They’re screaming it from the rooftops: “addiction is a disease, and you can’t stop it without medical treatment”! But why are they screaming it so loud, why are they browbeating us about it, why is it always mentioned with a qualifier? You don’t hear people constantly referring to cancer as “the disease of cancer” – it’s just “cancer”, because it’s obvious that cancer is a disease, it’s been conclusively proven that the symptoms of cancer can’t be directly stopped with mere choices – therefore no qualifier is needed. On the other hand, addiction to drugs and alcohol is not obviously a disease, and to call it such we must either overlook the major gaps in the disease argument, or we must completely redefine the term “disease.” Here we will analyze a few key points and show that what we call addiction doesn’t pass muster as a real disease.
Real Diseases versus The Disease Concept or Theory of Drug Addiction
In a true disease, some part of the body is in a state of abnormal physiological functioning, and this causes the undesirable symptoms. In the case of cancer, it would be mutated cells which we point to as evidence of a physiological abnormality, in diabetes we can point to low insulin production or cells which fail to use insulin properly as the physiological abnormality which create the harmful symptoms. If a person has either of these diseases, they cannot directly choose to stop their symptoms or directly choose to stop the abnormal physiological functioning which creates the symptoms. They can only choose to stop the physiological abnormality indirectly, by the application of medical treatment, and in the case of diabetes, dietetic measures may also indirectly halt the symptoms as well (but such measures are not a cure so much as a lifestyle adjustment necessitated by permanent physiological malfunction).
In addiction, there is no such physiological malfunction. The best physical evidence put forward by the disease proponents falls totally flat on the measure of representing a physiological malfunction. This evidence is the much touted brain scan[1]. The organization responsible for putting forth these brain scans, the National Institute on Drug Abuse and Addiction (NIDA), defines addiction in this way:
Addiction is defined as a chronic relapsing brain disease that is characterized by compulsive drug seeking and use, despite harmful consequences. It is considered a brain disease because drugs change the brain – they change it’s structure and how it works. These brain changes can be long lasting, and can lead to the harmful behaviors seen in people who abuse drugs.
The NIDA is stating outright that the reason addiction is considered a disease is because of the brain changes evidenced by the brain scans they show us, and that these changes cause the behavior known as addiction, which they characterize as “compulsive drug seeking and use”. There are three major ways in which this case for the disease model falls apart:
- the changes in the brain which they show us are not abnormal at all
- people change their behavior IN SPITE OF the fact that their brain has changed in response to repeated substance use jump to section
- there is no evidence that the behavior of addicts is compulsive (compulsive meaning involuntary) (point two addresses this, as well as some other research that will be presented) jump to section
This all applies equally to “alcoholism” as well. If you’re looking for information on alcoholism, the same theories and logic discussed here are applicable; wherever you see the term addiction used on this site, it includes alcoholism.
Brain Changes In Addicts Are Not Abnormal, and Do Not Prove The Brain Disease Theory
On the first count – the changes in the brain evidenced by brain scans of heavy substance users (“addicts”) do not represent a malfunctioning brain. They are quite normal, as research into neuroplasticity has shown us. Whenever we practice doing or thinking anything enough, the brain changes – different regions and neuronal pathways are grown or strengthened, and new connections are made; various areas of the brain become more or less active depending upon how much you use them, and this becomes the norm in your brain – but it changes again as you adjust how much you use those brain regions depending on what you choose to think and do. This is a process which continues throughout life, there is nothing abnormal about it. Here, Sharon Begley describes neuroplasticity: [2]
The term refers to the brain’s recently discovered ability to change its structure and function, in particular by expanding or strengthening circuits that are used and by shrinking or weakening those that are rarely engaged. In its short history, the science of neuroplasticity has mostly documented brain changes that reflect physical experience and input from the outside world.
So, when the NIDA’s Nora Volkow and others show us changes in the brain of a substance user as compared to a non-substance user, this difference is not as novel as they make it out to be. They are showing us routine neuroplastic changes which every healthily functioning person’s brain goes through naturally. The phenomenon of brain changes isn’t isolated to “addicts” or anyone else with a so-called brain disease – non-addicted and non-depressed and non-[insert brain disease of the week here] people experience neural adaptations too. One poignant example was found in the brains of London taxi drivers, as Begley and Jeffrey Schwartz pointed out in The Mind and The Brain. [4]
Is Being A Good Taxi Driver A Disease?
A specific area of the brain’s hippocampus is associated with creating directional memories and a mental map of the environment. A team of researchers scanned the brains of London taxi drivers and compared their brains to non-taxi drivers. There was a very noticeable difference, not only between the drivers and non-drivers, but also between the more experienced and less experienced drivers:
There it was: the more years a man had been a taxi driver, the smaller the front of his hippocampus and the larger the posterior. “Length of time spent as a taxi driver correlated positively with volume in…the right posterior hippocampus,” found the scientists. Acquiring navigational skills causes a “redistribution of gray matter in the hippocampus” as a driver’s mental map of London grows larger and more detailed with experience. [4]
So, the longer you drive a cab in London (that is, the longer you exert the mental and physical effort to quickly find your way around one of the world’s toughest to navigate cities), the more your brain physically changes. And the longer you use drugs, the more your brain changes. And indeed, the longer and more intensely you apply yourself to any skill, thought, or activity – the more it will change your brain, and the more visible will be the differences between your brain and that of someone who hasn’t been focused on that particular skill. So, if we follow the logic of the NIDA, then London’s taxi drivers have a disease, which we’ll call taxi-ism, that forces them to drive taxis. But the new diseases wouldn’t stop there.
Learning to play the piano well will change your brain – and if you were to compare brain scans of a piano player to a non-piano player, you would find significant differences. Does this mean that piano playing is a disease called Pianoism? Learning a new language changes your brain, are bilingual people diseased? Athletes’ brains will change as a result of intensive practice – is playing tennis a disease? Are soccer players unable to walk into a sporting goods store without kicking every ball in sight? We could go on and on with examples, but the point is this – when you practice something, you get better at doing it, because your brain changes physiologically – and this is a normal process. If someone dedicated a large portion of their life to seeking and using drugs, and their brain didn’t change – then that would be a true abnormality. Something would be seriously wrong with their brain.
Its not just physical activity that changes our brains, thoughts alone can have a huge effect. What’s more, whether the brain changes or not, there is much research which shows that the brain is slave to the mind. As Begley points out elsewhere, thoughts alone can create the same brain activity that would come about by doing things[2]:
Using the brain scan called functional magnetic resonance imaging, the scientists pinpointed regions that were active during compassion meditation. In almost every case, the enhanced activity was greater in the monks’ brains than the novices’. Activity in the left prefrontal cortex (the seat of positive emotions such as happiness) swamped activity in the right prefrontal (site of negative emotions and anxiety), something never before seen from purely mental activity. A sprawling circuit that switches on at the sight of suffering also showed greater activity in the monks. So did regions responsible for planned movement, as if the monks’ brains were itching to go to the aid of those in distress.
So by simply practicing thinking about compassion, these monks made lasting changes in their brain activity. Purely mental activity can change the brain in physiologically significant ways. And to back up this fact we look again to the work of Dr Jeffrey Schwartz[3], who has taught OCD patients techniques to think their way out of obsessive thoughts. After exercising these thought practices, research showed that the brains of OCD patients looked no different than the brains of those who’d never had OCD. If you change your thoughts, you change your brain physically – and this is voluntary. This is outside the realm of disease, this shows a brain which changes as a matter of normality, and can change again, depending on what we practice choosing to think. There is nothing abnormal about a changing brain, and the type of changes we’re discussing aren’t necessarily permanent, as they are characterized to be in the brain disease model of addiction.
These brain change don’t need to be brought on by exposure to chemicals. Thoughts alone, are enough to rewire the very circuits of the human brain responsible for reward and other positive emotions that substance use and other supposedly “addictive” behaviors (“process addictions” such as sex, gambling, and shopping, etc.) are connected with.
The Stolen Concept of Neuroplasticity in the Brain Disease Model of Addiction
Those who claim that addiction is a brain disease readily admit that the brain changes in evidence are arrived at through repeated choices to use substances and focus on using substances. In this way, they are saying the disease is a product of routine neuroplastic processes. Then they go on to claim that such brain changes either can’t be remedied, or can only be remedied by outside means (medical treatment). When we break this down and look at it step by step, we see that the brain disease model rests on an argument similar to the “stolen concept”. A stolen concept argument is one in which the argument denies a fact on which it simultaneously rests. For example, the philosophical assertion that “reality is unknowable” rests on, or presumes that the speaker could know a fact of reality, it presumes that one could know that reality is unknowable – which of course one couldn’t, if reality truly was unknowable – so the statement “reality is unknowable” invalidates itself. Likewise, the brain disease proponents are essentially saying “neuroplastic processes create a state called addiction which cannot be changed by thoughts and choices” – this however is to some degree self-invalidating, because it depends on neuroplasticity while seeking to invalidate it. If neuroplasticity is involved, and is a valid explanation for how to become addicted, then we can’t act is if the same process doesn’t exist when it’s time to focus on getting un-addicted. That is, if the brain can be changed into the addicted state by thoughts and choices, then it can be further changed or changed back by thoughts and choices. Conditions which can be remedied by freely chosen thoughts and behaviors, don’t fit into the general understanding of disease. Ultimately, if addiction is a disease, then it’s a disease so fundamentally different than any other that it should probably have a completely different name that doesn’t imply all the things contained in the term “disease” – such as the idea that the “will” of the afflicted is irrelevant to whether the condition continues.
People change their addictive behavior in spite of the fact that their brain is changed – and they do so without medication or surgery (added 4/18/14)
In the discussion above, we looked at some analogous cases of brain changes to see just how routine and normal (i.e. not a physiological malfunction) such changes are. Now we’re going to look directly at the most popular neuroscientific research which purports to prove that these brain changes actually cause “uncontrolled” substance use (“addiction”).
The most popular research is Nora Volkow’s brain scans of “meth addicts” presented by the NIDA. The logic is simple. We’re presented with the brain scan of a meth addict alongside the brain scan of a non-user, and we’re told that the decreased activity in the brain of the meth user (the lack of red in the “Drug Abuser” brain scan presented) is the cause of their “compulsive” methamphetamine use. Here’s how the National Institute on Drug Abuse (NIDA) explains the significance of these images in their booklet – Drugs, Brains, and Behavior: The Science of Addiction :
Just as we turn down the volume on a radio that is too loud, the brain adjusts to the overwhelming surges in dopamine (and other neurotransmitters) by producing less dopamine or by reducing the number of receptors that can receive signals. As a result, dopamine’s impact on the reward circuit of a drug abuser’s brain can become abnormally low, and the ability to experience any pleasure is reduced. This is why the abuser eventually feels flat, lifeless, and depressed, and is unable to enjoy things that previously brought them pleasure. Now, they need to take drugs just to try and bring their dopamine function back up to normal.
[emphasis added]
They go on that these same sorts of brain changes:
..may also lead to addiction, which can drive an abuser to seek out and take drugs compulsively. Drug addiction erodes a person’s self-control and ability to make sound decisions, while sending intense impulses to take drugs.
[emphasis added]
That image is shown when NIDA is vaguely explaining how brain changes are responsible for “addiction.” But later on, when they try to make a case for treating addiction as a brain disease, they show the following image, which tells a far different story if you understand more of the context than they choose to mention:
Again, this graphic is used to support the idea that we should treat addiction as a brain disease. However, the authors mistakenly let a big cat out of the bag with this one – because the brain wasn’t treated at all. Notice how the third image shows a brain in which the red level of activity has returned almost to normal after 14 months of abstinence. That’s wonderful – but it also means that the NIDA’s assertions that “Addiction means being unable to quit, even in the face of negative consequences”(LINK) and “It is considered a brain disease because drugs change the brain… These brain changes… can lead to the harmful behaviors seen in people who abuse drugs” are dead wrong.
When these studies were done, nobody was directly treating the brain of methamphetamine addicts. They were not giving them medication for it (there is no equivalent of methadone for speed users), and they weren’t sticking scalpels into the brains of these meth addicts, nor were they giving them shock treatment. So what did they do?
These methamphetamine addicts were court ordered into a treatment program (whose methodology wasn’t disclosed in the research) which likely consisted of a general mixture of group and individual counseling with 12-step meeting attendance. I can’t stress the significance of this enough: their brains were not medically treated. They talked to counselors. They faced a choice between jail and abstinence. They CHOSE abstinence (for at least 14 months!) – even while their brains had been changed in a way that we’re told robs them of the ability to choose to quit “even in the face of negative consequences.” [5]
Even with changed brains, people are capable of choosing to change their substance use habits. They choose to stop using drugs, and as the brain scans above demonstrate – their brain activity follows this choice. If the brain changes caused the substance using behavior, i.e. if it was the other way around, then a true medical intervention should have been needed – the brain would’ve needed to have changed first via external force (medicine or surgery) before abstinence was initiated. They literally wouldn’t have been able to stop for 14 months without a real physical/biological medical intervention. But they did…
Substance Use Is Not Compulsive, It Is A Choice
In his classic book Addiction & Opiates, Alfred R Lindesmith PhD explained the requirements of reliable scientific theories explaining the causes of things such as heroin addiction:
…a genuine theory that proposes to explain a given phenomenon by relating it to another phenomenon must, in the first place, have clear empirical implications which, if not fulfilled, negate the theory.
If the theory is that neural adaptations alone cause uncontrolled behavior, then this proposition can easily be shown to be false. I demonstrated above that in the midst of having fully “changed” or “addicted” brains, people do indeed stop using substances, so essentially, it is case closed. But the depths to which the brain disease theory of addiction can be negated go even further, because the basic theory of addiction as representing uncontrolled substance use has never been explained. Explanation of the mechanism by which substance use happens without the individual’s consent is conspicuously missing – yet such explanation is a necessary part of such a theory, as Lindesmith writes (again in Addiction & Opiates):
…besides identifying the two types of phenomenon that are allegedly interrelated, there must be a description of the processes or events that link them. In other words, besides affirming that something causes something else, it is necessary to indicate how the cause operates to produce the alleged effect.
“Here Comes the Bogey-Man” by Goya, circa 1799
There doesn’t seem to be any explanation or evidence that substance use is involuntary. In fact, the evidence, such as that presented above, shows the opposite. Nevertheless, when the case for the disease is presented, the idea that drug use is involuntary is taken for granted as true. No evidence is ever actually presented to support this premise, so there isn’t much to be knocked down here, except to make the point I made above – is a piano player fundamentally incapable of resisting playing the piano? They may love to play the piano, and want to do it often, they may even be obsessive about it, but it would be hard to say that at the sight of a piano they are involuntarily driven by their brain to push aside whatever else they need to do in order to play that piano.
There is another approach to the second claim though. We can look at the people who have subjectively claimed that their substance use is involuntary, and see if the offer of incentives results in changed behavior. Gene Heyman covered this in his landmark book, Addiction: A Disorder of Choice[3]. He recounts studies in which cocaine abusers were given traditional addiction counseling, and also offered vouchers which they could trade in for modest rewards such as movie tickets or sports equipment – if they proved through urine tests that they were abstaining from drug use. In the early stages of the study, 70% of those in the voucher program remained abstinent, while only 20% stayed abstinent in the control group which didn’t receive the incentive of the vouchers. This demonstrates that substance use is not in fact compulsive or involuntary, but that it is a matter of choice, because these “addicts” when presented with a clear and immediately rewarding alternative to substance use and incentive not to use, chose it. Furthermore, follow up studies showed that this led to long term changes. A full year after the program, the voucher group had double the success rate of those who received only counseling (80% to 40%, respectively). This ties back in to our first point that what you practice, you become good at. The cocaine abusers in the voucher group practiced replacing substance use with other activities, such as using the sports equipment or movie passes they gained as a direct consequence of abstaining from drug use – thus they made it a habit to find other ways of amusing themselves, this probably led to brain changes, and the new habits became the norm.
Long story short, there is no evidence presented to prove that substance use is compulsive. The only thing ever offered is subjective reports from drug users themselves that they “can’t stop”, and proclamations from treatment professionals that the behavior is compulsive due to brain changes. But if the promise of a ticket to the movies is enough to double the success rate of conventional addiction counseling, then it’s hard to say that substance users can’t control themselves. The reality is that they can control themselves, but they just happen to see substance use as the best option for happiness available to them at the times when they’re abusing substances. When they can see other options for happiness as more attractive (i.e. as promising a greater reward than substance use), attainable to them, and as taking an amount of effort they’re willing to expend – then they will absolutely choose those options instead of substance use, and will not struggle to “stay sober”, prevent relapse, practice self-control or self-regulation, or any other colloquialism for making a different choice. They will simply choose differently.
But wait… there’s more! (Added 4/21/14) Contrary to the claims that alcoholics and drug addicts literally lose control of their substance use, a great number of experiments have found that they are really in full control of themselves. Priming dose experiments have found that alcoholics are not triggered into uncontrollable craving after taking a drink. Here’s a link to the evidence and a deeper discussion of these findings: Do Addicts and Alcoholics Lose Control? Priming dose experiments of cocaine, crack, and methamphetamine users found that after being given a hit of their drug of choice (primed with a dose) they are capable of choosing a delayed reward rather than another hit of the drug.
Three Most Relevant Reasons Addiction Is Not A Disease
So to sum up, there are at least two significant reasons why the current brain disease theory of addiction is false.
- A disease involves physiological malfunction, the “proof” of brain changes shows no malfunction of the brain. These changes are indeed a normal part of how the brain works – not only in substance use, but in anything that we practice doing or thinking intensively. Brain changes occur as a matter of everyday life; the brain can be changed by the choice to think or behave differently; and the type of changes we’re talking about are not permanent.
- The very evidence used to demonstrate that addicts’ behavior is caused by brain changes also demonstrates that they change their behavior while their brain is changed, without a real medical intervention such as medication targeting the brain or surgical intervention in the brain – and that their brain changes back to normal AFTER they VOLITIONALLY change their behavior for a prolonged period of time
- Drug use in “addicts” is not compulsive. If it was truly compulsive, then offering a drug user tickets to the movies would not make a difference in whether they use or not – because this is an offer of a choice. Research shows that the offer of this choice leads to cessation of substance abuse. Furthermore, to clarify the point, if you offered a cancer patient movie tickets as a reward for ceasing to have a tumor – it would make no difference, it would not change his probability of recovery.
Addiction is NOT a disease, and it matters. This has huge implications for anyone struggling with a substance use habit.
References:
- 1) NIDA, Drugs Brains and Behavior: The Science of Addiction, sciofaddiction.pdf
- 2) Sharon Begley, Scans of Monks’ Brains Show Meditation Alters Structure, Functioning, Wall Street Journal, November 5, 2004; Page B1, http://psyphz.psych.wisc.edu/web/News/Meditation_Alters_Brain_WSJ_11-04.htm
- 3) Gene Heyman, Addiction: A Disorder of Choice, Harvard University Press, 2009
- 4) Sharon Begley and Jeffrey Schwartz, The Mind And The Brain, Harper Collins, 2002
- 5) Links to the 2 methamphetamine abuser studies by Nora Volkow:
http://www.jneurosci.org/cgi/content/full/21/23/9414
http://ajp.psychiatryonline.org/cgi/reprint/158/3/377
Important Notes from the author to readers and especially commenters:
On “badness” or immorality:
Please do not attribute to me the idea that heavy substance users must be “bad” or “immoral” if they are in fact in control of and choosing their behavior. I do not think this. I think that at the time they’re using, it is what they prefer, given what life options they believe are available to them – and I don’t think it’s my job to decide what other people should prefer for themselves, and then declare them bad if they don’t live up to my vision of a “good” life. That’s what the disease recovery culture does, de facto, when they present the false dichotomy of ‘diseased or bad’. To say that addiction is chosen behavior is simply to make a statement about whether the behavior is within the control of the individual – it is not a judgment of the morality of the behavior or the individual choosing it.
On willpower:
Please do not attribute to me the suggestion to “use willpower.” I have not said that people should use willpower, nor do I think it’s a coherent or relevant concept in any way, nor do I think “addicts lack willpower” or that those who recover have more willpower, nor, and this is important, do I believe that a choice model of addiction necessarily implies willpower as the solution.
“Addicts” do not need extra willpower, strength, or support, to change their heavy substance use habits if that is what they want to do. They need to change their preference for heavy substance use, rather than trying to fight that preference with supposed “willpower.”
On compassion:
Please don’t accuse me of not having compassion for people who have substance use problems. You do not know that, and if you attack my motives in this way it just shows your own intellectual impotence and sleaze. I have a great deal of compassion for people with these problems – I was once one such person. I am trying to get at the truth of the nature of addiction, so that the most people can be helped in the most effective way possible. I don’t doubt the compassion of those who believe addiction is a disease, and I hope you’ll give me the same benefit of the doubt. I assure you I care and want the best for people – and I don’t need to see them as diseased to do so. When you see someone who’s gotten themselves into a mess, don’t you want to help, even if it’s of their own making? Why should we need to believe they have a disease to help them if the mess is substance use related? I don’t get that requirement.
Some Agreement I’ve Found From Addiction Researchers (added 6/10/14)
I began working out my understanding of the brain disease model back in 2005 as I started working on a book about addiction; published this article in 2010; and was happy to find in 2011 when I went back to work with Baldwin Research that they had arrived at a similar conclusion. The way they stated it amounted to “either everything is addiction, or nothing is” – referring to the fact that the brain changes presented as proof of addiction being a brain disease are so routine as to indicate that all behavior must be classified as addiction if we follow the logic.
I was also gratified to have found a neuroscientist who arrived at the same conclusions. I think Marc Lewis PhD and I may disagree on a few things, but it seems we may see eye to eye on the logic I presented above about such brain changes being routine, and thus not indicative of disease. Check what he wrote in 2012 for the PLOS Blog, Mind The Brain:
every experience that has potent emotional content changes the NAC and its uptake of dopamine. Yet we wouldn’t want to call the excitement you get from the love of your life, or your fifth visit to Paris, a disease. The NAC is highly plastic. It has to be, so that we can pursue different rewards as we develop, right through childhood to the rest of the lifespan. In fact, each highly rewarding experience builds its own network of synapses in and around the NAC, and that network sends a signal to the midbrain: I’m anticipating x, so send up some dopamine, right now! That’s the case with romantic love, Paris, and heroin. During and after each of these experiences, that network of synapses gets strengthened: so the “specialization” of dopamine uptake is further increased. London just doesn’t do it for you anymore. It’s got to be Paris. Pot, wine, music…they don’t turn your crank so much; but cocaine sure does. Physical changes in the brain are its only way to learn, to remember, and to develop. But we wouldn’t want to call learning a disease.
….
In my view, addiction (whether to drugs, food, gambling, or whatever) doesn’t fit a specific physiological category. Rather, I see addiction as an extreme form of normality, if one can say such a thing. Perhaps more precisely: an extreme form of learning. No doubt addiction is a frightening, often horrible, state to endure, whether in oneself or in one’s loved ones. But that doesn’t make it a disease.
I think that quote is very important, because it highlights neuronal changes that occur in the same region implicated in addiction (whereas the examples I presented earlier in the article represented some other regions).
In a brilliant paper titled “The naked empress: Modern neuro science and the concept of addiction”, Peter Cohen of The Centre for Drug Research at University of Amsterdam, states that:
The notions of addiction transformed into the language of neurology as performed by authors like Volkov, Berridge, Gessa or De Vries are completely tautological.
He essentially argues that Volkow et al take for granted that heavy drug and alcohol use is uncontrolled, identify neural correlates, and present them as evidence of uncontrollability. Yet they don’t do so with other behaviors, and he provides plenty of examples. He notes that they start with assumptions that certain patterns of behavior (e.g. heavy drug use) are uncontrolled, and others are controlled – based purely on cultural prejudices. He accurately identifies addiction as a learned behavior, or as routine bonding to a thing, and then expresses something very close to my thesis presented above (that all learned/intensely repeated behaviors result in “brain changes”).
The problem of course is that probably all learning produces temporary or lasting ‘change in neural systems’. Also, continuation of learned behavior may be functional in the eyes and experience of the person but less so in the eyes of the outsider. Who is right? We know of people remaining married in spite of-in the eyes of a beholder- a very bad marriage. Who speaks of lasting ‘neural change’ as the basis of the continued marriage? But, even when a person herself sees some behavior as counter functional, it is not necessarily seen as addiction. It may be seen as impotence, ingrained habit or unhappy adaptation. It all depends on which behavior we discuss, not on the brain.
The great points contained in this article would be done an injustice if I tried to sum them up here, so check it out for yourself at The Center for Drug Research University of Amsterdam. As with Marc Lewis, I suspect that Peter Cohen and I might have some substantial disagreements about the full nature of addiction and human behavior in general, but I think we at least agree that the changes in the brain of an “addict” do not necessarily represent disease, and more likely represent a routine process.
Writing in 2013 for the journal Frontiers In Psychiatry, esteemed behavioral and addiction researcher Gene Heyman pointed out something so painfully obvious that we don’t even take notice – no causal link has ever been found between the neural adaptations caused by excessive substance use and continued heavy use. That is, correlation is not causation:
With the exception of alcohol, addictive drugs produce their biological and psychological changes by binding to specific receptor sites throughout the body. As self-administered drug doses greatly exceed the circulating levels of their natural analogs, persistent heavy drug use leads to structural and functional changes in the nervous system. It is widely – if not universally – assumed that these neural adaptations play a causal role in addiction. In support of this interpretation brain imaging studies often reveal differences between the brains of addicts and comparison groups (e.g., Volkow et al., 1997; Martin-Soelch et al., 2001) However, these studies are cross-sectional and the results are correlations. There are no published studies that establish a causal link between drug-induced neural adaptations and compulsive drug use or even a correlation between drug-induced neural changes and an increase in preference for an addictive drug.
Did you get that? Let me repeat the words of this experienced researcher, PhD, and lecturer/professor from Boston College and Harvard who, in addition to publishing scores of papers in peer reviewed medical journals has also had an entire book debunking the disease model of addiction by Harvard University press (I say all of this about his credentials so that I can hopefully STOP getting commenters who say “but you’re not a doctor, and what are your credentials wah, wah, wah,……” here’s a “credentialed” expert who essentially agrees with most of what I’ve written in this article – so please, for the love of god, save your fallacious ad hominems and appeals to authority for another day!)- he (Gene Heyman PhD) said this, as of 2013:
There are no published studies that establish a causal link between drug-induced neural adaptations and compulsive drug use or even a correlation between drug-induced neural changes and an increase in preference for an addictive drug.
And this was in a recently published paper in a section headed “But Drugs Change the Brain”, in which he continued to debunk the “brain changes cause addiction” argument by saying:
There are no published studies that establish a causal link between drug-induced neural adaptations and compulsive drug use or even a correlation between drug-induced neural changes and an increase in preference for an addictive drug. For example, in a frequently referred to animal study, Robinson et al. (2001) found dendritic changes in the striatum and the prefrontal cortex of rats who had self-administered cocaine. They concluded that this was a “recipe for addiction.” However, they did not evaluate whether their findings with rodents applied to humans, nor did they even test if the dendritic modifications had anything to do with changes in preference for cocaine in their rats. In principle then it is possible that the drug-induced neural changes play little or no role in the persistence of drug use. This is a testable hypothesis.
First, most addicts quit. Thus, drug-induced neural plasticity does not prevent quitting. Second, in follow-up studies, which tested Robinson et al.’s claims, there were no increases in preference for cocaine. For instance in a preference test that provided both cocaine and saccharin, rats preferred saccharin (Lenoir et al., 2007) even after they had consumed about three to four times more cocaine than the rats in the Robinson et al study, and even though the cocaine had induced motoric changes which have been interpreted as signs of the neural underpinnings of addiction (e.g., Robinson and Berridge, 2003). Third [an analysis of epidemiological studies] shows that the likelihood of remission was constant over time since the onset of dependence. Although this is a surprising result, it is not without precedent. In a longitudinal study of heroin addicts, Vaillant (1973) reports that the likelihood of going off drugs neither increased nor decreased over time (1973), and in a study with rats, Serge Ahmed and his colleagues (Cantin et al., 2010) report that the probability of switching from cocaine to saccharin (which was about 0.85) was independent of past cocaine consumption. Since drugs change the brain, these results suggest that the changes do not prevent quitting, and the slope of [an analysis of epidemiological studies] implies that drug-induced neural changes do not even decrease the likelihood of quitting drugs once dependence is in place.
Read the full paper here – it’s an amazingly concise summary of the truths about addiction that contradict many of the accepted opinions pushed by the recovery culture – Heyman, G. M. (2013). Addiction and Choice: Theory and New Data. Frontiers in Psychiatry, 4. doi:10.3389/fpsyt.2013.00031
Why Does It Matter Whether or Not Addiction Is A Brain Disease?
When we accept the unproven view that addiction and alcoholism are brain diseases, then it will lead us down a long, painful, costly, and pointless road of cycling in and out of ineffective treatment programs and 12 step meetings. You will waste a lot of time without finding a permanent solution. When we examine the evidence, throw out the false disease concepts, and think rationally about the problem we can see that addiction is really just a matter of choice. Knowing this, we can bypass the rehabs, and find the true solution within ourselves. You can choose to end your addiction. You can choose to improv your life. You can choose to stop the endless cycle of “recovery” and start living. You don’t need to be a victim of the self-fulfilling prophecy that is the brain disease model of addiction. There are alternative views and methods of change which I hope you’ll take the time to learn about on The Clean Slate Addiction Site.
There are many different ways to argue against the brain disease model of addiction. I have only presented 3 basic arguments here. But beyond just addiction, many modern claims of “brain disease” are fatally flawed, in that they are founded on the logically impossible philosophical stance of psychological determinism. From this standpoint, any evidence of any brain activity is immediately interpreted as a “cause” of a particular mind state or behavior – with no regard for free will/the ability to choose one’s thoughts and thus behaviors. If you understand the impossibility of psychological determinism (or “epiphenomenalism”) then you’ll take all such claims with a grain of salt. For a detailed examination of this issue, see the following article: The Philosophical Problem with the Brain Disease Model of Addiction: Epiphenomenalism
How To End Addiction, Substance Dependence, Substance Abuse, Alcoholism, and General Drug and Alcohol Problems (updated 11/4/2015)
Due to the fact that most conventional rehab and addiction treatment programs follow the false belief that addiction is a disease, they are generally not effective at dealing with these problems – so I really can’t ethically recommend any “treatment” programs other than a run of the mill detoxification procedure if you feel you may be experiencing physical withdrawal symptoms – you can find that through your local hospital or emergency room; by asking your primary care doctor; or by calling 911 if you feel your life is in danger due to withdrawal (beware that withdrawal from alcohol and some prescription drugs such as the class known as benzodiazepines can lead to fatal seizures). But what comes after detoxification is simply personal choices, and treatment programs actually discourage productive personal choices by attempting to control people and feeding them nonsense such as the disease theory and idea of powerlessness.
If you want to end or alter your own substance use habits you need to make the choice to do so. Many readers will object to this answer as flippant, cruel, out of touch, et cetera. I realize this, but I chose to change, and in reality everyone who moves beyond problematic substance use chooses to change as well.
There is too much to unpack within what people believe is contained in the statement “choose to change.” I have tried to address some of that here in the past, but I realize this article is not the place to do that. This article’s scope needs to remain limited to the question of whether or not addiction is a disease.
My conclusion is that addiction is freely chosen behavior, and that the person who continues heavy substance use despite mounting costs still sees heavy substance use as their best viable option at the time they’re doing it – even though they recognize many costs and downsides. Choosing to change then, really means that they rethink whether heavy substance use is their best viable option. The only way I know to come to new conclusions is to re-examine the issues methodically, and this may often mean gathering new information and perspectives. Thus, the help that can be given to troubled heavy substance users is information. Helpers can provide accurate information that troubled people can use to change their perspective and come to believe they have better viable options than continued heavy problematic substance use.
I endeavor to give accurate information here that will help people to understand that change is possible, and that they are not doomed to a lifetime of addiction. Hopefully, this helps them on their way to believing in better viable options.
About this article:
I originally published this article on September 25, 2010. I have since added some significant supporting work I was able to find over the years, and those additions are noted. Some other minor edits from the original article are not noted.
Author
Hi, I’m, Steven Slate, the author of this post and of all content on this website. Yes, I was what you would call an “addict.” If you want to know more about me, go to the About page. If you want quotes from PhDs and such (as if I haven’t given enough here already) go to my Quotes From Experts About Addiction page. Please be civil in your comments, and many of your angry comments may already be answered on my FAQs page, so maybe check that out before you scream at me.
Man -up means quit being such a delicate snowflake, Beau. Quit expecting others to accommodate your childish neediness….. Stop your “Boo Hooing… …..please fell sorry for me because I’m an addict…. and caterwauling about how “choice” is TOO SIMPLE of a concept for [you] to understand” .. And of course, If YOU don’t undestand it, one else will either..waa, waa, waa– Arguing with others without understanding what you’ve read… OR, what you’ve written …Truly, Youth Is Wasted on the Young !!!
Im not asking people to feel sorry for me. I am asking people to feel sorry for others. I dont go to AA. I am sober because of me. I do it all on my own. I get it though man…you have that cookie cutter life experience. You had an abusive mom or dad…maybe abadoned. You are angry. Anger is an emotion…a feeling. Your kids probably think you are an asshole. Your grandkids think you are funny. Anger is rooted in fear bud. Its ok you are loved. You dont have to be a dick anymore
And btw i hate when people feel bad for me. I feel uncomfortable exposing my weaknessess. But that is another issue i have to deal with
You wanna lesson in maturity? Why dont you comment out a list of your weaknesses and post it here. Are you man enough to admit your own down falls. Focus on fixing yourself and stop expressing the hurt you are feeling inside by taking it out on people like me. Stop trolling the internet picking fights. Stop wasting your time trying to out smart people on the internet and go spend the limited time you have left on this Earth with your family. Connect with someone. Learn empathy. That is what a man truely is
And i am honest this time in saying this is my last post replying to you. I have an itch for debate…but this is just a huge waste of time for the both of us. If you wanna continue on with out me go ahead. I have finals to study for and work to do. I have to admit to myself that trying to convince one oldschool tough guy to empathize is not only not worth it, but is not getting either of us no where. We can do some constructive shit besides this. Much love man. I am truely sending love your way
I’ve bern clean for over 10 years through the 12 step program. Non addicts should not write about addiction.
And what is the point of expressing this opinion here? Seems like a non-sequitur.
So only cancer sufferers should write about cancer? Yes, addiction can be a personal experience- but personal experience is not justification for to have a monopoly of the truth. If we push the experiential position only someone actively using HERE AND NOW is qualified
Exactly.
Non addicts don’t know what they’re talking about because addiction is experience based. Cancer can be studies from the outside. You don’t need to get cancer to understand it.
After reading this I must say I am very much in agreement with your position on addiction NOT being a true disease but rather an unhealthy behavioral pattern driven by choice. As a recovered addict myself, I have been exposed to the process of indoctrination that defines the 12 step recovery business. And business exactly what it is. There is lots of money to be made promoting the disease concept of addiction. Personally, I made a conscious decision to quit using when the pain it was causing me in my life reached an intolerable level. Difficult as it was, I am 6 years clean and leading a happy and productive life, feeling empowered by my success rather than “powerless” over my addiction.
After thinking about why it might be harder for some to make the choice to stop using…there must be much more than just a greater desire to use that makes it harder. Differences in executive functions from person to person are gonna play a big role. Some of those differences are gonna be genetic.
Yes. And those with mental illness, those who are avoiders of stress, pain, etc. Former addicts are very brave. I think that taking responsibility for your choices is extremely empowering. I am not sure what a “true understanding” of addiction will achieve for you, but I hope you find it. The ASAM for example, which is probably not a “disease model” but seeks to rate severity and progress of the “disorder” in various dimensions, helped me help my son because I found this clinical tool to increase my understanding in a very concrete and factual way, which enables me to make the best choies.
We are still traveling that road, but he too is taking responsibility and sees his continued recovery as a matter of an everyday choice not to “use.” I don’t like to hurt other addicts parents’ feelings, but I personally worry that defining it as a disease is enabling and indeed, I have a sister who seems to expect me to excuse her drug use and continuing bad behavior; I believe she feels entitled to continue her antics because she believes she has a disease. Even if I were in a position to expend more energy and money than I have already, “helping” her would only serve to send the message that I’m open to being used so that she has more resources to feed her habit. In the end that’s not going to help her and so I wouldnt go there even if I could.
Oops beau, I thought you were the author.
That is not how “my addiction is a disease” should be taken. It doesn’t enable the person that is truly wanting recovering or in recovery. Think about it, this isn’t the first thing she’s used to excuse her usage, am I Right? The point is, most cannot overcome this mental disability, addiction, without proper help. Let me help you by comparing it to depression.
Whether it be the 12 step program or other NA/AA groups, (or therapy/guidance counciling for depression) or medication, methadone, suboxone, etc. (Or antidepressants in the case of depression) help is help. And it does wonders for the person afflicted.
Though, yes, sometimes, not often but sometimes, there is the occasional addict (or sufferer of depression) that can overcome such things on their own.
I myself am an addict that is recovered but was unable to overcome Addiction on my own, but I am also a sufferer of depression. And I was able to overcome that without medication and therapy. The medication actually made it worse, making me more depressed, like drug abuse treatment medication, some people are different, and the medication makes it worse.
Now one can be like your sister in the same terms, and use said depression as an excuse for their behavior. It’s done all the time.
Only with addiction is it actually looked at differently from other mental disorders, and people see it as something you can control or change, when someone uses excuses like that for depression, no one goes on to question it in fear of hurting, triggering, or worsening the depression.
Also, genetics do play a role. Over 80% of users come from a family of addiction, whether it’s alcohol, drugs, caffeine, cigarettes etc.
Also, there are many ways to help your sister without dumping money into it. If she’s convinced you otherwise, sorry to say she probably just wants your money, or doesn’t want you to send her to rehab.
There are a few rehabs that are covered by insurance, though rehab is often seen as ineffective. Personally, I see many people relapse right out of rehab all the time.
But there are many, many outpatient services also covered by insurance or are free, depending on the drug – say it’s the drug I’m recovered from; a little over 1 year clean for the first time in over 5 years of usage, with partial thanks to this outpateint service – heroin, there is methadone and suboxone to get you off the drug, make it so only go through minimal withdrawal, mostly block out opiates from affecting you/getting you high(you can still sometimes get through the blocker but youhl have to use dangerously high amounts), and diminish cravings.
Or you can do something a little more drastic like the Vivitrol shot, it’s given once a month, and it effectively blocks out ALL of opiates, no way around it.
Also depending on your sisters drug of choice, sometimes the person needs to move away from the area they are so used to doing it in, they affiliate it with using, along with other recovery options. Sometimes moving is all it takes. But that’s a bit risky to hope that such an expensive action like moving and rehoming yourself just to leave the possibility that it wasn’t enough for them and they need treatment.
Whoever wrote this article is a total dumbass I have no knowledge of addiction apparently I can’t understand why this is even on here this here can missguided people and cause further damage. This whole article as a crock of shit. It may not be the same as cancer or diabetes but it is a disease it is a proven fact.
Hi, I’m the dumbass who wrote this. I welcome criticism, but I just ask that it’s specific and a little more substantial than “it is a proven fact.” Otherwise, what’s the point? My article doesn’t just spew a bunch of ugly names, anger, and hate. I expressed a thought through opinion, and guide the reader along on my thinking, offering evidence to establish the points along that road. Do you have something to offer?
How is it a proven fact that addiction is a disease? In what way do you believe it is a disease, and what is the evidence to back that up?
-Steven Slate
Hi, I’m an addict. I’ve been struggling with getting and staying clean sing 2006. On new years eve I will have 100 days for the first time since I’ve started getting high. This is my opinion. .we all have one. .but I truly believe doing drugs is a choice as well. That’s me, an addict saying so. I had a choice to do it back in 2006 and I still have a choice today. Like the article says, or brains change according to what we do with our lives. Thanks for the great read!
So if it is a choice then what the hell are you struggling with?
Either use and just enjoy the life or quit!
I mean, you know. If its a choice.
I learned from Rehab that this is a disease of addiction that I’m dealing with. And I agree what the other guy said ‘non addicts shouldn’t have a say cause they don’t don’t what they are talking about’ no offense but this article goes against what addiction counsellors and all the videos that taught and leant is what we are dealing with. And these counsellors are also recovering addicts.
It is hilarious how people who have no clue what it’s like to be an addict so their opinions mean nothing unless you’ve been there and apparently all these people leaving comments have no clue what it’s like so you just make yourself look like a true asshole commenting on something you have no clue what it’s about until you experienced it keep your mouth shut. And I hope that none of you have to experience it. But since you want to be so judgmental on people with a disease of addiction you better pray to God nothing ever happens to you where you have to get on an opiate for a long period of time and you can’t get clean on your own then you will see the hell that people have to go through to try and get their life back.
It is not a disease…….. Put an addict on a deserted island (yes for arguments sake there is plenty of food/water) and a cancer patient. Who will “magically” be cured while stranded there for, oh let’s say a year or two??? Addiction is a choice. True disease cannot be stopped/cured by simply stopping an action. My husband “cured” himself of “alcoholism” 10 years ago by simply putting the bottle down for good. Amazing! Too bad one cannot simply will a true “choice less” disease like cancer away.
Your father did not just will himself into putting the bottle down. If he is in fact an alcoholic then undoubtedly alcohol had kicked his ass so much and so bad that he was forced to stop before the shit killed him. Or before he lost his job. Or before he lost his wife and kids. Probably had a health scare or two from his doctor. If he even remembers going to see a doctor.
I have heard of people quitting on their own but it’s usually under these or similar circumstances that they are COMPELLED to stop.
What looks like a choice to you, if the person is really an alcoholic, is really the result of a whole lot of pain and suffering that someone like you would not be aware of.
I don’t know how old you are, but you have been seeing and coming into contact with these kinds people all of your life. I suspect you can’t accept that it is real because you have never experienced this kind of life yourself. I cannot help you with that! But please don’t try to throw your father up in our faces. I don’t know if he was an alcoholic or not! Don’t care!!! I know what it was like for me and a whole lot of other people.
Plus I heard all this kind of crazy ass talk before back in the ’80’s.
I really don’t know what you’re point is or what you’re trying to accomplish but I suspect you are going to lose this one.
The reason being it’s not designed for you to win.
For the record I did not read the article. Maybe about half a paragraph and then I started skimming right through it. It is very academic! I don’t know what his point in all that research and trying to prove a point is supposed to do. Does he just want people to CHOOSE not to drink or use anymore? Okay! Poof!!!
Done and Done.
Now
What’s next?
Sorry.
I said father and I was certainly thinking father too.
But I was referring to your husband.
Sorry.
I said father but I meant husband.
Yes obviously your husband was not drinking so much that he had physical withdrawal from it. So it’s much easier than an opiate to just ‘put down’.
Opiates come in many disguises. Docs hand them out like antibiotics, then once a person wants to stop using said opiates they cannot. It wasn’t their choice to be prescribed to a drug they most likely didn’t know the possible consequences of? So how is it their fault? And no I know some addicts dont start off with a prescription and end up with an addiction, but my point is, it’s situational. Your primal instincts in your midbrain are literally overridden, and using whichever, drug or alcohol, is put at the very top of your survival instincts (eat, sleep etc.) To have a PHYSICAL on top of mental addiction makes recovery literally 10x harder. Physical dependency on alcohol can and will often kill you if ‘just put it down’.
You know they did a study in mice of this. They put out a “feel good” button for the mouse, when pressed , it would administer a small bit of drugs to the mouse. Even after a couple tests, they re-made the button so when pushed, the drug would still be administered to the mouse, but would give them a little zap also.
The mice ALWAYS ended up starving to death pushing that drug button.
That doesn’t seem like much of a “choice” to me..
Kevin Chaffin
I don’t think you were born ignorant but you sure do work hard at being stupid. I am an EX-Addict, EX-Alcoholic. I RECOVERED! I don’t have a Chronic Progressive Brain disease-and NEVER did. I have N E V E R been powerless. I chose to stop drinking and drugging because I was tired of the pain and sorrow and because other things in my life became much more important than the “high.”
Most [majority] of addicts K N O W absolutely that they really DO NOT have a brain disease. Most [majority] of addicts K N O W absolutely that they are not really P O W E R L E S S. But hey, when in Rome, do like the Romans. For addicts, claiming to have a “disease” is nothing more than an avoidance strategy to shirk from the responsibility of making decisions about their own lives and to dodge the consequences of their own poor choices. It’s used to justify an endless parade of reprehensible behavior under cover of “disease.” They explain away their immorality by blaming it on their “disease.” Every perversion is to be accepted because of the implied threat of being labeled as intolerant or unloving if you don’t.
To translate for you Kevin, that means “Brain Disease Theory” and “POWERLESSNESS” is all juvenile BULLSHIT. When you mature a bit, you might begin to understand this.
Ohhhhhhhhhhh I am not stupid by a long shot pal!!!
I just read the reasons why you claim to have chosen to stop and I am telling you that you didn’t choose a damn thing! ( If you are in fact an alcoholic/addict)
You stated you were in pain and sorrow and you had priorities you were neglecting. I am paraphrasing of course.
You made that sound just a bit to easy. You don’t sound like a real drunk or an addict at all. Most drunks that I know, and I am putting myself at the head of the list, have experienced all the things you described and none of us just stopped! WE STILL DRANK AND USED ANYWAY!!!!!!!!! A LOT!!!!!!!!!!AND REPEATEDLY!!!!!! UNTIL THE THE PROBLEMS BECOME SO COMPOUNDED THAT YOU ARE ON YOUR KNEES BEGGING GOD
FOR HELP!!!! BEGGING GOD TO FIX YOU AND RESTORE YOU, etc….
Drunks/addicts are COMPELLED to stop using. They don’t just stop by using some rational judgment. Man that is simply just not going to do it.
Quite frankly, you really don’t sound like you were a addict/drunk to me. That what you described is something that a normal person does. You realize you are having problems, you identify the source, you remove the source and, hey! Problem solved.
Alcoholics don’t act that damn way!
You don’t sound as if you had that experience of being COMPELLED TO STOP. So for that reason I am kind of
dismissive toward your point of view.
If you want to believe that the majority of addicts “KNOW” such and such, and so and so, then all I can tell is that people believe what they want to believe.
It appears that you have armed yourself with a lot of research facts about the brain and whatever the hell else. And all I can say about that is; I actually started out trying to read it and I didn’t get past the first paragraph before I started laughing. Not because the content was funny (wouldn’t know… didn’t read it). But because this guy really has a hair up his ass about this shit. He went thru sooooooo much trouble to prove a point that I really care little about. Clearly he wants to change the perception of what addiction means/is. I am sure a lot of people would FEEL BETTER if he did. He may succeed at it but I am certain that addictions and compulsive behavior are still going to flourish by any other name.
I do think cognitive behavior therapy is a good thing! But it is by no means a panacea.
Okay
I’ve spent enough time.
Milton out
It’s not a disease, man. The point is some people like to make excuses for themselves instead of making serious life decisions that can she their lives. Serious alcoholics and drug addicts get clean and sober every day. It’s the ones that truly “find God” or go through a tramatic life change to better themselves or for the people that love them, that they know it’s time to change their life. They never think about doing drugs/alcohol again. They are in peace with themselves and enjoy life being sober. I know people who have done this. People in very bad shape. I was one of those people. I You can’t continue living life making excuses for yourself not being able to control your own life. The point of this clean slate page is to tell you there’s a way to be clean again without wanting to go back to drugs, because it is not a disease. You are in charge of your life and you can make a difference. Cancer patients etc.. do Not have a choice. You really want to be clean and have a fulfilling life? Change your life and make that decision because you do have a choice. Period.
It’s a bit debilitating to basically say only through finding god can you get clean.
I’m a recovered addict, fully believe the SCIENCE behind addiction = disease, (I didn’t believe it at all and thought it to be total BS until it was scientifically and facfactually explained/proven to me) and did so through outpatient rehabilitation, not finding God. That’s why I hate 12 step programs and most groups because they all tell you the same stuff: you cannot get clean without god. And that’s screwed up.
ANYWAY, thanks to methadone I’m a little over 1 full year sober. The explanation of addiction as a disease helped me better understand my addiction, and made it actually a bit easier to recover from, in reality. Any addict that isn’t serious about getting ckean will use it as an excuse, just like they use everything else as an excuse to not get clean, (I just got a job, gotta celebrate, I just lost my job, I’m sad and want to use. My father passed away and I am mourning, so I need to drink. I am depressed and can’t handle reality. I need drugs) it being a disease explained also helps outsiders and loved ones better understand what they struggle with.
Hi Milton,
This is not an open discussion forum on addiction. This comment section is for people who have read this article and want to discuss the points in it/related to it. Please discontinue commenting here.
-Steven
Yeah sure Mickey! You quit cold turkey without any assistance and never looked back? You are a liar and you still continue to be a cruel person. Why are there 12 step programs in over a 100 countries now? Because it doesn’t work? Get over yourself. You nor anyone on here (including myself) are not qualified to make determinations on addiction. Just because a few people have quit doesn’t mean that works for everyone. I have met people with 53 years clean by way of a 12 step program. You and your rants are so full of shit. If your way is so damn good why haven’t you coined it and taken it to over 100 countries across the world? Maybe Malibu Scapes and you know something that the rest of the world does not? 12 step programs do not condone bad behavior. The lady that wrote that has a sister that has not hit her bottom yet and will not change until she hits her bottom or dies. You must have been in a 12 step program and refused to learn about spiritual principles. All this crying 12 steppers supposedly do is done in meetings of their fellowship. if they cry out here they have not found the principles that so many others have. Your assessment of 12 step programs is coming from a person who spent literally tens of thousands of dollars in rehab. Not everyone is so fortunate Mickey. The fellowships offer recovery for any one who seeks it. Not just people who’s parents or their professional medical insurance has paid for. I have already stated and repeatedly stated that there is some truth to Steve’s claims. Yet you continue to only think your way is the best way. Maybe for you and Steve and others. It does not however work that way in the real world for many others. Get off your high horse and try empathizing with others instesd of condemning them. Offer hope instead on contradiction. Fine if you think it’s a personal choice kudos to those that do. Those that have a harder time aren’t any less of a human. Be a human doing not just criticizing those that are making an effort to stop
Hi Howard,
Something to think about is that institutions stay in existence for many reasons, and sometimes those reasons have nothing to do with it being effective at it’s stated goals. To use a really pat example, I’d raise bloodletting. It was around for many centuries in wide practice. Many historians seem to think it hurt far more people than it helped. It had no positive effect for the vast majority of conditions it was used to treat. However, people felt they needed help, and it was what was available. When they got over their ailments by their own immune system, they would then attribute their recovery to bloodletting, and swear by it. It was killing people though. In the case of bloodletting, it provided a needed placebo when no other help was available, and so it remained popular for literally centuries.
Rehabs don’t work. People who get addiction treatment have success rates no better than those who don’t get treatment, and in fact they often do worse in many ways. Nevertheless, they stay in existence, and in fact the industry has thrived even while it’s results have been dismal. We see articles written by angry parents whose children have died of drug use, but they’re angry they couldn’t get more treatment or enough insurance coverage for it etc. Or even when the parents were rich and could spend tons of money on all the available treatments and the children still died, the parents then go on a crusade to recommend the very treatments that failed their family. Why???
Treatment serves a purpose for people, even if that purpose isn’t to truly help the people who get the treatment. The ritual of intervening to get your loved ones into treatment, using tough love to coerce them into continued meeting attendance and aftercare, and “battling the disease of addiction” side by side makes the family feel good. It makes the family feel as if they’re doing what needs to be done; they are being a good and loving family by promoting the idea their children are diseased and in need of treatment. It gives the family an answer. It is comforting to them. Thus, it remains an institution, even though it doesn’t achieve its stated goal – it’s serving that other need of making us feel like we’re being compassionate and loving.
Best,
Steven Slate
Please mate you are making me so angry. You really have no clue. You are not an addict. You know shot about it. Rehab worked for me and I’m grateful for it. I use the 12 steps to get by each day at a time. I still have using thoughts which when I do I need to get to a meeting. I’m 2 years clean but the desire to use does not disappear!!!
Hi Ozi,
There is no way to say this without sounding condescending, and for that I apologize, but: move along, and don’t bother reading this website. I could argue with you until the cows come home proving my points, but it is not my intention to dissuade you from believing what you think you need to believe in order to safely exist. If at some point you find that those beliefs have outlived their usefulness to you, this site will be here for you, with many links and recommendations of other sources to find a new understanding.
Best (and I mean it sincerely),
Steven Slate
You said in your long essay Rehabs don’t work, did you or did not? I’m living proof it does!! It saved my life and the aftercare is really good. In England anyway. I would have died if wasn’t for the support I have in recovery. So please each to their own opinion. But I’m standing by my view because I’m living proof it works. Sorry to burst your bubble 👍
This is absolute trash. You have no knowledge of the interplay between biochemical and environmental factors concerning the onset of physiological dysfunction (you state, quite plainly, in your opening lines, that there is no such mechanism, without any reasoning or evidences to support this claim (one that is crucial to your argument as a whole, might I add)). What is more, I am fearful that much of what you have to say is rooted in a lack of empathy or, perhaps more aptly (I pray), a lack of experience with persons struggling with addiction. While I would not wish anyone to have to suffer through the disease of addiction and subsequently experience the physical, mental, and emotional toil imposed upon a person, or to experience the pain that comes as a result of having to watch a loved one wrestle with the disease, I must inform you that, supposing the latter (aforementioned) is true, you speak from a position of privilege in this way and thus perhaps are not capable of truly understanding the full extent of a topic such as addiction.
There is no evidence of a physiological malfunction that “causes” people to crave and use substances without choice. There is reasoning and evidence to support this conclusion in the article. I show how the mere existence of neural adaptation isn’t enough to prove compulsion – and I do so in this way because that’s how the case itself is usually presented. The brain disease argument is usually presented as “here is evidence of changes in the brain – therefore people are compelled and it is a brain disease.” My claim is that heavy substance use is ordinary freely chosen behavior – the extraordinary claim is that it is compulsive diseased behavior. The burden of proof falls on those making the extraordinary positive claim. That is, I cannot prove a negative apropos of nothing – I can only prove it isn’t extraordinary in the way they claim.
Other lines of reasoning I used were to show that people quit despite their neural adaptations; I linked to a review of the brain disease research that found there hasn’t been a single published study establishing causation between drug induced neural adaptation and continued drug use/liking; and I offered up contingency studies, demonstrating choice factors guide drug use. Outside of this article, there is much more research linked to all over the site that shows that so-called addicts are in control of their substance use. Although, I doubt you’d look at the rest of the site, because you didn’t even look at the “about the author” section at the end of the article before tearing into the author for not having experienced addiction.
Man you are making me laugh!!!
You must really think you are smart.
All this writing and researching you are doing is not going to stop addictions from occurring. If you don’t want to see it classified as a disease then what label do you want to slap on it?
Milton IS probably diseased. I believe him that he is. So Milton, be as DISEASED as you want to be. Good luck with that. Milton is definitely POWERLESS.
Powerless over his inability to read and comprehend. Powerless over his inability to utilize critical thinking skills like reason and logic.
Apparently the poor guy is powerless, diseased, sick insane, not wired right etc. because of his Chronically Brain Diseased condition. Perhaps that disease is what’s preventing him from making sense in this forum.
In reality, addicts are not powerless and they know it. Addicts don’t have a chronic progressive brain disease and they know it. No one really needs a Big Book, 12 step, new age, Occult ” psychic change” to be fully human. Addicts don’t need childish 12 step groups to get back to the starting line of living a balanced and healthy life.
Fortunately I don’t neeeeeeed this forum. Been clean and sober since 2001 and cigarettes free since 2002. Haven’t been to one meeting in all that time. That includes S.O.S. groups (one of which I happened to have been a cofounder in the city in which I reside) and the Rational Recovery groups. I didn’t confound a group but was there in the early days.
I don’t need to exercise a lot of reasoning and logic skills in regards to this matter. It’s implications that concern me.
You are a pompous ass Mickey. You are a legend in your own mind. Get off your high horse already.
See? no empathy!
Not sure I undserstand your terminology..but isn’t the fact that the brain makes more opioid receptors in response to opioid use, an example of a physiological brain chance that causes craving?
This article is a very good read and every addict needs to read this. I chose to be sober and went through hell for a while, but I feel great now and life is my drug. I chose to quit. Addiction is a choice overtime and you can stop when you want to with self motivation. Addiction is not a disease and this article tells you why it is not. Fantastic article great inspiration for those who actually want to be sober and adapt to other things that make you happy that is not drugs or alcohol.
“I’m Brain Diseased and I’m Powerless” 12 step groups are intellectually and spiritually impoverished and, at worst, are intellectually and spiritually corrupt, deceptive and non-virtuous. In addition, 12 step groups create an emotionally and mentally unhealthy environment. What does it benefit a person to hold onto -and embrace- the belief that they’re diseased, sick, insane, not wired right, unable to think straight and powerless to have any control over their own lives? Especially when they’re many years away from their “last drink or drug?” That’s very destructive. Many 12 steppers speak of their “disease” as if it’s a malevolent entity or independent being, separate from themselves, that is bent on their annihilation. [I.e. my disease wants me dead or my disease is out in the parking lot doing push-ups] It’s a very strange phenomenon! It reminds me of people who suffer from Munchausen syndrome. If you don’t know already, that is a factitious disorder, a mental disorder in which a person repeatedly and deliberately acts as if he or she has a physical or mental illness when he or she is not really sick. Munchausen syndrome is considered a mental illness because it is associated with severe emotional difficulties. That constant grousing 12 step groupers engage in about their trouble-making “disease” is nothing more than an avoidance strategy to shirk from the responsibility of making decisions about their own lives and to dodge the consequences of their own poor choices. It’s used to justify an endless parade of reprehensible behavior under cover of “disease.” They explain away their immorality by blaming it on their “disease.” Every perversion is to be accepted because of the implied threat of being labeled as intolerant or unloving if you don’t. One guy in a particular group I visited, relapsed on cocaine, burned down a lady’s house who he felt had maligned him and the rest of the group claimed that it wasn’t him that burned it down, it was his disease. It’s doesn’t get more Effed up than that! History and science have shown us that the claim of addiction as a disease is pure speculation. Just saying it’s a disease, doesn’t make it true. Nevertheless, medical professionals and American culture enthusiastically embraced the disease concept and quickly applied it to every possible behavior from alcohol abuse to compulsive lecturing and nail biting. The disease concept was a panacea for many failing medical institutions and pharmaceutical companies, adding billions of dollars to the industry and leading to a prompt evolution of pop-psychology. Research has shown that addiction is a choice, not a disease, and stripping abusers of their choice, by applying the disease concept, is a threat to the health of the individual. The theory of addiction being a disease has disempowered people and turned them into passive whimpering victims.
That is your perspective. How about allowing what works for others happen? What worked for you worked for you. Not everyone is superman like you Mickey. Have a heart.
The 12 step habit is what has kept millions of people enslaved to addiction. Treatment based on 12 step nonsense and 12 step groups like AA, NA, and CA don’t “cure” addicts. They C R E A T E addicts. Those who can K I C K the 12 step habit, are those who have something other than drugs and alcohol to build their lives around. 12 step treatment and groups create an emotionally and mentally unhealthy environment. What does it benefit a person to hold onto -and embrace- the belief that they’re diseased, sick, insane, not wired right, unable to think straight and powerless to have any control over their own lives?
I have used this fantastic piece on numerous occasions now to try and get people to think away from the brain disease myth. Why am I back reading this at 04:15am on New Year’s Day? lol – Well I just listened to a really irritating U.S based commercial about calling a phone number for help with addiction, that it’s not your fault and that you are genetically predisposed via a brain disease.
It actually really pissed me off because I have a hunch the advertisement is linked to medication that seems to be taking off States side. From what I gathered from a presentation on TED (Hollywood actress who used to drink a lot and subscribes to the disease myth) it acts in a similar way to Champix for smokers.
Are they legally allowed to make claims that science tells us that addiction is a brain disease? Science does absolutely no such thing.
I have so many issues with this, and quite honestly, I don’t have hours to pick apart this article piece by piece. I cannot even begin to address this shit (excuse my language, but that’s what it is- complete shit). Have you ever seen the documentary “Pleasure Unwoven”? It was created by an addict that set out to disprove the theory that addiction is a disease and wanted to prove that addiction was a choice. By the end of his research, he found that addiction undeniably was a disease, not a moral failing or a choice. People that deny that addiction is a disease further stigmatize addicts, and, in turn, make it more difficult for addicts to seek the help they so desperately need due to the social consequences of identifying as an “addict”. Medical care, such as detox & rehabilitation, is most times NECESSARY to put this disease into remission. In the Three Most Relevant Reasons Addiction is Not a Disease section, you wrote, “if you offered a cancer patient movie tickets as a reward for ceasing to have a tumor – it would make no difference, it would not change his probability of recovery.” And yes, perhaps a person with cancer cannot choose whether or not they have a tumor; but this perspective is too limited. Addiction/alcoholism is often referred to as an allergy. So, take for instance, someone that has an allergy to peanuts and apply their case to the “movie ticket” situation. If they CHOOSE not to eat peanuts, they will not have an allergic reaction. HOWEVER, they still have a peanut allergy; just because they do not eat peanuts does not mean that their allergy goes away or is cured. Similarly, with addiction, a clean addict can CHOOSE not to take drugs; but they still have the disease of addiction. No one chooses to become an addict. No sane person willingly decides to ruin his/her life & the lives of loved ones, or to become homeless. Drugs drastically affect many areas of the brain; in particular, the midbrain, responsible for primal instincts, will prioritize drugs above water, food, sleep, and sex. And yes, the brain can recover in time, but that does not mean that a clean addict is by any means “cured” or even more farfetched, never had a disease in the first place. And I will close with this, I know I was an addict way before I ever drank or touched drugs because of the way that I think, my obsessive compulsive thoughts. Today, I am glad that I have found a new way of life and that I am sober, but I will forever and always remain an addict.
Rachel wrote: “I know I was an addict way before I ever drank or touched drugs because of the way that I think”
Sheesh … this is just delusional … and indictative of a severe psychological/ emotional disorder .. not a disease.
Rachel do not waste your time with this site. They have narrow minds and believe that what they believe is how everything really is. PapaMick only ratns and raves about how righteous he is and how ignorant the rest of us are.
Dry drunks here. Addicted to being assholes.
Best article I have read in years. I think telling people that addiction is a disease is psychologically damaging and is a cop out. It removes a level of responsibility like “it is not my fault” – “I can’t help it” and “I have a disease” and “I have no control over it” for the addict. I come from a family full of addicts and a general lack of accountability is a major issue.
Addiction is a voluntary behavior (such as drinking alcohol or using drugs) that persists against your own better judgment. Thus, addiction cannot be “diagnosed” or attributed to you by others, including physicians. It’s not a “disease” and you are not “powerless” over it. Addiction is a compulsive psychological behavior and is a symptom: no more, no less. It is solely up to you to decide if your drinking/drugging threatens or harms others and yourself. You must decide now whether continuing your addictive pleasures is worth the destruction that will likely result. In other words, you are free to choose between drinking and not drinking — between the high life and family life and between right and wrong.
You said addiction is a symptom?
A symptom of what?
@Papamick
Somebody has been reading Rational Recovery =oP
All joking aside, good job and I agree. It was actually Rational Recovery that really cemented my belief that addiction is not a brain disease. Interestingly enough I haven’t even felt the “beast” since quitting. I just completely changed so many areas up and made sure I implemented plans and targets for my future as well as being a regular member of a group on Facebook. Life moves on and booze is left behind. I am very happy about this 🙂
I call the 12 step religion Bubble-Gum Theosophy aka shallow & juvenile fake spirituality. It’s all about “soul surgery” [Oxford Group- Frank Buchman Occult nonsense] and “god guidance” [more Oxford Group BS] with ZERO interest in empirical evidence, proven science, or critical thinking and the use of logic. Big Book 12 step groups are most definitely N O T Christian based organizations! Most of the steppers believe that they are specially blessed by G O D and receive “guidance from God” and that attending the 12 step meeting [to keep the God guidance antenna tuned in properly] is the only way they can avoid “jails institutions and death. In fact, if a person does use logic, that person is quickly mistreated, abused and hurriedly drummed out of the group with claims of “being in denial,” not being a real alcoholic/addict or worse, being dangerous to new-comers. I asked several of them how they were sure T H E I R “guidance” was coming from God and not their own imagination. Their angry answer, with a smarmy smile, was: It’s one of the promises of [Bill W] and “more will be revealed.” I also pointed out that if two steppers claimed to have THE RIGHT answer, “guided by God” that contradicted the other, one of them had to be wrong and that that guidance, logically, was NOT from God. They got even angrier.
Thanks for posting my comment, as I provided valid reasoning that counters your argument…
Rachel
You posted NOTHING that was “valid” or that countered the conclusions reached in the article. What you posted was a rant full of emotion and devoid of facts. For example: “Medical care, such as detox & rehabilitation, is most times NECESSARY to put this disease into remission.” This is ABSURD… Do you mean to tell us that people who have been through reab/ detox 7..8… 9…10 or more times are each time putting their non-existent “disease” into remission? This is utter foolishness. How convenient for the “professional revolving door reahab” patient i.e…. the diseased addict, to have foolish supporters like you who keep the Golden Goose alive and well $$$$$$
Mickey! Good to see that you’re still putting people down and passing judgement. You like to put yourself above others. Ego. That’s part of addiction. Self centered is another. Pride and intellect yet another. You must be on the non-profit board for Stevens organization. All you do is condemn people and pat yourself on the back on how strong willed you are and how everyone is so weak, yet you continue to let others know just how smart you are and how dumb or ignorant everyone else is. Do you ever admit or even try to see another’s point of view? Just because you say so doe not make it so. If will power was all that was needed many would have quit using long ago. I am not saying that there is no truth to what Steven says and have stated so. However, you my friend have never been anything but condescending, sarcastic, and cruel. Do not forget my friend you have children and grandchildren. I pray that none of them ever are effected by addiction. If you are who they come to for understanding or compassion they will surely die before the receive that from you. Some people are able to quit. The initial choice is ours to make. I have seen a lot of Heroin addicts get clean through the subxone program. Try going and volunteering at a shelter or somewhere that you find some gratitude that you aren’t like everyone else and you can share your message of recovery to those that can’t seem to get it. Better yet help continue to pack the prisons with addicts and find loop holes to not pay your taxes like opening a non-profit organization. God bless you.
Howard Griego
As is typical, your comments are disjointed, discombobulated, juvenile and senseless. Example: “Better yet [Mickey] help continue to pack the prisons with addicts and find loop holes to not pay your taxes.”
And: “Ego. That’s part of addiction. Self centered is another. Pride and intellect yet another. ” Sheesh Howard, you can’t even keep your AA Big Book talking points straight.
It is easy to identify the commenters here who have been brainwashed by the 12 step Religion- lots of negative emotions and addled accusations but very little common sense or coherent rationality.
God Bless You Too, Howard – LOL
I can see where Papamick is coming from folks and I certainly don’t see arrogance in his responses. It’s very frustrating when the author puts forward a fantastic piece that will only get stronger as science advances, and people are still locked into the old mentality that by and large does not work. The brain disease myth completely incarcerates most people.
@Steven Slate – Have you written any other pieces similar to this? Like I said in another comment, I keep coming back to it. It’s been such an eye opener not just for me, but for those I have shared it with. Excellent work!
Wow, this “papa” guy is a total turn-off . WT possible F could “Irishkissass” be talking about? Unless this site”s purpose is to cause addicts and even former addicts to consider suicide since they’re not worth crap. This .org site is not educational. Are faux-educational sites allowed to have 501 status? What qualifies this as a nonprofit?
The Author was not convincing at all. He is not even proficient at repeating himself accurately. It is in an almost random and meandering fashion that he somehow staggers from one point to the next claiming To have reached some kind of logical conclusion. He says he wants feedback and is trying to understand his addiction, not generate hate.
Yet I see pure, vitriol, pride & hatred oozing out of half the words in this commentary that have passed moderation . My guess is that Steven has never passed a university chemistry class and has had little if any biology. Furthermore the people praising him and his papa are shill-trolls. They don’t offer “specific” comments because they know its BS pseudo-neurobiology.
If I could infect this site with a virus that could insert HTML, this page would be littered with images of every type of the most disgusting fecal piles, because people deserve to know this is a cesspool of bullshit and hate.
An accomplished neuroscientist seems to agree with my pseudo-neurobiological thesis:
Addiction changes the brain but it’s not a disease that can be cured with medicine. In fact, it’s learned – like a habit, by Marc Lewis PhD, Neuroscientist
Carolyn’s unhinged, lunatic screed includes the following hallucinations:
“this site”s purpose is to cause addicts and even former addicts to consider suicide”
“I see pure, vitriol, pride & hatred oozing out of half the words in this commentary”
“Steven has never passed a university chemistry class”
I want to “ …infect this site with a virus that could insert images of every type of the most disgusting fecal piles”
“people deserve to know this is a cesspool of bullshit and hate.”
Yikes… Carolyn’s demented diatribe is a perfect example of what happens to a person who stops taking their antipsychotic meds
I’m not sure exactly what kind of pieces you’re looking for, but if you click the Myths tab up top, those are what I think are some important topics, and click the blog tab too, and you can browse through about 200 or so posts.
I think one of the most important points that Stanton Peele has been saying for years is that the general picture we have about addiction is just wrong – people aren’t chronically having this problem, their use ebbs and flows, loss of control has never been proven, most people quit/moderate without treatment, etc. So, once you get to a topic like this – the brain disease – you have to ask, what is this brain disease model even rferring to? Basically, it’s explaining a picture of addiction that is false to begin with. Same goes for genetics. People always say this is genetic, but what exactly are they referring to? People don’t literally “lose control”, so loss of control can’t be genetic, because it doesn’t exist!
My biggest reading recommendations would be this paper by Gene Heyman that I link to all the time: http://journal.frontiersin.org/article/10.3389/fpsyt.2013.00031/full
And if you really want to understand how the entire narrative about addiction is just a straight up invention, see The Myth of Addiction by John Booth Davies. That book is genius.
If you have specific topics you want to know about, then let me know and I’ll see what else I can recommend.
Best,
Steven Slate
IrishAido
Here is the synopsis from the film “The Business of Recovery.” Talk about an EYE OPENER. I highly recommend watching it. It definitely underscores Steven’s conclusions and his [yours, mine] desire to see changes in the way we view and treat addiction so that addicts can get REAL science based [compassioned based] assistance.
“As drug and alcohol addictions skyrocket, The Business of Recovery examines the untold billions that are being made off of families in crisis. With little regulation or science, the addiction treatment industry has become a cash cow business that continues to grow while the addiction death rates continue to rise.
Through unique access to internationally recognized treatment facilities, as well as emotional stories of addicts and their families, the film reveals how the treatment industry in the United States preys on addicts with little more than promises of hope and a huge bill.
The film challenges us to reconsider our assumptions about treating addiction and the human cost we will pay by allowing the industry to continue business as usual.”
http://www.thebusinessofrecovery.com/
I’ve tried to find ‘The Business of Recovery’ online to watch but am having no joy at all. Is there somewhere I can watch it that you are aware of? It sounds fascinating
IrishAido
I purchased “The Business of Recovery” on Itunes for $12.99 (US)
https://itunes.apple.com/us/movie/the-business-of-recovery/id1114249736
It’s also available for purchased download at Google Play and Amazon.
Congrats on the 50 days … Bravo Zulu … We are NOT powerless and we sure as hell DON’T HAVE a [fake] Chronic Progressive Brain Disease…
I think this documentary is extremely important to watch and it UNDERSCORES and supports much of the research and conclusions of Steven’s work.
“”Annual drug overdose rates have skyrocketed from 36,000 in 2013 to almost 50,000 last year. Something has to change in the way we “treat” addiction in this country.[As Steven is pointing out ] Real people are dying every day, while greedy predators profit on the pain and bleeding of loved ones and family members. The addiction recovery industry makes billions of dollars each year while death tolls continue to climb. In communities all across the nation, rehab facilities, sober living homes, safe houses and other addiction-related businesses are capitalizing on the lack of regulation and destroying neighborhoods. The Business of Recovery lifts the veil on this adulterous bride to reveal what is really going on behind the scenes. Drugs. Alcohol. Lies. Deceit. Fraud. Death. And lots and lots of money. See the film that The Daily Beast called, “…an extraordinary look into the secretive and unregulated world of alcohol and drug rehab.””
The Atlantic Magazine
The Irrationality of Alcoholics Anonymous
Its faith-based 12-step program dominates treatment in the United States. But researchers have debunked central tenets of AA doctrine and found dozens of other treatments more effective.
“The 12 steps are so deeply ingrained in the United States that many people, including doctors and therapists, believe attending meetings, earning one’s sobriety chips, and never taking another sip of alcohol is the only way to get better. Hospitals, outpatient clinics, and rehab centers use the 12 steps as the basis for treatment. But although few people seem to realize it, there are alternatives, including prescription drugs and therapies that aim to help patients learn to drink in moderation. Unlike Alcoholics Anonymous, these methods are based on modern science and have been proved, in randomized, controlled studies, to work.
Nowhere in the field of medicine is treatment less grounded in modern science. A 2012 report by the National Center on Addiction and Substance Abuse at Columbia University compared the current state of addiction medicine to general medicine in the early 1900s, when quacks worked alongside graduates of leading medical schools. The American Medical Association estimates that out of nearly 1 million doctors in the United States, only 582 identify themselves as addiction specialists. Most treatment providers carry the credential of addiction counselor or substance-abuse counselor, for which many states require little more than a high-school diploma or a GED. Many counselors are in recovery themselves. The report stated: “The vast majority of people in need of addiction treatment do not receive anything that approximates evidence-based care.””
http://theatln.tc/1K8BHUZ
The heart of the disease theory [and the associated 12 step occult religious GIBBERISH] is the idea that people are helpless to change themselves; to manage their own lives. The disease theory of addiction denies, in the face of all available scientific evidence, the human potential for growth and change that we are all endowed with.
It is ABSURD to believe that convincing someone they are “diseased” and powerless to change an unwanted habit or dependence helps them [somehow] to change it.
The result of an addict’s belief in the disease theory of addiction is not an empowered, self-controlled individual (which would be explicitly against 12 Step philosophy). The result instead, is an individual preoccupied in a confused way with his/her depressed emotions and addicted actions, seeking vainly for explanations in the wrong places– for a destructive way of life that 12 step programs do not remedy, but rather exacerbate and embody.
The (12 step) Disease Model Doesn’t Work— It Does More Harm than Good. It sets people up for failure. ..It makes matters worse than they are…It stigmatizes people for life. .. and …..WORST OF ALL, It brutalizes and brainwashes the young. The disease theory of addiction does far more HARM than good.
Go to: http://bit.ly/2iUyOl2
I like this from Alphonse McGee who posted here on
November 4, 2016 at 11:28 AM
“It’s obvious the disease model [movement] is a cult due to the emotional and childish reactions of those who oppose your thesis. As in politics and religion, many are ruled by emotion rather than reason. A major downfall of the Human species to this day. It’s never healthy to accept delusions to further a cause.
I applaud the courage of your stance Steven. As Galileo, Copernicus, Darwin, Kepler, Newton or Einstein might attest, speakers of truth are rarely lauded initially. It’s only time that proves them right…
And no, I’m not equating you to those giants, only to the idea of elevating science, reason and rationality above feel good nonsense…”
I AGREE !!!!
Without meaning to stray too far from Steven’s piece too much, I’m headed well past 50 days without booze and the whole ‘powerless’ notion is nothing short of Hog-Wash. I’ve never felt so alive and in control of my life.
What infuriates me is when I am then told by those who subscribe to the disease model that clearly I wasn’t a true addict to begin with. It’s like having your cake and eating it. It reminds me of some of the cult like evangelical churches you hear about. ‘Ah well if he/she upped and left the church and is now living a life of sin, they weren’t a true Christian in the first place etc etc.’ It’s almost as if those who invented and brandished the lie in the first place see it as their authority to categorize, label and box others who have physical, mentally and spiritually debunked the entire disease theory, solely for the purpose of protecting and preserving their lie.
IrishAido
To get a broader picture of the “victimology” of the Disease theory, read “The Diseasing Of America” by Dr. Stanton Peele
” Many have joined my attack on the tendency to call every human problem a disease, create a twelve-step group for each “disease,” and excuse criminal misconduct as the result of such diseases. Books such as Wendy Kaminer’s I’m Dysfunctional, You’re Dysfunctional and Charles Sykes’s A Nation of Victims have focused attention on how ludicrous and counterproductive the Diseasing of America has been.”
Peele, Stanton. Diseasing of America: How We Allowed Recovery Zealots and the Treatment Industry to Convince Us We Are Out of Control (Kindle Locations 146-150). Broadrow Publications. Kindle Edition.
Nice one Mick. Thanks for your input and the many suggestions you have made
I wrote:
“That constant grousing 12 step groupers engage in about their trouble-making “disease” is nothing more than an avoidance strategy to shirk from the responsibility of making decisions about their own lives and to dodge the consequences of their own poor choices. It’s used to justify an endless parade of reprehensible behavior under cover of “disease.”
Carolyn wrote:
“I personally worry that defining [addiction] as a disease is enabling and indeed, I have a sister who seems to expect me to excuse her drug use and continuing bad behavior; I believe she feels entitled to continue her antics because she believes she has a disease. Even if I were in a position to expend more energy and money than I have already, “helping” her would only serve to send the message that I’m open to being used [abused] so that she has more resources to feed her habit. In the end that’s not going to help her and so I wouldnt go there even if I could.”
**** Notice the use of the word “HABIT” to describe her sister’s drug use rather than the word “disease” ******
Not only is Carolyn agreeing with me but she has unwittingly underscored the point of Steven’s article.
Just goes to show ya… even a blind squirrel finds an acorn every now and then
Might I add another point, that readers coming from the ‘disease myth’ should certainly not read Steven’s piece or any comments in agreement with despise and hostility. Personally I was never quite sure about what addiction was, but I would have assuredly been affected by the constant waves of pro-disease propaganda that is thrown at us on a daily basis. When I finally came around to believing that addiction was not a disease I found it incredibly liberating. It’s the very thing that led me down the sober road; and one I will never look back from.
Life really is way too short to be getting hostile at ex-addicts who do not believe they have a brain disease. I realize for some of you it sort of sweeps the entire rug from beneath their feet, and that can be a very bitter pill to swallow, however the most important thing is what it all leads to. If by taking a haymaker to your set of beliefs you get to live free from addiction, resulting in learning to love yourself and others again, then I highly recommend taking it. There is absolutely no point shooting the messenger on this one.
You are an alcoholic and always will be. If you pick up another drink you will be right back to where you were when you quit. Attacks on people who are trying to change their life by what ever means available to them is warranted? Stay in recovery!
Howard, when ignorance gets started it knows no bounds. [Your] stupidity is the deliberate cultivation of ignorance. Nothing in all the world is more dangerous than sincere ignorance and conscientious stupidity.
Attacking and vilifying people who disagree with the “Brain Disease” “I’m Powerless” theory of addiction is very typical of the tyrannical, egomaniacal [ass-backward] distorted and twisted mindset of the 12 step occult religion and its senseless, brainwashed, hateful adherents. Howard is a perfect example of this.
Anyone who disagrees with the 12 step bubble-gum [juvenile] theosophy is automatically accused of being HATEFUL and of being “harmful,” even deadly to other addicts. Nothing could be further from the truth.
The brain diseased, powerless 12 steppers like Howard say that our message of choice, of hope, of individualism, of self-empowerment and of healthy living [which is available to all who suffer from addiction but is outside the destructive confines and depressive enslavement of their delusional powerless, diseased world] – is detrimental to an addict’s recovery.
We know the exact opposite is TRUE. We know how harmful and DEADLY years and years of browbeating, indoctrination and bullying young addicts into believing they will N E V E R recover can be. We KNOW how detrimental and DEADLY it is to constantly PREACH “powerlessness” and the inability to escape a “Chronic Progressive Never-Ending Brain Disease” that’s “doing push-ups in the parking lot.” We know how destructive this Occult 12 step bullshit has been to the friends and families of addicts and to the addicts themselves.
We have been witnesses to the suicides of family members, friends and associates who had 10, 15, 20 years away from their last drink/Drug- but still ended their lives, all because they could never escape from the ceaseless, debilitating destructive and deadly effects of the 12 step occult DYSTOPIA.
ALWAYS Hammering away at these poor young addicts with endless tales of human misery, oppression, and disease.
Years and years and years of: “you’re sick, you’re diseased, you’re insane, your best thinking got you here, you’ll never really recover, once and addict always an addict, you’re thinking is flawed, you have endless character defects that you’ll never be rid of, you can’t do it without us, Your “Intellect” and “pride” in self-empowerment will kill You. You are a victim, you were born with this disease and it’s getting worse-even if you stop using, You
M U S T love and tolerate all reprehensible, criminal behavior otherwise you’re hateful, you MUST accept US – this “group of drunks”- as your GOD, you MUST turn your life and will over to US because you can’t live life by yourself” and on and on and on ad nauseam.
The FAILURE of the malignant 12 step ethos [especially in treatment centers] is E X A C T L Y why Annual drug overdose rates have skyrocketed from 36,000 in 2013 to almost 50,000 last year while the business of recovery has jettisoned into a $35 billion a year industry.
IT D O E S N ‘ T F U * K I N G WORK !!!!!! It DOESN’T HELP addicts ….. It C R E A T E S addicts!
I can truly say I’m what is considered by the courts and most people an alcoholic. I also know the only reason I don’t fix my problem is because I don’t want to. Just so you sir I found this article a very worth while read. Which helps to back up what I have always felt on the subject after being put through several different programs. Thanks for the well written article.
In the last 25 years, the number of addiction treatment facilities in the United States has tripled to over 14,000, and the annual revenue generated by the addiction treatment industry has tripled to over 35 billion.
Yet, drug overdose death rates have also tripled?
Drug overdose death rates are now the leading cause of injury deaths in the United States—surpassing motor vehicle accidents.
In that same time cancer death rates have gone down by 22%.
THE WAY WE TREAT ADDICTION HAS TO CHANGE!
NO MORE 12 STEP BULLSHIT !
Using drugs or alcohol in the first place is always a choice. A commitment to abstinence, which is what “sobriety” means, is always a choice. One can say exactly the same about obesity which is equally “simple” to cure: just stop eating. Fasting works.
That being said, there are some things that are not a choice. Being born with a dopamine-reactive brain is not a choice. When a non-alcoholic takes a drink it is natural and normal to want another (I won’t bore anyone with the physiological reasons this is true) but also incredibly easy to say, “No, no more tonight because I have to work in the morning and I know I will not feel well.” When an alcoholic takes a drink, the DESIRE to drink another can be like offering a single potato chip to a starving person.
This, or something quite like this, would explain why some people become addicted and some do not. The genetic aspect of vulnerability to addiction is well-studied and documented. Drugs DO NOT cause addiction but activate different brains in different ways. It is very much like side-effects of any medicine, which we see in some people and not on others.
The disease concept is a straw man and devoid of meaning, but ignoring what neuroscience is telling us seems willfully ignorant. The average member of the public, who demonize addicts, see this as confirming the “just say no” philosophy,
Good article, Steven. As I’m sure you know, many addiction professionals, myself included, are conducting similar research and reaching many of the same conclusions as you are. I’m very glad to hear that you beat your addiction, however you went about it. Please continue to “science” anything you want. And don’t sweat the haters. You don’t have enough sweat.
Gee, I can hardly wait to tell my friends who have been dealing with deep, dark depression and anxiety that all they have to do is make the conscious effort to manipulate their brains by substituting all of those horrible feelings with tickets to the movies or maybe go tanning or have your nails done. I can’t imagine how my good friend ,whose son is schizophrenic , will react to such an easy solution. I am almost afraid to tell her the good news. I can’t wait to tell her that when the ” numbers” are talking to her son, DO NOT GIVE HIM MEDCATION!! Take him to the show, instead. . . . I can’t tell you how grateful I am to have found your article. I will be a hero amongst all of the people who have spent, and still do, all those hours, days, months and years hiding from life, sad, scared to death and delusional, that a normal life is right around the corner, that they could come out now, will be the happiest day of their lives. They can just forget all about their sick brains and those daily doses of medications and think about doing something else, like riding a bike or flying a kite, then after a short while, off to a normal life you go. Thankyou so much for the education on the brain and the answers you have given that I couldn’t get from the brightest minds in the world. To think that such an easy answer to the most complex part of the body was right here under my nose; on the Internet…..so it must be true!!!
I couldn’t agree more, Papamick. What-ever treatment that is in place now and has been in place forever, has been put in place by design!! I am sick and tired of pushing programs on people with addictions , programs that have, and have had,an eighty-ninety per cent failure rate since their inception. Where else on earth could you operate with that kind of failure rate and still continue to stay in business??? The government and the big pharma have made themselves and their investors multi-millionaires. I would like to also forget about the 12 step program and take a different course of action; maybe something similar to the Chicago Democtratic Convention in 1967. I am so angry and have been for so long , listening to all the bullshit advise these programs give to people who are in addiction, or to the loved ones of an addict that I am ready to hit the streets, the ONLY way to make any type of significant change in society. People think I am nuts for saying these things, but look at what Black Lives Matter were able to do in a matter a just a few weeks; they got the Chicago police superintendent fired and ruined the mayors political career. They stood in the streets for days, blocked Lake Shore Drive and other major roads, with very little violence, if any. If we have to throw a few rocks, then we throw a few rocks but WE need to FORCE change. We need to get our asses off of the couch and out of these meetings and do things in a way that is as drastic as this epidemic. Anyone interested in further discussion, please email me. Once again, WE NEED TO MAKE THE CHANGES!!!
I am a recovering alcoholic. I use the 12 steps. Attending the meetings is a choice. How alcohol effects me is not. How does alcohol effect me? Once I pick up a drink I crave another, I can stop myself after one or two but it’s a struggle. The only way I can be happy AND drink is to not fight it and give in which leads to drinking until I pass out or run out. I’ve heard this is due to an abnormal response to acetylcholine but I don’t care, I know what it does to me.
Everybody does stupid shit when they drink, that’s the point of lowering inhibitions. When I allow addiction in my life it effects my choices, not while I’m drinking necessarily but in between binges. My self esteem is lower, terribly lower. I become antisocial and paranoid. I suspect the worst of others that I would normally trust. My instincts concerning sex and social situations and material needs gets all screwed up. I rack up resentments to promote my dive into a very dark place. I forget about others and become very selfish.
I am a better man when addiction is not a part of my life.
I choose to hold a proper perspective by attending aa. Whether my whatever you call it is a disease or selfishness run wild doesn’t matter. I currently lead a life of peace. I don’t need to codify or judge (even though sometimes I still do), when I get angry I look to myself to try to figure out what I’m afraid of, I fear a lot less than I used to though. I don’t need a social lubricant to feel comfortable talking to people. I can help others because I’m not constantly wrapped up in my own shit. My children like me, I like myself. I’m not happy go lucky all the time but am generally happy and can take life’s obstacles in stride without losing my balance.
The 12 steps applied to any addiction are basic suggestions that many people seem to follow just fine without having to be taught.
1. Acknowledge that life is unmanageable if addiction has a hold over me.
2. Find something bigger than me to believe in( your choice, knock yourself out).
3. Allow that something to run the show.
4. Take a good look at yourself
5. Talk to someone about that
6. As your something bigger than you to help you quit being an asshat
7. Make a list of people we hurt
8. Take a deep breath and prepare to eat some crow.
9. Say sorry….. mean it.
10. Take a look at yourself often to see if you’re screwing up
11. Build a stronger relationship with that something bigger than you.
12. Take what you learned and help someone.
Nothing cultish or secret or voo doo about any of this. For many it’s common sense. Addiction has a way of pushing all of the good stuff away. We develop our strongest bonds with that addiction. The 12 steps breaks those bonds and brings all the good shit back in.
Call it whatever you like.
I hope you all find as much peace as I would ask for myself. I’m Jason and I am a recovering alcoholic/addict
Oops, I slightly screwed up steps 6,7 and 8 but it’s real close from a big picture perspective