Maia Szalavitz: So, What Made Me an Addict?

Posted by Kendall Harmon

Many people think they know what addiction is, but despite non-experts' willingness to opine on its treatment and whether Britney or Lindsay's rehab was tough enough, the term is still a battleground. Is addiction a disease? A moral weakness? A disorder caused by drug or alcohol use, or a compulsive behavior that can also occur in relation to sex, food and maybe even video games?

As a former cocaine and heroin addict, these questions have long fascinated me. I want to know why, in three years, I went from being an Ivy League student to a daily IV drug user who weighed 80 pounds. I want to know why I got hooked, when many of my fellow drug users did not.

A bill was introduced in Congress this spring to change the name of the National Institute on Drug Abuse (NIDA) to the National Institute on Diseases of Addiction, and the National Institute on Alcoholism and Alcohol Abuse (NIAAA) to the National Institute on Alcohol Disorders and Health. In a press release introducing the legislation, Sen. Joseph R. Biden Jr. (D-Del.) said, "By changing the way we talk about addiction, we change the way people think about addiction, both of which are critical steps in getting past the social stigma too often associated with the disease."

But opinion polls find weak support for the concept of addiction as a disease, despite years of advocacy by such agencies as NIDA and NIAAA and by recovery groups. A 2002 Hart poll found that most people thought alcoholism was about half disease, half weakness; just 9 percent viewed it wholly as a disease.

So what does science have to say?

Read it all.

Filed under: * Culture-WatchHealth & Medicine* TheologyEthics / Moral TheologyPastoral Theology

Posted August 28, 2007 at 6:36 pm [Printer Friendly] [Print w/ comments]

1. AnglicanCasuist wrote:

The current popular understanding of alcoholism as a disease had its beginnings after the end of Prohibition, but especially during the 1940s, with the emergence of Alcoholics Anonymous. The self-help organization’s main publication, the Big Book, describes a theory of alcohol addiction, which speculates that the alcoholic has a severe allergy to alcohol and therefore is helpless in its power.

This disease model served to present a fatalistic picture of the alcoholic’s eventual descent. The original fellowship of A.A. proposed that the only way for the alcoholic to find release from the hell of addiction is via a spiritual path of surrender to a “higher power.” Co-founder Bill Wilson credited Carl Jung with this insight after Jung responded to inquiries from Wilson. Previously Jung had admitted that the theory and methods of psychoanalysis had proven to be ineffective in helping the alcoholic, and he suggested that the limitations of science could be turned around by the alcoholic and used as an admission of defeat. This very helplessness in the face of a devastating illness, which defies human gnosis, Jung proposed, could be called upon to bring about a spiritual transformation in the alcoholic.

AA developed a slippery relationship with the “disease” model of aloholism. Alcoholics were incurable. Science couldn’t help the alcoholic. Only complete spiritual conversion in reliance on a higher power could. A later scientific theory of alcoholism as a “treatable” disease is linked with Marty Mann, who along with Yale University researcher E.M. Jellinek, sought funding from the alcohol industry. Jellinek was a researcher on beverage alcohol and headed the prestigious Research Council on the Problem of Alcohol (RCPA). Mann claimed to be the first woman to become sober through AA and had been hired by RCPA to do promotional work. Marty Mann took the fledgling National Council on Alcoholism and promoted it into a hugely successful national organization. She did this largely by presenting alcoholism as a medical disease akin to lung cancer or TB.

Most people today think alcoholism is treatable, even though this wasn’t at all what the founders of AA had in mind. But state subsidized treatment (often court mandated), and relying heavily on AA, can’t very well send people to a fellowship which asks people to admit complete defeat and (in desperation) turn to a higher power - who will grant a daily reprieve, not a cure.

August 28, 7:59 pm | [comment link]
2. Revamundo wrote:

Current developments in drug treatments have helped many people get sober and stay sober. Suboxone for heroin addicts and Naltrexone for alcoholics. Research showing how the brain works (enhanced MRI), how it reponds to “triggers” for using are helping scientist learn more and more how to cure addiction.

Alcholism has been around since the first fermented grape. AA came along at a God-ordained time and has helped countless people. Even if you’re not an alcoholic or drug user the Big Book is one to read.

There is hope and A bill was introduced in Congress this spring to change the name of the National Institute on Drug Abuse (NIDA) to the National Institute on Diseases of Addiction, and the National Institute on Alcoholism and Alcohol Abuse (NIAAA) to the National Institute on Alcohol Disorders and Health sounds like a good idea.

August 28, 9:25 pm | [comment link]
3. Words Matter wrote:

My experience among alcoholics is slightly more complex than described in #1. The way I learned it is that (per AA) alcoholism is an allergy of the body coupled with an obsession of the mind. Abstinence from alcohol treats the allergy, surrender to a higher power treats the obsession.  Note that the “higher power” need not be a supernatural “god” being. There’s a famous story about the first self-defined “atheist” who came to AA, maintained his atheist stance, and to the great surprise of the membership, got sober and stayed sober. It was for him that “god as we understood him” replaced “god”. It’s true that the 12 steps are compatible with Christianity, and many Christians belong to AA quite comfortably. But “spiritual” recovery doesn’t require a specific religious commitment.

Alcoholism is “treatable”, not “curable”. But there’s the rub: AA readily admits that not all people with a drinking problem are “alcoholics” and cheerfully offers what they have to anyone that wants it.

August 28, 10:49 pm | [comment link]
4. Revamundo wrote:

Alcoholism is “treatable”, not “curable”. At this time.

August 28, 11:50 pm | [comment link]
5. Stuart Smith wrote:

#4:  the wonderful virtue of the AA spiritual approach is that it has as its ultimate goal more than sobriety.  SERENITY, achieved by the restless heart finding its rest in God, is the deeper pursuit of AA. 
Is alcoholism “curable”?  Well, if medicine alone can “cure”, the disease is probably something other than the addiction which AA seeks to address spiritually.  You know, you can remove a cancer (“cure it”), but if the same psycho-somatic condition of the patient remains in place, a person might very easily re-develop another cancer.  Did the sugery “cure” that cancer?  Yes.  But, the deeper issue of WELLNESS may not be present.  So, with “curing” alcoholism:  can a new medicine replace alcohol, so that the patient atttains “sobriety”.  Yes.  But…alcoholics speak of the condition of being a “dry drunk”:  meaning, that it is possible to be sober while having the same spiritual problems ruining one’s life.

August 29, 12:33 pm | [comment link]
6. the roman wrote:

I was once a dry drunk. I quit drinking on my own at the age of 24 (without AA) after 7 years as a binge drinking black-out drunk with 2 DWI and 6 P.I arrests. I stayed sober the next 21 years and still managed to run my life into the ground before, at the age of 45,  I decided it was a good idea to drink again. Talk about throwing gas on the fire. After 2 years of a self-made hell I did something I should have done in the first place, I fell on my knees and prayed to a God I had fired years before to help me. He answered my prayer and I have been a grateful recovering alcoholic the past 5 years with a new life and a restored faith. I admit I believe because I have seen and I feel deep humility before those who have always believed but have not seen. I understand how my 21 year vacation from alcohol still didn’t keep me from ruining my life. During that time it was still all about ME, I was the ultimate authority, I could justify anything I said or did. I was spiritually bankrupt as a result. Pride is such a destroyer isn’t it? Now I chuckle whenever I see my favorite bumper sticker; “No Jesus, no peace. Know Jesus, know peace.” And add my own, “Amen, amen!”

August 29, 1:50 pm | [comment link]
7. Revamundo wrote:

The point I was trying to make is eventually there will be a cure for alcohol/drug abuse that is trippered in the brain. I’ve known poeple who’ve never had a drink or a drug that are “dry drunks.” I honor the 12-steps and believe they were God given. I can’t think of a single problem in life that can’t be helped by working the steps.

August 29, 1:57 pm | [comment link]
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