Recovery Nation: America’s Addiction Recovery Movement is a Black Hole
How the recovery movement goes, so goes America
The idea that addiction is a disease to be recovered from is a recent invention, unique in the history of human thinking. The traces of mental illness and substance addiction first appeared when human civilization became organized around agriculture — perhaps 12,000 years ago. Even then, these were not separate areas of human concern but a part of the larger social structure and functioning. Since then, both have grown as central preoccupations of civilization. They – and recovery from them – are now twin stars around which American social existence and discourse are organized.
A General Social Model of Mental Illness and Addiction (12,000 BCE-1800 CE)
Nothing humans felt or consumed was outside the realm of normal human experience before the modern civilized era. Prior to that time all such issues were handled as part of ordinary human discourse and social organization — including acceptance, occasional ostracization, and simply the failure of some humans to procreate, or even survive.
Homosexuality, mental illness, alcoholism and addiction were not “things” until about 200 years ago. People might be given distinct cultural roles when they acted like people who today we place in these categories. But society did not label them and devote special resources to them. All were folded into ordinary cultural and social processes.
The Evolution of Institutionalization (1800-2000)
Michel Foucault is the principal philosopher of the relationship between power and conceptions of humanity. This relationship explains how, around the turn of the nineteenth century, institutions — asylums — were created to deal with those who fell outside usual categories of behavior, experience and thinking. Along with these assignments came the designations of insanity (mental illness) and addiction (preoccupied substance use). Asylums and such designations weren’t created to benefit their recipients. The primary purpose of this movement was to isolate such individuals from normal society. Since then the concepts of mental illness and addiction have been reified and have followed their own narratives.
The Concepts of Mental Illness and Addiction (1800-2000)
The consolidation of medicine as a scientific body of work – and along with it the presentation of mental illness and addiction as medical diseases – occurred rather late in the nineteenth century. Sometime later the Harrison Act of 1914 officially placed drugs (including opioids, cocaine and marijuana) outside of socially regulated human behavior. This alienation of mental illness, addiction and drug use from ordinary experience has been a defining feature of modern society for a hundred years and more. It has driven medical and biological science.
A separate chapter must be devoted to alcohol, which actually preceded the classification of what we regard as drugs as addictive. This concept of addiction was promulgated by the Temperance Movement, from 1830 to the present. The alienation of alcohol consumption from ordinary behavior is especially notable since the ethanol molecule and alcoholic beverages appeared alongside the development of human civilization.
Recovery as a Cultural Paradigm (1950-2000)
With the disease concept of addiction and mental illness came the formulation of “recovery,” first by AA. AA recovery originally demanded anonymity. But, by the latter part of the 20th century, recovery became an identity, performance, and mass social movement. Public figures in the entertainment and intellectual (for instance, writers) world jockeyed to announce and promote their recovery journeys. (Politicians were somewhat more reticent.)
In the 21st century, announcements about entering recovery are standard — so much so that it almost seems likely that any former prominent youthful musician will undergo recovery as a necessary life stage. Although certainly many younger and older musicians and actors still drink and take recreational drugs, each new recovery story is cheer-led with cultural approbation and proclamations of support.
Recovery, Trauma, Bipolar et al. as Identities (1980-present)
The recovery movement has been led and modeled by former drinkers and drug users. At the same time, there has been a confluence of substance recovery with mental illness and trauma. Public figures — particularly in the entertainment world — regularly unveil their childhood, family and young adult traumas as part and parcel of their ongoing emotional problems and addictions.
This process and these labels are so ubiquitous now that it is almost surprising (inviting suspicion) for someone to claim, “I had a normal, supportive childhood, haven’t experienced any traumas, and don’t have any mental conditions or addictions.” I use bipolar as a generic for such conditions but ADHD, OCD, autism spectrum, imposter syndrome and plain old depression — as well as (accusatorily) narcissism, sociopathy, etc. — can be slotted in as well.
Recovery as THE Cultural Paradigm (2000 – present time)
There can be said to have been a further development since swarms of people began self-labeling as recovering, bipolar, depressed and so on. We are at a cultural point where these once-claimed “disease states” are now considered standard traits for masses — potentially a majority — of people. Perform the thought experiment of asking everyone you know or meet if they are traumatized, suffering from an emotional condition or addiction, etc. from which they need to recover. Wouldn’t most say “yes”?
Cultural and Policy Implications
The US is by far the world’s leading therapatized society. Yet the claim is constantly made in the US that we need to devote much greater resources to treating mental disorders and addiction and to overcome the “stigma” associated with admitting that we have such conditions.
One remarkable example of this in the 21st century has been the expansion of “harm reduction” treatments for drug addictions. That is, AA (like Temperance) was strictly abstinence oriented. But mental illness treatment in America now focuses on medications. The conflated recovery paradigm is resolved by creating a pharmacopeia of addiction treatment drugs (e.g., Naltrexone, methadone, buprenorphine, Suboxone). These drugs have metastasized over the last decade. Yet the claim by harm reduction therapy and policy influencers is that we must vastly expand both their availability and their utilization.
What signs are there that they are not being utilized? These include the most fundamental social measures: drug deaths, suicides, decreasing life expectancy. Why aren’t they being utilized? The large majority of people for whom use is indicated reject using them. This rejection leads to the idea that greater coercion is required in prescribing addiction drugs — as it is for psychiatric medications— to make people use these medications rather than their drugs of choice.
Consider this formulation in Foucault’s terms: “Society has decided that people should use one class of drugs rather than other drugs that they prefer – or simply experiencing life without drugs.”
And, yet, 21st century America is a society awash in record drug deaths, suicides, reported and claimed trauma, and emotional disorders diagnosed by self and institutionally. There is a strong economic and social basis for these negative life outcomes. Yet Generation Z (ages 12-26) as a group consistently reports worse mental health than prior generations: “Less than half (47%) of Gen Z Americans are thriving in their lives — among the lowest across all generations in the U.S. today and a much lower rate than millennials at the same age,”
As a leading cultural figure – one enmeshed in the privileged class – declares:
I felt sad, talking to friends dropping daughters at college, to hear of rampant anxiety, campuses awash in S.S.R.I.s — serotonin boosters found in drugs like Prozac and Lexapro — and long waits for therapy. It is a major topic among moms: daughters struggling with anxiety or the effects of anti-anxiety medications, which can include weight gain and loss of libido. Many young college women are ping-ponging between anxiety, without pills, and numbness and body insecurity, with them.
What are they to recover from, and to?
If you enjoyed this blog, you may also enjoy this episode of our weekly podcast about the American “recovery” concept.
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