Addiction in Society

Addiction—the thematic malady for our society—entails every type of psychological and societal problem

On the "Honor" of Being Selected One of the Most Influential Addiction Experts in America

A new 12-step journal selects me as most influential - then slays me

The Fix is a new, highly-touted, on-line 12-step recovery magazine. It currently has listed "America's Most Influential Addiction Experts." Dr. Drew is listed first; I'm tenth.

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. I was selected as A.A.'s and Recovery's fall guy because of my "stubborn resistance to abstinence and A.A.," which Fowler feels have 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This makes me "a little outdated in a field that's ever-expanding in knowledge."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 (whom Fowler expresses her own reservations about) 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 that Heavenly enclave.

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(These quotes, which appeared in the original piece, have now been removed from Fowler's article.)

As it is, I beg to differ with Ms. Fowler about what the science shows. Indeed, we have different views about the nature of science. Like many (including Nora Volkow, also on the list), Ms. Fowler thinks that doing laboratory research proves that something is scientific. It's not. Science is research and thinking that accurately describes reality and directs effective interventions. AA and the 12 steps, as well as Volkow's brain images, do neither.

As for my scientific credentials, some regard The Meaning of Addiction as a landmark in the modern conceptualization of addiction. At its core, my model is that people become addicted to powerful experiences, whether pharmacologically generated or otherwise, and that cognition and culture impact the nature of these experiences and their addictive potential. I am the forebear of the new recognition that addiction is not limited to drugs (which I first announced in 1975 in Love and Addiction, and which DSM-5 is only coming around to acknowledging in 2014), harm reduction (The Fix's bête noire) and the CBT and purpose-drive approaches that are at the forefront of contemporary addiction treatment.  Unlike Dr. Drew, I have published in the leading addiction journals in the United States and internationally.

I disagree, of course, with what Ms. Fowler imagines clinical and "scientific" research 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 "Twenty 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 of 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.) The advantages of wet housing both economically, and in tems of reducing alcoholic drinking (even while not achieving abstinence), has been shown in medical journals like JAMA.

NESARC represents a different version of science from what Ms. Fowler imagines it to be. It is 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 of 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 -- which includes utilizing these insights in my Life Process Program for addiction treatment.

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. In fact, although several of my colleagues were upset at the way I was depicted in this publication, I feel good to be recognized - even by the enemy - as one of the most influential figures in the contemporary addiction field.

Of course, when they say good things about me, that will be a real breakthrough!

 

Stanton Peele, PhD, JD, is the author of Recover! He has been a pioneer in the addiction field since publication of Love and Addiction in 1975.

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