Further Reading

Does natural remission still work as well as treatment; how do you do it?

Dr Peele,

I have read your website and greatly respect your intellectual insightfulness and integrity. However, I also have a daily pot habit and was precribed 4-5mg. a day of Ativan for anxiety 5 years ago, and still take them. I now feel it is time to ask you a question on my mind. I want to wean off both these substances and my therapist suggested the AA approach. When I told him of your evidence of the fact that self-cure is just as effective, he stated that you were using old statistics and that now drug counselors have new data which validates the AA approach. Is this true? And if not, what other resources do you feel are most valuable (after willpower) to get to a place where one doesn't want to take substances and where one finds they can still feel good about themselves, even better, without them? Which I assume is the grand goal of all methods. I know I used to smoke cigarettes and eventually ended up feeling that way about them. I look forward to your response. Thanks!

Dave


Dave:

Well, Dave, old is old and new is new. The main data favoring the 12-step approach for alcohol dependence is Project MATCH, which said that it was no worse than other alcohol treatments. However, abstinence rates were unimpressive, and the benefits were mainly reduced drinking, which the NIAAA and its director, Enoch Gordis, say is not possible for alcohol dependent people. In any case, that study didn't compare a treated with an untreated group, and other government research shows remarkable natural recovery rates.1

Recently, Barry McCaffrey, drug czar, and the government's Substance Abuse and Mental Health Services Administration, announced as proof that treatment works a study in which 1,800 people were surveyed after treatment (in other words, this was a "pre-post" comparison): One in five were still clean and sober. How's 20 percent to you? Once again, they are pushing reduced use (which otherwise they claim is impossible) to prove their point — a 45 percent drop in cocaine use, a 28 percent drop in marijuana use, and a 14 percent drop in heroin and alcohol use. These last two seem fairly minimal.

In addition, youthful users showed the least benefit (following treatment, there was no net increase in abstinence from alcohol or crack). Aside from the fact that we have wasted a ton of money on adolescent treatment, this is really an argument about natural recovery, also called "maturing out." Young people don't mature out because they are still young. On the other hand, a long list of data show high maturing out rates for drugs such as cocaine.2

The most valuable resources for quitting an addiction are (1) a desire to do so, based on the feeling that you will feel better without the addiction than with it, (2) enough reasons to quit in terms of such things as people who care that you quit, a desire to be healthy, activities that the addiction interferes with, and so on to raise the stakes to a place where you want to quit, (3) enough support and alternative endeavors to allow you to be positively occupied and supported at times where you previously were involved in the addiction.

And, buddy, if you have quit smoking, you have quit the very toughest addiction. Therefore, you are right to feel empowered by quitting that habit and also that it serves as a road map for how to quit such "minor" addictions as marijuana and anti-anxiety drugs.

Good luck and god bless!

Stanton

Notes

  1. Peele, S. (Spring 1998), Ten radical things NIAAA research shows about alcoholism. The Addictions Newsletter (The American Psychological Association, Division 50) (Vol 5, No. 2), pp. 6; 17-19; Peele, S. (March/April 1998), All wet. The gospel of abstinence and twelve-step, studies show, is leading American alcoholics astray. The Sciences, pp. 17-21.
  2. Peele, S. (1988), How strong is the steel trap? Review of The Steel Drug: Cocaine in Perspective. Contemporary Psychology, 33:144-145.; Peele, S. & DeGrandpre, R.J. (1996), Cocaine and the concept of addiction: Environmental factors in drug compulsions. Submitted for publication.