Archive for 16 March 2011

B.C. Treats Alcoholism As A Medical Condition

One problem with the current disease model of addiction is that it doesn’t actually result in treatments that approach addiction as a disease. It says, “Addiction is an incurable progressive disease over which you are powerless. Therefore you need a spiritual awakening… .” Nonsense. Since when does medical science believe we’re powerless over a disease?

JD brought us an article today about how B.C. is about to adopt an approach to addiction that seeks to actually bring medical protocols to the treatment of addiction, which is a step in the right direction. I don’t think the current disease model has been at all useful, but if you need to call it a real disease in order to quit with the faith healing, then I’m not going to stand in your way.

“If somebody is diagnosed with a chronic illness, then treat it in a preventive way, rather than in a crisis intervention way.”

Dr. Shao-Hua Lu, an addiction psychiatrist, who chaired the BCMA committee that produced the report, said the government’s move will help push acceptance and expansion of medical treatment for addiction.

“What B.C. has done is to become the first jurisdiction in Canada to formally recognize [addiction] under the chronic disease management program and formally recognize the role of medicine as an important component in the treatment of addiction,” he said.

So, according to this, treating alcoholism as a medical condition means being reasonable and adopting a preventative approach, which is antithetical to the current AA wisdom, which believes that one must “hit bottom” before the “solution” will work — as causeandeffect pointed out in the comments. This new approach also seems to value medicine… in fact, it seems that it will be open to anything that can support wellness.
There’s a little AA bullshit at the bottom of the article, for balance, I guess:

Family care physicians are ideally placed to broach the subject of addiction and the need for treatment, said Gordon Harper of the Umbrella Society for Addictions and Mental Health in Victoria.

“I really want to celebrate the role that primary care physicians have but they can’t take the person by the hand and walk them into their first AA meeting,” said Harper.

“Walking into your first AA meeting is the scariest thing you’ll ever do in your whole life.”

I’m not sure what this dude’s skeptical tone is about — I think “scold” is the baseline with some of these people. What’s interesting about his comment is the assumption that the sole function of these doctors will be to send people to AA. But it doesn’t sound like AA is the only thing on the agenda here, especially if these doctors actually begin boning up on addiction research.
(Thanks, JD)

Salon Joins the Act…

In today’s Salon advice column by (AA? I believe so…) Cary Tennis, an AA member writes in to say that he has hated every bloody minute he has spent in AA. So, Salon doesn’t actually have to dive in and write an AA critical article, it gets one of its readers to do it for them. Whatever. It’s a start. The conversation is picking up…

I’m Sober, I’m Depressed and I hate AA

Dear Cary,

It’s Saturday night and in a few more weeks I will have been sober six years, with the help of AA, daily meetings, sponsors, steps, the whole bit. I’ve had times of peace and serenity, and gratitude for my healthy body and mind. But, for the most part, I’ve hated it from the beginning. And it’s just getting worse. I try other meetings — there are hundreds every week in the city I live in. I’ve also been to meetings in many different countries, and in the U.S. from Anchorage to Key West.

I’m a musician and travel a lot. That’s another thing. I don’t find any joy in my music anymore. My neighbors are having a jam tonight and I am in bed, listening, trying to watch a movie, wishing I could be there drinking a beer and jamming with them. My joy is gone. Vamoose. It went back in March of ’05. And now, even if drinking means death to me, it seems like a better choice than continuing to live this way. Continue reading Salon Joins the Act…

Questioning Orthodoxy

It seems that the subject of Charlie Sheen is gradually turning into the subject of addiction treatment — which, up until a couple of weeks ago, seemed taboo.  Finally, we’re having this conversation out loud. The author even cites the NIAAA study:

How Effective is Alcoholics Anonymous 12-Step Message of Sobriety?

Now I feel like I’m the crazy one, because Charlie Sheen is starting to make sense. Because contrary to what the talking-head television therapists have been saying, addiction doesn’t have to end in rehab or death. In fact, some figures show that most drug addicts stop doing drugs without help.

According to America’s National Institute on Alcohol Abuse and Alcoholism (NIAAA), 75 per cent of drinkers quit on their own, and many heavy drinkers do not have alcohol dependence. An NIAAA official made the statement that alcoholism “isn’t usually” a “chronic, relapsing disease”.

On the surface, Sheen’s porn-star-and-juice detox seems dubious. But Pax Prentiss, co-founder of the Passages Addiction Cure Centre in Malibu, California, says: “He did pee clean. He may have stopped and he may stay stopped. But if you take Charlie out of the picture, there are people who just stop using. In those cases, what happened to the disease?”

Prentiss and his father have been called the “Holocaust deniers of the addiction-recovery movement”, because they believe that alcoholism and drug addiction can be cured.

As Charlie Sheen’s soundbites sound more like Charlie Manson’s, it’s obvious that he needs some type of help. If AA defines insanity as doing the same thing over and over again – and Sheen has been going to rehab for more than two decades – it may be time to try another tactic. But anything other than admitting that you are powerless over your addiction is referred to in AA-speak as being “in denial”.

Celebrity meltdowns are supposed to follow a pattern. First comes the breakdown, and then the celebrity’s publicist suggests that it would be better for everyone if they go to rehab.

The 12-step philosophy has been so ingrained in our cultural philosophy that it’s been parroted on shows such as Intervention and Celebrity Rehab, which is like Celebrity Big Brother with methadone. We’ve seen it all before: the family members tearfully reading letters about how their loved one’s behaviour is affecting everyone, the threatening to stop enabling, and, eventually, tears and hugs.

Read it all…

Alan Marlatt Died

Devastating news…

Many people claim to be pioneers in addiction treatment, but few have left a more important legacy than G. Alan Marlatt, professor of psychology at University of Washington, who died of melanoma on March 14, at age 69.

Marlatt, who was also the director of the university’s Addictive Behaviors Research Center, was one of the first researchers to understand the importance of relapse in addiction treatment — and, more importantly, to develop and systematically test ways to help prevent an addict’s momentary slip from becoming a full-blown relapse. Marlatt recognized that enforcing immediate abstinence often deters substance users from getting or adhering to treatment, and he advanced therapeutic approaches that focus on reducing alcohol- or other drug-related harm, without demanding strict abstinence.

Throughout his life, Marlatt labored to bring empathy and compassion into a field that had historically advocated harsh and coercive techniques that were not effective.