Before you comment on the site, please give this a read – you might find that your questions and comments are already addressed here. This is by no means an exhaustive list of frequently asked questions; it will be expanded over time.
Who writes this stuff? Whoever they are, they must not be an addict.
All content on the site is written by me, Steven Slate. I don’t consider myself an addict, because I don’t subscribe to that label. However, my former behavior would probably classify me as an addict in most anyone’s book. Between 1994 and february of 2002, I used drugs and alcohol on a daily basis, with a few short periods of abstinence. I lied, cheated and stole in order to fund my habit. Made several trips through the addiction treatment system and several 12-step groups. I felt powerless at certain points, as if I needed drugs, and was unable to stop. I ended up homeless for a while, was arrested many times, and did a short stint in jail. Luckily, I found an answer, and changed my substance use habits in 2002.
What makes you qualified to talk about addiction?
I’ve studied it for 14 years. Before that, I lived it. I have 7 years experience working for Baldwin Research Institute/Saint Jude Retreats (a non-12-step educational program for people with substance use problems) as an instructor, lead instructor, instructor trainer, director, and author/researcher. I have chapters on addiction in college textbooks. I count Mark Scheeren and Stanton Peele (both giant thinkers in the field in my eyes) as personal mentors in helping me to understand this fascinating phenomenon and make my own contributions to understanding it.
I ask no one to believe my views based on my personal and professional experience with substance use problems alone. I hope you’ll look at the information on the site, check out some of the citations for yourself, analyze the ideas critically, and form your own opinions.
Stop bashing AA. Why don’t you create a program instead of knocking other programs?
I don’t think I’m really “bashing” AA (based on my concept of bashing), but yes I’m very critical, and I won’t stop. I’m here to explore and spread the truth about addiction, and I will continue to feel free to criticize anyone who I believe stands in the way of that mission and/or actively spreads misinformation. If you don’t like it, close the window. If you’re about to send me hate-mail telling me that I’m killing people with my words, save it – I’ve gotten that email about a million times.
I work developing solutions for people with substance use problems. I created my own educational program that I used with clients as part of coaching for a few years; then I worked with Stanton Peele translating some of his work into a distance learning program; and then I went back to work with the Saint Jude Retreats, where I co-authored the 13th edition of the Saint Jude Program (published May 2014), and have been intimately involved in the development of our Cognitive Behavioral Education method of helping people with substance use problems.
I knock other programs because it is actually addiction mythology spread by those programs that keeps people feeling trapped in addiction. They cause more problems than they solve.
You say “addiction is not a disease” – don’t you know the authorities say it is definitely a disease?
I do know that NIDA, ASAM, the AMA, Nora Volkow MD, Dr Phil, Dr Drew, and many others say that addiction is a disease. Just as I hope you don’t uncritically take my word on the issue, I hope you don’t uncritically take their word on it as well. Please think critically, and judge the evidence for yourself. I have looked at the evidence and arguments presented for the disease model of addiction, and I can’t find anything that holds up to scrutiny.
If authority is all you care about, then let me say this – I can list plenty of authoritative sources who have also concluded that addiction is not a disease: Gene Heyman PhD of Harvard; Sally Satel MD of Yale; Stanton Peele PhD of NYU and The New School for Social Research; Peter Cohen PhD of the Centre For Drug Research in Amsterdam; Thomas Szasz; Professer David Hanson PhD; Professor Jeffrey Schaler; Dr Tom Horvath and the many other PhDs behind SMART Recovery. There are more to be listed, in fact there have been several polls over the years asking doctors if they believe addiction or alcoholism is a disease, and majorities have said they don’t believe it is a disease.
So we could come up with two groups of professionals that hold opposite opinions about whether addiction is a disease or not. What would we do then – count them up and see which side has more people? Is that how you decide a scientific truth – by a vote? Obviously it is not. A fact is a fact regardless of how many people believe it or not. So please, analyze the available information, and judge for yourself.
For you people who can only comprehend appeals to authority, here is a page full of quotes from credentialed experts. LINK to Quotes from Experts About Addiction. I hope and pray that you gain the courage one day to think for yourself and trust your own judgment.
Why does it matter whether addiction is a disease or not? Let’s just help people.
There is such a thing as a stupid question, and this is one. If you want to solve a problem, you need to understand the nature of the problem. If your car won’t run because it’s out of gas, changing the battery won’t do a damn thing to fix that problem. Likewise, if people are experiencing problems with drug and alcohol use, we need to understand why they are using drugs and alcohol. Is the use caused by a disease or something else? This is important to know because it will direct your approach to solving the problem.
If heavy drug and alcohol use isn’t caused by a disease, then why do people do it?
People freely choose to use drugs and alcohol because, at the time they’re doing it, they believe it will make them happy. At the time they do it, they believe it is their best available option for attaining happiness.
But there are horrible consequences to heavy drug and alcohol use. How can that make people happy?
Those negative consequences (or costs) may not make people happy. The consequences are often extreme and disastrous, even fatal. Obviously, the consequences put people through a lot of turmoil, so they’re not happy about the consequences when they set in. Nor are they necessarily happy in times where they simply feel regret about continuing their destructive habit. However, this doesn’t change the fact that at first, when the high kicks in, they experience a certain kind of happiness/pleasure.
So people use drugs and alcohol because they’re depressed?
No. I see how people arrive at that conclusion, and I see how a state of depression can be used as a reason to use drugs and alcohol, but it’s important to know that depression (or other troubling mood states such as anxiety or stress) doesn’t directly “cause” drug and alcohol use. A vast majority of people experience depression without reacting by using drugs and alcohol. Why is that? Probably because they don’t believe that drug and alcohol use is their best viable option for attaining personal happiness. Again, people use drugs and alcohol because they believe it will bring them happiness.
But I have stress/anxiety/trauma/depression, and these problems make me use drugs and alcohol. Are you saying I shouldn’t get help for those things?
No. You should get whatever help you feel is necessary for those things. However, as long as you believe that drugs and alcohol are your best viable option for happiness, you will continue to use drugs and alcohol – no matter what help you’re getting for your other problems. On the issue of “addiction”, you will change it when you cease to believe that heavy drug and alcohol use is your best option for finding happiness. Work on changing that belief if you want to change your habit.
Believing in the “underlying causes of addiction” (and/or “self-medication”) model creates a more complicated problem. If you invest in this idea, then every time life sends a problem your way, or when you feel the very normal emotions of sadness, depression, stress, or anxiety – then you will feel as if you must use drugs and alcohol. If you cease to believe that heavy drug or alcohol use is your best option for happiness then you will cease the heavy use of drugs and alcohol – regardless of whether you continue to face depression, stress, anxiety, etc.
But what about physical addiction – tolerance and withdrawal – doesn’t that cause people to use drugs and alcohol?
No it doesn’t. These are medical problems which are separate from the behavioral pattern known as addiction. Withdrawal syndrome is a set of physical symptoms people experience when they stop using alcohol and certain drugs. It doesn’t cause you to do anything other than experience the consequences of detoxification. If you believe you’ll be happier detoxifying with medical help or not, then you will do that. If you believe you’d be happier taking more drugs and alcohol, you will do that. But in neither case are you forced to do anything behaviorally. If you’re experiencing withdrawal symptoms, the best choice is usually to seek medical help from your local emergency room, as withdrawal from alcohol and some drugs can have fatal consequences.
Consider the fact that a large proportion of people who receive medical help with detoxification go back to heavy drug or alcohol use after withdrawal symptoms are gone. What caused them to do that? You guessed it – they thought they’d be happier drunk or high. Substance use is a choice like any other choice that people make every day of their lives: people do what they think is their best option within their power to be happy.
You say addiction is a choice, so what do you suggest people do, use willpower to quit?
No. Willpower is a confused concept. I suggest people stay as far away from that idea as possible. “Addicts” have no less or no more “willpower” than anyone else. Every behavior that every person makes at any given time is, in a sense, an expression of willpower. To do something is to exercise the power to carry out your will. If you’re choosing to use drugs, then that is your will. If you’re choosing to ride your bike, go to work, clean your house, or drink a smoothie – then those are also your will. I don’t suggest that anyone go on a hunt for some special level or source of “willpower.”
What you can do, is change your will. When you start looking for new options in life, re-evaluating your usual options, and examine and change the beliefs that underlie the “will” for heavy drug and alcohol use – then your “will” will probably change. Essentially, if you choose to think differently about drugs and alcohol, and about how they fit into your life and competing goals, then your desire for them will change.
When we think about using willpower to change a substance use habit, we’re probably accepting the desire/will for substance use as an inevitability – a thing we’re stuck with, that we must battle with this special force called willpower. And in a certain sense, we’re thinking of it as not being our own will. But it is. If you’re doing a thing, you are willing it – and you can’t will it’s opposite at the same exact time.
See how confusing all of that is? But it is the trap we get into when we conceive of willpower as a force we need to build in order to battle our own will – a sort of circular thinking necessitated by modern willpower theorists.
However, if you think of the context in which willpower is usually mentioned, it often represents the act of subjugating your immediate gratification desires to your longer-term goals. If you care more about those longer term goals, believe you can achieve them, and think it’s worth delaying your gratification – then you will end up without the will to use substances heavily – no special power needed, just a different set of thoughts and perspective. But then, the concept of willpower needn’t be involved at all – because it only mucks up the situation, and makes you feel like you’re weak and need to summon some extra strength. You don’t. You just need to believe in a different path to happiness, and thus have a different “will” to carry out. Some people who are successful in 12-step programs invest in the idea of carrying out god’s will. It becomes so attractive to them, that they no longer have the will to use substances. That’s wonderful for them, but that idea doesn’t appeal equally to all people.
So what should I do to change my substance use habit?
If you think you may need help for physical withdrawal symptoms, get it (from a hospital, emergency room, or private doctor). Then…
The simple answer is: make different choices. The slightly more complex answer is: develop a vision of a lifestyle and choices that will make you happier than how you’re living now – this will lead to the motivation to live differently and make new choices. It’s not an easy answer, because it means that you have the responsibility for change in a very personal way: you need to think about what you want for yourself in a big way, and go about pursuing it. This answer doesn’t allow you to blame any “causes of addiction”, or attempt to shift the responsibility for change onto a therapist, god, support group, or medication. It requires new thoughts from you, if you want change.
There are infinite paths that will get you to a place where you no longer believe that heavy substance use is your best option for happiness. I mentioned one in the FAQ above – some people come to believe that they’d be happier with the 12-step lifestyle than with a heavy substance use lifestyle. Unfortunately, I can’t recommend that one, because it comes along with a set of beliefs that undermine most people’s efforts at change (and with AA’s 95% dropout rate, it clearly isn’t attractive to most). Nevertheless, some still find it to be a better option than heavy substance use – they find it so attractive that they can actually become somewhat impervious to the negative teachings and dynamics of the 12-step world. The good news is that most people figure out that they’d be happier with a new course of behavior on their own, without formal help. You can be one of those people. There is no set of easy steps that will help everyone to find their happier lifestyle, and there is no way to force someone to believe that they’ll be happier with a different lifestyle. Each individual must think for themselves about the value of their habit, and to think of their happiest options, and whether to pursue change or not.
I maintain strongly that everyone already has what it takes inside of them to change their substance use habits. If you have your heart set on getting formal help with a substance use problem, the only program I can wholeheartedly recommend is the Saint Jude Program. It’s the solution I used for my own life back in 2002, and it is offered by the company I now work for – and as of today (3-25-14) they are advertising on this website. You’ll see their number listed above and in some banner ads on the site. As with everything I say here on the site, please don’t just take it on my authority – see what else is out there, and see what they have to say, and use your best judgment to compare.
My recommendation comes mostly from my hardline stance that addiction is not a disease, and that substance users of all stripes are always in full control of the choice to use substances. The Saint Jude Program is the only one I’ve found that truly operates with these facts as its foundation. Furthermore, it doesn’t prescribe a specific lifestyle or demand abstinence as 12-step programs do. It puts the responsibility on the troubled person to develop their own vision of a happier lifestyle, and gives them a forum which encourages doing so, and the knowledge to efficiently make personal changes that last – rather than being distracted by battling an imaginary disease or weakness.
“Why are you so obsessed with Cognitive Behavioral Therapy (CBT)? I did it at rehab and it didn’t work.”
I AM NOT.
People keep falsely attributing a recommendation of Cognitive Behavioral Therapy to me. I’m not sitting here recommending it. In fact you probably won’t find me recommending any therapy or treatment other than detoxification. So, I don’t know where this comes from.
On the other hand, I have studied CBT, and found it to contain much wisdom. Much of that wisdom – but not all of it – is identical to what I think is most meaningful for understanding personal problems such as heavy substance use, and how to change such problems.
Also, my employer, Saint Jude Retreats/BRI, have a pioneered an alternative method of help for people with substance use called Cognitive Behavioral Education – CBE. The E is key. E stands for education. Education is what I go in for – not therapy. I’m not recommending therapy. Nor do I provide therapy. I am a CBE Presenter, which is a unique title for a practitioner of a unique model of help only available through the Saint Jude Program. It is information and learning based – it is not based on therapy, support, treatment, etc. It is a choice based model of help.
“I agree with you Steven, people choose to get addicted. It’s their fault because they chose to do drugs in the first place, and then got addicted.”
I realize this isn’t a question, but it’s a frequent comment that I need to address. Now, please take note of my response to this sentiment, and let me be totally clear:
WE ARE NOT IN AGREEMENT BECAUSE THAT IS NOT HOW I SEE THIS.
The way I see it, is that all substance use is freely chosen. All of it. No one ever “gets addicted” by the power of a drug and enters a state where they can’t stop using drugs. There has never been a solid demonstration of the notion that those who are called addicts (or those who feel addicted; or those who feel/believe/say that they cannot stop) are involuntarily using drugs (or alcohol). The best evidence shows the opposite – that the same factors that influence other voluntary behaviors also affect the behavior of substance use in those considered “addicted.”
So I don’t think it’s people’s fault that they got addicted, because I don’t believe anyone gets addicted. “Addicted” in the common usage of the term, means unable to choose to stop – compelled to continue to use substances.
I am also not looking to “blame” people. I’m not looking to judge them as morally bad. I am looking to identify the fact of where control of substance use resides, and to use that knowledge to help people solve their problems. The control resides squarely in the mind of the individual.
Don’t get addiction confused with withdrawal syndrome and tolerance either when making this silly statement. These are very different things. Even NIDA understands that these are separate things. This is NOT a controversial point at this time in history of knowledge about substance use. Here’s a quote from NIDA about the distinction:
Is there a difference between physical dependence and addiction?
Yes. Addiction—or compulsive drug use despite harmful consequences—is characterized by an inability to stop using a drug; failure to meet work, social, or family obligations; and, sometimes (depending on the drug), tolerance and withdrawal. The latter reflect physical dependence in which the body adapts to the drug, requiring more of it to achieve a certain effect (tolerance) and eliciting drug-specific physical or mental symptoms if drug use is abruptly ceased (withdrawal). Physical dependence can happen with the chronic use of many drugs—including many prescription drugs, even if taken as instructed. Thus, physical dependence in and of itself does not constitute addiction, but it often accompanies addiction. This distinction can be dificult to discern, particularly with prescribed pain medications, for which the need for increasing dosages can represent tolerance or a worsening underlying problem, as opposed to the beginning of abuse or addiction.
Please keep in mind I don’t endorse that entire quote, but it makes the basic distinction clear. And now that we have that to think about, maybe you’ll want to change your position? IDK. But if you’re just thinking of physical dependence, then you may want to modify your statement to reflect that? Still, it wouldn’t apply to everyone. There are many people who have unwittingly gained a physical dependence to drugs prescribed by a doctor. That’s not their “fault” if you’re concerned with fault. However, they also aren’t “addicted.” They have a physical condition, which with many drugs and with many people, will simply cause discomfort when they cease to use, and will go away in a matter of days uneventfully as long as they don’t make it out to be more meaningful than it is. With some other drugs (primarily alcohol and benzodiazepines), in some people, depending on levels and frequency of use, medical help may be needed to safely go through withdrawal (take care, the effects can be fatal – the only way to find out for sure is to seek proper medical care). Nevertheless, this is not addiction, and these people are not compelled to continue using at high levels. This is medically handled in a matter of days. If it was what we call “addiction” then everyone could be cured of addiction in 3-14 days in hospital detox unit. Those detoxes are revolving door centers though – because people still CHOOSE to use at high rates even after their withdrawal symptoms and tolerance are gone, and dig the hole of negative consequences all over again. This behavior is what is referred to as addiction. In light of this common pattern of behavior known to all who work at detoxes, the withdrawal syndrome is actually completely INCONSEQUENTIAL to what is called addiction.
If you try to make some comparison to cancer or diabetes, then you look like a total idiotic fool, and I hate to be associated with you. I hate it. Your argument is so silly on it’s face. People say nonsense such as:
“You don’t choose to get cancer but you choose to get addicted. You didn’t have to take drugs but you did, and now you got yourself addicted, and it’s your fault – so addiction isn’t a disease, it’s a choice.”
God, I really can’t get across how much I HATE being associated with such views. I completely disagree.
Here’s a simple hole in that statement: you absolutely can make choices that bring cancer upon yourself. Lung cancer from smoking is the perfect example. And now your whole argument has fallen apart. So if your contention is that any condition acquired by choices is not a disease, then you are wrong. PLENTY of disease are acquired by our freely chosen behavior. The fact is that you can make the choices that develop cancer, but then the cancer has a life of it’s own, and you can’t choose to not have it in an instant. It requires medicine or a fluke of a miracle to reverse/stop the progression.
Also, in such an argument, YOU ARE AGREEING WITH THE MAIN FEATURE OF THE DISEASE MODEL OF ADDICTION. You are saying that they’ve gotten into an addicted state in which they can’t stop. You may say you don’t believe addiction is a disease, but YOU BELIEVE IN EXACTLY THE SAME THING.
The debate here, for people who are seriously interested in addiction is whether or not people who use substances are compelled or currently in control. It’s not about their past choices – it’s about their present ability/or inability. I believe they have the ability to choose now, and I believe my conclusion is a solid scientific conclusion based on all the evidence I have been able to gather and analyze.
I can’t say this enough times: people choose every single instance of substance use. They aren’t “addicted” they are freely acting at all times. IF YOU THINK PEOPLE “GET ADDICTED” THEN YOU AND I DISAGREE.
How are you a .org?
This question was recently asked of me, and I can only assume it was asked to troll me and suggest some kind of wrongdoing, since I’m always being accused of doing something nefarious here – but I’ll answer it anyways. I wanted the name cleanslatedotcom, but that wasn’t available. I started looking up other variations, like thecleanslatedotcom. Had that been available, I would’ve registered it. I saw that .org was, and so I jumped on it, end of story.
According to Wikipedia:
The domain org was one of the original top-level domains, with com, us, edu, gov, mil and net, established in January 1985. It was originally intended for non-profit organizations or organizations of a non-commercial character that did not meet the requirements for other gTLDs.
Registrations of subdomains are processed via accredited registrars worldwide. Anyone can register a second-level domain within org, without restrictions. In some instances subdomains are being used also by commercial sites, such as craigslist.org. According to the ICANN Dashboard (Domain Name) report, the composition of the TLD is diverse, including cultural institutions, associations, sports teams, religious, and civic organizations, open-source software projects, schools, environmental initiatives, social, and fraternal organizations, health organizations, legal services, as well as clubs, and community-volunteer groups.
Why is your site named The Clean Slate?
It’s a play on my own name (Steven Slate), the word “clean” which is recovery lingo, and the goal of the site – which is to “wipe the slate clean” of everything you thought you knew about addiction. I really do believe that if our world was rid of the harmful recovery & addiction rhetoric, less people would develop substance use problems, and those that did would get over them quickly – lacking the self-defeating disease model of addiction.