Tell Me How to Change My Thinking and Treatment of Addiction
Dear Stanton,
I’m reaching out to you about you and what your work means.
Your work on addiction and recovery has popped up on my radar more times than I can count, sparking a mix of intrigue and skepticism.
How do you see your theories and approaches fitting into the broader landscape of addiction treatment today?
Moreover, what misconceptions about your work would you like to clarify?
Intrigued,
A Skeptical Thinker
NOTE: This FAQ has been generated with AI assistance. The response from Dr Peele is entirely his own work.
Dear Skeptical Thinker,
You’re my favorite audience!
I HAVE been around a long time. Twenty twenty-five (2025) marks the half century anniversary of my classic book (with Archie Brodsky), “Love and Addiction.”
Love and Addiction changed the face of addiction theory and practice. To wit, it is generally given credit for inaugurating the concept of “process addiction”. In terms of clinical practice, it identified natural recovery and life factors rather than substances as the causes of (not just the prompts to) addictions.
But I don’t use the term “process addiction,” or draw essential distinctions between addictions to substances and those to other activities and involvements.
What does that translate to in theory and practice?
As we wrote in “Love and Addiction,” “If addiction is now known not to be primarily a matter of drug chemistry or body chemistry [a prescient insight that has only solidified more in the fifty years since then], and if we therefore have to broaden our conception of dependency-creating objects to include a wider range of drugs, then why stop with drugs? Why not look at the whole range of things, activities, and even people to which we can and do become addicted? We must, in fact, do this if addiction is to be made a viable concept once again.”
Which I proceeded to do in “Love and Addiction” and in the “Life Process Program“.
WE NEED A NEW WAY OF CONCEIVING AND TREATING ADDICTION.
But we seemingly cannot (or refuse to) do so.
Case in point: the rush to new meds (called medications for opioid use dependence, or MOUD) to “cure” addiction. This holds not only for the bio worshippers who have always dominated addiction theory and practice (like Nora Volkow, head of the National Institute on Drug Abuse since 2003).
It also includes the biggest names in drug policy reform, such as Ethan Nadelmann and Maia Szalavitz.
They just can’t resist the notion that addiction resides somewhere in the brain. If only we can ferret it out, they figure, then remove or defang it — Voila! No more addiction.
Meanwhile, this magic potion approach has been transferred to psychedelics. (Remember Timothy Leary?) Recently, a top researcher has accused his mentor — Johns Hopkins researcher Roland Griffiths — of intellectual fraud:
“Perhaps unsurprisingly, he (Griffiths, now deceased) held a vaunted, even prophetic role among psychonauts, the growing community of psychedelic believers who want to bring the drugs into mainstream society. For years, critics have denounced the outsize financial and philosophical influence of these advocates on the insular research field.”
“Dr. Griffiths has run his psychedelic studies more like a ‘new-age’ retreat center than a clinical research laboratory,” reads an ethics complaint filed to Johns Hopkins by Matthew Johnson, who worked with Dr. Griffiths for nearly 20 years but resigned after a charged dispute with colleagues.
Anyone who believes that a magical potion can change an addiction knows nothing about addiction.
ADDICTION IS A LIVED EXPERIENCE BY A SENTIENT HUMAN BEING IN A DEFINED ENVIRONMENT.
Those things — the value of the addiction experience, the thinking and feeling of the individual, their life situation — have to change to reduce the addiction.
Nothing else suffices.
To paraphrase John Donne in “For Whom the Bell Tolls,” “Never send to know for whom the bell tolls; it tolls for thee.” Translated to addiction: “Never ask what causes addiction; ask who is the addicted person and what is their situation.”
Simply removing or replacing the object of addiction is like taking a popsicle stick out of the sand at the beach and thinking that you have created a permanent open space.
I have low, mid and upper back pain. The pain is Chronic. Oxycodone isn’t working well. Now my backs much worse and I now have knee pain too.My DR wants me to change meds.
She said maybe Buprenorphine and then Saboxone. My back pain is really bad. Is there another better pain reliever that is as good or a better choice?
Everything Dr. Peele says is correct, applicable and useful, after the developmental error has hardened a dependent patten that feels autonomous. Do we have to wait for symptoms to apply some of these concepts before symptoms? No we do not. The big change from this perspective is the relevance of the cause of addiction.