosecutors and the Davis family aimed at preventing her from capturing media attention. But in the past, the housewife and mother of two has described herself as a recovering alcoholic who rebelled against that label.
Traditional 12-step treatment programs such as AA are based on the belief that alcoholism is a disease that cannot be cured - and that once someone becomes an alcoholic, they will always be an alcoholic even if they never again drink.
That stigma, Kishline reasoned, becomes an enormous weight and deterrent for people to seek help. Kishline in 1994 wrote that after undergoing abstinence-based treatment, she was disgraced and demoralized, and was compelled to return to alcohol.
She describes discovering that she could teach herself to drink moderately - not chronically as alcoholics do.
As recently as 20 years ago, researchers and noted psychologists were proposing moderation as a healthy habit. Kishline, who has no formal training in the field, took the work of these people and wrote it into a self-help format without the medical jargon.
Though her ideas were not original, media attention to her book made her the spokeswoman for a controversial, rapidly growing movement.
Never accepted in the established alcohol treatment community, the group shined among the general public, attracting many drinkers for whom abstinence treatment had already failed.
While still promoting the movement, in January Kishline logged on to the Moderation Management Internet news group to announce that she could no longer sustain moderate drinking and that she would leave her organization to join several abstinence-based 12-step recovery programs.
The announcement was a shock, said MM board member Marc Kern. During the ensuing debate and angst within the network, some people dropped out while the publicity attracted newcomers as well.
Two months later, Kishline failed sobriety altogether. State troopers at the crash scene found her unconscious. A partially empty bottle of vodka and a container of the prescription anxiety drug Alprazolam were found in her truck.
Supporters have argued that Kishline's failure was due to abstinence-based treatment, not moderation.
According to the National Institutes of Health, there are far more problem drinkers in the United States than chronic drinkers who are severely dependent on alcohol and need to quit.
MM proponents say traditional abstinence-based programs that do not consider moderation as an achievable goal are themselves a form of denial. They maintain that a majority of problem drinkers can on their own learn to drink less, while some need guidance - a book, a support group or professional help.
But Kern, a Los Angeles-based psychologist, said that for most people with real alcohol problems, moderation is not viable.
In a sense, MM worked for Kishline, he said, because working through her own methods helped her learn she has a more serious problem. Many members who routinely attend MM meetings end up choosing total abstinence, he said.
"Because it is a very rational, gentle forum, they find that this forum is better to talk about their alcohol problems than other methods," Kern said.
MM critics say it is impossible to predict when a person "crosses the line" into alcoholism, though. Because of that, they contend that abstinence is the safest course of recovery - and some blame Kishline for leading drunks to believe they could safely drink.
In a sharply worded critique in June, Stacia Murphy, president of the National Council on Alcoholism and Drug Dependence, said Kishline's denial of her alcoholism has contributed to the progression of the disease for thousands of Americans and their families.
Like programs fashioned after Alcoholics Anonymous, Moderation Management stresses certain steps and rules, though it omits the highly spiritual aspects of AA and other organizations.
For example, MM-ers must first abstain for 30 days in order to clear their system and lower their tolerance. But they need not put their lives "into the hands of God," as many 12-step programs ask.
"If you can't do 30 days on your own, you'll never be able to sustain moderation," Kern said.
Kishline in her book also lists drinking guidelines that differ for men and women of various weights.
Typically, the group allows three drinks per day for women and four for men. By comparison, the U.S. Department of Agriculture in new dietary guidelines released in May defines moderate drinking as one drink a day for women, two for men.
Teetotalers argue that MM's liberal guidelines were attracting drunks looking for an excuse to leave AA - concern shared even by psychologists who actively support the organization, Kern said.
Stanford University psychologists, at the invitation of the group, have studied the program. Their results are due later this year.
In various media accounts following the death of the Davises, Kishline is reported to have denounced Moderation Management and its members for denying their alcoholism. But her close associates say she made no such statement and still believes in the principles of moderate drinking.
After pleading guilty on June 29, Kishline apologized - admitting that nothing she says or does could reverse the destruction she caused.
"I am giving this statement in a public forum because I pray that my story can touch at least one other alcoholic," Kishline said in Kittitas County Superior Court. "When I failed at moderation and then failed at abstinence, I was too full of embarrassment and shame to seek help."
Her confession has done little to still the debate over Moderation Management. A little more than a week later, 36 noted professionals in the alcohol abuse treatment field issued a statement supporting both moderation and abstinence-based approaches as equally viable answers to problem drinking.
Many more treatment professionals, however, continue to advocate abstinence as the only path to recovery.
Kern added that the debate, sparked by "a horrible, horrible, horrible tragedy," has been helpful. It put the discussion of recovery methods back on the table in a big way, forcing people to look into the "gray area" of alcohol abuse.
Kishline will have plenty of time to re-examine the gray areas, her life and the future of her movement. She faces a sentence of 41 months to life in prison, although the Kittitas County prosecutor is expected to ask for 54 months in custody, followed by two years of community supervision that would include a locking device on her car's ignition.
Copyright 2000 The Seattle Post-Intelligencer. All rights reserved.