The Editorial Board at Columbia University’s newspaper, The Columbia Spectator, published a scathing piece today recommending that the university cut ties with CASA (The National Center on Addiction and Substance Abuse), a high profile research organization founded by former US Health Secretary Joseph Califano. They cite rampant scholarly criticism as well as journalistic sensationalization of the center’s dubious claims as their reasons:
as numerous media outlets and renowned researchers have brought to light, the methods that CASA uses to research substance abuse are shoddy and questionable, and reports of CASA’s “findings” are often misleading and sensationalized. Bollinger’s implicit endorsement of CASA not only tarnishes Columbia’s reputation as a world-class research institution, but it also promotes poor analyses of issues that deeply affect our society.
Refusing to consistently submit their reports to peer review, CASA ignores the standard scientific practices that help ensure accurate and reliable results. Investigative journalists who have questioned the center’s studies, such as one that claimed alcohol is involved in 90 percent of campus rapes, have been unable to find any evidence to support the numbers. This absence of accountability leads to a distortion of the facts. The Chicago Daily Herald noted in 2005 that Joseph Califano, the founder and chairman of CASA, had blown up numbers relating to teenage drinking by more than 100 percent. CASA has little to no basis for some of its claims, and makes an insufficient effort to prove otherwise.
The entire piece must be read to be believed – kudos to the Spectator’s editorial board for speaking with authority. However, they may not realize that their criticisms can be even more widely applied outside of CASA. For example, they also cite the lack of control groups and causation vs correlation errors as a major criticism of CASA’s findings. The entire addiction research field is riddled with exactly those problems – even the gold standard “peer reviewed” studies. The sad fact is that when you start reading the actual research (as opposed to sensational media reports) – beyond the abstract section – you will find that nearly every so-called “scientific” claim about addiction is thoroughly false and unsupported by any reliable scientific method.
As they pointed out themselves, The Spectator isn’t the first to criticize CASA or Califano, a 1998 piece by Stanton Peele and Archie Brodsky called the organization a “neo-temperance” movement, and went on to criticize them for confusing causation with correlation in their promotion of the “gateway drug” concept:
Califano and CASA relied on data from a 1991 government survey to show that both adolescents and adults who have used cigarettes, alcohol, and marijuana are hundreds of times more likely to use cocaine than those who have never used any of the three substances. Califano’s conclusion: The most critical step in stamping out dangerous drug abuse is to prevent young people from embarking on the road to perdition through the gateway of smoking, drinking, or using marijuana.
The cause-and-effect relationships that Califano’s report took to be self-evident are in fact the subject of much scholarly debate. As (New York) City University Medical School pharmacologist John Morgan and his colleagues (1993, p. 217) noted, “This gateway concept seems to resemble driving slowly and safely as a gateway to driving recklessly and unlawfully. The reckless driver has always driven carefully at some point. How often does careful driving proceed to recklessness and does the careful driving cause the recklessness?”
Causation Versus Correlation Errors in the Push for Treatment
One of the most widespread causation/correlation errors in the world of addiction is the myth that treatment works. You’d be hard pressed to find a study of treatment effectiveness which includes a control group. Even Project MATCH, the most expensive study carried out by the US government on treatment effectiveness (with a $35 million dollar price tag) went so far as comparing the results of 3 different treatment methods – but not so far as to include a control group of untreated subjects!
Meanwhile, wide scale epidemiological studies such as NESARC have shown that the percentage of people who end their substance use problems (or “addictions”) after exposure to any form of treatment and/or 12-step meetings, is absolutely no higher than those who end their problems without any treatment or other targeted help.
What’s more, later investigation into the Project MATCH data revealed an unintentional (and previously unacknowledged) control group of those who signed up for the treatment, went through intake, but never attended a single session. Regardless of their non-involvement in the actual treatment, these untreated subjects were followed up with, and found to be as successful as those who attended treatment!
What this all points at is a massive causation/correlation error. Everyone who claims that “treatment works” is simply observing a correlation – that people tend to make some changes in their substance use habits when they enter treatment programs – but with rates of unassisted “recovery” being proven identical (or even better in some cases) – no case can be made that the treatment actually caused the “recovery” observed. Instead, the treatment likely coincided with these life changes and choices- that is, some people (1 in 4) get treatment when they decide to change, most people (3 out of 4) don’t get treatment when they decide to change – but the data shows that at any given time, 75% of people with past substance use issues, whether treated or not, are no longer dependent. So in confusing correlation with causation, treatment advocates and most addiction researchers are taking credit for something that would’ve happened without their involvement!
The Spectator must be applauded for their criticism of CASA, but we should all take note that their criticisms truly apply to the whole of the recovery culture, and not just this single organization.
Yup. Found that copy of The Spectator, coincidentally, on the train yesterday and read the article. I was nearly applauding on the subway when I finished. CASA and the rest of the “treatment” industry is highly tainted by political and economic considerations as well–it’s agenda-driven manure pretending to be “data/science driven” research.
I did 2 years in a 12-Step Fellowship and saw that the ranks of successfully “recovering” (as in more than a couple months of non-addictive behavior) folks was never more than say 4 or 5 people for every 30. Mostly meetings were stories of failure, failure, failure and all the B.S. of powerlessness, plus with new and exciting, hitherto never even considered before, ideas for how to “act out” that I got from other people’s “shares.” When I realized that the longest duration of time I ever had away from my particular addiction had been when I was employing my own strategies and methods, long before I ever decided to enter the “rooms,” and that my problem had actually gotten worse in the time I “kept coming back” to 12-Step meetings–that’s when everything clicked for me and I “stopped coming back.” AA-based stuff is as dubious in its claims as anything that comes out of CASA, and the “proofs” just as shoddy.