Addiction in Society

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

Rehab as Cause of Death

While American addiction experts self-confidently proclaim the success of their methods, it becomes increasing clear that 12-step recovery is a risky business and that the United States does more than any other nation to kill addicts and alcoholics. Read More

Death after rehab

I don't quite see why you characterize Ethan Nadelman's comments as "startling." They are true and supported by voluminous amounts of data and are not just his personal opinion. You may not agree with him and that is your prerogative but to denigrate his statement and refer to it as "startling" is wrongheaded and simple minded.

Wow -- here's someone

who thinks I'm against Ethan N. and his idea that our 12 steps/abstinence mania kills addicts due to my use of the word "startling" (which he says is denigrating), showing that I am "wrongheaded and simple minded."

John, if you had to summarize my blogpost, what would you say my point was? Did you happen to see that I repeated Ethan's point further down in my post, and quoted him again from his interview? Wouldn't that tend to indicate that I like and respect what he said, and that his conclusions are startling to the field in a way which I indicate should be paid attention to?

It doesn't really pay to actually write anything -- does it? I'm going for a drink.

(John, I'll send this to Ethan -- if he responds, I'll let you know what he says.)

Oh no -- you're right John!

Yup, he’s right. “Trenchant comment” would have been more accurate than “startling declaration,” not least because it’s the sort of thing I’ve been saying for a couple decades. EN

Nadelmann say natural fit between 12-step recovery and harm reduction!!

Stanton, what do you make of the paragraph below the one you quote?

"But there can be a natural fit between 12-step recovery and your goals?

Yes. The 12 Steps and harm reduction share some things: The notion of one step at a time, one day at a time; the importance of peer groups; the important role that dignity plays. This is why I admire Howard Josepher—he has both harm reduction and recovery programs. Some of the most significant leaders of the harm reduction movement are in 12-step programs. They say, “I have hit a point where I realize I cannot drink or use drugs; the 12-step approach worked for me,” but they've also seen many people where it did not work. They realized they needed a fallback strategy, and therefore see 12-step and harm reduction as complementary. On my board, on my staff, in the drug policy reform movement, one of the most dynamic and fast-growing elements is people in recovery."

Nadelmann when he refers to the "12-step" thing clearly is critiquing the conflation of 12-step ideals with treatment and the criminal justice system, not 12-step itself. The charge you make that people in 12-step recovery are ideologically opposed to harm reduction is somewhat undermined by the fact that 'Some of the most significant leaders of the harm reduction movement are in 12-step programs' and he has 12-steppers his board and staff. His elegant description of how the 12-steppers he knows are able to reconcile their own choices with other peoples realities is quite moving and quite frankly shows your cartoonish caricatures of people in recovery for what they are.

Most people in recovery I know, including myself, are NOT hostile to the health and welfare needs of our peers, let alone doing "everything we can to ensure that addicts who continue to use die!?!".

Indeed it is through bitter first hand experience that many people in recovery know of the pressing need for harm reduction(without which many would not have made it) and the futility and harm of the war on drug(users).

Here in Australia, NA members were among those who started the first illegal needle exchanges (as was the case in the Netherlands) and early harm reduction efforts were very much in tandem with recovery ideals and efforts before they became professionalized and medicalised. People in recovery have continued to be active in the harm reduction movement and at the forefront of services such as needle exchanges, safe injecting rooms and even leaders of drug user organisations.

And your charge that "the American recovery movement says they are as good as dead if they continue to use, then does everything it can to make sure that this happens." ?!!? this is really hostile and inflammatory stuff.

Do you have any evidence that peak organisations such as Faces and Voices of Recovery is doing "everything it can to make sure addicts die if they continue to use"?

What do you make of the fact that they gave an award in 2013 to an organisation called PATH that actively promotes therapeutic justice measures and harm reduction policies such as Good Samaritan laws to reduce overdose deaths and ... Moms United to End the War on Drugs.

http://www.facesandvoicesofrecovery.org/about/trainings_events/ahr_2013/...

If I sound offended it is because I am. It is one thing to critique the rehab business and 12-step but this relentless demonizing of people in recovery is really repellent, counter productive and demonstrability misinformed.

It's an honor

(almost) to be put down by such a high-class comment and commenter!

Maybe you can help me to make peace with Ethan (how many times have we conflicted over this at dinner?)

Here is my problem: While I certainly don't want to demonize recovering people, I believe that recovery thinking is ruining the world. I mean, Ethan -- a highly successful human being who is doing much good -- is in a different business from mine, but is it strange to say, in one sentence, that recovery thinking has led to 100,000s of deaths in the US, but recovering people are playing a good role in drug policy reform?

More fundamentally, teaching people that they are powerless over their addictions does not fit well -- I don't care how many organizations give how many awards -- with the idea that we need to change our approach/policy/laws towards/about addiction/alcoholism. Recovery thinking opposes a basic reorientation in thinking that we must make -- that I believe we will and are making -- in order to survive as a species. But there is a chance we won't make it, and we in the U.S. will "happily" experience more and more addiction and addiction death (see comments by Hazelden's chief medical officer in the wake of Cory Montieth's death -- http://www.cnn.com/2013/07/15/health/addiction-relapse-cory-monteith/ind...). Sorry!

Along with that basic contradiction is that your Australian formula for combining recovery and drug policy reform doesn't work here. In the U.S., recovery thinking is more of a liberal proposition than a conservative one. So leading liberals in recovery (most notably Patrick Kennedy and William Cope Moyers) are the most vocal opponents of marijuana et al. legalization, since their views are that drug use (their drug use) can't be controlled, and therefore society can't control drug use. Sorry!

But things are worse than that. In Europe and the U.K. a forceful imposition of 12-step thinking has become a significant counterforce against harm reduction -- which, as Ethan points out, has saved hundreds of thousands of lives worldwide, and killed hundreds of thousands of people here. See my post "AA is Ruining the World" here: http://www.huffingtonpost.com/stanton-peele/problems-with-aa_b_989832.html. Sorry! (The funny thing is that when they seek someone to argue against this thrust, they look to either Ethan or to me -- and Ethan roots me on!).

This is a very serious conversation we are having. Ethan sees people like you as important, crucial allies -- you're not going to change drug policy in the U.S. confronting recovery people, who completely control the conversation here. But I am in the business of epochal thinking -- how cultures conceive and confront substance use, addiction, and -- yes -- the possibility/likelihood of recovery. And the only way this conversation can advance is to get beyond the cultural-historical anomaly of the 12 steps that the U.S. has foisted -- and continues to do -- on the world. Sorry!

But -- and here's the hardest thing to say -- I believe that 12-step thinking -- even aside from preventing and prohibiting needle exchanges, heroin maintenance, wet housing, and which has thus killed many more people than it has saved through those policies -- has actually killed many more people than it has helped at the level of individual recovery -- e.g., Cory Montieth et al. It's a self-contradicting way of thinking that prevents most people exposed to it from making the changes that people actually most often (although not always, which gives 12-step recovery room to operate) make on their own. I'm sorry to tell you that this is true -- you seem like a very nice person. But do you think I should stop saying these things if I think that they are true -- and the evidence is inescapable that they are?

If you can help me to see the error of my ways, it will improve my dinners with Ethan -- and I love Ethan. If, on the other hand, I am right -- and do keep in mind that I have anticipated every development in the addiction field in the last fifty years: that addiction is not linked specifically to drugs, that harm reduction is possible/typical/the best way to go, that practical-goal-oriented treatments are far superior to the bullshit spirituality of AA (sorry, that just burst out of me) -- then my voice is an essential one to be heard.

So what's your verdict?

Yours sincerely,
Stanton Peele

P.S. Oh, OF COURSE, people (you) should quit whatever substance you want to/feel you need to (starting with smoking -- by the way, did you join a recovery group to do that) -- REMEMBER, one of my big arguments is with the methadone (disease) people who say people have a metabolic disease that means they can never leave narcotics behind -- a patently absurd/wrong message that it is immoral to tell people.

Why Thankyou Stanton

I'd be delighted to help improve Ethan's dining experiences with you.

'Recovery thinking is ruining the world' now that’s a big call - rising sea levels? overpopulation? peak oil? I can't quite see the connection but then you're the addiction expert.

I know you get terribly upset about this powerless thing, but think of it this way - powerlessness just is a recognition of the need for help - many people send years trying to prove to themselves they have power over their addiction, (“this time it will be different”) before they finally surrender to that fact they don't.

You don’t need to surrender to a god, reality will do.

After all, if you did have power over your addiction you wouldn't need help of any kind, whether it be your little for-profit outfit Life Process Program or 12 step.

By the way if a client of yours dies after saving thousands of dollars by avoiding those nasty rehabs, do you acknowledge that your treatment program caused their death, after all, from your article I gather that if A happens and then B happens then, it follows that A caused B, post hoc ergo propter hoc, that's how it goes, doesn’t it?

In fact if I did have power over my addiction I could click my fingers and *poof* it would be gone - just like that. By acknowledging that I'm powerless over my addiction, not only am simply facing facts, I stop struggling with myself and I can direct my energies into discovering and accessing a power that IS greater than my addiction.

Whether its external or internal is irrelevant, besides that self/other thing is sooo 20th century. It’s not what the higher power is or whether it exists or not, it’s my relationship to it that matters.

At first that was sheer blind hope, terribly old-fashioned unscientific concept, I know, but it worked for a while. Then it was my friends in the rooms who were able to give me advice as to whether whacking half a gram of meth before a night shift at the nursing home would be a good idea or not - they can still be helpful at times.

I cycled through the atheist version of G.O.D. i.e. good orderly direction (gets boring after a while), group of druggies (see above), great out-doors (I still like that one). For a while I worked with the “observing self” they talk about in Acceptance and Commitment Therapy, but it just stares at things, doesn’t do anything, friggin useless!

Then eventually I settled on my future self. Yes, I got my concept of a higher power from a superannuation seminar. What would my 65 year old self (who has a more-than-just-financial interest in me making it to that age) advise me to do, not terrible mystical I know, but that's bullshit 12-step spirituality for you. Hey, note how I surrender to myself to gain power over my addiction, cool huh! Call it “make believe”, pretend, act of creative imagination, paradoxical, self-contradictory, who gives a f**k. Practical goal oriented approach, tick!

In short I know that concepts of powerlessness and higher power deeply offend the Western, self-reliant, rational, solitary, asocial, autonomous, internal focus of control, hairy-chested big-balled, ‘I don’t need anyone’, master-of-my-own-destiny image we are expected to revere as the ideal human life. Whereas us 12-steppers who lead lives of relying on others and having them rely on us, lives of mutual support, of social interdependence with other human beings who’ve shared our experience - heeding the advice of people you love and respect, who love and respect you - is - as we are so often told, surely the lives of debased, pathological weak personalities.

You say that “teaching people that they are powerless over their addictions does not fit well with the idea that we need to change our approach/policy/laws towards/about addiction/alcoholism.”

So are you saying we need to go back to the freely chosen, rational choice idea that is at the centre of the moral model – that drug use is always a freely chosen act of will - based on a conscious rational cost-benefit calculation – well that certainly fits the uber-He-man ideal.

If that’s the case then all you need to do to tackle the drug problem is raise the costs ie jail, disease, death and minimise the benefit, and people will just stop, right?

I’m not actually a big fan of the 12-step disease model - what was meant to be a functional metaphor, an early version of the holistic bio-psycho-social model, an antidote to the prevailing moral model, has become hopelessly conflated with the bio-medical disease model.

The bio-medical model tells us that addiction in us humans (who after all are no more than walking bags of chemicals, bumping into other bags of chemicals) can be treated by adding more chemicals, which will automatically sort out that other fluffy stuff that doesn’t really matter cause it doesn’t fit into the bio-medical model – things like thinking and emotions, and relationships with friends and families (except in so far as they are other bags of chemicals), environment, society, culture, yadda, yadda.

This is indeed a very serious conversation we are having. Recovery thinking is a threat to the survival of the species, you say! I had no idea the stakes were so high. I’m grateful, therefore that you have deigned to answer my comment.

I don’t have your track record of anticipating developments in the addiction field or much experience in the exalted “business of epochal thinking”, but I am also fascinated how cultures conceive and confront substance use, addiction, and recovery, all of which I see as fundamentally social and cultural, hence the need for social and cultural approaches both at the individual level (12-step) and collectively (drug policy reform) - Crap! We may even agree on something?!

Interesting that you can’t accept Ethan's observation that recovering people are playing a good role in drug policy reform. You find Ethan’s nuanced take on things strange. Yes, imagine that, 12-steppers not behaving to stereotype. It must indeed be disturbing to have friends that can acknowledge that people don’t necessarily stay in the neat orderly boxes we try and cram them into. It's much easier when the world is black and white, good and evil, isn’t it.

Perhaps those evil 12-steppers that have surrounded Ethan will take him out when he least expects it, after all as you say "we will do whatever we can to ensure that addicts who continue to use, die".

Of course, you have already warned him of that, haven’t you? I am beginning to understand why dining with you has become such an uncomfortable experience for him. Not sure if I have helped either of you out, but give him my regards and do let me know how dinner goes.

Yours sincerely,

Jock M

Crap I do agree with you?!

Right with you on the methadone forever nonsense.

Rehab deaths...

I don't know that people are more prone to dying after rehab. I do know they are very prone to accidental overdose or poisoning before going and many have several ER admissions (which you never hear about) in which they are close to death from drug and alcohol overdoses. People in recovery are pretty closed mouth (outside of meetings) about their experiences with hospitals prior to rehab and many are told by their doctors, who may or may not be "Recovery" friendly that they should never have another drop as it may lead to the binge, given their past history of lack of control in the quantity they take, that finally stops their respiratory systems and kills them. Experience shows that for most alcoholics, of the kind that ultimately finds themselves in a 12 step meeting, no doctor of any standing would feel comfortable in telling someone with this level of compulsion that a few drinks are OK. (Given the clinical history and piles of medical documentation, on alcoholics just trying to "have a few", 90 % of which have never seen the inside of an AA meeting or rehab, it would likely constitute malpractice). Most people at meetings have a near death experience due to the abuse of alcohol and a related hospital admission due to the nature of the illness and the craving required by the basal bundle in the brain (which has been programmed to treat alcohol as a primary reward like breathing, eating, sex and sleep in the predisposed alcoholic). No amount of rational thought from the cerebral cortex can stop someone from consciously holding their breath for an indefinite amount of time. FMRI's show activity in this area when it comes to alcohol consumption. So it is no wonder that alcoholics regularly drink to the point of death.

Wait for the results of the autopsy

Because it could just be cardiac arrest. It happens in young healthy fit men, under 35 but with an ignored underlying issue and has the sudden death syndrome or SDI, but goes on records as " natural causes".

And don't bite my head off please.

He seemed a nice and level headed young man, so sad.

PS: The brother of Amy Winehouse blames bulimia for her death, not addiction, he says " she would have died eventually the way she was going". A charmer that one, the starving killed her not the 416 mg of alcohol in her blood. One hell of a dysfunctional family. He does not look like he follows a diet.
Her father and brother work for the foundation they set up, called the Amy Winehouse foundation, ain't that sweet. Maybe the anorexia revelation ( like we had not noticed) means they are expanding in the eating disorder market.

Always good to wait but,

early reports (this from USA Today) were he wasn't abstinent, and "watering holes" are usually bad places for people recently out of rehab (combined with police statement he returned to hotel in the early AM):

"TMZ.com also recapped the actor's last days, saying he spent them hanging out with friends in Vancouver and enjoying a few cold ones.

Monteith was also reportedly spotted hanging out Friday night at two local watering holes, the Roxy and the Queen's Republic Nightclub."

http://www.usatoday.com/story/life/people/2013/07/15/monteith-autopsy-up...

There will be a frenzy of made up stuff.

I assume the few cold ones is not cold fizzy water on tap.

If he had "fallen off the wagon" , the fault will be him or not - addiction is a disease - but not with abstinence model.

He was in crazy show, so expect crazy stories. I hope decency and compassion are shown to his family, friends and girlfriend but I am not holding my breath.

Ok so it was a few cold ones and heroin.

There is nothing worse than combined alcohol and cocaine for your liver and especially the heart.

You tolerate well and then one day you go into heart failure. Alcohol and heroine ouch.

Addiction is an addict in action

Before it is labeled a disease, it is labeled a syndrome. Before it is labeled a syndrome, it is labeled a condition. For the addict in action I believe that in varying degrees of intensity, frequency, and duration the condition is a lack of substance. To overcome a lack of substance, the addict in action abuses substances for substance. The action is compensatory, it serves a purpose and in all purposeful behavior, such as substance abuse, the goal is to feed the human condition.

The human condition is a wanting condition never satisfied, it is a condition of wanting competence and independence. At least this is the goal of early substance use, however, when substance use transitions into substance abuse, the want is out for the need to avoid incompetence and dependence. The solution to the problem is then the problem, for the inadequacy of incompetence fosters the need in dependence, the dependence of substances. Of course this is a matter of perspective, a perspective of control. To surrender control is to surrender the human condition. To surrender the human condition is to live the grateful dead; grateful to be sober but dead, flat-lined to a life of substance (e.g., challenge, purpose, and fulfillment). How does one rehabilitate the human condition let alone institutionalize that process?

rehab

All this rehab stuff has left a bad taste in my mouth and thankfully, Stanton cuts through all of this "bullshit." Until recently, I kept an open mind about rehab and AA. That was until the realism of addiction surfaced when my spouse admitted to having a secretive narcotic problem that escalated over an eight year period. Because my wife is medical support staff at a local hospital, she was sent to a rehab which was financially covered through insurance at work. It turned out this rehab followed the 12 steps because that is how they justified the $20 000.00 price tag for 60 days of treatment. One thing they won't help you with there is smoking; the smoking pit and cigarette sales in their store see to that. Needless to say, the many problems that surfaced in our marriage over her addictive years very damaging. But I can honestly say that more damage is being done to our relationship now with my wife hopelessly stuck in AA.

Loving someone with an addiction is hard going.

And I have been on both side of the dance.

AA or AACult totally depends on people believing they are defined by their faults and failings, it Puritan branding all over again but with a “ I am free do your own stigmatization thank you ” sticker .

You swap one identity "addict" for "in AA". Maybe there is safety in that, in the sense of belonging in being in a group when your sense of self is so fragile or you feel so powerless as yourself, but anything that start as a crutch will be a strait-jacket if it does not allow for change.

typing too fast - typing too fast - makes no sense.

Sorry should not say - I am free do your own stigmatization thank you -

It should be - I am free to do my own stigmatization thank you -

It looks like progress that you can highlight a fault and not be run out of town , but you are still stuck with an bad brand forever that reads - POWERLESS & IN RECOVERY FOR EVER.

A Cause of Death in a Different Way

I'd make the case that lung cancer and other smoking related illnesses are the leading causes of death stemming from rehab and AA.

I'm a member of AA, and one of my biggest beefs with it is how cigarette smoking is so widespread among members & so widely accepted. Fortunately, all the buildings have gone no-smoking, but if a group decides to have the meeting outside in nice weather, there will be a mushroom cloud over the group in a matter of minutes.

Yet, it seems like I'm the only one who wonders whether the smoking goes against the "attraction rather than promotion" concept in the Twelve Traditions...

Dr. Peele, this tidbit may interest you...there's an inpatient psychiatric center near my house where the on-site AA meeting was recently disbanded. Stated reason was the center's patients simply weren't coming to the meeting. Even in a psych ward, you have to figure a good percentage of the patients also have substance abuse problems.

Rehab

Are you SERIOUSLY trying to make the supposition that Treatment Centers kill people and that AA is a bad thing? I take it you are not an alcoholic or an addict, have never been to rehab and do not know what the 12 steps entail. Yes, Rehab is a billion dollars business but it has helped MANY people including myself to recover. (I’ve been sober for 12 years) The fact that some people die after leaving treatment is because they choose to use and EVERY alcoholic knows to drink is to die. It’s an advancement of their disease and NOT a failure of the treatment center or AA which has helped millions of people recover from alcohol addiction. Your article is so blatantly irresponsible and will lead to many not seeking help because of it. Shame on you!

Shawn P:

What's your reaction to E. Nadelmann's statement that 12-step nuts, who couldn't accept any use, sent 100,000s of injecting American addicts to their deaths unlike in other countries where abstinence nuts don't hold sway (like Britain, Australia, and Holland) and active clean needle programs were established?

What's your reaction to the death of George McGovern's daughter, drunk on the street, after being in and out of rehab, because she could never learn how to love herself there, but (according to DOREMI above) might have learned the opposite?

Or are these questions you, I, and PT Blogs are not allowed to consider because you haven't considered them?

"The fact that some people

"The fact that some people die after leaving treatment is because they choose to use and EVERY alcoholic knows to drink is to die."
I thought people who die after 12 step treatment do so because they have a disease and weren't working the steps.

Hey Shawn

Maybe the many will google Stanton Peele and check out one of his books on addictions or his website.
Some of the books are listed on this page, on the right.

My steps

1) I am not powerless over alcohol/ sex/ drugs / food —my life may be unmanageable, but if I got myself in a mess - I - can retrace my steps and find where I f*** up, one molehill at the time and use tools to get myself better. I will start by blaming my parents and their parents, then understand them and move on.
2) I can restore my sanity, the Power greater than ourselves is still trying to work out world peace, poverty and world’s hunger.
3) I am not turning my free will over to someone who made me from a guy’s rib. I just got the right to vote, to have sex with marriage and bank account in my name fairly recently.
4) I don’t need a fearless moral inventory to work out that I am f**cked in this moment in time .
5) I will admit my wrongs to a good friend or therapist (confidential) not complete strangers.
6) God can’t remove defects of my character (as he is still working on world peace)
7) My shortcomings are the yin to my yang, I love them all so they stay.
8) I don’t do lists of people , life lessons don’t come in Tiffany boxes with bows on them. Life is not a Hollywood movie, the good guys don’t win. I will not go on Dr Drew.
9) Made direct amends by being someone people want to be with and not cross the road from. I will walk the walk and let my actions talk the talk. Some bridges get burned for good reasons.
10) I will listen to myself and not conform to what someone wants me to be.
11) I will seek better understand of myself to avoid self harm and leave God to work on world peace, poverty and world’s hunger.
12) I will not become one of those rude, intrusive, lecturing, boring sanctimonious sobriety evangelists who ask me if I want to be saved and who make me feel bad for drinking my wine, but who gets offended when I ask them about their women-hating degenerate cousins in Texas. I will use my spiritual awakening to work on world peace, the working out the sound of one hand clapping, the education of women and the worshipping of men who truly love women and don’t fear them.

Pretty damn good,

DOREMI. Edit it and send it all over the Internet (if you haven't yet).

Editing

1) I accept that I have power over my addiction even as my life has become unmanageable.
2) I, and I only can restore my sanity, I will use all the help I can get while rejecting shaming methods.
3) I make the conscious decision to exercise my free will to restore my sanity.
4) I work to locate my inner strength and resilience, or gain those attributes.
5) I will admit my problems to an medical expert and someone I can trust.
6) I will not need to remove the “ defects” of my character just my learned and handed-down defective responses.
7) I will accept, work and learn to love my shortcomings because I am not my introject.
8) I will achieve awareness of the damage my addiction has caused using compassion not guilt.
9) I will try to make amends while not seeking sainthood or feeding my ego.
10) I will listen to myself and practice self-respect always, trying to be a good person but not conform to what others want me to be.
11) I will seek better understanding of myself to avoid further self-harm and respect mother nature because respecting her means respecting myself.
12) I will love my fellow human beings because loving them is loving myself. I will offer help if asked, but I will listen first and always with compassion.

http://www.youtube.com/watch?v=ULKmb3_P_N8

And I will enjoy every sandwich.

THE TWELVE STEPS OF MINDFULNESS AND COMPASSION IN ADDICTION

THE TWELVE STEPS OF MINDFULNESS AND COMPASSION IN ADDICTION
1. I accept my own power to combat my addiction even after my life has become distressed.
2. I, and only I, can restore my sanity. I will use all the help I can get -- so long as it isn't shaming or belittling.
3. I make the conscious decision to exercise my free will and to develop my ability to do so sensibly.
4. I will work to locate my inner strength and resilience, and/or to gain or augment those attributes.
5. I will admit my problems to myself, my friends and family, and my helpers/counselors.
6. I will work to improve these problems and my defective responses to them, but I will reject NO part of myself or of my character.
7. Because I will not reject myself, I will accept, work with, and learn to love my shortcomings like all of my traits.
8. I will be mindful of the damage my addiction has caused, and will correct it and be compassionate to myself and others for this damage.
9. I will try to make amends without either shaming or belittling myself or feeding my ego.
10. I will develop my mindfulness to get a better grasp of myself, to avoid further self-harm, and to cease or reverse any harm I do to myself or others.
11. I will be mindful of and meditate on my love and respect for this world and my life in it.
12. I will love myself and express compassion to and help others (without being intrusive or patting myself on the back) -- for compassion for them and love of myself go hand in hand.

Shame on you

Your subjective ignorant musings are irresponsible.Dr. Peele
bases his statements and opinions on hard clinical data, a vast
body of it. Your idiotic assertions are predicated upon the idea
that inpatient 12 step based rehabs are the only model of treatment as well as totally ignoring real aspects of mental
health care, treatment by trained clinicians for the emotional
problems, psychological issues and life circumstances that
cause excessive use of drugs/alcohol. "Every alcoholic" (a term
so imprecise and loosely defined it is meaningless) does not
"know to drink is to die." How dare you purport to speak for
all those who drink too much the vast majority of whom will not
die.It is not a progressive fatal disease.Dr. Peele has done
real research as well as having a volume of imperical observation
of those with substance abuse issues that you do not.You are
spouting lies made up by Bill Wilson with which you have been
brainwashed. Were your psychological health to be evaluated by
a trained psychologist using objective clinical standards as
they've been created by decades of hard science and study I
doubt you'd be described as well adjusted. If you were it would
be because of your foundational psychology which existed from
about the age of 16 and your life situation family,relationship,
job, finances and a host of other things. To think that your
personal anecdotal story and uninformed assertion about the
millions of people "helped by rehab and AA" outweighs Dr.Peele's
serious expertise in his field is the height of arrogance and
ignorance.

Market for AA Expats bigger that the Recovery market ....

As some have figured out, and have begun to make a living from it, the population of disaffected AA members is probably much larger than those who live by it's disciplines. Despite saying that there is no accountability and that everything is put on the disease and the alcoholic takes no responsibility for his past actions claiming the devil made them do it, ironically, Step 4, where you are actually held to some account for past actions, is the real thing that sends them running from the rooms by the dozen. (about 90% are unwilling or unable to begin taking responsibility for the damage caused by their drinking. This includes a full financial accounting and restitution for all monies owed, stolen, taxes, etc., full and frank apologies to family and friends harmed by their addiction, ) This will regularly require an individual member, in case someone may be in prison for a crime they committed under the influence, to turn themselves into the police for past crimes. While ultimately it is the individual's choice whether they do so or not, I have seen several members do just that, some of which are given suspended sentences due to the length of time past and some of which are convicted and do the requisite time in jail. I know of a case where people turned themselves in for a 20 year old murder only to be released within 24 hrs. as their confessions could not be corroborated due to the length of time since the murder. Most of the anti's on this and other websites are most likely 4th step refugees, the bigger their crimes, the louder and more elaborate their objections.

Thank you for writing this

I've been a sober member of AA for over 20 years but more and more I now see how harmful its choke-hold on nearly all available treatment in this country is. People with addiction problems are assumed to be worthless, lying, unloving, and less than human because of how Bill Wilson viewed alcoholics in the Big Book back in 1938. Most women, and many men, come to AA already thinking they have no worth, then they are told to abolish their ego and constantly look for their defects and how every thought they have is probably selfish and self-centered with self-centered fear. After so many years of that a person can start assuming self-hatred is the mark of "recovery".

One thing your article didn't stress enough is the idea of relapse shame. We are told in AA that to have one drink is as much of a relapse, failure, and loss of status as a week-long binge. And we are told that once we have the first drink we cannot stop. Is it surprising that a person who takes that first drink is quite likely to go on to consume a huge quantity of alcohol/drugs? If you are going to lose your "time" and have to "start over" and face shame in "the rooms" you might as well get your humiliation's worth, and they said you couldn't do any different anyway.

min-vans -- you and I

have to team up. This is great -- please send it everywhere -- I'll put it up at Facebook.

AA makes many people drink more, wonder why?

I have been helping people with addiction for 19 years, using hypnotherapy and NLP. It is empowering, giving a person their power to create a healthy mind and body. So many people who confide in me tell me that AA meetings make them want to drink/use more. It is no wonder, you surround yourself with sad people, who all are to feel powerless and scared, and live in the past mistakes and any of us would need a bottle!
Different world that we are creating with a new paradigm of addiction treatment.
If AA did not work for you, it is said that you did not hit "your bottom" or you did not "surrender".
That is simply bad programming and will only make you dive deeper into hopelessness.
THere is something different, that works without shame and defeat of the spirit.
www.theaddictionproject.com

I find bodywork combined with

I find bodywork combined with cognitive therapy really helpful. Addicts deny the reality of what is happening in their body, sometimes the logic thing to avoid reliving past traumas.
When unwanted emotions surface during therapy, massages really help reduce the stress these bring to the body and ground you.

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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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