When I paid tribute to the remarkable career of Alan Marlatt, a colleague for decades who died in 2011, I naturally thought about my own career. I have presented a wide swath of unpopular, "radical" positions. It occurred to me that most have now been accepted by mainstream addiction science.
1. Of course, my most radical position was to base my 1975 book with Archie Brodsky, Love and Addiction, on the essential insight that addiction was not a side-effect of drugs, but a universal experience characteristic of powerful human involvements. In 2013, American psychiatry, in DSM-5, for the first time recognized that addiction occurred outside the realm of substances.
2. In my last post, I noted that natural recovery from drug addiction and alcoholism was now broadly accepted in the addiction field. I have emphasized throughout my career, beginning with a popular 1983 article I wrote for American Health, and at length in my 1985 book, The Meaning of Addiction, that natural remission was the standard course for addiction. I based my 1991 self-help book, The Truth About Addiction and Recovery, with Archie Brodsky and Mary Arnold, on that phenomenon.
3. The recognition that alcohol significantly reduces heart disease—and thus mortality—over broad populations has now been officially accepted in the 2010 Dietary Guidelines for Americans. I had noted this phenomenon for some time, as well as Americans' resistance to the idea of alcohol's benefits, and presented this information in the American Journal of Public Health in 1993.
4. If we are slow to accept that alcohol reduces heart disease in the United States, the idea that moderate drinking is an antidote to dementia is even harder to swallow. After I announced this phenomenon in an article with Archie Brodsky in the Journal of Drug and Alcohol Dependence in 2000, a number of studies have added onto this result, leading to confirming meta-analysis after meta-analysis.
5. I won the Mark Keller Award from the Rutgers Center of Alcohol Studies for my 1987 article refuting the idea that alcohol consumption was related in a straightforward (unilinear) way to drinking problems, but showing rather that individual and cultural drinking styles determined positive versus negative drinking outcomes. In 2002, the ECAS cross-national survey found this inverse relationship between drinking levels and problems across European countries.
6. From Love and Addiction through The Meaning of Addiction, Diseasing of America, and The Truth About Addiction and Recovery, I have shown that most substance use is moderate, including even the most powerful illicit substances. This has been—and will always be—a difficult thing for Americans to recognize and accept. Recently Carl Hart, author of High Price, has made the point that “Eighty to 90 percent of people are not negatively affected by drugs, but in the scientific literature nearly 100 percent of the reports are negative."
7. The idea of mine that has resulted in the most negative consequences for myself and others presaged the modern movement of harm reduction—that is, the truism that most people reduce the harms from substance use without abstaining. Saying that in 1970s-1990s America was enough to end your career, as I described in a 1983 article in Psychology Today.
8. Throughout the 1980s, fetal alcohol syndrome was the new boogeyman—so much so that pregnant women were warned not to touch alcohol. I analyzed the harm done by this hysteria in a 1990 national magazine article entitled, "The New Thalidomide." In 2013, both medical journals and popular parenting books have begun pointing out that mild-moderate drinking during pregnancy doesn't harm the fetus.
9. I have time and again shown the critical role of psychosocial factors and lived experience in addiction—which is the heart of The Meaning of Addiction. My perspective falls between the cracks of the ideas that some drugs are inherently addictive, that people are born to be alcoholics/addicts, that trauma is the source for all addiction, and that it is simply the amount of a drug or alcohol consumed that creates addiction (point 5). Instead, as I have shown, addiction is a relationship an individual forms with a given experience (The Addiction Experience was a best-selling Hazelden pamphlet).
10. For decades (as in Diseasing of America, 1989, The Truth About Addiction and Recovery, 1991, and 7 Tools to Beat Addiction, 2004), I have argued that 12-step, AA treatment is not the be-all and end-all of recovery. In addition to natural recovery (point 2), practical life- management therapies have been shown to be most effective, while people's self-empowerment, values, and purpose in life are their best guide out of addiction. Empirical comparisons of treatment effectiveness have shown these things to be true; I developed a residential treatment program on this basis.
Now I'm ready to publish my most radical, true ideas yet in Recover!: Stop Thinking Like an Addict and Reclaim Your Life with The PERFECT Program, in which I indicate (with Ilse Thompson) the best way to recover from addiction is to change how you think about it and yourself. Then I'll have to figure out the next radical addiction idea.
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