FAQs

Before you comment on the site, please give this a read – you might find that your questions and comments are already addressed here. This is by no means an exhaustive list of frequently asked questions; it will be expanded over time.

What’s your solution?

Who writes this stuff? Whoever they are, they must not be an addict.

All content on the site is written by me, Steven Slate. I don’t consider myself an addict, because I don’t subscribe to that label. However, my former behavior would probably classify me as an addict in most anyone’s book. I was an avid substance user between 1993 and 2002. For the last 5 of those years, I used drugs in a very troubling on a daily basis, with a few short periods of abstinence. I felt as if I needed the drugs during that time. I lied, cheated and stole in order to fund my habit. Made several trips through the addiction treatment system and several 12-step groups. I felt powerless at certain points, as if I needed drugs, and was unable to stop. I ended up homeless for a while, was arrested many times, and did a short stint in jail. Luckily, I found an answer, and changed my substance use habits in 2002.

What makes you qualified to talk about addiction?

I’ve studied it for 16 years. Before that, I lived it. I have 12 years experience working for Baldwin Research Institute/Saint Jude Retreats  (a non-12-step educational program for people with substance use problems) as an instructor, lead instructor, instructor trainer, director, and author/researcher. I have chapters on addiction in college textbooks. I count Mark Scheeren and Stanton Peele (both giant thinkers in the field in my eyes) as personal mentors in helping me to understand this fascinating phenomenon and make my own contributions to understanding it.

I ask no one to believe my views based on my personal and professional experience with substance use problems alone. I hope you’ll look at the information on the site, check out some of the citations for yourself, analyze the ideas critically, and form your own opinions.

What do you think about Harm Reduction?

I’m all for it. The ultimate harm reduction measure, as I see it, would be full legalization of all drugs for adults. This would remove the harms of the black market, including especially the harms coming from unknown quality of drugs, and exorbitant drug prices artificially inflated by prohibition and the drug war. And of course, if people didn’t have to worry about arrest and deal with being caught in the legal system, their lives would be harmed far less by their victimless choices. Liberty for drug users would go furthest in reducing harms.

Needle exchange is obviously good, full legalization of needles would be good too. We could go on and on with great things that are being done and can be done to reduce harms. I’m all for it.

I have one major issue with Harm Reduction though, and that’s the rhetoric surrounding it. Many seem to base it around the idea that people with drug use problems are incapable of solving their problems. Fuck that. They can, and we do them a disservice by conveying the message that they can’t. And by “solving their problems” I do not exclusively mean abstinence. I mean, they can stop feeling the need to use drugs in a destructive way. But while we’re at it, abstinence can also be the ultimate harm reduction – yet many (not all) in the harm reduction movement seem to pit harm reduction against abstinence. And again, they suggest that it’s impossible for some. Now I don’t believe anyone should be required to abstain, or led to believe they must abstain – but they also shouldn’t be told that abstinence is bad or impossible. I was abstinent of all drugs for almost 5 years, and I believe it was the absolute best choice for me at that time of my life. I think that to help people, we have to help them to explore their choices, which means openly exploring abstinence and forms of moderation – as well as continued heavy use with harm reduction measures. Let’s put it all on the table. The anti-abstinence camp is overreacting to the history of enforced abstinence, in my opinion.

On a personal level, I think the easiest thing any individual can do to help reduce harms is stop badgering people to quit. They’re already stressed the fuck out, and more pressure isn’t gonna make their journey any easier. Also, stop portraying them as powerless. If they like getting high, accept that – it is their life, not yours. Don’t put them in the position of having to justify their preferences to you. This only confuses them and deepens the problem. I know this from being on the receiving end of the pressure to quit and to justify myself. I only dug my hole deeper in response to that crap.

What do you think of buprenorphine / methadone / MAT / OAT / OST?

I am critical of the hype around these addiction treatments, but I am not against them in any way. I think that the claims of their effectiveness have been very deceptive. Activists have focused on evidence of reduction in fatal overdoses associated with use of these medications, which is important. But this evidence has been conflated with the claim that these medications are effective at treating addiction. Addiction is a slippery concept to be sure, but one thing it means to most people is continued excessive use of a substance despite high negative costs and consequences. So, an effective addiction treatment, in most people’s minds, would be something that helps people to reduce their substance use. Evidence of overdose reduction is not evidence of success in treating addiction. It is evidence of preventing one negative consequence of addiction. I’m not trying to downplay that. Preventing overdoses is a great thing. It’s just not the same thing as successfully treating addiction.

To be clear, my issue with the hype around these medications is that they are claimed to be the “gold standard of opioid addiction treatment” and said to have a lot of evidence to prove that, but this claim is almost always followed by a reference to evidence of overdose reduction. It would be more accurate if activists just made a claim about overdose reduction instead of conflating overdose reduction with treating addiction.

I have not been able to find evidence that these treatments help people to significantly reduce their substance use beyond a period of a few months. When I criticize, I am not trying to deter anyone from taking these medications. I am simply arguing for realistic presentation of the reality of these treatments. While there are certainly anecdotes of success with these medications (and anecdotes of failure), there does not seem to be a good body of evidence of long-term effectiveness at reducing excessive drug use with them. My opinion, based on the evidence I’ve seen, is that successes seen in methadone/buprenorphine patients are usually a matter of regression to the mean. That is to say, these successes represent changes the individual would’ve gone through even if they hadn’t taken the treatment.

Some important context needed in assessing the effectiveness of any addiction treatment: most people get over these problems without treatment. For example, 88% of the American soldiers in Vietnam with heroin addictions quit upon returning home and did not relapse. Only 2% received treatment when coming home. In 24 year follow up, 96% had recovered. Date from NESARC 2002 epidemiological survey showed that the probability of recovery from prescription opioid addiction is 96%. Furthermore, 88% of people who’d had heroin addictions at some point were currently recovered for a year or more, and those who received treatment did not have a higher rate of recovery than those who received treatment. When we hear a story of someone recovering with a particular treatment, we tend to think the treatment was the cause of the recovery, when in fact the person is just as likely to recover without it – which makes it very hard, when you think critically, to credit the treatment for their success. For this reason, I am skeptical of all claims of treatment effectiveness, not just MAT.

With that said, I am happy for anyone who finds methadone or buprenorphine personally helpful and lifesaving. There is nothing for you to be ashamed of, and nothing wrong with taking a medication for the rest of your life when you find that the benefits personally outweigh the costs.

For anyone who thinks they may need buprenorphine, you can find prescribing doctors through the SAMHSA Buprenorphine Practitioner Locator.

Many (not all) MAT activists have made the issue very black & white, and seem to be intolerant of any opinion that doesn’t glorify these medications. For this reason, many are quick to portray me as being against these medications, or as a denier of any success associated with their use.

To be clear I am not anti or pro these medications. I am neutral. While I do not think that they work like many think they do, this is not the same as being against them or against people taking them. I also support full legalization of all drugs, for any adult to walk into a pharmacy and buy without a prescription – that includes methadone and buprenorphine. This does not mean that I recommend them or against them.

Stop bashing AA. Why don’t you create a program instead of knocking other programs?

I don’t think I’m really “bashing” AA (based on my concept of bashing), but yes I’m very critical, and I won’t stop. I’m here to explore and spread the truth about addiction, and I will continue to feel free to criticize anyone who I believe stands in the way of that mission and/or actively spreads misinformation. If you don’t like it, close the window. If you’re about to send me hate-mail telling me that I’m killing people with my words, save it – I’ve gotten that email about a million times.

I work developing solutions for people with substance use problems. I created my own educational program that I used with clients as part of coaching for a few years; then I worked with Stanton Peele translating some of his work into a distance learning program; and then I went back to work with the Saint Jude Retreats, where I co-authored the 13th edition of the Saint Jude Program (published May 2014), and have been intimately involved in the development of our Cognitive Behavioral Education method of helping people with substance use problems.

I knock other programs because it is actually addiction mythology spread by those programs that keeps people feeling trapped in addiction. They cause more problems than they solve.

You say “addiction is not a disease” – don’t you know the authorities say it is definitely a disease?

I do know that NIDA, ASAM, the AMA, Nora Volkow MD, Dr Phil, Dr Drew, and many others say that addiction is a disease. Just as I hope you don’t uncritically take my word on the issue, I hope you don’t uncritically take their word on it as well. Please think critically, and judge the evidence for yourself. I have looked at the evidence and arguments presented for the disease model of addiction, and I can’t find anything that holds up to scrutiny.

If authority is all you care about, then let me say this – I can list plenty of authoritative sources who have also concluded that addiction is not a disease: Gene Heyman PhD of Harvard; Sally Satel MD of Yale; Stanton Peele PhD of NYU and The New School for Social Research; Peter Cohen PhD of the Centre For Drug Research in Amsterdam; Thomas Szasz; Professer David Hanson PhD; Professor Jeffrey Schaler; Dr Tom Horvath and the many other PhDs behind SMART Recovery. There are more to be listed, in fact there have been several polls over the years asking doctors if they believe addiction or alcoholism is a disease, and majorities have said they don’t believe it is a disease.

So we could come up with two groups of professionals that hold opposite opinions about whether addiction is a disease or not. What would we do then – count them up and see which side has more people? Is that how you decide a scientific truth – by a vote? Obviously it is not. A fact is a fact regardless of how many people believe it or not. So please, analyze the available information, and judge for yourself.

For you people who can only comprehend appeals to authority, here is a page full of quotes from credentialed experts. LINK to Quotes from Experts About Addiction. I hope and pray that you gain the courage one day to think for yourself and trust your own judgment.

Why does it matter whether addiction is a disease or not? Let’s just help people.

There is such a thing as a stupid question, and this is one. If you want to solve a problem, you need to understand the nature of the problem. If your car won’t run because it’s out of gas, changing the battery won’t do a damn thing to fix that problem. Likewise, if people are experiencing problems with drug and alcohol use, we need to understand why they are using drugs and alcohol. Is the use caused by a disease or something else? This is important to know because it will direct your approach to solving the problem.

If heavy drug and alcohol use isn’t caused by a disease, then why do people do it?

People freely choose to use drugs and alcohol because, at the time they’re doing it, they believe it will make them happy. At the time they do it, they believe it is their best available option for attaining happiness.

But there are horrible consequences to heavy drug and alcohol use. How can that make people happy?

Those negative consequences (or costs) may not make people happy. The consequences are often extreme and disastrous, even fatal. Obviously, the consequences put people through a lot of turmoil, so they’re not happy about the consequences when they set in. Nor are they necessarily happy in times where they simply feel regret about continuing their destructive habit. However, this doesn’t change the fact that at first, when the high kicks in, they experience a certain kind of happiness/pleasure.

So people use drugs and alcohol because they’re depressed?

No. I see how people arrive at that conclusion, and I see how a state of depression can be used as a reason to use drugs and alcohol, but it’s important to know that depression (or other troubling mood states such as anxiety or stress) doesn’t directly “cause” drug and alcohol use. A vast majority of people experience depression without reacting by using drugs and alcohol. Why is that? Probably because they don’t believe that drug and alcohol use is their best viable option for attaining personal happiness. Again, people use drugs and alcohol because they believe it will bring them happiness.

But I have stress/anxiety/trauma/depression, and these problems make me use drugs and alcohol. Are you saying I shouldn’t get help for those things?

No. You should get whatever help you feel is necessary for those things. However, as long as you believe that drugs and alcohol are your best viable option for happiness, you will continue to use drugs and alcohol – no matter what help you’re getting for your other problems. On the issue of “addiction”, you will change it when you cease to believe that heavy drug and alcohol use is your best option for finding happiness. Work on changing that belief if you want to change your habit.

Believing in the “underlying causes of addiction” (and/or “self-medication”) model creates a more complicated problem. If you invest in this idea, then every time life sends a problem your way, or when you feel the very normal emotions of sadness, depression, stress, or anxiety – then you will feel as if you must use drugs and alcohol. If you cease to believe that heavy drug or alcohol use is your best option for happiness then you will cease the heavy use of drugs and alcohol – regardless of whether you continue to face depression, stress, anxiety, etc.

But what about physical addiction – tolerance and withdrawal – doesn’t that cause people to use drugs and alcohol?

No it doesn’t. These are medical problems which are separate from the behavioral pattern known as addiction. Withdrawal syndrome is a set of physical symptoms people experience when they stop using alcohol and certain drugs. It doesn’t cause you to do anything other than experience the consequences of detoxification. If you believe you’ll be happier detoxifying with medical help or not, then you will do that. If you believe you’d be happier taking more drugs and alcohol, you will do that. But in neither case are you forced to do anything behaviorally. If you’re experiencing withdrawal symptoms, the best choice is usually to seek medical help from your local emergency room, as withdrawal from alcohol and some drugs can have fatal consequences.

Consider the fact that a large proportion of people who receive medical help with detoxification go back to heavy drug or alcohol use after withdrawal symptoms are gone. What caused them to do that? You guessed it – they thought they’d be happier drunk or high. Substance use is a choice like any other choice that people make every day of their lives: people do what they think is their best option within their power to be happy.

You say addiction is a choice, so what do you suggest people do, use willpower to quit?

No. Willpower is a confused concept. I suggest people stay as far away from that idea as possible. “Addicts” have no less or no more “willpower” than anyone else. Every behavior that every person makes at any given time is, in a sense, an expression of willpower. To do something is to exercise the power to carry out your will. If you’re choosing to use drugs, then that is your will. If you’re choosing to ride your bike, go to work, clean your house, or drink a smoothie – then those are also your will. I don’t suggest that anyone go on a hunt for some special level or source of “willpower.”

What you can do, is change your will. When you start looking for new options in life, re-evaluating your usual options, and examine and change the beliefs that underlie the “will” for heavy drug and alcohol use – then your “will” will probably change. Essentially, if you choose to think differently about drugs and alcohol, and about how they fit into your life and competing goals, then your desire for them will change.

When we think about using willpower to change a substance use habit, we’re probably accepting the desire/will for substance use as an inevitability – a thing we’re stuck with, that we must battle with this special force called willpower. And in a certain sense, we’re thinking of it as not being our own will. But it is. If you’re doing a thing, you are willing it – and you can’t will it’s opposite at the same exact time.

See how confusing all of that is? But it is the trap we get into when we conceive of willpower as a force we need to build in order to battle our own will – a sort of circular thinking necessitated by modern willpower theorists.

However, if you think of the context in which willpower is usually mentioned, it often represents the act of subjugating your immediate gratification desires to your longer-term goals. If you care more about those longer term goals, believe you can achieve them, and think it’s worth delaying your gratification – then you will end up without the will to use substances heavily – no special power needed, just a different set of thoughts and perspective. But then, the concept of willpower needn’t be involved at all – because it only mucks up the situation, and makes you feel like you’re weak and need to summon some extra strength. You don’t. You just need to believe in a different path to happiness, and thus have a different “will” to carry out. Some people who are successful in 12-step programs invest in the idea of carrying out god’s will. It becomes so attractive to them, that they no longer have the will to use substances. That’s wonderful for them, but that idea doesn’t appeal equally to all people.

So what should I do to change my substance use habit?

If you think you may need help for physical withdrawal symptoms, get it (from a hospital, emergency room, or private doctor). Then…

The simple answer is: make different choices. The slightly more complex answer is: develop a vision of a lifestyle and choices that will make you happier than how you’re living now – this will lead to the motivation to live differently and make new choices. It’s not an easy answer, because it means that you have the responsibility for change in a very personal way: you need to think about what you want for yourself in a big way, and go about pursuing it. This answer doesn’t allow you to blame any “causes of addiction”, or attempt to shift the responsibility for change onto a therapist, god, support group, or medication. It requires new thoughts from you, if you want change.

There are infinite paths that will get you to a place where you no longer believe that heavy substance use is your best option for happiness. I mentioned one in the FAQ above – some people come to believe that they’d be happier with the 12-step lifestyle than with a heavy substance use lifestyle. Unfortunately, I can’t recommend that one, because it comes along with a set of beliefs that undermine most people’s efforts at change (and with AA’s 95% dropout rate, it clearly isn’t attractive to most). Nevertheless, some still find it to be a better option than heavy substance use – they find it so attractive that they can actually become somewhat impervious to the negative teachings and dynamics of the 12-step world. The good news is that most people figure out that they’d be happier with a new course of behavior on their own, without formal help. You can be one of those people. There is no set of easy steps that will help everyone to find their happier lifestyle, and there is no way to force someone to believe that they’ll be happier with a different lifestyle. Each individual must think for themselves about the value of their habit, and to think of their happiest options, and whether to pursue change or not.

I maintain strongly that everyone already has what it takes inside of them to change their substance use habits. If you have your heart set on getting formal help with a substance use problem, the only program I can wholeheartedly recommend is the Saint Jude Program. It’s the solution I used for my own life back in 2002, and it is offered by the company I now work for – and as of today (3-25-14) they are advertising on this website. You’ll see their number listed above and in some banner ads on the site. As with everything I say here on the site, please don’t just take it on my authority – see what else is out there, and see what they have to say, and use your best judgment to compare.

My recommendation comes mostly from my hardline stance that addiction is not a disease, and that substance users of all stripes are always in full control of the choice to use substances. The Saint Jude Program is the only one I’ve found that truly operates with these facts as its foundation. Furthermore, it doesn’t prescribe a specific lifestyle or demand abstinence as 12-step programs do. It puts the responsibility on the troubled person to develop their own vision of a happier lifestyle, and gives them a forum which encourages doing so, and the knowledge to efficiently make personal changes that last – rather than being distracted by battling an imaginary disease or weakness.

“Why are you so obsessed with Cognitive Behavioral Therapy (CBT)? I did it at rehab and it didn’t work.”

I AM NOT.

People keep falsely attributing a recommendation of Cognitive Behavioral Therapy to me. I have studied CBT, and found it to contain much wisdom. Much of that wisdom – but not all of it – is identical to what I think is most meaningful for understanding personal problems such as heavy substance use, and how to change such problems. I have respect for CBT.

Also, my employer, Baldwin Research Institute, have pioneered an alternative method of help for people with substance use which they called Cognitive Behavioral Education – CBE. The E is key. E stands for education. They also called it CBL (Cognitive Behavioral Learning) at some point. While both of these names have been abandoned, and our approach is now named The Freedom Model, It never was a form of therapy, and I do not personally recommend or discourage therapy. BRI’s and my approach is educational. We provide educational experiences.

The confusion over the name of our approach, and the fact that we do cite research and principles identified in the CBT world may be the reason some people think I am recommending generic CBT. But again, the only things I recommend are education about the facts of “addiction,” and medical help with detoxification when needed.

“I agree with you Steven, people choose to get addicted. It’s their fault because they chose to do drugs in the first place, and then got addicted.”

I realize this isn’t a question, but it’s a frequent comment that I need to address. Now, please take note of my response to this sentiment, and let me be totally clear:

WE ARE NOT IN AGREEMENT BECAUSE THAT IS NOT HOW I SEE THIS.

The way I see it, all substance use is freely chosen. All of it. No one ever “gets addicted” by the power of a drug and enters a state where they can’t stop using drugs. There has never been a solid demonstration of the notion that those who are called addicts (or those who feel addicted; or those who feel/believe/say that they cannot stop) are involuntarily using drugs (or alcohol). The best evidence shows the opposite – that the same factors that influence other voluntary behaviors also affect the behavior of substance use in those considered “addicted.”

So I don’t think it’s people’s fault that they got addicted, because I don’t believe anyone gets addicted. “Addicted” in the common usage of the term, means unable to choose to stop; compelled to continue to use substances; using substances involuntarily.

I am also not looking to “blame” or “shame” people. I’m not looking to judge them as morally bad. I am looking to identify the fact of where control of substance use resides, and to use that knowledge to help people solve their problems. The control resides squarely in the mind of the individual.

Don’t get addiction confused with withdrawal syndrome and tolerance either when making this silly statement. These are very different things. Even NIDA understands that these are separate things. This is NOT a controversial point at this time in history of knowledge about substance use. Here’s a quote from NIDA about the distinction:

Is there a difference between physical dependence and addiction?

Yes. Addiction—or compulsive drug use despite harmful consequences—is characterized by an inability to stop using a drug; failure to meet work, social, or family obligations; and, sometimes (depending on the drug), tolerance and withdrawal. The latter reflect physical dependence in which the body adapts to the drug, requiring more of it to achieve a certain effect (tolerance) and eliciting drug-specific physical or mental symptoms if drug use is abruptly ceased (withdrawal). Physical  dependence can happen with the chronic use of many drugs—including many prescription drugs, even if taken as instructed. Thus, physical dependence in and of itself does not constitute addiction, but it often accompanies addiction. This distinction can be dificult to discern, particularly with prescribed pain medications, for which the need for increasing dosages can represent tolerance or a worsening underlying problem, as opposed to the beginning of abuse or addiction.

From: Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition) 2012 by NIDA (National Institute on Drug Abuse) (accessed 2/15/16)

Please keep in mind I don’t endorse that entire quote, but it makes the basic distinction clear. And now that we have that to think about, maybe you’ll want to change your position? IDK. But if you’re just thinking of physical dependence, then you may want to modify your statement to reflect that? Still, it wouldn’t apply to everyone. There are many people who have unwittingly gained a physical dependence to drugs prescribed by a doctor. That’s not their “fault” if you’re concerned with fault. However, they also aren’t “addicted.” They have a physical condition, which with many drugs and with many people, will simply cause discomfort when they cease to use, and will go away in a matter of days uneventfully as long as they don’t make it out to be more meaningful than it is. With some other drugs (primarily alcohol and benzodiazepines), in some people, depending on levels and frequency of use, medical help may be needed to safely go through withdrawal (take care, the effects can be fatal – the only way to find out for sure is to seek proper medical care). Nevertheless, this is not addiction, and these people are not compelled to continue using at high levels. This is medically handled in a matter of days. If it was what we call “addiction” then everyone could be cured of addiction in 3-14 days in hospital detox unit. Those detoxes are revolving door centers though – because people still CHOOSE to use at high rates even after their withdrawal symptoms and tolerance are gone, and dig the hole of negative consequences all over again. This behavior is what is referred to as addiction. In light of this common pattern of behavior known to all who work at detoxes, the withdrawal syndrome is actually completely INCONSEQUENTIAL to what is called addiction.

NEXT 

If you try to make some comparison to cancer or diabetes, then you look like a total idiotic fool, and I hate to be associated with you. I hate it. Your argument is so silly on it’s face. People say nonsense such as:

“You don’t choose to get cancer but you choose to get addicted. You didn’t have to take drugs but you did, and now you got yourself addicted, and it’s your fault – so addiction isn’t a disease, it’s a choice.”

God, I really can’t get across how much I HATE being associated with such views. I completely disagree.

Here’s a simple hole in that statement: you absolutely can make choices that bring cancer upon yourself. Lung cancer from smoking is the perfect example. And now your whole argument has fallen apart. So if your contention is that any condition acquired by choices is not a disease, then you are wrong. PLENTY of disease are acquired by our freely chosen behavior. The fact is that you can make the choices that develop cancer, but then the cancer has a life of it’s own, and you can’t choose to not have it in an instant. It requires medicine or a fluke of a miracle to reverse/stop the progression.

Also, in such an argument, YOU ARE AGREEING WITH THE MAIN FEATURE OF THE DISEASE MODEL OF ADDICTION. You are saying that they’ve gotten into an addicted state in which they can’t stop. You may say you don’t believe addiction is a disease, but YOU BELIEVE IN EXACTLY THE SAME THING.

The debate here, for people who are seriously interested in addiction is whether or not people who use substances are compelled or currently in control. It’s not about their past choices – it’s about their present ability/or inability. I believe they have the ability to choose now, and I believe my conclusion is a solid scientific conclusion based on all the evidence I have been able to gather and analyze.

I can’t say this enough times: people choose every single instance of substance use. They aren’t “addicted” they are freely acting at all times. IF YOU THINK PEOPLE “GET ADDICTED” THEN YOU AND I DISAGREE.

How are you a .org?

This question was recently asked of me, and I can only assume it was asked to troll me and suggest some kind of wrongdoing, since I’m always being accused of doing something nefarious here – but I’ll answer it anyways. I wanted the name cleanslatedotcom, but that wasn’t available. I started looking up other variations, like thecleanslatedotcom. Had that been available, I would’ve registered it. I saw that .org was, and so I jumped on it, end of story.

According to Wikipedia:

The domain org was one of the original top-level domains, with com, us, edu, gov, mil and net, established in January 1985. It was originally intended for non-profit organizations or organizations of a non-commercial character that did not meet the requirements for other gTLDs.

Registrations of subdomains are processed via accredited registrars worldwide. Anyone can register a second-level domain within org, without restrictions.[4][5] In some instances subdomains are being used also by commercial sites, such as craigslist.org. According to the ICANN Dashboard (Domain Name) report, the composition of the TLD is diverse, including cultural institutions, associations, sports teams, religious, and civic organizations, open-source software projects, schools, environmental initiatives, social, and fraternal organizations, health organizations, legal services, as well as clubs, and community-volunteer groups.

Why is your site named The Clean Slate?

It’s a play on my own name (Steven Slate), the word “clean” which is recovery lingo, and the goal of the site – which is to “wipe the slate clean” of everything you thought you knew about addiction. I really do believe that if our world was rid of the harmful recovery & addiction rhetoric, less people would develop substance use problems, and those that did would get over them quickly – lacking the self-defeating disease model of addiction.

73 comments

  1. Just curious… If I am to “Make better choices and create a vision for my life” exactly how might I go about doing that? Where may I find the support to continue doing that on sustained basis? and If it is in your book… how come I gotta BUY it… all the other people, agencies, non profits, and such, etc… offer that for free? Will church work?

    1. Hi Mike,

      Despite the fact that you started by saying “Just curious…” I don’t think this is a good faith question. But since it’s a distortion of what I’ve said, and seeks to paint me in a negative light, I will respond in defense of myself, and hopefully also for the benefit of other readers who are interested in learning something.

      Your posted the quote “Make better choices and create a vision for my life” as if it’s something I said. In fact, I didn’t say it, and although I’ve used similar words, it isn’t even an accurate paraphrase of what I’ve said here. Searching the page for these words, I see that another commenter used them to derisively sum up what I’ve said. I also see that I used some of these words in a 600 WORD ANSWER to the question “So what should I do to change my substance use habit?”

      “Make better choices and create a vision for my life” does not even come close to summing up what I said there, and I encourage you to scroll up to what I wrote, and give it a read if you are somehow convinced that’s what I said. I started by saying:

      The simple answer is: make different choices. The slightly more complex answer is: develop a vision of a lifestyle and choices that will make you happier than how you’re living now – this will lead to the motivation to live differently and make new choices. It’s not an easy answer, because it means that you have the responsibility for change in a very personal way: you need to think about what you want for yourself in a big way, and go about pursuing it.

      And then I go on explaining some nuances. But the point in that passage is that to make different choices regarding substance use you’ve gotta change your perspective first. You need to find a way to see your options differently, and once you do that, you will be motivated to make different choices. At the end of the day, it is all a choice, which is why I started with that as “the simple answer”, clearly denoting it would be followed up with a little more explanation.

      How do you choose to change your career? You start thinking about what it would be like to work somewhere else or in another field. If the scales tip enough to where a change in career becomes more attractive and viable to you, then you make the choice to follow that path. This is how all non-arbitrary choices are made in life – we develop reasons in our mind why some option is better than the others. That includes “vision” because we don’t always know exactly what the other option will be like until we try it.

      You ask “Where may I find the support to continue doing that on sustained basis?”

      At the core of The Freedom Model approach that I’ve developed with my colleagues at Baldwin Research Institute is figuring out that you’d like to make a change, rather than being scared into making a change, or panicked and coerced into making a change. Because when you initiate it in the pursuit of happiness you have motivation. When you don’t, you’re just trying to deter yourself from using, and it’s a struggle of willpower – of resisting urges and cravings. Again, this sometimes takes some imagination (or vision) – but once you’ve done it, and become convinced that a path of less or no substance use can be genuinely happier for you than heavy substance use, it takes no willpower, no special level of “self-control”, no resistance of desire, strength, or “support.” It doesn’t require long stretches of aftercare or meetings. I did not require “support” or anyone to cheerlead me on to get heroin in any way when I believed it was what I needed to be happy. I had endless drive to do it and overcame most obstacles to get it, all alone. Likewise, once I became convinced that life without heroin could and would be happier, I required no “support” or cheerleading to carry out that preference. I just didn’t do it, because I didn’t think I needed it to feel good anymore. To get back to my career analogy – when you’ve found you’re happier not working at that old job anymore, you don’t need a support or aftercare system to keep you from walking into your old office. It just doesn’t really cross your mind to do so. You’ve moved on. And if people told you that you needed to fight going back to that old office for the rest of your life, and you believed them – they’d have helped to make your change much more difficult than it has to be in reality, and introduced tons of unnecessary self-doubt into your life. You really can just move on. It’s great. I love life without heroin. There was a time when I liked heroin more than anything else, and now I don’t. Case closed.

      You also ask “and If it is in your book… how come I gotta BUY it… all the other people, agencies, non profits, and such, etc… offer that for free? Will church work?”

      And that’s the part that really tells me you’re just trying to paint me in a negative light. My book costs $30 for paperback, and $13 for a kindle version. Our services cost more, but still less than the cash price of most 28 day inpatient rehabs. I’m sorry that if you want books and services you have to pay for them, but everything in life comes at some price. We wouldn’t be able to offer these things, just like you wouldn’t be able to offer your rehab services if somebody didn’t pay for them in some way. You’re trying to portray me as greedy, and I don’t like it. And not that I need to justify myself, but I do give plenty away for free, including all the information on this website, which no one pays me to write, and nobody has to pay to read it. I have gotten countless emails over the years from people who’ve said that they used the ideas and information on this site to solve their own substance use problems. My organization BRI also gives away a lot of help for free.

      Also, you ask “how come I gotta BUY it…”

      The great thing is that my message is that you don’t have to buy anything. Unlike people who send the message that addiction is a disease that you can’t stop without treatment – my message is the truth that most people quit/moderate without treatment, and that everyone who gets over their problem ultimately does so by choice, and so obviously most everyone does it without me. I make it a point to tell people that they do not need me or my help, but if they want it, I have it to offer. I do not tell people they are powerless over their own behavior, because they are not. They are in control of their own use of substances at all times. They only need to figure out that they’d like a change better than continuing, and then do it. I make it a point to say that there are infinite ways to get to that realization. This sort of answers your final question “Will church work?” Some people find perspective-changing ideas in church, and then they change. I believe that’s been happening for thousands of years. But I take issue with the word “work” because it implies that just sending people to church will change them. They will only change if THEY change their perspective of their options – that’s the only thing that “works”, though there are a number of different things that people might find/believe help them to do that.

      Any other snide questions?

      Steven Slate

      1. Bravo, Steven! I love a proper academically polite but ferociously thoroughly response to trolls. Excellent content on your blog and I have enjoyed the unbelievably refreshing change in my own mind that has occurred in the past hour since stumbling across the Freedom Model during some research on current social issues. I’ve struggled for half my life with daily drinking, gone through AA, outpatient treatment, counseling, not to mention the years and years and years of feeling like my own label of “functional alcoholic” was just me being in denial, dreading the inevitable “recovery” of never touching another drop. To be free of the label…to release my own identity from the shackles of powerlessness and instead look at my choices on a simple boolean scale. Happy/Happier or perhaps if I’m feeling low and tempted, I may need to invert it to Unhappy/Unhappier ….anyway, I’m blown away by the simplicity of it. Wow. Thank you!

      2. Incredibly written and completely agree. Almost relieved that someone else feels this way about calling it a “disease”. I have been Feeling outrage over the righteous attitude of a family member hanging on to the word “disease”, as if that gives them an excuse for any relapse which is merely a choice they prefer at that time.

  2. Truly, congratulations if NA and AA worked for you, however, for the majority of OUD patients, MAT therapy with Buprenorphine has been a godsend. Opioid addiction hits some people harder and deeper than others and for the thousands of patients treated here at Brightside clinics, suboxone and the like are in their words a “miracle”. If cold turkey and AA works, awesome, and if it doesn’t, then you know there is a wonderfull alternative. Just don’t let anyone guilt or shame you into thinking that you are wrong or weak if you can’t do it on your own. We all need help at some point in life. Its OK!

  3. Hi Steven,

    Thanks for the well written and free content! The world needs more people like you and Mark/Michelle challenging the status quo and finding and telling the truth.

    Brian

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