Perhaps the best brief summary of Diseasing of America.
North Shore (Vancouver) News, June 7, 1999
Reprinted with permission of North Shore News.
Stop Making Excuses for Drug Addiction
An anti-drug rally held in Abbotsford last week and fronted by former heavy weight boxer George Chuvalo and federal MP Randy White sported the usual confused rhetoric about drugs and addiction.
It was a mixture of demands and accusations to government; the tone resembling an ideological hangover from the days of the Temperance Movement and the Prohibition, topped with a dose of AA scare tactics.
Incidentally, the misconceptions about addiction unite social conservatives and liberals alike. Both factions seem to feel it is the humane thing to describe what is essentially a problem of behaviour, as a disease, even though it is not.
Liberals as much as conservatives, support coercive means of treatment. All are oblivious to the stupidity of forcing an occasional user to confess to a life-long debilitating "disease." All are blind to the violation of liberty and the futility of forcing someone into rehab.
In a radio interview, MP Randy White expressed his well-meaning support for the disease conception of addiction.
Asked to explain why proponents of the disease model of addiction refuse to address the fact that drug addiction involves choices, values and preferences, he refused to do so.
"Have you not made a mistake ever?" he admonished the host.
As if embarking on a life of drugs was about one unfortunate glitch. The dangers of gathering more and more behaviours under the disease label is not something about which politicians or health-care specialists care to think, despite the scary ramifications for a society already committed to "morality lite" and to diminished personal responsibility.
One esteemed addiction researcher, Stanton Peele, is different.
In his book Diseasing of America, Peele states that the disease conceptions of misbehaviour are bad science, and morally and intellectually sloppy.
"Once we treat alcoholism and addiction as diseases," writes Peele, "we cannot rule out that anything people do but shouldn't is a disease, from crime to excessive sexuality to procrastination."
The application of the medical disease model to addictions was developed to "remove the stigma from these behaviours."
There is, however, no genetic marker for alcoholism or drug addiction. Still, the misconception that these behaviours are linked to a genetic vulnerability is aired repeatedly by the media, all in the absence of evidence.
The rationale for using the disease model to describe addiction, even though it is intellectually dishonest, is that medical treatment is effective. This is also untrue.
An overview of controlled studies indicates that "treated patients do not fare better than untreated people with the same problems."
The evaluation of one program for heroin addiction, for instance, showed a recidivism rate of 90% soon after treatment. This is because a behavioural problem cannot be remedied by medical intervention. Addicts are cured when they decide to give up the habit.
Most cigarette smokers who quit give up cold turkey with no help, and there is no indication treatment for smokers is any more effective than no treatment.
The disease conception of addiction is a means of separating the behaviour from the person.
Much like the flu, drugs are said to "get a hold" of you, to use Mr. Chuvalo's words when describing his son. But an honest look is always more productive than a clouded one, and an honest look at drug-use means we cannot separate it from a person's values, strengths or lack thereof.
Once someone becomes involved with drugs, we explain everything they do by saying it was because of the drug, neglecting in the process of this circular argument to note that the source of the addiction is the person and not the drug.
Heroin addicts are highly disposed to having social problems even before they become addicted. And good predictors of future drug use are truancy and smoking behaviour, indicating that certain people by virtue of their personality characteristics or social circumstances are more at risk than others. If you fail to hold the kid who goes astray responsible for his actions then you cannot praise the kid who doesn't. That's the logic of diminished responsibilities all round.
Once again the myths about drug use in the general population come from what Dr. Peele calls "extremely self-dramatizing addicts who report for treatment, and who in turn are extremely attractive to the media." Which calls into question the wisdom of using video footage such as was used during the rally, in which a heroin addict, described in positive personal terms, tells about his life.
This portrays the addict as a hero, and separates the addict from his behaviour with the protective rampart of a disease label.
Indeed, there are activist groups down town campaigning for respect for the addict, pointing towards the degree of confusion in our thinking. Because the more undeserved respect addicts get, the more events they attend as "witnesses," the more they will stay addicts and the more addiction will be glamorized.
Positive reinforcement increases rather than extinguishes behaviour. Pavlov's dog could tell you that.
Unfortunately, the various accelerated programs school kids are exposed to year in and year out are breeding out of them the protective effects of personal responsibility, and the healthy disdain for addicts.
They are taught by mouthpieces of the activist industry that "It" can happen to anyone, that they have little control and that once "diagnosed" as an addict always an addict.
This sets in motion where there is already some drug use a self-defeating cycle of abstinence and relapse, not to mention an overall rise in drug-related involvement.
All in all, most teens and college students outgrow their occasional binges and turn into responsible adults. For doing what teens and college students do as a rite of passage, youngsters do not deserve to be labelled diseased.
It is plain stupid.
The paranoia of the temperance and the prohibition era, which has culminated in AA disease dogma, needs to be replaced with an emphasis on personal, parental, and community power.