A reader asked me about the disease devotees:
when you challenge these peoples thoughts, they get so mean and hateful. I just wonder if they are scared, because they have bought into the medical model of addiction, It isnt your fault you are sick, etc. and then people like us challenge that, do you think thats why so many angry hurtful comments come about?
Answer:
The short answer is yes, they are scared. However, it’s important to know why. I think that most (not all) people who inhabit the recovery culture build their personal change on a foundation of fear – and they work hard to keep that fear alive. Let me explain.
We all know the rock bottom stories, and not everyone goes through such drama, but there is a principle there. If people seek out help with their substance use habits, they’ve usually had some bad things happen that are scaring them into making a change. They are running away from some nasty consequences. Of course, the other way of looking at this is that they’re seeking to improve their lives – that they are running towards better life results. It’s all a matter of framing. It seems like those who successfully stop struggling make an important transition from the initial fear frame to a positive frame. Unfortunately, the popular recovery culture promotes the fear frame, and many get stuck in it for life.
The recovery culture is unfortunately filled with people who view a reduction in substance use as deprivation. Many of them are committed to the idea that substances cure all of their emotional problems and offer the best possible feeling in life – and they never question this. For example, Russell Brand, who at 10 years abstinent from substances writes:
The last time I thought about taking heroin was yesterday. I had received “an inconvenient truth” from a beautiful woman… she told me she was pregnant and it wasn’t mine.
… I am becoming possessed. The part of me that experienced the negative data, the self, is becoming overwhelmed, I can no longer see where I end and the pain begins. So now I have a choice.
I cannot accurately convey to you the efficiency of heroin in neutralising pain. It transforms a tight, white fist into a gentle, brown wave. From my first inhalation 15 years ago, it fumigated my private hell and lay me down in its hazy pastures and a bathroom floor in Hackney embraced me like a womb.
Do you see it? He romanticizes heroin as the thing that will cure his emotional pain, and thus he still craves it after 10 years of devotion to the steps.
With this outlook, for Brand and the masses in the recovery culture, it is a punishment, loss, or deprivation to reduce or quit substance use. They remain highly motivated to use substances, yet they fight this motivation. And what do they fight it with? The thing that originally seemed to motivate them to stop: fear of negative consequences.
They could have simply looked for better things to move on to, but because they’ve been fed and believe the addiction mythology, they enter into a lifelong fight with the boogieman of addiction – a fight fueled by fear. As Brand says of his 10 years of abstinence “The price of this is constant vigilance”.
The addiction mythology and the “support” groups serve as their ongoing source of fear needed to fight their motivation to use. They MUST believe in “loss of control” because it scares them straight. They MUST believe that moderation is impossible, because this scares them straight. They MUST believe that everyone who stops attending meetings has completely fallen apart, because that keeps them in the meetings which keeps them scared, which keeps them straight. They must hear of the tragedy that happens to “active addicts and alcoholics”, to keep them scared straight. Aaron Sorkin’s recollection of an exchange with Philip Seymour Hoffman serves as a good example of this attitude:
On breaks during rehearsals, we would sometimes slip outside our soundstage on the Paramount lot and get to swapping stories. It’s not unusual to have these mini-AA meetings—people like us are the only ones to whom tales of insanity don’t sound insane. “Yeah, I used to do that.” I told him I felt lucky because I’m squeamish and can’t handle needles. He told me to stay squeamish. And he said this: “If one of us dies of an overdose, probably 10 people who were about to won’t.” He meant that our deaths would make news and maybe scare someone clean.
The fear is the thing they focus on constantly, and through all of this, their assessment of substances as the only thing that can make them comfortable in their own skin, et cetera – stays completely intact. Thus their high motivation to use drugs and alcohol (aka “overwhelming cravings to use” or “powerful urges”) stays completely intact.
With the motivation to use intact, then the fear must stay intact too. As we saw above, Sorkin and Hoffman believe[d] that fear is the savior of addicts. The fear is what’s saving them. Therefore anything that threatens to dismantle their fear, is perceived as a threat to their life. So they take it extremely seriously whenever anyone comes anywhere near challenging their mythology.
They’ve come up with many ways to deal with and insulate themselves from these threats. For one example, consider the “real alcoholic” argument. They dismiss any evidence of people changing their substance use habits outside of the 12-steps as evidence that those people were never really alcoholic to begin with. They must grasp onto the belief that they are in a different class, so they can grasp onto fear, and shelter themselves from triggers – people, places, and things – and “cunning, baffling, powerful” substances – and hide in the recovery subculture.
Again – this isn’t everyone in the recovery culture, but I think it’s a great majority of people who are active in the recovery culture (by which I mean support meetings – even many of the alternatives – and ongoing treatment/counseling).
So, when you challenge their mythology you are threatening their life (from their perspective). Just look at the way they betray it in their comments here and anywhere else a choice perspective of addiction is promoted. They vehemently assert that addiction is a disease without even attempting to demonstrate it logically, they use all manner of foul language and ad hominem to shout down other opinions, and then they justify their irrationality by claiming that the other addicts reading just need to know it’s a disease or they’ll die. So, they don’t really debate the point, they just assert that the belief in the disease keeps alcoholics alive, because without it they’d think it was safe for them to have a drink. That is to say, they wouldn’t be full of fear.
[Having a single drink is basically pretty safe btw, notwithstanding pre-existing medical conditions. Once you get into the realm of several drinks in a short span of time, that’s not safe. Loss of control doesn’t exist – anyone can moderate, if that is what they truly want, because loss of control does not exist.]
Little do they know, they could move on without the mythology, end the constant inner struggle, and be much happier in their lives. They could take the meaning and power away from substances by understanding that drugs and alcohol:
- Are NOT cunning, baffling, and powerful
- Do not “medicate” their emotional/psychological problems or provide comfort
- Do not provide the courage and confidence they need, et cetera
And instead, they could understand that substances simply provide a cheap thrill, which is easily rivaled by so many other life options. With this understanding, the motivation to use diminishes greatly (i.e., becomes “manageable”) or completely goes away, and thus the need to battle it with fear goes away too. The fear and self-doubt of the recovery culture and addict mindset is replaced by self-confidence and a direct pursuit of greater happiness (which can mean abstinence or some form of moderate substance use). A fear frame can be replaced with positive pursuit of greater happiness frame. Instead of resisting urges and craves, avoiding triggers, getting ongoing support, etc – you are simply choosing to do what makes you happier than that old troublesome pattern of substance use that is now in the past because you know it won’t offer you what you want anymore.
For what it’s worth, I would never seek out a conversation with a committed recovery culture enthusiast who is happy with their system, and try to convince them that their beliefs are wrong. However, there are too many people out there who know that these beliefs are mucking up their attempts to change – and they know that there must be something better. They look for answers, and sometimes they find me. And those are the people with whom I have the talk about changing the angle of approach and challenging the tenets of the recovery culture.
The overdose comment reminds me of the dedication plaque at the NABA club in Atlanta where I attended meetings a quarter century ago. The last line on the plaque is “So others may live.” This is of course the last part of the AA slogan/admonishment that “Some have to die so others may live.”
I am currently in the middle of watching a marathon of A&E’s ‘Intervention’. With little interest in engaging in other activities today, I thought I’d force myself to watch the “one-eyed idiot box” and this program to remind myself of all the things I believe to be wrong with the addiction/recovery philosophy prevalent in American society. This TV program clearly demonstrates the power of fear, which has well served human survival for millennia. Unfortunately, the risk inherent to fear is its “irrationalization”. The irony here is that fear can go from being a useful survival tool or skill to becoming the complete antithesis, i.e. the thing that destroys us or prevents us from living an optimally functioning, physically and mentally healthy life. After all, it is fear that has driven government propaganda against various drugs for over a century now, and, it is fear that has fueled the modern “War on Drugs” for over forty years.
I often wonder if the “administrators” of recovery programs truly understand addiction any better than those who find themselves immersed in an addiction. There are many commonalities among addicts, however, I don’t know if there are any universal “truths” in terms of an addict’s response to organized treatment. This is where some will point to “all of the devastation” caused by addiction. While I would never argue that many lives haven’t been destroyed by addiction to various substances, I will argue that this isn’t universally true. I personally know a number of folks who regularly use various substances and still hold important positions in the work force and function very well in their professions, as well as have stable, healthy private lives. This is where some will say that it’s all an illusion and that these people are all secretly miserable and on the verge of death and destruction. However, some of these folks claim an addiction that has been part of their lives for decades and exhibit no discernable detriment. (And this is where some will now say, “But just imagine how much better their lives would be if they didn’t use their drug of choice.” (…..and thus begins the circular argument.) So it seems that the number one weapon of choice for the proponents of the “addiction-recovery complex” is fear. It is a useful tool, as has been clearly established by biological and anthropological research pertaining to hominid/human evolution. Certainly addicts should be concerned with the health risks inherent to any given substance. One could make a valid argument that they should fear these risks and potential consequences. But for these people, it is useful because of its “irrationality” rather than its classic role in survival. It is a tool that allows, or even enables, one to dissociate one’s personal responsibility, i.e. to conclude that the addict is completely powerless, that one cannot moderate or even taper down and, eventually, off their chosen drug. “Cold turkey”, or relatively rapid “detox” followed by complete abstinence is the only way they believe to be effective. I don’t believe this to be true. Addiction takes many forms and can be attributed to many reasons. For some recovering addicts, their substance use is THE problem, while for others, it is a manifestation of underlying problems. I will argue that it isn’t ALWAYS the best, most healthy manner of treatment for even the core “issues” to coerce an addict into treatment/recovery by completely removing one’s drug of choice. Confronting and overcoming even s single issue can be difficult enough. It stands to reason that coercing and addict to confront multiple problems all at once could prove to be even more difficult and lead to an even stronger sense of hopelessness/helplessness. Some addicts, some people in general, are mentally/emotionally stronger than others and are capable of managing their substance use much better, if not completely ceasing to use a substance, without being in a perpetual state of fear which, to me, seems unhealthy in and of itself.
Having said all of this, I realize that there is legitimate debate as to whether or not addiction is (or is not) a “disease”, be it mental or physiological. I often struggle with this concept as I am one who prefers that things “fit” into some nice, neat category. For instance, an eagle is an animal, the chestnut tree is a plant, a Volkswagen is an automobile, schizophrenia is a mental disorder, and chronic pancreatitis is a physiological disease. To ease my own conscience, I often view addiction as an opportunistic pathogen that can lead to disease. Escherichia coli is a species of bacteria that resides in the human gastrointestinal tract. It is referred to as “normal flora”. It is actually essential to human life as E. coli is involved in the synthesis of vitamin K, which is essential to a healthy, functioning blood clotting cascade. However, when other normal flora are reduced by antibiotic use or introduced into the upper GI tract, E. coli can cause disease. Although ethyl alcohol, methamphetamine, heroin, etc. are not part of the human “normal flora”, these substances can cause various mental and/or physiological diseases. I guess my point is that, regardless of whether or not one believes addiction to be a legitimate disease in and of itself, it is important to understand, acknowledge, and agree that addiction can at least cause disease and, thus, will need to be treated as a disease, mental, physiological, or both.
Smoking nicotine can cause lung cancer and emphysema but nicotine use is NOT A DISEASE. Steppers can frame it anyway they want to justify the actions and effects of their dangerous 12 step cult religion … But the truth is still the truth.
I look at it as part of a lifestyle, like anything else. Some people like to live extreme lifestyles, like extreme skiiers or race car drivers, that don’t even involve drugs but still endanger their chances of living a long, healthy life. They live it because they love to do it, but we don’t think of it as dysfunctional in any way even though it’s almost identical to what a lot of drug addicts do if you replace “extreme sports” with “drugs”.
The story that I heard was about two *extreme* skiiers, guys in their early 30s with wives, and one of them died while skiing some incredibly insane mountain…but his wife didn’t hate him for it. She said that she was grateful that he died doing what he loved. And it’s OK now for someone to love something like that, definitely not normal but not stigmatized because we don’t have a problem with what he was pursuing.
Now, if instead you have a person who loves playing music and doing drugs, if that person does it to an extreme they are sick, and if they die from it it is a shame. We don’t believe that they died doing something that they loved (even if it was bad for their lifespan), we believe that they were sick and imprisoned by their fear and acting out. Really, what I believe is that the musician who loves drugs and the extreme skiier are the same kind of person. If one of those guys is an addict, they both are. The only thing is that one of them does an activity that we feel is an acceptable thing to do with your life, even if it is risky and will kill you, and the other does not. The line is totally arbitrary and is only relative to what our society values, and has nothing to do with what is objectively a harmful thing.
So what we are doing is criminalizing and stigmatizing a lifestyle choice. People who participate in this “bad” lifestyle are sent to the drug equivalent of gay camps, where they learn to “pray the gay away” (gay being drugs, of course), and then you spend the rest of your life pretending that you don’t love what you love. At least it is safe now to be a homosexual in the wider society (even if it still may be dangerous in localized areas, or stigmatized by your family) because we have found a way to relate the homosexual drive to the “normal”, heterosexual drive for sex. What we don’t have is a way for people who use drugs to relate to “normal” society, because their drives are still seen as alien, the way homosexuality used to be portrayed. So “normal” society fears The Addict.
Only when there is a way that society can view drug use as an outlet for a normal human urge, without fear, can we look realistically at the “drug problem”, which is on par with overconsumption of food or anything else. Right now, altering your own consciousness is seen as a deviant urge. The way out of the pit that we are in right now is for us to understand that it is not deviant, but an essential part of our human drive and has been ever since the dawn of humanity. I don’t even want to use the words “legitimize” or “normalize”, because that assumes that it isn’t normal to start with. It is.
So, in the most objective sense, that is how I view addiction.
T. Smith,
That’s an interesting point of view. I hadn’t really thought of it in exactly those terms but, it does make sense.
From my own experiences, my continued long-term use comes from the desire to ease primarily physical pain but, it has done wonders for me in terms of easing emotional pain, certainly much better than antidepressants/antipsychotics.
I think it’s pretty disgusting that Sorkin and Hoffman are so full of themselves as to believe their deaths would “save others” like some sort of 12 step mini Jesuses. And it’s disturbing that so many people who have control over what gets into movie and TV storylines are having “mini AA meetings”on the set. It’s extremely convenient for pre-indoctrinating the population, so it sounds not just plausible but Actually True to people who get caught up/forced into in a 12 step re-education. But that’s been going on since they made “Days of WIne and Roses”.
On top of the use of fear in 12 step indoctrination, there’s an element of identity politics. A lot of the people who buy into the 12 steps see themselves as not only being different than the rest of the population, but also superior to those who have not lived out the sin-and-redemption that AA/NA/whateverA promotes among members. (“That which does not kill us makes us strong” – leaving out the bit that most people in 12 steps haven’t faced death as part of their own personal sin-and-redemption narrative)
12 step cheerleaders also are very prone to over-dramatizing. A couple of years ago, there was an event in Portland OR called “Hands Across the River” – basically 12 Steppers standing on the sidewalk of a bridge over the Columbia River, demonstrating I don’t know what. But some of the participants were interviewed and claimed the 12 steps saved them from certain death. Looking at these young and healthy people claiming to have been so close to certain death – as opposed to the crapshoot of unpredictable black market dosages, I don’t think most of these people used so many drugs so many times that they did death-defying damage to their organs. Most recreational drugs are among the least dangerous drugs (I know this sounds weird to anyone subjected to decades of US government “Dangerous Drugs” propaganda). But compare heroin to acetaminophen – the difference between a a therapeutic dose of acetaminophen and a deadly dose is surprisingly low. But if one uses clean needles to inject a known dosage of heroin is not inherently harmful (compare 2 people who use a strongly-habit-forming drug for 30 years – heroin and nicotine, the latter will have substantial measurable damage to lungs, circulatory system, etc. but the heroin user will not) Marijuana has never killed anyone. The supposed damage to teeth from meth? Well, the Meth Mouth photos were collected by an employee of the Multnomah County Jail in Portland OR, who chose the scariest photos he could for the express purpose of scaring people away from meth. So those photos are not typical, but extreme. Oh, and btw, Portland does not fluoridate its water, and Portlanders have some of the worst teeth in the country, even those who have never done meth.
One thing that does concern me is that even if we were to get rid of drug prohibition in one fell swoop, like the 21st Amendment ended alcohol prohibition, people whose livelihoods depend on believing in the disease/12 step treatment model (not just the “addiction specialists” who don’t even have to have a GED, only a history of “addiction”, as well as all the employees of government agencies private foundations and rehab entrepreneurs), and those who base their self image on their 12 step indoctrination (like Sorkin and Hoffman) will continue to be a force for pseudoscience in our country for some time to come.
This article as great, as Steven’s often are. There was one point that I expected him to make, but am somewhat surprised he didn’t.
It’s that, aside from the fear, many “steppers” believe that drugs are all-powerful and that they escaped certain death because it makes them feel accomplished. I feel like you can really hear this in Brand and Sorkin’s words.
If you started making better decisions, that’s great, and people will respect you, but they won’t give you a medal for it. However, if you believe that A) drugs are the greatest thing in the world and B) drugs can kill you, then you’re going to feel like you deserve a medal.
So, to add to what Steven says in the article, it seems like fear is only part of why members of the “recovery” movement are threatened by alternative ideas. It’s not just a fear that they’ll die. It’s also a feeling that they need to be heroes, overcoming the deadly and supernatural force of drugs. They want to be heroes.
Many of these people have unrealistic expectations for themselves – they grow up thinking that they need to be unrealistically extraordinary, and then they abuse drugs to deal with the fact that they’re merely human.
The recovery movement, though, never actually tells them, “It’s ok, you’re merely human.” It tells them, “You are a superhero for being in this program.”
This is the ultimately sad core of the recovery movement. It is so unspeakably sad that few people in recovery will look it in the face, for all their talk of “rigorous honesty”. Again, I don’t think that feeling proud of recovering from drugs is a bad thing…until they try to state it as medical fact and enforce it with law. Then, the illusion is a problem. A real problem, not one that someone made up to feel better about themselves.
I work in treatment and have been sober for 36 years. I dont believe in anyone thing will get or keep you sober except a personal desire to live another way. My job is to just help them see themselves in,all their many facets. . I have given up on any scare tatics (never really used them). If anything I scare them into loving and live from their SWEET SPOT.