Addiction is NOT a disease
THE GROWTH OF ADDICTION TREATMENT in the United States, predicated on the idea that alcoholism and addictions of all kinds are diseases, is a public-relations triumph, and not a triumph of reason or science.
The idea that modern addiction treatment—like that provided at private alcoholism hospitals—is eminently successful is a myth. More people quit alcoholism and addiction on their own than do so through treatment, and evidence is that in many cases people trying to quit an addiction (such as smoking) are better off attempting it without the help of typical treatment programs. There are therapies that work better than disease-oriented alcoholism clinics or nicotine gum therapies for smokers, but you would be hard-pressed to find such treatment if you tried. That’s why we developed the Life Process Program.
We believe that many people want an open-minded, realistic way to understand and deal with addictions—their own, their spouses’, their children’s, their friends’ and employees’. This book is a response to that need. It begins by making clear what addiction is and what it is not. Addiction is an ingrained habit that undermines your health, your work, your relationships, your self-respect, but that you feel you cannot change. Addictions are difficult to change, because you have relied on them—in many cases for years or decades—as ways of getting through life, of gaining satisfaction, of spending time, and even of defining who you are. Whereas some addictions involve drugs (like smoking or problem drinking), some do not (like shopping, or eating, or sex). It is impossible, therefore, to relate addiction to one chemical or biological process or another.
Because of the distinctive approach we take, you will find guidance here that in most cases you cannot get elsewhere. That is, we do not regard addiction of any kind as a disease. Thus, we do not recommend that you see a doctor or join a twelve step group organized for one disease or another as a way of dealing with addiction. These approaches, we believe, have already been shown to be less effective than others that are available. The same is true if you are concerned that your children and their friends are using alcohol and drugs—the common practice of putting them in a hospital will usually do more harm than good. Our approach for changing destructive habits, called the Life Process Program, is instead rooted in common sense and people’s actual experience.
This approach is more empowering—and therefore more effective—than conventional treatment or self-help methods. Because our approach differs so drastically from the messages you get constantly in public-service announcements and advertisements for alcoholism centers, we review a great deal of evidence to show you that the conventional notion of addiction as an uncontrollable “disease” is baseless. It doesn’t get at what causes people to be addicted and it is ineffective for most people as a method of treatment or self-help. It is disturbing that an approach to addiction that is widely claimed to be scientific is actually false and is more often harmful than beneficial.
The good news is that many people are beginning to question how accurate or helpful it is to think of addiction as a “disease.” These may be people with substance-abuse problems whose needs are not met by twelve-step support groups. Or they may be people who don’t buy the claim of the alcoholism movement that announcing you are powerless helps you change. They may be researchers who find that the evidence doesn’t back up the personal testimony of addicts who tell us incessantly in the media that conventional treatment works.
They may be individuals who have been exposed to the treatment system—because their children used drugs or because they were arrested for drunk driving—and who were appalled by its coerciveness and irrationality. They may be especially mystified that anyone wants to weigh adolescents down with the message: “Because you have been drinking or using drugs, or because your father or mother did, you have a disease you can never overcome.”
Sometimes people with questions like these stumble upon the best-kept secret in the addiction treatment industry—that many more people give up addictions on their own than through treatment, without taking on the stigma that they suffer from a disease. TV talk-show host Oprah Winfrey, for example, discussed her struggle to lose (and keep off) weight on a show she did on the disease theory of alcoholism. She remarked that she could accept the disease theory “intellectually,” but that she just didn’t see how believing she was forever “powerless” could possibly help her with her weight problem. What Oprah and others like her should know is that calling addiction a “disease” is just as wrong “intellectually” as it is unhelpful.
Indeed, what about all the people who are so uncomfortable with twelve-step groups that they can’t bring themselves to attend one or don’t stick with it if they do attend? Are these people all, like Oprah, really in “denial”? As a result of such “failures,” many people mistakenly think they can never overcome their addictions. Wouldn’t they benefit from knowing that the great majority of people with addictive habits—particularly young people—can outgrow them without entering a hospital program or following a twelve-step regimen?
They may be able to do it on their own. Or they may benefit from the kind of treatment represented by the Life Process Program—treatment that builds on people’s own strengths, values, and confidence in themselves and on their existing ties with friends and family, while improving how they deal with their lives.