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An old
Arab legend says that the Egyptian Sultan, beaten by Goffredo di Buglione’s
crusaders, offered his invaders a still designed to produce a beverage which
he called Al-Kohol (the subtle). According to Haroum, his alchemist, “this
diabolic gift will make them more harmed than the greatest defeats and most
terrible epidemics. Mahomet the prophet, with his sensible and prudent laws,
was able to protect all his children from the fatal liquid,
but your
enemies who don’t take it into account will die in thousands, and their
children too, so you will be venged”.
History
The foundation, formation and work of the Clubs of
treated alcoholics were initially connected with the revolutionary movement in
psychiatry, in nineteenfifties. At that time, some advanced countries started to
develop the ‘open door policy’ in psychiatry system.
This meant unlocking the doors of psychiatric institutions, releasing
psychiatric patients of various coercive measures, introducing therapeutic
communities, group work, and the new drugs into psychiatric treatment.
Prof. Vladimir Hudolin spent the years 1952/53 in Great Britain and Sweden on
a WHO scholarship, and thus directly participated in this new approach. He
worked in Maxwell Jones’ Therapeutic community at the Belmont Hospital, in small
psychotherapy groups with Joshua Bierer, and in large psychiatric hospitals (in
London, Leeds, Inverness, Edinburgh, Aberdeen etc.).
When he returned to Zagreb he was appointed deputy head of Neuropsychiatric
Department at the Dr. M. Stojanovic in Zagreb, today the Sestre Milosrdnice
University Hospital, due to the illness of the current department head. This was
when he introduced the “open door policy” in psychiatry system with a
therapeutic community, work in small groups, a family approach, and therapy.
Many psychiatric institutions in Croatia and elsewhere did the same but much
later, and some have not done it yet. A great percentage of admittances,
especially urgent cases, were alcoholics. This is still so in many psychiatric
institutions.
Alcoholics were admitted, they recovered, stopped drinking, were discharged,
and after a short time, had to be re-admitted for another treatment. The
discharge papers regularly had the remark: improved. And as it is often the case
in psychiatry, after every discharge the situation had improved, but in the long
run it had in fact deteriorated. This happened with alcoholics as well.
These negative results working with alcoholics, long-term experience with
therapeutic community in psychiatry, his own reflections brought Prof. Hudolin
to remove alcoholics from psychiatric department and to start working with them
in separated therapeutic community.
At the same time he organised work with alcoholics in smaller groups-clubs in
the presence of their families and a therapist (we then called so the
servant-teacher) in certain parts of Zagreb, outside the hospital structure.
This is how the Clubs of alcoholics in treatment were born.
On April 1st, 1964, the alcoholism department for the hospital treatment of
alcoholics was officially opened as a part of Neurology and Psychiatry
Department, together with a Day Hospital for alcoholics, and Alcoholism
Dispensary, a Sobering Station and the Centre for Research and Prevention of
Alcoholism and other Addictions for scientific activities. Later, the week-end
Hospital was opened. The Department for other psychoactive substances (drugs)
was opened in 1971. By coincidence, the address of the Hospital is in Vineyard
street.
At the same time Clubs of alcoholics in treatment were opened in several
Zagreb municipalities, and soon spread to other parts of Zagreb, Croatia and
other Republics of former Yugoslavia. Before the Patriotic War began there were
about 300 Clubs of alcoholics in treatment in Zagreb, about 1,000 in Croatia and
about 2,000 in the whole Yugoslavia.
The development of a territorial network of support holds a very important
place in working with alcohol related problems. In Croatia we started that work
very early by founding a Committee for Mental Health Protection and Suppressing
Alcoholism and Other Addictions in various municipalities. The Clubs of
alcoholics in treatment were involved in that work from the beginning. By the
time the Patriotic War in Croatia started, that kind of network covered the
whole country. The Clubs of alcoholics in treatment are an important factor in
the network of support for health protection.
Education, training, continuous schooling and formation of Club members and
workers is a very important part of Club work. From the beginning there was a
great need for that kind of work. Professional personnel had to be educated
about alcoholism, and then trained to work with alcoholics on the Alcoholism
Department, Day Hospital, dispensary, and especially the Clubs of
alcoholics in treatment. That is why we organised Courses providing basic
information and guidelines for work almost from the first day.
Education gradually developed: first at Alcoholism Department and than
spreading to the territory. In 1975 the School for Social Psychiatry, Alcoholism
and other Addictions (The Zagreb Alcoholism School) was finally founded. The
School had changed its curriculum. For alcohol related problems there were week
long courses (50 hours) about the medical-social approach to alcohol related
problems, a six month school of alcoholism (specialisation) and post-graduated
study (two years) at the University of Zagreb.
Developing their activities in Italy since 1979, the Courses and School went
through continuous changes. Today teaching, training and organisation have been
established in Italy on various levels.
One of the most important stages in Clubs of treated alcoholics development
was the Congress of Clubs of Yugoslavia and Italy held in 1985 in Opatija. On
that occasions prof. Hudolin read the introductory paper where he stated his
opinion that alcoholism is not a disease but a disorder in behaviour and
lifestyle. Resistance appeared immediately after the lecture, mainly from
alcoholics. They wanted to be ill, protected, without personal responsibility
for their behaviour and lifestyle. Experts in various fields resisted later, and
some still do today. Medicalisation and psychiatrisation in work with alcoholics
appear quite often, and can be considered a form of relapse of behaviour. The
Clubs gradually accepted the stand that alcoholism is a behavioural and life
style disorder.
At the end of 1979 Prof. Hudolin and his associates were invited to hold the
first Course on the Medical-Social Approach to Alcoholism, as they were then
called, in the Santa Maria della Misericordia Hospital in Udine (Italy). Shortly
before that the first Club of alcoholics in treatment was founded in Italy at
Mr. and Mrs. Pitacco's house in Trieste. Prof. Hudolin and his associates were
the first servant-teachers in that Club, and this is how the project began in
Italy.
From Trieste and Friuli-Venezia Giulia, Clubs of alcoholics in treatment
spread all over Italy and they now are calculated to be more than 2,200.
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Dal 10/04/2008
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