Gooding doctor a pioneer in addiction treatment

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GOODING, Idaho (AP) — Treating addiction was sometimes as simple as holding someone's hand as their body convulsed from withdrawals.

This is how Dr. Douglas Smith helped detoxify alcoholics at the Salvation Army in Pasadena, Calif., in 1968. At the time, Smith was completing his internal medicine residency.

This type of detoxification was called "social detox." The withdrawal is tough, and severe cases required admitting the person to a hospital.

Though addiction treatment has come a long way since, the idea of treating individuals with support and dignity has not wavered at treatment centers such as the Walker Center in Gooding.

"The message of the Walker Center is to provide hope, help and healing," said Deborah Thomas, chief executive officer of the Walker Center. "What is special is the culture of the treatment. We treat you like a brother, mother, sister or father. The dignity of everyone is the same."

This philosophy is due in large part to Smith, who helped facilitate and guide many of the programs at the Walker Center, a not-for-profit alcohol and drug addiction center in Gooding.

Smith, 80, was the first medical director, has served as a past board president and sits on the board of directors. In 1983, he paved the way for addiction treatment in Idaho and became the first addictionologist in the state.

"There were several physicians treating addiction, but they were not certified," Smith said.

As Smith roamed the hallways of the Walker Center Friday, he was greeted by counselors and other staff. Carmalin Resz, director of clinical services and performance, gave Smith a hug.

"He is a leader in our field in our state," Resz said.

In 2005, Resz began to research the benefits of gender specific treatment. She found that men and women were less likely to open up in front of each other. She also discovered that when it came to the gender of counselors, it had no effect on the process. Resz has spent 19 of her 21 years of experience working within substance abuse treatment at the Walker Center.

Today, there are more than 4,000 addictionologists in the U.S. When Smith started his career, many viewed people with addictions as lacking will power, discipline and having deficiencies in character. That viewpoint has largely changed, though some still reject it. Many in the medical community, including the American Medical Association, classify addictions such as alcoholism as a brain disease based on scientific research that has shown alcohol and other drugs can change brain structure and function.

Smith moved to Gooding in 1969 to start his private practice. In those days, there were no EMT's and Smith often rode in the ambulance with his patients. The nearest hospital was in Boise, and that was before I-84 was built. The route meant taking back roads and two-lane highways.

Smith also worked at the Idaho State Tuberculosis Hospital. His sub-specialty was in chest diseases, particularly tuberculosis.


A Center is Born

When new medicine was created to treat the disease three years later, Smith was approached by Archie Walker.

"There was a guy with a beard who liked to shoot pigeons," Smith said. "He said, 'I need you to be a medical director for a center I'm going to start.'"

In 1973, Walker and Smith, along with William Hart, Arthur Latta and Robert Hatch submitted the articles of incorporation to form the Chemical Dependency Action Committee. The first patient entered treatment at the Idaho Regional Treatment and Training Center on Oct. 4, 1976.

This center was renamed the Walker Center in 1980 in honor of Archie and Bertha Walker. The center occupied space in the old tuberculosis hospital from 1976 to 1981 and a wing of the old Gooding hospital from 1981 to 2003. The Walker Center moved to its current location in 2003.

In the beginning, finding counselors was one of the biggest struggles. Finding those to treat was much easier.

"We got people coming in quickly when they heard of the treatment center," Smith said.

Today, the Walker Center has has helped thousands overcome drug and alcohol addictions. Smith has trained others about the disease of addiction, including Reid Lofgran, current medical director of The Walker Center.

Before the establishment of the Walker Center, the nearest treatment center was a Schick Shadel Hospital program in Wendell. Schick Shadel is a type of aversion therapy that has been in use for more than 80 years. Patients are given medicine that will make them sick when they drink or use drugs.

The Schick Shadel Hospital describes the treatment like this: You really love cherries. One day you eat too many cherries and make yourself sick from eating them. Then for some time later, the thought of cherries makes you nauseous because you associate them with getting sick.

The Walker Center's approach blends the philosophy and principles embodied in 12-step programs, like Alcoholics Anonymous and Narcotics Anonymous. It offers a complete continuum of care such as medically supported and clinically managed residential withdrawal management, detoxification monitoring and residential treatment for adults, individual counseling and outpatient treatment.

It also follows ASAM's six dimensions of a multidimensional assessment, which includes exploring an individual's past and current experiences of substance use and withdrawal and exploring an individual's readiness and interest in changing.

"Some can be very motivated while others it's all external motivation. We have to flip it so it's meaningful to them so they stick to it longer," Thomas said.

Methodone was once used in the detox process, but was stopped after people became addicted to it. Subutex is now used because it's administered in a dissolvable strip and contains two drug. These two features help guard against misuse.

Phenobarbital — once used to treat seizures caused by detoxification — has been replaced by Librium. The idea now is to stop the seizures before they happen.

The Walker Center also has outpatient offices in Boise and Twin Falls. There are facilitated alumni support groups in Boise, Gooding, Twin Falls and Pocatello.


Changing a Culture

When Smith first moved to Gooding, he noticed alcohol abuse was tolerated. He remembers people driving around with open containers.

"You go to dinner in Bliss and take a bottle of beer," he said. "It wasn't really treated hard. It was just the cowboy stuff — have a drink at the end of the day."

Last year, the Walker Center treated 500 people in its residential center in Gooding. There were 40 people living at the Walker Center Friday. A typical stay is 28 days, depending on how a patient progresses. The center's patients on average are 48 percent women and 52 percent of men. Alcohol is the primary addiction. Approximately 14 million Americans, 7.4 percent of the population, meet the diagnostic criteria for alcohol abuse or alcoholism.

However, in the last three years, opioid abuse has topped alcohol abuse.

"It's a national trend, prescribed opiates," Smith said. "There's has been a return to heroin use because it's cheaper than Oxycontin," Smith said.

A high-ropes challenge course was installed 10 years ago to help people overcome their addictions. Thomas is writing a grant to build a labyrinth. A current trend many treatment facilities are employing is going smoke-free. The Walker Center went smoke-free May 1.


Information from: The Times-News,

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