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Saturday, December 6. 2014

A Struggle for the Soul of Addiction Treatment

"As opposition to the war on drugs grows louder, a movement to challenge traditional ways of treating—and doing treatment with—people who have difficulties with drugs is also reaching critical mass."


A Struggle for the Soul of Addiction Treatment


After 30 years of Nixon's politically-motivated War on Drugs - the criminalization of almost all drug use and sale except for alcohol - has failed. Anybody who wants illegal drugs can buy them almost anywhere in the US within 30 minutes. All prohibition does is to raise their prices, to create abundant new criminals, violence, and gangs, and to make drugs more appealing to defiant youth.


Things were better before The War on Drugs. I think that drug addiction is a terrible, often soul - and life-destroying thing, but many drug addicts do quite well in life in places where criminalization is less harsh.


We can't criminalize everything we disapprove of. Help for addicts and abusers is plentiful anywhere for anybody who wants it, for free or close to free. I think every sort of help is fine and not worth fighting over, but I remain an advocate of AA.


This week is the 81st anniversary of the end of Prohibition in the US.


Posted by Dr. Joy Bliss in Our Essays, Psychology, and Dr. Bliss at 13:07 | Comments (15) | Trackbacks (0)

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I hope Dr. Kellog simply misunderstands AA - I'd hate to think that he's intentionally misrepresenting the quote he selected as suggesting that AA represents alcoholism as a deficit of character, being a bad person, rather than as a spiritual malady simply because it competes with his preferred method of treatment.
#1 David Smith on 2014-12-06 13:53 (Reply)
From a libertarian standpoint, not criminalizing taking any drug or food is a good thing, provided you don't have to pay for the results. (I'm pretty sure the 63% increase in my CT small business health insurance was due to mandatory payments for drug and alcohol rehab services in Obamacare).

The only caution is to realize that at various times many countries tried some form of alcohol prohibition (and almost all criminalized drugs). In the US we did it by constitutional amendment which implies a great deal of support. My guess is there is a tipping point for heavy drinking and drug use that society cannot tolerate. I suspect that was the case in the Post WWI US (and parts of Canada/Scandinavia).

We may be that close for some drugs today despite prohibition. Currently 50-70% of all applicants for welders at nuclear power construction sites fail drug tests. I think we may better use a "vaccination/Quarantine" model for drugs than a strict prohibition. Use social stigma to discourage drug use, limit employment in certain critical jobs (let employers make the decisions), and let the drug users make choices themselves to sink or swim
#2 DirtyJobsGuy on 2014-12-06 14:36 (Reply)
I disagree and I think you have missed some significant points. If making drugs illegal is bad because people still use drugs then what about all the laws that people still ignore? Is that the proper criteria to decide what should be illegal.
Secondly, we can't afford to "treat" drug addicts if all drugs are simply legalized. We can't afford to take care of drug addicts who hurt themselves or others. IF we must legalize drugs then we MUST force/allow drug users to pay the costs of their mistake and not force law abiding not drug users to pay for it. If you use drugs then you cannot use our health care system or our welfare system. Impossible you say? Indeed it is impossible but the alternative is that we bankrupt the nation taking care of all the drug users. In fact I would say that is where we are today; $18 trillion in debt and $1.2 trillion in welfare every year. THAT is why drugs are illegal not the strawman excuse that some uptight lawmaker doesn't like drugs. So there it is: our choice it to let the drug users kill themselves without our help or we help them and go bankrupt destroying honest lives. You see this isn't about some libertarian talking point it is about taking my money, my assets and my livelihood to prop up drugs users.
If you want more Fergusons and Chicago's then allow more drugs. It is naive and foolish to think legalizing them will make the problem go away.
#3 GoneWithTheWind on 2014-12-06 14:53 (Reply)
Thank you. Drug legalization is my humble opinion the end of America as we know it. We already have a huge segment of society scheming and scamming ways to milk the system through fraudulent disability claims. Open up Meth-R-Us stores and Heroin Kiosks at the mall and we might as well turn over the keys to our country to the Barbarians because it's all over now Baby Blue.
#3.1 bill on 2014-12-07 08:38 (Reply)
"We can't criminalize everything we disapprove of."

Do you include meth in your statement? Right now in my area it is just totally out of control and literally we have hundreds of people wandering the streets twitching, talking to themselves, acting violently. The violent psychosis is the scariest aspect. Assaults, robberies and drug related murders steadily increase. Property crime is also out of control as addicts break in everywhere looking for stuff to steal so they can buy drugs.

Seeing the effects of meth literally every day, I frankly support the Asian traditional method of publicly executing drug dealers. But that would not get much play here. So we watch our city fall apart because of drugs.
#4 Jim on 2014-12-06 15:08 (Reply)
If other less dangerous alternatives to meth were legal nobody would do it. Meth has been around for decades, but it only has gotten "popular" as other drugs have gotten more expensive due to the increased enforcement.
#4.1 B Moe on 2014-12-06 18:10 (Reply)
I am doing an internship at a treatment center full of young , largely white heroin users. I routinely hear if heroin was legal and available, they would be out of treatment and using. Legalization is surrender to deviancy on a national scale.
#4.1.1 bill on 2014-12-07 08:43 (Reply)
Meth is quite similar to Adderal.
#4.2 Bird Dog on 2014-12-07 06:36 (Reply)
I'm not sure where the doctor gets his idea that AA treatment is based on the idea that the addict is a bad person; in both that fellowship and, especially, Narcotics Anonymous, addiction is regarded as a disease, not a moral failing, and the substance abuse is regarded as a symptom of a deeper issue. The 12 Steps are applied to foment change from the inside, and promote the personal growth needed to arrest the progress of the addiction. I can say with some authority that even though society stigmatizes using addicts as bad people- with plenty of reason - if you've never felt the pull of doing something that you like, because it can potentially make you feel good - like playing the slot machines at a local casino - then it's impossible for you to understand the nature of someones overpowering compulsion to engage in that behavior, regardless of whatever moral character that they possess. The reason a 12-Step program like NA sees success is empathy. Without that, treatment success can be a great deal more elusive. Of course, there are bad eggs in any 12-Step fellowship, just like in society at large, but they are a minority, and some of the best folks I've ever met are in 12-Step recovery.
#5 Kv on 2014-12-06 17:05 (Reply)
"Addiction" ...has a physical component.. where you literally get sick if you don't have your drug or alcohol. Addiction is also a spiritual DISEASE where day to day life is dominated by painful and uncomfortable beliefs and attitudes. Fear.. resentment ..self pity ..self condemnation along with crazy beliefs like "life should be fair" make living without the relief of drugs and alcohol impossible.. A.A. calls these things character "defects".. and tries to change these unhealthy and very uncomfortable beliefs and attitudes. We're not "bad" folk ..we just need help "seeing things differently"...
#5.1 Kevin on 2014-12-08 10:25 (Reply)
The biggest problem with the war on drugs is public perception. Because they are illegal and socially unacceptable, the only examples people see are the fuck ups, the hard core addicts who can't maintain themselves so that is what people think all drug users are like. I know hundreds of people who use drugs in moderation and lead perfectly normal productive lives, including families and owning and running businesses.

Most of the most dangerous and addictive drugs in play are the direct result of the war on drugs.
#6 B Moe on 2014-12-06 18:14 (Reply)
I wouldn't criminalize drug use, but I'd sure as heck confine anyone whose addiction made him incapable of controlling himself on the street. If the confinement spectrum runs from benign treatment centers for the non-violent to prison for the violent, that's fine--as long as they can be gotten off the street.

But anyone who can use drugs and still hold down a job, well, that's his business. It may wreck his marriage, life, and so on, but it's not a job for the criminal justice system.
#7 Texan99 on 2014-12-06 23:41 (Reply)
You're right. Drugs are ubiquitous, adulterated, overpriced and fuel unbelievable criminality. Prohibition failed. Jim raises the issue of meth but that's freely available as well. And widely used.

Users should be 100% accountable for their choces. No employer should be forced to hire users. Whatever arguments raised about the perils or costs of legalization, they are insufficient to justify continued enforcement.

Legalize and get on with the job of dealing with the aftermath.
#8 Col. Bunny (Link) on 2014-12-07 01:42 (Reply)
So what do we do with the thousands of drug addicts that litter the streets? "Disappear" them like they do in South America? Just let them rot and die like is happening now? Should everyone carry and those threatened by strung out addicts have the right to shoot to kill? Where I live these are serious questions. The number of the "homeless" in my city is up to 12,000 now, increased from 6,000 in the past year. The vast majority of those folks are homeless because they are on drugs. The impact these folks have is way beyond just screwing up their own lives and brains, they have made most of the public areas unusable and are costing us millions of dollars to deal with. Most houses in the urban core now have bars on the windows, something you wouldn't have seen even 5 years ago.
#9 Jim on 2014-12-07 18:02 (Reply)
Show me a case study of a person who is active and bottoming out in their addiction to alcohol who is not self centered in the extreme, to the point of delusional for many, and I'll take this simplistic dismissal of the 12 step path seriously.

AA may not be for everyone but it's simply a fact that most people bottoming out in their addictions are extremely self absorbed. Science shouldn't have a problem accepting this psychological phenomenon, a psychologist can use different rhetoric without the moral overtones, but denying it doesn't help anyone.
#10 Dave on 2014-12-09 10:52 (Reply)

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