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Everything We Think We Know About Addiction Is Wrong

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addiction
Regular readers know that I’m frequently at odds with both the prohibitionists and the addiction community, usually meaning the people and organizations who profit from the status quo viewpoint like AA and others. As I’ve written before, I don’t think alcoholism is something everyone is at risk for and I definitely don’t agree that total abstinence is the answer. If you want any background to what I’m talking about, check out Tipping The Sacred Cows Of Addiction, What Is Addiction?, America’s Addiction Treatment Goal: Perpetual, Lifelong Abstinence or Recent Addiction News Roundup.

I’ve often argued that, from my own experiences, that there as many societal and individual factors for why any individual becomes addicted to something, and it seems to be that it’s the mind rather than genetics or biology that more often determines or causes it.

Here’s yet another powerful denunciation of the prevailing view, entitled Everything You Thought You Knew About Addiction Is Wrong, which looks at ‘experiments in the 1970s by famed professor of psychology Bruce Alexander,” which revealed “that more times than not, the real culprit in addiction is a lack of human connection.”

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And that makes perfect sense to me, as I’ve observed it’s usually something wrong in an individual’s life that causes them to become addicted to something, and the addiction is the result of that, not the problem in and of itself. The conclusion of the study was essentially “addiction is just one symptom of human disconnection,” and that it’s a more “complex disease” then simply “just say no” can address. Obviously, the video below uses heroin and cocaine as examples, but it’s just as applicable for any addiction, alcohol included. And frankly, it makes more sense than almost anything else I’ve read or heard, and yet seems curiously removed from the addiction debate even though apparently its findings are from the 1970s.

It was created by Kurzgesagt as part of a series for Patreon, and was “adapted from Johann Hari’s New York Times best-selling book ‘Chasing The Scream: The First and Last Days of the War on Drugs.'”

Moderation Is Better Than Abstinence

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i-quit-turkey
I’ve long believed that AA, while obviously effective for some, is not the only way to treat problem drinking. Especially given that drinking moderately can increase one’s longevity over those who abstain, I’ve always believed that a better goal would be to take people who can’t moderate their drinking and teach them how to do just that. That’s an approach often taken in other countries, but is one that can’t even be discussed here in the U.S. without an uproar from the addiction community and the anti-alcohol wingnuts. Several years ago, I wrote about this in a long post entitled Tipping The Sacred Cows Of Addiction. And Adi Jaffe, Ph.D. echoed the same sentiment in All About Addiction, a piece for Psychology Today.

The New York Times published an op-ed piece on New Year’s Day entitled Cold Turkey Isn’t the Only Route. In it, author Gabrielle Glaser also noted how entrenched Americans are in abstinence as the only cure for alcoholism.

The cold-turkey approach is deeply rooted in the United States, embraced by doctors, the multibillion-dollar treatment industry and popular culture. For nearly 80 years, our approach to drinking problems has been inspired by the 12 steps of Alcoholics Anonymous.

Developed in the 1930s by men who were “chronic inebriates,” the A.A. program offers a single path to recovery: abstinence, surrendering one’s ego and accepting one’s “powerlessness” over alcohol.

Despite the fact that studies have shown that AA doesn’t work, it’s undoubtedly the dominant treatment method in America. So much so, that most people do in fact believe that if you’re an alcoholic you can never ever touch a drop of alcohol for the rest of your life. But the obvious problem with that point of view is that it suggests that a cure is not only difficult but actually impossible. Because learning to deny yourself something you have trouble moderating is hardly a cure. It’s a band-aid at best that may remove some of the negative aspects of one’s drinking problem, but being based on the concept of “powerlessness” means not only giving up on yourself but it actually removes any possibility of real help. It’s a bad bargain, in my opinion. But that’s where the money is, sad to say. Addiction clinics, retreats, programs, along with insurance companies, etc. don’t make their money by curing people, they make money by treating them. And if the treatment lasts the rest of their lives, then that’s the best thing for the bottom line.

Despite the dominance of abstinence-based treatments, there are a growing number of alternatives, apparently, including Moderation Management, Moderate Drinking and others. Amazon now lists many books claiming to help people achieve moderate drinking, which is encouraging.

But I love her conclusion. “We don’t treat cancer, depression or asthma with the same tools we used in 1935. We need to get away from the one-size-fits-all approach to drinking problems.” Indeed, A.A. has changed little since its inception, while our understanding of addiction, its underlying causes and the benefits of moderate drinking have all grown immeasurably. It would be great if as a society we could eradicate alcoholism, but we can’t do that by simply burying our heads in the sand and just removing alcohol from the equation. If prohibition taught us anything, it’s that such an approach is doomed to fail. It’s time to change the goal from abstinence, a nation of teetotalers, to a society filled with only moderate drinkers. That would certainly make the world a better place.

freedom-responsibility

A Clockwork Orange Approach To Alcoholism

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This is a strange one, and I’m not entirely sure what to make of it, though my natural skeptical tendencies run toward worry. As reported in the USA Today last week in an article entitled Kudzu Compound Could Help Alcoholics Quit Drinking, “[a]n ingredient derived from the [Kudzu] vine noted for gobbling up native Southeast landscapes could help treat alcoholism.

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Essentially the plant Kudzu, a vine that’s a native of Japan, later introduced in the U.S. and growing wild throughout the southeast, has been found to have a substance contained in it, daidzin, which researchers believe may help in the treatment of alcoholism. The article is based on a study published in the November issue of Alcoholism: Clinical and Experimental Research under the title Suppression of Heavy Drinking and Alcohol Seeking by a Selective ALDH-2 Inhibitor.

But here’s the odd bit, at least for me. The Daidzin found in Kudzu (and which the scientists now believe they can synthesize) makes “drinking alcohol an unpleasant experience.” Isn’t that how they treated the violent kids in Anthony Burgess’ novel A Clockwork Orange? In the novel (and film by Stanley Kubrick) the protagonist undergoes “a form of aversion therapy, in which Alex is given a drug that induces extreme nausea while being forced to watch graphically violent films for two weeks.”

Apparently using Kudzu in this manner is an ancient Chinese folk remedy, thousands of years old. To learn more about it, check out The Amazing Story of Kudzu. The addiction community seems interested. “The results seem promising, says Raye Litten, co-leader of the medications development team at the National Institute for Alcohol Abuse and Alcoholism. ”

But I can’t help thinking that’s still not the right way to treat addiction. I suppose if it’s reserved for the very extreme cases or is done voluntarily, but still I worry. Remember when fluoride was added to the drinking water? Sure, dentists are convinced it helps prevent cavities, but not everyone is so sure, and even today there are people who don’t believe it. (Doc, this would be a good place for you to chime in.) My mother — a nurse — and countless other parents complained and protested when they added it to the school water fountains in the mid-to-late 1960s. What’s to stop certain groups from trying to add this to the water to stop all people from drinking alcohol? Sure I sound paranoid, but it sure would make a good action/adventure flick, don’t you think?