The Alcenas Hospital and Lakeside Milam
By Kenneth Anderson, MA
The history of alcohol treatment since the 1960s has been a history of practitioners ignoring science and the scientific method and forming conclusions based on observations of clinical populations without testing hypotheses, then self-publishing these hypotheses or publishing them in the popular press rather than in peer-reviewed scientific journals. Some of the most notorious examples of this are Hazelden and the Johnson Institute, which will be discussed in later blog posts. Another notorious example is Lakeside Milam, founded by James Robert Milam (Mar 3, 1922 – May 6, 2016). This is a far cry from Shadel Sanitarium, which meticulously published its data in peer-reviewed journals in the 1940s and 50s.
James Robert Milam
Milam was born in the state of Washington, the son of schoolteacher Carey Harris Milam (Oct 6, 1891 – Feb 2, 1985) and Ruth Helen Milam nee Brauer (Feb 26, 1894 – Oct 23, 1961). Milam served in the Air Force during World War Two, then entered the University of Washington, where he received a PhD in psychology in 1959. Milam married Beverly Jean Greenwood (Nov 16, 1927 – Feb 25, 2000) on August 8, 1947. They had one child, Kathryn Milam.
In March of 1967, Patrick Joseph Frawley, Jr., owner of Shadel Hospital (formerly Shadel Sanitarium), hired Milam as behavioral research director at Enzomedic Labs. Enzomedic Labs was attempting to cure alcoholism with a formulation of nicotinamide adenine dinucleotide (NAD) named Enzopride. However, Enzopride never made it to the market.
According to the June 22, 1975 issue of the Seattle Times, Milam became a consultant at King County’s Cedar Hills Treatment Center in 1967 and was awarded two federal grants for the study of alcoholism. He also served on the executive committee of the Washington State Council on Alcoholism and the board of directors of the University of Washington Alcoholism Institute.
Milam’s Personality Inventory for Alcoholics
While Milam was at Cedar Hills Treatment Center, he began giving a personality inventory to alcoholics shortly after admission and readministering the test after 30 to 60 days of abstinence. Milam found that much of the psychopathology present during the first administration of the test had cleared up by the time the test was administered the second time. Based on this, Milam concluded that it was always alcohol that caused psychopathology and never psychopathology which caused addiction to alcohol. Milam claimed that this was the reverse of the prevailing view of the time, espoused by the National Council on Alcoholism, that alcoholism was always caused by psychopathology, i.e. “character defects.” Today we know that neither view is completely correct; there exist both pre-existing psychiatric conditions that lead to substance use and substance-induced psychiatric conditions that disappear with abstinence.
How a Faulty Conclusion Became The Basis for Treatment
In an interview on this topic, the October 27, 1968 issue of the Seattle Times quoted Milam as saying, “The alcoholic is a dirty, no-good bum because he drinks. He is not a drinker because he is a dirty no-good bum to begin with.” In a July 22, 1971 article in Seattle Times, Milam said, “A drinking alcoholic is the world’s most practiced liar…alcoholics are incompetent to diagnose or treat their own condition.”
In 1968, Milam explained his theories on alcoholism to Dorris Maye Hutchison nee Lyon (Sep 28, 1926 – Sep 30, 2012), wife of ex-jockey and horse trainer Charles Hutchison (Feb 24, 1929 – Feb 8, 2015). As a result, Dorris opened a 14-bed treatment ward for alcoholism on Capitol Hill.
The History Behind Alcoholism Center Associates (ALCENAS)
In 1970, Dorris Hutchison and James Milam partnered together to form Alcoholism Center Associates (ALCENAS). Together, they moved Dorris’s treatment program into the old David Edward Skinner mansion at 725 14th Avenue East on North Capitol Hill. This was known as Alpha House. The program was 28 days and incorporated the principles of AA. James Milam was president of the company and Dorris Hutchison was director of the treatment program.
Beverly Milam divorced James Milam on grounds of cruelty on February 11, 1971. Dorris Hutchison divorced Charles Hutchison around this same time and shortly thereafter, James Milam married Dorris Hutchison.
In March of 1971, James and Dorris Milam moved their alcoholism treatment program into the former Fairfax Psychiatric Hospital at 10240 Northeast 132nd Street in Kirkland and dubbed the new facility the Alcenas Hospital. This was a 40-bed facility.
In 1971, Milam self-published The Emergent Comprehensive Concept of Alcoholism (51 pages) through Alcoholism Center Associates. This allowed Milam to put forth his theories on alcoholism without subjecting them to peer review.
In 1973, Laura Ann Mueller nee Seat, MD (Mar 3, 1942 – unknown) became medical director of the Alcenas Hospital. Dr. Mueller received her MD from the University of Missouri Columbia School of Medicine in 1968. After an internship at the Swedish Medical Center, she moved to Seattle, where she was medical director of the Puget Sound Social Programs, Inc. Methadone Treatment Program until she joined the Alcenas Hospital in 1973. Dr. Mueller wrote two books with Katherine Ketcham: Eating Right to Live Sober (1983) and Recovering: How to Get and Stay Sober (1987). Although Mueller jumped aboard the recovery publishing boom, she published no research on alcoholism or anything else in a peer-reviewed journal.
Dorris divorced James Milam on September 14, 1973; however, they were remarried on July 15, 1974. Dorris divorced James for a second time on July 2, 1976. On July 8, 1976, Dorris remarried her previous husband, Charles Hutchison. Dorris divorced Hutchison a second time on October 29, 1979, then remarried him again on April 12, 1980.
In April of 1976, Alcenas Hospital moved into a new 82-bed building at 10322 Northeast 132nd Street. On April 1, 1981, Alcenas Hospital was sold to CompCare.
How Myths Become “Scientific Evidence”
In October of 1981, Milam and Katherine Ketcham published Under the Influence: A Guide to the Myths and Realities of Alcoholism through Madrona Publishers, a small press based in Seattle. The book was picked up by Bantam Books, which published a paperback edition in December of 1983; this became a million-copy bestseller. Ketcham was a professional nonfiction writer who translated Milam’s ideas into simple layman’s terms. Unfortunately, those things which Milam claimed to be realities were largely myths of his own creation not supported by science. Those things which Milam claimed to be myths were often realities with a great deal of scientific support. Thus, Milam managed to help spread the mythological and antiscientific picture of alcohol problems far and wide. Many of the erroneous concepts put forth by Milam had already been pioneered by the mythmaking of the Minnesota Model.
Alcoholism as a Disease
In his book, Milam puts forth the utterly bizarre claim that he originated the idea that alcoholism was a physical disease and not a mental disease or the result of mental illness. In fact, the battle to establish alcoholism as a physical disease rather than a mental disease had been in progress since the 1940s. In 1956, the American Medical Association in the Proceedings of the House of Delegates – Clinical Session stated that alcoholism should be treated in general hospitals and not just in state and private mental hospitals. It is often erroneously stated that this was a declaration by the AMA that alcoholism was a disease; however, alcoholism had always been listed as a disease since the first official US classification of diseases, A Standard Classified Nomenclature of Disease, was published in 1933. Even before there was a standard nomenclature, the disease theory had been generally accepted by physicians by the 1890s. It would have been as redundant for the AMA to declare alcoholism a disease in 1956 as for the AMA to declare the common cold a disease today. If Milam had had even a cursory familiarity with the alcoholism literature of his era, he would have known that there was nothing original in his contention that alcoholism was a physiological disease.
Questioning the Disease Theory of Addiction
Today, it is well established that in many cases, alcohol use disorder is the result of underlying depression, anxiety, trauma, etc., although in many other cases there is no underlying psychopathology. So it is simply untrue that all psychiatric symptoms of people with alcohol use disorder are the result of drinking alcohol. Moreover, the disease theory of addiction remains as controversial as ever, with some scholars, such as Stanton Peele, arguing that the disease theory is harmful and hinders recovery.
Milam also promoted the erroneous idea that “alcoholics” and non-alcoholics are as categorically different as Mendel’s green and yellow peas; that alcoholics had some fundamental physiological difference from normal people which led them to inevitably become alcoholic from the first time they took a drink. Moreover, Milam claimed that environment was irrelevant, and that alcoholism was entirely physiological and genetic. Today, we know that there is no such categorical difference, that susceptibility to alcohol use disorder lies on a continuum related to hundreds of different genes and countless environmental factors.
Milam further claimed that alcoholism was inevitably progressive and, unless treated, inevitably fatal. Today we know that over 90% of people with alcohol use disorder recover, and of those who recover, nearly all do so on their own, without treatment, and without AA. In fact, 5% recover per year after onset, meaning that some people hardly progress at all before recovering. Milam also denied that any alcoholic could return to controlled drinking; however, current research shows that half of people with alcohol use disorder recover via controlled drinking.
Milam also claimed that over 95% of alcoholics were hypoglycemic, and that “Alcohol immediately brings the blood sugar level up and makes the symptoms disappear. After one or two drinks, the hypoglycemic feels remarkably better.” This is, in fact, false, since alcohol can either raise or lower blood sugar depending on a myriad number of factors. Although a healthy diet and vitamin supplements are important for any heavy drinker, they are hardly cure-alls.
Top Shelf to Milam to Lakeside
On October 25, 1982, Top Shelf Corporation was incorporated as a for-profit corporation in the state of Washington with a capitalization of $50,000. On March 16, 1983, Top Shelf Corporation was renamed Milam Treatment Centers, Inc. On June 2, 1983, Milam Treatment Centers, Inc. was renamed Milam Recovery Centers, Inc.
The officers of Milam Recovery Centers, Inc. were George Slocum Hiddleston, Sr. (Dec 11, 1916 – Jan 12, 2007), board chair; Charles Hughes Kester (Feb 22, 1932 – Feb 9, 2022), president and chief of operations; and James Milam, secretary and treasurer. Kester was an AA member who had undergone treatment for alcoholism at the American Lake, Washington VA Hospital in 1969, after which he went to work at King County’s division of alcohol and substance abuse. After earning a master’s degree at Seattle University, he was put in charge of the department, where he remained until 1983. Kester’s wife Helen was the family program director at Milam Recovery Centers.
Milam Recovery Centers, Inc. opened its first alcoholism treatment facility in 1983; this was a 40-bed facility located at 14500 Juanita Drive Northeast in Bothell, Washington. Dr. Mueller was the medical director. Dr. Mueller left Milam Recovery Centers in late 1984 to serve as medical director of the Harold Hughes Treatment Center at Ringgold County Hospital in Mount Ayr, Iowa.
By 1989, Milam Recovery Center began calling itself Lakeside Recovery Center. Branches of Lakeside Recovery Center were in operation in Anchorage, Alaska (outpatient); Fairbanks, Alaska (outpatient); Juneau, Alaska (outpatient); Ketchikan, Alaska (outpatient); Portland, Oregon (residential); Bothell, Washington (residential); Kirkland, Washington (outpatient); and two outpatient clinics in Seattle. By 1990, branches had been added in Colbert, Pullman, Olympia, and Silverdale, Washington. Even more branches were added in 1991.
In 1991, Milam Recovery Centers, Inc. legally changed its name to Lakeside Recovery Centers, Inc. A Moscow, Idaho branch was added in 1992.
In 1995, Lakeside Recovery Centers returned to 10322 Northeast 132nd Street, where it remains today. The name became Lakeside/Milam Recovery Centers around this time. In 2012, Kester’s son, Carlton Mark Kester took charge as CEO and president.
Lakeside/Milam Recovery Centers Today
Today, Lakeside/Milam Recovery Centers offers inpatient treatment at 10322 Northeast 132nd Street in Kirkland, Washington and outpatient treatment at Auburn, Everett, Kirkland, Puyallup, Renton, and Seattle, Washington. Their website states, “The model for our treatment centers is taken right from the pages of Under the Influence, written by our namesake, Dr. James R. Milam and Katherine Ketcham. We continue to use the book in treatment today.”
Certainly, some people may benefit from a stay at Lakeside/Milam. However, it is the outright rejection of science and the scientific method by treatment providers who think they know better than scientists which has kept American addiction in the dark ages and led to the worst overdose death crisis in history. It is time to stop basing America’s treatment programs on the divine revelations written down in AA’s “Big Book,” and to bring science to bear on the problem instead.
If you liked this article on the ALCENAS Hospital, you might also enjoy: The Non-Science of the Wegscheider-Cruse Family Roles Theory