On the 'Honor' of Being Named One of America's Leading Addiction Experts

I beg to differ with Ms. Fowler about what the science shows. The cutting edge of addiction science and policy isn't that everyone who develops a substance problem either abstains or dies.
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The Fix is a new online recovery magazine. It recently featured a list of "America's Most Influential Addiction Experts." Dr. Drew was listed first; I was 10th.

Although the story purportedly "uncovers those who are quietly working to improve the care, treatment, research, policy, public image and understanding of the disease," that's not why I'm on the list.

I'm there as the representative of "harm reduction," although that term is never used by the article's author, Ruth Fowler, author of "No Man's Land," which documented her pre-sobriety experiences as a stripper in Manhattan. I was selected as A.A.'s and Recovery's fall guy because of my "stubborn resistance to abstinence and A.A.," whose effectiveness Fowler feels has been "proven" through "scientific and clinical studies."

This makes me "a little outdated in a field that's ever-expanding in knowledge." But, in an act of mercy, Fowler holds out hope for me -- I could join the anointed! "Now, if Stanton Peele could incorporate his viewpoint in with scientific, biological, genetic, emotional and spiritual ingredients, he'd have his finger on the pulse."

Ah, "But then he wouldn't be Stanton Peele -- begrudger of abstinence, sobriety, Dr. Drew and A.A." If only I could get on board with A.A., developed in 1935, and insist that all sinners -- oops, I mean addicts and alcoholics -- come to Jesus and abstain, then I could be welcomed into the Heavenly enclave.

So, although she's somewhat benign about it, Fowler views me just as Henry Kissinger did Daniel Ellsberg, whom Kissinger called "The Most Dangerous Man in America." As for me, I feel like Daniel Schorr, who commented on finding himself on Nixon's enemies list, "If it weren't for the honor, I'd just as soon have skipped it."

As it is, I beg to differ with Ms. Fowler about what the science shows. The cutting edge of addiction science and policy isn't that everyone who develops a substance problem either abstains or dies. The latest science (represented by the largest epidemiological study of alcoholism ever conducted, by the National Institute on Alcohol Abuse and Alcoholism, called NESARC) found that "[t]wenty years after onset of alcohol dependence, about three-fourths of individuals are in full recovery; more than half of those who have fully recovered drink at low-risk levels without symptoms of alcohol dependence. Only 13 percent of people with alcohol dependence ever receive specialty alcohol treatment" (including A.A.).

Let me rephrase. Only a small minority of alcoholics ever enter A.A. or rehab. Yet most of these alcoholics nonetheless recover, half while still drinking.

And then that leaves all those who reduce their drinking and minimize their harms without actually achieving full recovery, or who can nonetheless be protected despite being unable or unwilling to quit, one example of which is wet housing for alcoholics. (One of my nine cohorts whom The Fix identified as being among the most influential is the founder of "sober housing," which boots out drinkers, in opposition to which "wet housing" was specifically named.)

NESARC represents a different science, the science of how people behave in real life, as opposed to how cells behave in laboratories. This science -- called "epidemiology" -- tells us that most recovery takes place outside the tip of the iceberg represented by A.A. meetings and rehabs. Epidemiological science doesn't count in The Fix. For the body of that iceberg, the one representing the large majority of alcoholic Americans, you need to turn to my work.

I'm okay about being the sole avenue of scientific expression for the 87 percent other than those on whom The Fix is fixated, and which it self-righteously decides is the whole of the known world of addiction.