Why and by Whom the American Alcoholism Treatment Industry is Under Siege - Vietnam Veteran Heroin Addicts

Written by Stanton Peele

Wallace (1989: 266) particularly objected to my citing data from Robins and Helzer regarding returned Vietnam veteran heroin addicts: "For the record, I have personally long admired the work of these researchers. My admiration is not diminished by their careful, forthright, and fascinating study of heroin use and addiction among Vietnam Veterans. Helzer and Robins' discussions of their findings on the possible use of narcotics by previously addicted soldiers without readdiction is a model of restraint .... One does not come away from reading Helzer and Robins' work with the feeling that opiate or other drug use has been sanctioned or encouraged. I am of the opinion, however, that the same cannot be said of Peele's work."

Here is what Robins and colleagues (1980) found: (1) "Heroin use progresses to daily or regular use no more often than use of amphetamines or marijuana" (p. 216); (2) "Of those men who were addicted in the first year back. . . of those treated, 47 percent were addicted in the second period; of those not treated, 17 percent were addicted" (p. 221); and (3) "Half of the men who had been addicted in Vietnam used heroin on their return, but only one-eighth became re-addicted to heroin. Even when heroin was used frequently, that is, more than once a week for a considerable period of time, only one-half of those who used it frequently became re-addicted" (pp. 222-223). These data undermine the foundation of the beliefs on which Wallace bases his entire model of addiction and addiction treatment. Given his respect for these researchers and their work, what does Wallace make of these findings? Where in his writings or work does he make use of them?

Robins and colleagues (1980: 230) tried to deal with their "uncomfortable" results in the last paragraph of their article, which was subtitled "How Our Study Changed Our View of Heroin": "Certainly our results are different from what we expected in a number of ways. It is uncomfortable presenting results that differ so much from clinical experience with addicts in treatment. But one should not too readily assume that differences are entirely due to our special sample. After all, when veterans used heroin in the United States, only one in six came to treatment."

The Robins group's research suggests a model of addiction as something other than a lifetime disease. The exploration of normal human development out of addiction is especially crucial today because of the rapid expansion of the application of the disease concept, not only to people with milder drinking problems, but—in treatment centers such as Hazelden and CompCare and others—to labeling and treating (including hospitalizing) those suffering from such diseases as "codependence" and addictions to sex, gambling, overeating, and shopping. This madness must be exposed for what it is.

Acknowledgments

The author is grateful to Chad Emrick, Richard Longabaugh, and Archie Brodsky for their input.

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