Anyone Can Escape Addiction—But Fatalistic Views of Biology or Trauma Persuade People Otherwise
Earlier this year, Maia Szalavitz, my fellow Influence columnist and an old comrade-in-arms, released her masterful book,Unbroken Brain, one that displays skills I only wish I had, and that I try to emulate. In it, she’s kind enough to praise my own Love and Addiction (1975, with Archie Brodsky), as “groundbreaking.”
I’ll add my voice to the many praising her work and its valuable insights.
Yet I will politely differ with one of her key themes—that, although ”potential addicts cannot be identified by a specific collection of personality traits,” based on her own experience, they nonetheless inherit a variety of neurologic sensitivities that lead to “the desire to feel accepted and secure when you typically feel alienated, unloved, anxious, and in danger.”
I don’t believe that God puts people on earth to be addicted.
(Note: I will speak of God in this post. For the record, I am a Jewish atheist. I don’t believe in God. But I am imbued with a Jewish outlook that I find helpful for progressing through life.)
In our 2015 book Recover!, Ilse Thompson and I express the Buddhist truth that we all have a place on earth, that no one doesn’t belong here. We use mindfulness meditations to help people realize their places through radical self-acceptance—the act of embracing themselves.
I reject world-views which tell people that their bad feelings, their need for addictive experiences, sometimes their doomsday spirals, are inbred, or branded on them forever by trauma, and can never be escaped. And sadly, these fatalistic stories can emerge from both 12-step and harm reduction thought.
My rejection of such fatalism isn’t just based on hunch. It’s borne out by the reality that people often recover from addiction and improve their feelings and their lives (see my last column, where I recounted that only a quarter ofuntreated people who were ever alcohol-dependent are still dependent at the time they were interviewed in NESARC).
Of course, Maia has also driven this home. As she put it in a classic article: “Most people with addiction simply grow out of It. The idea that addiction is typically a chronic, progressive disease that requires treatment is false, the evidence shows.”
But some people don’t get better, I hear you reply. And you’re right. And those people deserve our care and love and, even more important, their own self-care and self-love.
Yet while it’s true that some people remain addicted, that does not demonstrate that in no circumstances would it be possible for them to recover. Neither is it true that people who don’t initially get better can’t do so eventually. Rather, belated recovery very often occurs.
Gene Heyman, a Boston College epidemiologist, analyzed the most recent NESARC data according to a timeline of people’s likelihood of quitting a drug dependence. He found that “each year a constant proportion of those still addicted remitted, independent of the number of years since the onset of dependence.”
Translation: Some people retire from their addictions late, even very late, in life, and after many years of reliance on an addiction. Natural recovery does not discriminate based on how long a person has been addicted.
Let’s turn to smoking. In 2002, the Department of Health and Human Services published a volume entitled, “Those Who Continue to Smoke.”
The volume’s researchers uniformly assumed that those who continued to be addicted to smoking were handicapped in some way.
Their results confounded all expectations. Despite a variety of research efforts to discover the core resistance that prevented people from quitting smoking, the investigators found instead:
“In summary, these trends do not suggest that the population of smokers who remains is more addicted, more resistant to cessation messages, less likely to attempt cessation, or increasingly composed of those with limited activities or poor mental health” (p. 143).
One particularly interesting and surprising finding in the monograph was an interaction between age and degree of dependence in smoking cessation: More dependent younger smokers were less likely to quit than less dependent ones; more dependent older smokers were more likely to do so than less dependent ones.
Jettisoning all assumptions about addiction, a sensible deduction would be that older heavier smokers, sensing their mortality and wanting to delay death, which they knew was more likely to ensue given the severity of their habit, were more motivated to quit and more often did so.
The whole point of such smoking cessation research was to classify smoking as addictive, something which is now universally accepted. Yet these results confound our notion of addiction—or certainly the ironclad, neuroscientific, brain-disease version of it.
So what do we accomplish by telling people that they have a disease?
My colleague, Steven Slate, has recently presented to TEDx the freedom model, which he learned at St. Jude Retreats, an alternative program. There he reversed all that he had been taught about addiction, including that it was a lifelong disease. Instead, St. Jude taught him that he could choose not to be addicted.
Steve says, “I know this sounds simplistic, and that many people think this is an offensive message. But to me, it was and still is a massive relief.” He quit and hasn’t used for 14 years.
It’s inspiring stuff—although I do think the message is a bit oversimplified. People don’t quit just because they learn that they can. Escaping addiction is still a process—one that should be followed knowing that given the right circumstances in their lives, the right support, the belief that they can quit or moderate, and the desire to do so, people are able to leave their addictions behind.
It is never our job to convince them otherwise.
And if people have become convinced that their heroin addiction or alcoholism is a lifelong metabolic condition (Dole and Nyswander), God-bestowed biological trait (AA), or chronic relapsing brain disease (Nora Volkow), what do I do?
I pray to differ, to set out my evidenced reasons for believing otherwise, and to offer them a larger vision of themselves, of how the universe accepts and welcomes them, and offers them a place in which to explore life.
I once created a residential rehab program. People tended to go there as a last resort—that is, after other treatment options had failed them, repeatedly.
One young resident told me, “I’ve failed at nine 12-step rehabs. This is my last stop.”
Then he argued with me that his substance problem was a disease, just as he had learned in all those other rehabs!
My program taught him, and other residents, otherwise.
I’m often roundly attacked for doing so. Steven Slate, who was also kind enough to credit my work, said of me: “We all owe Stanton a debt of gratitude for willing to be hated for so many years, while standing by what he knew to be the truth.”
I’m quite willing to be hated, by Recovery Nation or even harm reductionists, if that’s what it takes.
Without blaming people for their failures, I will always try to err on the side of convincing them of their potential to get better, and to do so largely under their own auspices.
Call it a Jewish-Buddhist faith of mine.