Following are five key ways in which addiction experts demonstrate a detachment from the most self-evident truths about addiction, and what causes their addiction delusions.
I. Most People Get Over Addiction. I have driven home the points revealed by the NIAAA's NESARC research -- the largest study of alcoholism ever conducted -- ad nauseam. Three-quarters of people overcome alcoholism, far and away most often without treatment, most without abstaining. The research led the NIAAA to announce its discovery that "alcoholism isn't what it used to be," reversing decades of the NIAAA's forceful adherence to disease and abstinence memes. Meanwhile, the NIDA's National Survey on Drug Use and Health shows that peak abuse of and dependence on drugs and alcohol occurs from ages 18 to 25, and declines by a third after age 25, and by half after age 30.
Addiction Delusions: No prominent figure in the addiction field acknowledges the obvious truth that alcoholism and addiction are usually self-remedying (not counting Harold Mulford, to whom my views of alcoholism are most indebted and who died recently, and Charles Winick, who announced the preeminence of natural recovery from heroin addiction in the 1960s). Why? Because it ruins their meme. How do addiction experts get away with it? Because they only see people who conform with their delusions -- the ones endlessly in treatment who undergo PET scans administered by NIDA researchers. Meanwhile, how many times have I heard harm reduction people account for the decisive fall-off of substance abuse with age: "Why, they all die!" (One in 10,000 people in this age group dies per annum due to drug overdoses, which occur mainly for older abusers.)
II. Addiction Treatment Is Not Necessary to Overcome Addiction. NESARC found that only 13 percent of people ever classifiable as alcoholic in their lives enter alcoholism treatment or join AA, and that they fare no better than untreated alcoholics (28 percent remain alcohol-dependent over their lifetimes, versus 24 percent of those who are untreated). While they are more likely to abstain (although still only a relative minority of treated alcoholics -- 35 percent -- do so), they are far less likely to drink without dependence, as two-thirds of untreated alcoholics will eventually do. In case you don't recognize it, the latter is harm reduction. (Not all are perfectly controlled drinkers, although many are, but all in this group have curtailed or limited the damage resulting from their drinking.)
Addiction Delusions: I prove addiction experts are delusional each time I speak by asking how many present have quit smoking, and how many of those quit due to treatment. All the experts would have to do to disprove their meme is to ask their dinner companions most evenings about their addiction histories. They all acknowledge that the hardest drug addiction to quit is smoking -- yet most smokers they know have quit, hardly any by using nicotine patches or gum.
III. Addiction Treatment Based on the Chronic-Brain-Disease Meme Is Detrimental to Licking Addictions. Do you know why most addiction experts think that people can't overcome addiction? Because they have convinced addicts to adopt that self-defeating delusion. My proof comes from the mouth of the horse: A team led by Harvard's Center for Global Tobacco Control found that people using NRT (nicotine replacement therapy) fare no better at quitting than those who quit without it, and that heavily nicotine-dependent smoking quitters are more likely to relapse on an NRT regimen. "We were hoping for a very different story," said Dr. Gregory Connolly, director of Harvard's global initiative. "We invested millions in treatment services."
Addiction Delusions: Here are the top three delusions I hear in response to this finding: (1) "The researchers were slaves to the tobacco companies." Not -- the global initiative people hate smoking like, well... No one hates it more. (2) "Of course, NRT failed -- there was no counseling." Of course there was counseling for this group in the study -- people who comment on blogs always think they are such geniuses, compared with the idiots at Harvard and elsewhere who do the research. (3) "Clinical trials prove the efficacy of NRT!" The study here followed quitters and noted their relapses over time. It found that people who successfully quit using NRT then relapsed just as often -- and more so when they were highly dependent. Why do you think that is? Because they have been convinced that they cannot succeed without NRT. This is indubitably false. Moreover, this idea, conveyed by the very therapy they receive, undermines their recovery.
IV. Addiction Is Not Limited to Some Drugs, Which Crushes the Brain-Disease Meme. I explained in Love and Addiction in 1975 that there can be no reasonable explanation for addiction that was (at that time) limited to heroin and narcotics, or that was limited to drugs at all. When I said that marijuana, gambling, and smoking were all addictive, I was laughed at. The addiction field has been catching up with my insights since then, and back-filling to make it seems as though these developments derived from their own mistaken notions which these developments actually irrevocably refute. This backfilling included declaring cocaine addictive in the early 80s (as pharmacologists had insisted it was not for more than half a century), cigarettes in the late 1980s (the 1964 Surgeon General's Report, "Smoking and Health," argued decisively that nicotine was not addictive, but only habit-forming), and marijuana in the 1990s (which harm reductionists still really have a hard time with). Now, for the first time, non-substance addictions are being recognized in DSM-5.
Addiction Delusions: Here's how medical historian Howard Markel explains these small oversights that occurred over the better part of a century, but that we have now happily laid to rest. (That last phrase is actually meant sarcastically -- I meant "look at how much work it requires to explain away our mistaken models of addiction"):
This definition of addiction was not always carefully applied (it took years for alcohol and nicotine to be classified as addictive, despite their fitting the bill), nor did it turn out to be accurate. Consider marijuana: in the 1980s, when I was training to become a doctor, marijuana was considered not to be addictive because the smoker rarely developed physical symptoms upon stopping. We now know that for some users marijuana can be terribly addictive, but because clearance of the drug from the body's fat cells takes weeks (instead of hours or days), physical withdrawal rarely occurs, though psychological withdrawal certainly can.
But now we've got it right! "It's all about the dopamine," says Nora Volkow, director of the National Institute on Drug Abuse. Only one small glitch -- your baby smiling at you releases significant amounts of dopamine: "Dopamine is involved in reward and motivation for everything we do in life -- whether we're eating good food, drinking good wine or interacting with our kids and family." What does this tell us? That addiction cannot be explained by dopamine. As I put it in my last post, addiction occurs "when a person seeks out an experience, ritual, or reward to the exclusion -- and detriment -- of all other goals and activities. The measure of addictiveness is how absorbing, compelling, and harmful to the person an involvement is. Nothing else matters." Addiction "is not a label to be applied to specific things, but to an involvement a person creates in time and space."
V. The Brain Disease Model Is Antithetical to Harm Reduction. The New York Times article linked above in which Volkow declares "a dozen times a day": "Addiction is all about the dopamine," is titled, "A General in the Drug War." Why do you think that title was dictated? Because the dopamine, brain-disease model is essential for undergirding the war on drugs. But -- and here's the irony -- it actually fatally disproves the illicit drugs-alone-are-addictive-and-thus-require-a-war model that Volkow embodies! Let's turn to handmaiden-to-the-brain-disease meme, Howard Markel, for confirmation: "Dr. Volkow's group and other scientists have used PET scans and functional magnetic resonance imaging to demonstrate similar dopamine receptor derangements in the brains of drug addicts, compulsive gamblers and overeaters who are markedly obese."
Addiction Delusions: After all is said, dopamine has no inherent or exclusive linkage to drugs. The New York Times addressed a question I asked in HuffPost, "Is Eating (and Food) Addictive?" The Times announced: "Research shows that some foods really are addictive." And that's not just for the obese, as Markel indicates is the case; it includes plain kids with ice cream. That dopamine is an omnipresent part of human functioning and rewards is now well-known. That is, except by those who insist that addiction must be a neurochemical disease steeped in dopamine.
There IS addiction; we can HELP people with addictions; but not by convincing them of the (untruth) that addiction is a part of their brain's destiny and that addicts differ from all of us.
Need help with an addiction -- see Stanton's Life Process Program.
 Deborah A. Dawson et al. "Recovery from DSM-IV Alcohol Dependence, United States, 2001-2002." Addiction 100:281-292, 2005.
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