I'm in Europe, conducting workshops about drug and alcohol use, addiction, and policy. I was first in Scotland, where I debated Neil McKeganey in Glasgow and Edinburgh. Now I've been in Copenhagen (Denmark), speaking with Street Lawyers, a group representing drug users and addicts. Next I go to Liverpool, to present to the staff of the International Harm Reduction Association.

In Europe, AA nuts are evident, but not nearly so much in control as they are in the U.S.  Nonetheless, in my presentation, I show the decrease in drug and alcohol abuse and dependence that occurs over time. The data I present are STRICTLY from American goverrnment sources. A typical table from the annual American National Survey on Drug Use and Health looks like this (the two columns represent the age group, and the percentage of those in that age group diagnosable according to DSM-IV as abusers of, or dependent on, drugs or alcohol):

Age Group  % Drug/Alc Abuse/Depend

16-17                           17

18-25                           22

26-29                           15

30-39                           12

40-49                             8

50-59                             5

60-64                             4

65+                                1

(Statistical note: This is a one-year snapshot of people in these age groups.)

Note the steady decline with age in substance abuse and dependence (as diagnosed by DSM-IV) in these government data, in a study designed by the National Institute on Drug Abuse (NIDA). Every piece of research ever conducted finds this "maturing out" phenomenon. To wit, if you turn to the National Institute on Alcohol Abuse and Alcoholism's (NIAAA's) website, you find written there:

Twenty years after onset of alcohol dependence, three-quarters of alcoholics 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 receive specialty alcohol treatment (AA, rehab).

Okay, so this is reality, as established by the NIDA and the NIAAA, two American government agencies who believe in and strive for abstinence from drugs altogether, and from alcohol for those diagnosed as alcohol dependent.

Now, what does someone in the audience always say? You don't know? It happens every time I present, in Europe or the U.S.

"Yes, there is that drop off because alcohol and drug abusers die in such droves." 

In other words, according to this vision of the world, 7 percent of all 18- to 25-year-old Americans die annually of alcohol and drug abuse, since the prevalence of drug/alcohol abuse/dependence drops by 7 percent for the late 20s age group. Do you believe that? Because if you do, you are psychotic.

In the United States, the Centers for Disease Control and Prevention tells us, 80 young people ages 15-24, out of 100,000, died in 2007. Let's see, that's 8 in 10,000 (or .0008, or .08 percent) of people in this age group who die of all causes combined each year.

So, let us say .0007 young people in this cohort die from drug- and alcohol-related causes each year (which is a wildly high proportion of these deaths--the CDC lists causes of death, and drugs and alcohol are not even on the list for this age cohort, although accidents are). If the objector believes that 7 in a 100 American young people are dying of drugs and alcohol annually, then he is 100 times removed from reality.

Now, what is the objector's background? That is, how did he or she come to be at my seminar? Of course, they're from AA/NA.

They are not stupid (okay, maybe a little). They are simply expressing the AA vision of the world that young people are dropping like flies due to drugs and alcohol, and that death is the only possible alternative to continued substance abuse (other than joining AA and remaining in it for the rest of their lives, of course). After all, the questioner and all the drug and alcohol "experts" she knows endangered their lives until they were saved by AA.

Now, if this vision of reality is true, then America's all-out war in drugs is justified; we're experiencing a genocide against young people. So let's have at it!

You know, the funniest thing in all of this is that likely some prominent drug policy reformers are in the room listening to this interaction. Never once has one reacted to the AA nut's comment, never once. 

Yet, the view the AAer is spreading, and which is widely accepted, outdoes a hundredfold all of the efforts of the reformers. They are sitting there with their hats in their hands watching all of their efforts turn into dust.

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P.S. See fan mail at the Comments section, not all of which is as positive as the following:

Keep it up Stanton
Submitted by Anonymous on September 28, 2011

Bravo Stanton!!!

I am an Addictions Counselor who facilitates 5-6 groups a week in an out-patient program in Canada. When our clients complete their first orientation session after their initial intake, our first slide is on the importance of "Harm Reduction" in our recovery group program. We allow the clients to define what their own "recovery" will be and we respect the fact that some clients' are attending our groups to reduce the harms associated to their substance misuse. We have had great success in having both clients who want to reduce and clients who have identified complete abstinence as their treatment goals in the same group. There is room for co-existence.

We often refer to substance abuse as an unhealthy coping strategy at dealing with life issues and expose the clients to new, more adaptive strategies to these matters and if it improves their quality of lives in the process, then the clients' define their treatment as a success or if it needs to continue to be worked on.

No one in our groups gets up in our group sessions and define themselves as "Addicts." We often discourage that. We encourage clients to identify themselves with the other more positive qualities they have in their lives. We focus on what they value and cherish in their lives and encourage them to set goals in those areas. With that, they then obsess less on "Not drinking anymore" and focus more on positive goals that sees them engaging or re-engaging in areas of their lives and gives them a sense of purpose (i.e., family, volunteering, health, etc).

I have been a supporter of yours and your approach with regards to substance misuse and your influence is ever present in my everyday practice. Thank you and keep standing up for Harm Reduction, an approach that allows the client to define the change they want to see and also avoids the imposing of goals by those who categorize those we see as being in "denial" or unable of change. In my experience, telling clients what to do is not a successful approach!!


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