Current Trends by Natasha Sapp

There have always been skeptics suspicious the day neuroscience announced its finding suddenly giving fellow scientists, researchers, social workers, treatment advocates, easily dubbed ‘addict sympathizers,’ a leg to stand on in putting forth the idea drug addicts are diseased, there is something wrong with them beyond character flaws, lax morals and waning willpower, whatever the last one is. Science suddenly espousing treatment was a better way of handling the portion of the war on drugs dedicated to those who take drugs, a more effective allocation of tax dollars, government funds than incarceration, scaring, primarily youth, straight, away from drugs with the duel threats of prison time and stigma seemed like a betrayal of the morality and decency America was founded on.  Naysayers equally happy to see 21st  neuroscience thus revise its claims, ecstatic to read authors like’s Laura Miller, see her and others jump on a different bandwagon ascribing instead to the personal responsibility mantra, naming a spade a spade, as it were, calling out addicts as weak, foolish, degenerate, calling out society for its contribution to almost anything becoming an addiction food, gambling, video games, porn, sex; though what societies culpability is, is never explained by her or the psychologist she quotes often. Both blog researcher and book author, studying addiction, taking after people like Robert A. Hall whose I’m tired speech continues to be a template for such talks bucking the common zeitgeist on a host of social issues, challenging overwhelming current social paradigms on work, the mortgage crisis, green energy, entitled youth and yes drug addicts in which he said, “I’m tired of being told that drug addicts have a disease, and I must help support and treat them, and pay for the damage they do. Did a giant germ rush out of a dark alley, grab them, and stuff white powder up their noses while they tried to fight it off? I don’t think Gay people choose to be Gay, but I damn sure think druggies chose to take drugs. And I’m tired of harassment from cool people treating me like a freak when I tell them I never tried marijuana.” Miller’s neuroscience’s and budding psychology’s stance as of the summer 2015 article, addicts don’t have a disease, addicts have picked up, literally conditioned their brains to some horribly destructive and bad habits, accounting for the physical, physiological changes present, actually visible on brain scans of addiction suffers, but the good news is marked changes are noted in parts of the brain tied to learning and development, meaning all addiction, be it heroin or cheeseburgers can be unlearned, doesn’t have to be permanent. Unlearning destructive patterns, which in another bombshell are not abnormal, just a form of learning gone tragically wrong, and replacing them with new ones then transfers the focus to what the addict can do to help themselves as opposed to the AA formula the first step being to admit your powerlessness over the addiction, moving it toward the realm of transcendence and god to quote the psychologist; belief that empowering addicts is more desirable than perpetuating powerlessness. Evidence supporting this theory provided by Dr. Marc Lewis psychologist and former addict, who wrote the Biology of Desire: Why Addiction is Not a Disease detailing cases where different parts of the brain, different neuropathways, emotional and social pathways lead to addiction; Miller citing 3 different examples representing 3 unique ‘emotional wounds,’ Lewis states were the foundation for their addiction, ultimately made worse by drug use. Lewis’ theory adopted and praised by Miller further reinforced by addicts who used something apart from AA to achieve sobriety, maintain lasting, long term sobriety, key reference, a heroin addict who taught herself to meditate in prison. Missing is any explanation of the psychological diagnoses surrounding those wounds, at least not included by Miller, or acknowledgement we are far beyond The Basketball Diaries, that most people don’t get clean in prison, adopt meditation unless there is a substance abuse program, counseling and life skills training surpassing the prison psych ward managing the severe mental illnesses of people who should probably be, have been remanded to a psychiatric hospital for the criminally insane, legally incompetent. The reality—the most addicts usually get from prison is exposure to more prescription, illicit drug varieties to get high on, new “rituals” as Lewis calls them to get high, maximize your high, new types of criminality to engage in to support a habit, added connections, acquaintances to propel them deeper into elements working outside the law. Had this been an open letter to doctors, addiction specialists, those on the front lines of treating actual addicts, one might be more inclined to hold their criticism feeling valid points had reached their target audience; unfortunately this was directed at both those who deal with addicts professionally and ordinary citizens, posted on  a news magazine website. Unclear is what either the Salon author or the psychologist/book author hope to achieve besides offering addicts more than AA as a treatment option for the former and a more tough love, take your life by the balls talk given to ‘society’s worst screw ups’ championed by the latter; crystal clear is what will happen if their brand of neuroscience seeps into the public consciousness. Decades of positive focus on treating addiction and restoring addicts to functional, productive lives, giving society back the type of citizen it wants goes up in smoke, taking us backwards not forwards. Back to viewing them as failures of character and morals, producing a response of shaming, scolding, she forgot name calling, while shouting for more willpower; strategy even Miller admits was “spectacularly ineffective.”

Before readers start to lump this article’s views in with climate change deniers and right wing republican lunacy to nonsense, understand I myself have spoken on the limitations of brain scans, what we know about them, the interpretations rendered especially connecting unhealthy foods and addiction, claims bad for you foods light up so called addiction centers in obese people’s brains, but like forgoing the argument in climate science of if climate change is man made for solutions to increasingly dangerous climate disruptions, the devastating consequences set to be visited upon us if the existing climate upheaval is left unchecked, continuing to classify drug addiction as a disease does more measurable good than tangible harm. Alert to the irrefutable proof neuroscience in this instance, in this context is like diet science; it changes rapidly in the course of a year, is almost unrecognizable throughout 5 years, astonishingly changed over the course of a decade. Eggs are bad for us, now good for us, cut our alcohol consumption, now red wine reduces everything from some types of cancer to heart disease, coffee is better for you than we originally thought, worse for you than we ever imagined, carbs are good then came the Akins diet and carbs lead to obesity; Akins’ being just one of the fad diets whose praises were sung by ‘experts.’ It isn’t just that Lewis and Miller’s approach to once and for all curing the addicted (something Lewis plainly states is possible, none of this being in ‘recovery’ the rest of your life crap) is more complex, can’t be boiled down to a sound bite, a take this pill, do these things prescription and instant gratification, triviality, consumption obsessed, shallow America hates complexity; it is that the Lewis/Miller method to confronting addiction drastically oversimplifies the physical components to addiction, the physical, brain changes that accompany it. They blatantly disregard the probable disease underlying, present in people who take their first drink, smoke their first joint and are hooked, can’t put it down, can’t stop without addiction intervention, treatment; ignore the genetic, family history factor working within alcoholics, drug addicts the same way it works against obese people, works in favor of thin people, its  role in multiplying your chances of  contracting diabetes, being diagnosed with cancer, suffering heart problems despite ‘good’ life choices, absent the implied behavior modeling element attached to addiction summed up in ‘of course you’re an alcoholic you grew up around a father/mother who was an alcoholic.’ Family history playing a role regardless of if you have had any contact with your addicted relative, were purposefully kept away from them due to their substance abuse issues. Lewis’ examples logically assumed to embody, in some facet, all addicts don’t cover people like Danny Bonaduce who while in rehab for pills, illicit substances, what have you was told by treatment organizers he was an alcoholic; he thought they were crazy. Unfortunately before long Bonaduce was drinking excessively and in rehab because of it; Carney Wilson talked to Oprah, back when she had her talk show, about having weight loss surgery and soon finding herself grappling with booze. Both of whom likely have what’s known in psychological circles as an addictive personality; treatable certainly yet persons affiliated must be on continual lookout, guarding against minor compulsions that could morph into addictions. Such persons “always have and always will contain a bomb” that must be vigilantly watched to avoid setting a match to it. They dismiss a chief difference between drugs like heroin and meth versus marijuana, minus the unnatural substances in literally toxic combinations and their tendency to chew on the body, damage every organ, nerve, cell and tissue, is also their almost instantaneous capacity for physical dependence; our opioid/heroin epidemic doesn’t stem from a steady sprouting of degenerates, newfangled parenting, social media and all the things people rag on turning out droves of weak, foolish, maladjusted individuals. 20/20’s exposé shows case after case of legitimate pain killer prescriptions given to people post a significant injury and before they knew it they were traveling down the vortex hell known as addiction, turning to heroin because it provided a substantially cheaper high, winding up dead by overdose either after treatment lowered their body’s tolerance for the drug or before successful help could reach them. Top reason why methadone works so well in weaning addicts is because it reduces, eliminates the intense cravings had by heroin, opioid addicts no amount of willpower could independently overcome; opioid blocker pills, shots and implants’ claim to fame and success is that the addict can’t get high even if they want to, try to, lost is it must stem cravings too. Details above prompting the question, if these people are not diseased, there isn’t something wrong with them, physically, neurologically, chemically, transcending the toxic chemicals they’ve put into their system, an abundance of alcohol they ingest regularly, why are opioid blockers and methadone so successful, how were doctors able to predict Mr. Bonaduce’s alcoholism; reaching head on into another popular ‘disgusting addiction,’ if fat people are addicted to food showcasing another section of weak, foolish degenerates, there is nothing wrong with them either apart from their own little, maybe not so little, personality quirks pushing them to consume unfathomable amounts of calories, why does deep brain stimulation work to eliminate powerful cravings they say they feel, describing the stark difference after the procedure?

Interesting too—hers, Miller’s, utterly disparaging tone regarding the outcome of drug dependency being characterized as a disease; taking offense it seems that it “ushered addiction under the aegis of the healthcare industry, whether in the form of an illness whose treatment can be charged to an insurance company or as the focus of profit-making rehab centers,” like that’s a bad thing, like it doesn’t facilitate more addicts getting help. Ironic considering the number of people found to be self-medicating with drugs or alcohol to manage mental illness; soldiers and servicemen returning post combat with varying degrees of PTSD, trauma related mental health problems turning to the bottle or drugs due to VA hang-ups, a military culture centered around tough it out. Confusing how she opens readers to her thinking these things don’t belong ‘under the aegis of the healthcare’ when bipolar disorder, depression, even anxiety and OCD are thought to be byproducts possessing organic causes; chemical imbalances in the brain in the first 2 to be exact, potentially in the last 2. Schizophrenia thought to originate via an organic brain malformation; branching forms of psychosis and auditory/visual hallucinations along with schizophrenia itself responding well to on market anti-psychotics when appropriately prescribed and used consistently by patients. People who find themselves in such a situation, self-medicating, is largely thanks to our attitudes on mental health not truly having moved as completely as our thoughts on drug addicts, nearly identically boiling them down to weakness, character flaws, perceptions on morality, lagging, non-existent willpower, stalling people from treatment; people brought to this marginalized threshold by insurance companies who, under the category psychiatric care, will only pay for therapy or medication, but not both, loved ones making the heartbreaking decision to institutionalize a son, daughter, mother, father, uncle must next do battle with insurance companies over care, despite doctor recommendations, a singular facility a trained  professional has the most confidence will be the greatest help to their patient. Individuals diagnosed with severe, debilitating mental health impairment blocked from critical therapies bridging the gap between success and not, independent living and not; think the PBS special on the blogger ‘I Am Adam Lanza’s Mother’ and her son chronicling their journey to get this, then 11 year old, help. Therapies on par with OTR, also a tool for people with autism, designed to teach those so impaired how to function, behave appropriately, normally in everyday situations their diagnoses often prevents them from understanding without explanation, role play practice; therapy she had to fight her insurance coverage to fund, independent it was for a child, could directly dictate his future. These just a hand full of stories, cases where insurance falls short of its mandate, what it was created to provide, yet Miller appears to imply treatment champions are pushing their agenda to somehow defraud the insurance company, healthcare system. Ah there’s the rub, it comes under mental health not medical; mental health still garnering the reputation we are psychiatrically just above bloodletting and leaches, lobotomies and merely warehousing the afflicted in a different kind of jail. While there are great failings in the mental health system, too much institutionalization and forget them versus help them mentalities, Freud is the father of modern psychology, meaning precursor, starting point not the be all and end all, the only psychology practiced in the 21st century; in fact, most of his theories have been totally debunked, laughed out of psychological academia, left well behind in psychological medical practice. Returning to the larger topic at hand,  let’s assume, playing devil’s advocate, as they say, Lewis is onto something and the roots of drug addiction, minimum in X percentage of patients, is emotional wounds; to follow that by saying we shouldn’t be able to bill an insurance company for drug treatment is equivalent to saying we won’t pay for cognitive behavior (talk) therapy for people suffering from depression, because it’s after the death of a loved one, divorce, significant life stressor, post suicide attempt, not a chemical imbalance. We won’t pay for the same therapy sought by a person confronting an abusive past negatively affecting their adult life, stable relationships all through their life, grappling past child sex abuse as an adult, because they have no true psychological diagnosis. Out too under said logic would be rape trauma counselling, counselling after natural disaster, mass shooting event, denied 9-11 survivors, 9-11 families, first responders, victims of violent crime, because it doesn’t require a medication, therefore is not medical, thus does not ‘belong under the aegis of healthcare’ and we don’t do that anymore; insurance is required to cover, frankly not enough, aspects of mental health care and management precisely because we understand, treating the laundry list of life experience induced traumas alongside hard and fast chronic mental illnesses, chemical depression, bipolar disorder, dissociative identity disorder, once known as multiple personality disorder, psychosis is astronomically important in preventing next to every level of crime, ensuring productivity of workers, decreases in welfare and disability payments to afflicted individuals, less burdens placed on society in the form of homeless shelters, rousting vagrants, domestic violence, disturbing the peace; both authors stubbornly oblivious to the problem trifecta mental illness, substance abuse and homelessness present to society, all three very much intertwined. That if someone is homeless it’s a sure bet they are suffering from one of the other two, often both; that treatment gives back mothers, fathers, sisters brothers, sons, daughters, uncles, aunts to worried family members, can ensure a child is given back a parent in their formative years to be an influential part of their life in a good way, break the cycle of mental illness leaving palpable emotional scars on the next generation, mirroring ways drug treatment can yield the same stabilizing good if used instead of, at worst, in conjunction with incarceration, for lesser offenders community connects to housing, jobs.

Socially relegating drug addiction to nothing more than ‘a dangerous habit’ has huge impacts, effects medically not singularly on society as a whole, starting with causing addicts, their friends and family, acquaintances desperate to help, to think they can detox themselves; never mind alcohol DVTs, heroin drug withdraw symptoms can kill, shock of cold turkey detox from any drug can lead to permanent damage done absent medical supervision, sometimes with it, promoting that line of thinking sets an addict up for yet another failure when they can’t go it alone, sets the people in their life up for compounded disappointment. Distilling addiction down to ‘a bad habit’ is a paltry, unworthy reasoning for people dragged through horrible abuse, neglect, trauma, battle zones, no family, foster care instability, jaw dropping stories making the news— living in filth, forcibly abused by siblings at a parent’s demand. Rare instances sure, but who was it, Makenzie Phillips who told the world on Oprah and in her new book, at the time, about her father shooting her up with drugs, victims dosed until addicted as a revenge plot. So much for Robert A. Hall’s, “Did a giant germ rush out of a dark alley, grab them, and stuff white powder up their noses while they tried to fight it off,” because in their case it did; the germ being a horrible parent hardly worth the distinction, a psychopath al-a Ariel Castro, a gang banger type seeking retribution—oh, oops. Standing out in the article below attempting to explain why white, middle class kids who, by all appearances have everything going for them would turn to heroin, from a former addict himself fitting this description and sandwiched in between more literary references and film maker/producer credits than even I, the English major can keep up with, isn’t the now standard millennial trashing, rehashing the redundant narrative of  good things being perceived instantaneous to this crop of youth, told they could buy the good life, consumption obsessed, hollow and empty otherwise, shells of supposed humans walking around, depicting how his generation will watch the end of the world on screens, filtered via social media, not experiencing even that firsthand, implication being, no wonder everything has lost meaning, 18-25 year old heroin addicts have lost themselves. It’s the snippets you almost miss; when Siegel talks about those born circa 1990 ‘not having a narrative [of their life] to lose’, the Cape Cod nod kids he references from a heroin documentary centered in the area, nodding being how he articulates a heroin addict’s function, diminished function while slave to the drug, ‘had at that time no horizon with which to cast themselves off into. There was no arc of time or foreseeable future,’ describing more than kids of this decade or geographical region. Remarking how closely the young heroin addicts lack of ability to envision a future resembles the plight of middle aged, working class whites “They’re dying off in record numbers from liver damage (cirrhosis), overdose (opiates) and suicide. The two former causes are merely suicide in its slower, more painful manifestations.”  Highlighting the boredom and lack of opportunity permeating even these affluent kids, how ignored they feel and are, at a time when parents were still pushing the get and education you’ll go far slogan; left off, the monumentally impossible expectations lobbed at kids perceived to have everything. He claims heroin induces a kind of now appeal, nullifies the future, a grim foreseeable future painted by cynical adults, “Whether financially, politically or climatologically, there is doom and gloom ahead. A Republican will win the election. The environment will putrefy,” foreshadowing the political gridlock around the corner, teens, prime of their life individuals turning 20 have come to accept. Except the looming social problem isn’t “a kind of Americanitis…;” one of the things Lewis did artfully well that Miller was able to capture with her quotes and excerpts from him, is his examples span across the western world. And while there probably is “a prevailing miasma, an irreducible, un-diagnosable discontent among the living [;] It deals in vanished meanings, subtly functioning beyond human volition.” The discontent is very diagnosable if you understand his heroin nodding compatriots came of age, graduated high school just as the 2008 recession smacked us all on our asses, very quickly already understood or coming to the conclusion middle class, even Cape Cod middle class, didn’t mean a college education free of student loans, college was a guarantee seeing as 401k’s and college funds were getting obliterated on the crashing stock market,  mommy and daddy’s connections, assuming they had any, would carry them through scary financial times. Millennial, early gen Z discontent skyrocketing out of we lied to them, told them to do X, Y and Z and they would achieve, arrive, doors would open for them, lies they were already starting to see through, see cracks in when Siegel began using. Again his age group, if not he himself, graduating high school to see Bernie Madoff arrested for a 20-30 year Ponzi scheme, juniors in college when occupy Wall Street took hold, coming out of college to no jobs and a broken system that kept moving the goal post; it wasn’t enough to get a degree, suddenly it had to be the right degree, it wasn’t enough to get a degree, you suddenly needed field related experience no business would give, certifications and certificates you weren’t told about by anyone, concurrently the business model that propelled their parents forward didn’t exist any longer. Feeling— their future had been ransomed by the adults before them in gargantuan national debt, crushing student loans, forget good equal instantaneous, working longer and harder for the basics, endless hours at startups for minimal pay and meaningless equity packages, the generation who ‘refuses to work’ piecing together part time jobs to make a life or doing odd jobs on the side of a 9-5 for monetary security in an increasingly freelance and unstable emerging employment economy all battling a recurring finger wagging stereotype. Only question left, why weren’t more kids doing heroin sooner, not why has it invaded subarea; why are so many cases tied to legitimate pain killer prescriptions not the modern day version of Alan Ginsberg’s Howl?  Born a decade earlier than today’s 20 somethings I can related to their disillusionment; I came out of college 2 years before they walked across high school grad stages with a degree I hoped would start a rewarding career in writing, creative, journalism I didn’t care, as long as I could make minimum wage, only to find out how badly I’d been lied to by ignorant ‘professionals,’ spent the next 5 and a half years in abysmal job training programs, feeling like I was training job placement workers earning a paycheck to help me, realizing a few short years later how meaningless my life was with exactly one friend, no desire for a boyfriend, husband, the family life, everyone already attached or looking to get attached, so forget making any new friends and the picture I had in my head of a few people to share special moments and holidays with, gone.  Had I known then what I know now I could have easily been Siegel; coming full circle back to our original author and quoted researcher, worse Lewis and Miller’s societal prescription doesn’t divulge a viable alternative. She quotes Lewis’ words on addict’s lack of requirement for medical intervention saying instead, “What they need is sensitive, intelligent social scaffolding to hold the pieces of their imagined future in place — while they reach toward it;” then leaves readers hanging sans one single, solitary example of what that scaffolding looks like, is comprised of.       

Channeling that same willful ignorance toward another piece of the addiction conversation, the Lewis program as detailed by Miller also operates under several fallacies, basically telling us to change our mindsets, belief systems away from things we never believed in the first place and to things we already know, with minimal explanations from a treatment specialist about the specific, individual addict we love, can get our heads around no problem. One, polar opposite the alluded majority “truth be told do quit without any treatment” they actually don’t; person’s she’s describing here are either recreational drug users neither physically nor emotionally addicted to the substance, activity that drove them to variations on AA, narc- anon, gamblers anonymous, enjoying their high on lower schedule drugs, pot, ecstasy likely the most potent, not to mention popular ‘party drug,’ taken or were never addicted to the behavior, friends, acquaintances, co-workers advised them to seek help for simply liked it a lot, wanted to spend all their free time on it, still meeting their obligations. 2 paragraphs later is a drastic misinterpretation of AA that, firstly is an outpatient, community, solely volunteer addiction recovery maintenance program not to be confused with a formal detox and addiction treatment facility non-profit or profit; secondly AA does not ‘ask you to recognize your powerlessness over addiction, mandating you surrender it, your addiction, to god’ and stop there; proper interpretation is the AA’s first step is to admit you have a problem, an addiction and you are powerless to do it alone, key word there, should start by asking god, as you understand him, to assist you and here are other tools, the remaining 11 steps, to also help you, if you work them daily. 90 meetings in 90 days is for the newly released from formal rehab to transition them from their recently controlled, totally supportive environment to the uncontrolled real world; where a newly clean addict has to make the conscience choice to walk past the bar not go in, bypass the liquor aisle in the grocery/convenience store, avoid casinos, online gambling opportunities, race tracks, sports bar betting, fantasy football, like criminals fresh out of jail actively avoid old friends still caught up in gangs, still out doing wrong, addicts must avoid places they used to cop drugs, old acquaintances caught up in that life. Or for minor relapses where someone has had a drink, placed a bet, taken pills, recognizes their slip and goes back to intensely pursuing the program, preventing a second, third or fourth round in 30, 90, day, yearlong rehab routinely at the tax payer’s expense. Swept under the rug by our Salon author and the snippets of Lewis’ book provided painting a picture, who knows if it’s an accurate one of his research, viewpoint, AA employs the use of sponsors, people who’ve worked the program, achieved at least X amount of time sober adding that personal responsibility and accountability authors thought missing. If a patient sincerely thinks they can devise an alternative plan to kick addiction for good, AA just doesn’t work to you it should be discussed with their therapist, addiction counselor; provided they can answer key questions on difficult, possible upcoming scenarios they should be permitted to try. Next there is no reputable treatment facility 30 day, 90 day or longer program that does not involve some level of cognitive behavioral (talk) therapy, group, individual, often both meant to get to the bottom of psychological, mental, emotional problems culminating in addiction and the downward spiral it lead you to; rehab many times the first time and addict is diagnosed with chemical depression, bipolar disorder, even SAD (seasonal effective disorder), borderline personality disorder, encouraged to, allowed to, forced to confront childhood abuse, are in a safe enough place to admit they were molested as a child, raped by a boyfriend, victim of a forced homosexual encounter, are perhaps transgender. The general public know this watching Sandra Bullock in 28 Days or the many cable television shows, appearances of Dr. Drew Pinsky psychiatrist, psychologist, drug counselor, rehab facility manger to the stars. Nor is there any reputable addiction doctor, counselor, social worker who doesn’t believe that part of treating addiction is replacing bad habits with good ones; they do however comprehend the complexity of reaching said objective.  Why haven’t people like Lewis and Miller done their homework enough to grasp such readily available information; Miller’s goal apparently to get America, society, persons all thinking beyond AA. Logical proceeding question, who said drug treatment had to be, was one size fits all, AA was the only, even the most effective option; and doctors who don’t know that shouldn’t be practicing addiction related medicine, addiction recovery counselling. AA is the most widely known publicly but hardly the only one; so called alternative rehab facilities abound and are nearly as mainstreamed. New Beginnings is right up Miller’s personal responsibility over the transcendence of god theme, holistic recovery centers who reiterate many commentaries on addiction and treating the whole person, using the whole toolbox, therapies and activities regiments listed were, yet not limited to: acupuncture, nutritional therapy, exercise routines, massage therapy, spiritual counseling, yoga meditation, art therapy, music therapy, tai chi, falling in line with Lewis’ self-created regimes, all attainable through a google search. Caution and warning many addict’s beef with AA isn’t they are atheist, agnostic finding the very notion of god abhorrent or mythically fictitious, aren’t mad god could let the atrocious things that happened to them happen, instead many addicts not ready to face their addiction, don’t want to admit they have a problem they can’t solve independently, without help, don’t think they should be lumped in with what we stereotypically associate with an addict, want to continue believing their drinking doesn’t constitute an issue, isn’t any more abnormal than anyone else’s, their recreational drug use is just that, a thing they can still take or leave, not crossing over into a compulsion they can’t live without, they are just as normal as their drug party friends and people are too uptight about drugs anyway, gambling, video games like drinking are legal so who cares if I do it to relax, I indulge more than once and a while, it’s no one’s business. Sex and porn are often explained away by I’m a guy, a significant other who’s never in the mood or a lack of a relationship to fulfill their sexual needs any other way. Critics of AA taking umbrage at the put it in the transcendence of god abdicating personal responsibility crowd are probably identically the ones working off the old paradigm putting faith in willpower, thinking addiction/lack thereof is simply a function of self-control, not that an addict’s brain processes alcohol differently, coincidentally a group who has probably never been addicted to anything, had an abnormal, intense compulsion of any kind, the abuses suffered by more and more addicts scarcely imaginable to them.  Hardly difficult imagining Lewis and Miller both apoplectically incredulous at Siegel’s true point—how they got here being less important than how we fix it; “and we must keep people alive long enough to find it. [meaning] That means we need supervised injection facilities, places for people to shoot up and be safe. That means we need naloxone, the chemical antidote to opiate overdose, available everywhere. That means we need heroin to lose the creeping across class lines narrative. That means heroin can longer be a secret. That means we need to love those using it and let them hang on long enough to find these meanings.” If it lines up with the 2016 released John’s Hopkins/Lancet commission on drug policy and health’s stance on current ‘war on drugs’ practices proliferating the spread of HIV, hepatitis C, contributing to overdoses, too bad.

Finally, sending Miller especially, and Lewis too the way of Freud hopefully once and for all, no, the illness model for addiction isn’t wrong, and dangerously so; the only thing dangerous would be classifying it any other way. By the by, classifying drug addiction a disease was never meant to be a cop out, an excuse, a reason to walk around on egg shells when interacting with an addicted person, given them extra, unwarranted attention, pity as one man in the comments to Miller’s piece described life with his father: “After suffering decades of my father’s alcoholism, it’s a relief to read that at least one individual agrees with me — a drunk doesn’t have a disease. A drunk is self centered, childish, manipulative, and selfish. He doesn’t stop drinking because he doesn’t want to. Being a drunk gets him everything he wants — attention, pity, patience, indulgence, and most of all he gets people to walk on eggshells around him. I told my father to either stop drinking or drink himself to death. I didn’t care. What he had wasn’t a disease. What he had was a tight grip on my mother’s and my belief he had to be treated like a baby or else. My mother died with the belief she failed to help him cure his “disease.” I walked out on him 10 years ago and never looked back. So he spent the rest of his life with his true love: a bottle of scotch.”[Sic] It was meant to say once you are an addict you are diseased here’s treatment, here’s help—use it; a classification designed not to mislead the masses rather based on what we knew at the time, a majority of neuroscientists still believe, to distinguish addition from other “dangerous, “bad” habits, true addiction from the slang usage exaggerating something someone likes a lot, a hobby they enjoy, favorite food, favorite alcoholic drink they always order on the sparse occasions they do drink. Changing lanes without using your turn signal is a bad habit, not wearing your seat belt is a bad habit, not donning your bicycle/motorbike helmet is a bad habit, crossing the street without looking both ways, distracted walking/driving is a bad habit, sitting too much, sleeping too much are bad habits, lack of exercise is a bad habit, fatty, salty, sugary foods in excess, frequently are a bad habit, waiting to the last minute to pay your bills, your taxes, renew your driver’s license is a bad habit, addiction, whatever shape it takes, is in an entirely different league.  Acknowledging that while yes treatment is effective in the long term, it routinely resembles peoples attempts to quit smoking, it may take several tries before it fully takes, but because cigarettes are legal, reasonably cheap compared to illicit substances, you can hold a job and smoke at the same time, we indulge, coddle, humor smokers in a way we won’t even treat drug addicts like human beings. Hints the classification, because how can you not call someone diseased who has done so much damage to their body, altered their mind so significantly; that they did it to themselves is irrelevant, we either help them or let them die, and with 600,000 heroin users alone 23.5 million alcohol and drug addicts, forget other addictions, in exclusively America and 208 million globally, limited to illicit drugs, not pharmaceutical abuse, alcohol or the videogame addiction sweeping westernized Asia, the latter being and old statistic going back almost a decade, you can’t call the let them die mentality anything short of genocide.  A classification aimed at shoring up that social scaffolding Lewis says is necessary for addict recovery; sensitive and intelligent added words he used to describe this mystery scaffolding. Social scaffolding that has to include judges willing to send addicts caught scoring drugs to rehab not jail, caught in theft, robbery to rehab before or after jail, meaning there have to be effective, functional rehab centers to send them to; social scaffolding that means if we have to design specific rehab programs for specific drugs, specific addictions then that’s what we need to be doing. As a taxpayer you should want your dollars going toward treatment, restoring lives rather than years to lifelong incarceration, also on your dime, to feed, clothe, provide medical care to thousands of persons while they simply sit in a metal box; as a citizen it should matter to you that by checking yes to voter ballot initiatives meant to give help to addicts, lending your voice to movements, concepts saying treatment over punishment can stave off your chances of being a victim of robbery, theft, violent assault for the 50 bucks in your wallet, valuables in your house because less people are high suspending reason and judgement, doing it to support a habit, a result not achieved by the Newt Gingrich ‘execute the drug addicts’ slogan, neither intelligent, sensitive nor functional despite its knee jerk, id appeal. Criminal justice reform a topic in the 2016 presidential election for precisely this reason, coupled with people fed up of seeing young black persons literally murdered in the streets for minding their own business, running from a cop fearing a crooked charge or worse attempts to get help misinterpreted, people are becoming equally fed up with citizens languishing away in jail cells, serving life sentences on 3 strikes laws for minimal amounts of drugs, non-violent drug offences, usually marijuana. Predictably coming down along racial lines the way we have long known lawyers, judges and prosecutors to come down on crack versus powder cocaine; predominately white, powder cocaine users are sent to diversion programs, given probation since the family is affluent, able to afford rehab, crack users are expediently Fed X’ed to prison do not stop, do not pass go, do not collect $200 and assuredly don’t ask what the hell is going on. Similarly white marijuana users are charged under misdemeanor laws for pot possession under a designated weight while minority users are prosecuted to the fullest extent of the law, locked down for life under 3 strikes, subject to lesser quality representation through a backlog of overworked, underfunded and limited legal aid staff doesn’t help; women discriminatorily sent to prison, jail almost as expediently as black and brown people according to the John’s Hopkins/Lancet study. Social scaffolding that means such racism, classism ends in deciding sentencing for drug users drug related crime; social scaffolding that means employers willing to give jobs to a person maintaining their sobriety somewhere between a minimum of 90 days and 6 months so they see the payoff of staying clean, the way criminals need to see ready benefits of staying on the straight and narrow, avoiding the wrong friends, avoiding old habits, avoiding temptation.  One of the reasons the recidivism rate is so high for both groups is because they attempt to do the right thing and are never rewarded for it, try to earn money, make a living legitimately, put the pieces of their life back together and no one will give them a chance, so they return to the criminal element, use money from odd jobs, petty theft to get high, relieve the stress of trying to do it like everybody else, stress attempting to stay clean has brought them.  Still need convincing, 30-40 odd years of the ‘war on drugs’ over 1 trillion, with a T, dollars spent and it still hasn’t worked, millions of Americans remain addicted, millions more worldwide; maybe it’s time to try something different, ‘radically’ different, as radically different as treating not shunning the addict to learn the cause of addiction and do our best to eradicate that cause.