We're at a Watershed on Addiction

I presented to Partnership at Drugfree—which once would have been impossible.

Posted Mar 14, 2014

We are now engaged in a great civil war over whether addiction is an uncontrollable scourge, or something that grows from within society and can be curtailed and remedied. The former position, as embodied by David Sheff, author of the memoir Beautiful Boy: A Father's Journey Through His Son's Addiction and his policy recommendation for medicalizing addiction, Clean: Overcoming Addiction and Ending America's Greatest Tragedy, is clearly dominant. In a nutshell, Sheff copes emotionally with his son's drug addiction by deciding it was an unavoidable biological event which can only be remedied medically. This fantasy—rather than being a new idea—is actually a recurrent theme in American history for the last hundred years, a period during which addiction has expanded exponentially in terms of both its prevalence and its incidence at earlier and earlier ages.

Sheff's best sellers and ubiquitous ideas contribute to this expansion. The best answer to addiction at both the individual and the cultural level is a feeling of efficacy. Sheff's work attacks our sense of efficacy at both levels.

I take the opposite position to Sheff's in my 2009 book, Addiction-Proof Your Child, in which I point to parenthood as the single greatest source of resilience against addiction. As with much of my work (like my 1975 Love and Addiction, newly re-released as an e-book) a raft of cultural developments have supported my analysis and contentions. In the case of Love and Addiction, these include the realizations that any powerful experience may be addictive; that practical, coping-oriented therapies are the most effective; that American's abstinence fixation is not the be-all and end-all of treatment; and that social and cultural trends define both what we consider addictive and the extent of its reach.

In making the case for parenting as an addiction antidote, I have recently come across a strong potential ally, The Partnership at Drugfree.Org, at which I presented a "Lunch and Learn" on Thursday. Although Drugfree (as its name indicates) has been known historically as a fiercely zero-tolerance operation, it also contains a crucial element that points in the opposite direction: that parents are the most important force for preventing substance abuse. Of course, a critical question is how "abuse" is defined. My argument in Addiction-Proof is that the spread of both addictive substances (e.g., the legalization of marijuana, the advent of massive misuse of pharmaceuticals) and the recognition of non-drug activities as addictive (electronic gaming et al.) make zero tolerance both meaningless and futile as a parenting strategy. In its place, we must strive to produce resilient, competent children.

The Partnership is engaged in a deep soul-searching about its mission. And it is being led by two of its clinical policy people, Jerry Otero and Denise Ocasio, very much in my direction. As a part of this movement by the Partnership, Otero and Ocasio, along with promoting Addiction-Proof, are strongly engaged with the work of the Center for Motivation and Change, led by Jeff Foote. Foote and his CMC team have written Beyond Addiction. Their book represents an amplification of the CRAFT approach to family counseling, which strives to create successful, self-sustaining internal dynamics for rewarding children and other family members for positive movement (I don't use the misnomer "sobriety"), while taking care of the parents and other innocent family members.

In focusing on the nitty-gritty of self-care, on love and empathy, and on communication skills, CRAFT (see the brief downloadable version of this work here) comes down squarely on the efficacy versus the disease side of the addiction debate. Indeed, CMC's book and work may become our last great hope for forestalling our massive cultural descent into hopelessness and addiction-proneness.

Stanton Peele's latest book, with Ilse Thompson, is Recover! Stop Thinking Like an Addict and Reclaim Your Life with The PERFECT Program, and he can be found on Facebook here.

David Sheff responds:

Your column

Submitted by David Sheffon March 17, 2014

To Mr. Peele,
I'd be grateful if you'd forward me an email address so I can write to you directly. Obviously you haven't read my books if you don't understand that I completely agree that we must -- and CAN-- addiction-proof our kids. Much of Clean and articles I've written are about how parents matter more than any other single force in our kids' lives and how we can learn to be more effective when it comes to protecting our kids--helping them to grow up healthily.
Commenter Profit PLZ quotes Tom McLellan. Another thing Dr. McLellan says is that people who are working to help our kids grow up safely and drugfree and working to end addiction circle the wagons and shoot inward. It makes no sense. We're in this together. We all want the same thing: to protect our kids from dying.
By the way, I work closely with the Partnership.

Thanks for being in touch, David

Submitted by Stanton Peeleon March 19, 2014

I appreciate your outreach. David, from what you have learned about psychology and CBT recently, does the following syllogism make sense: "The actual BELIEF in the disease theory makes recovery more difficult--if taken fully seriously, impossible." Ponder that idea -- it is quite significant if true, wouldn't you agree? It is the case I make in Recover!

Here are three references (two of which we cite in our book, the third of which has recently appeared) showing this to be fundamentally true:



(same refer): http://www.nytimes.com/2012/01/10/health/study-finds-nicotine-gum-and-pa...


(same ref.) http://www.nytimes.com/2014/02/23/opinion/sunday/should-obesity-be-a-dis...

Now, if this is true, David -- every time you focus on the idea of addiction as an irreversible disease, you produce worse outcomes -- something to conjure with, do you agree?

Yours truly,