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Drug and Alcohol Abuse Is a Way of Coping with Stress, But Is Not a Medical Condition
People who repeatedly abuse drugs or drink as a way of escaping or dealing with life's pressures, do so because they can't cope. But why do we, in the land of the free, make the inability to productively cope with life a crime? Addiction is a way of coping with life, albeit a largely destructive way— of artificially attaining feelings and rewards people feel they cannot achieve in any other way. As such, addiction, while not a crime, it is no more a treatable medical problem than are unemployment, lack of coping skills, or degraded communities and despairing lives. The only remedy for addiction is for more people to have the resources, values, and environments necessary for living productive lives. More treatment will not win our badly misguided War on Drugs. Nor will imprisonment. These approaches only distract our attention from the real issues of addiction.
That otherwise critical and skeptical drug reformers are accepting compulsory treatment plans, despite treatment's dismal success record, shows how much the therapeutic society has been oversold, and how much its assumptions remain unexamined. We will NOT benefit from increased substance abuse treatment (over already record levels) in the American justice system. Unfortunately, we may need to experience even more negative consequences of our treatment fixation before we become convinced of this. Alternately, we may simply have lost the ability to discern that something called "therapy" can be so harmful. We might need to run seminars with Americans whose lives have been ruined by coerced 12-step treatment — just as we need to present to Americans people whose lives have been ruined by drug laws — to make clear the dangers of the therapeutic state.
Forced Treatment Can Ruin Lives, Not Save Them
Take, for instance, Paul, one of my recent correspondents, a man who took marijuana to control his migraines. Although his story involves coercion at the hands of an employer, court-ordered treatment and/or AA or NA attendance is often administered under similar circumstances. It shows how coercive treatment sweeps up many people who by no standard could be considered addicts, and the ill-effects of forcing people into treatment for any and all drug use.
About 3 months ago I took a hair drug test at work. The test showed positive for marijuana. I had been using marijuana for a few years and only used a small amount each night before bedtime. After having severe migraines for years, I turned to it as a last resort (I had used Imitrex, Vicodin, among other painkillers almost daily and Covera HS) and it helped considerably, almost completely eliminating the migraines.
Upon failing the drug test I was subject to being terminated by my employer if I didn't enter an Employee Assistance Program. I had to go through a four-hours-a-day/four-days-a-week program for 3 weeks at a rehab facility, even though I still believe I was using the marijuana for relief of my migraines and sleeping disorders. I did not abuse the drug or use it recreationally.
After the hospital rehab program I've been forced to go to at least 4 AA meetings a week in order to be in compliance with my employer's EAP. People laughed at my marijuana habit at the first AA group I went to — one guy told me, "In LA we used to smoke marijuana after our AA meetings." I went to another AA group and admitted I was a marijuana addict. Afterwards, a lady came up to me and said, "You should say you are an alcoholic, you will be accepted better." I told her I don't drink alcohol and never developed a taste for it because of my migraines. So now I'm going to my third group, where I just say I'm an addict so I will be accepted by the group.
After about ten meetings I became so depressed I lost all my energy and I just lay around and have gained 20 lbs. I'm single, and recently have found myself thinking that life is no longer worth living. I feel that I'm not an addict and somehow I must take a stand with this issue.
But to do so will endanger his livelihood. Of course, if he were in treatment due to the legal system, his alternative would be to lose his freedom.
If we don't coerce people into treatment, how do we help them? Whether people succeed through treatment or on their own, they generally do so for similar reasons. Research has shown that certain characteristics of the patient, not the treatment, are crucial to the outcome of alcoholism and addiction treatment. Patients with stable family and work lives succeed far more often (this is why private treatment centers can claim better remission rates than public hospitals). "The best predictor of success is whether the addict has a job," says Dr. Charles Schuster, former director of the National Institute on Drug Abuse. And Dr. Herbert Kleber, the official in charge of demand reduction in the Bush Administration's War on Drugs, indicated that successful treatment for minority crack addicts, who are also saddled with poverty and lack social and economic resources, entails "habilitation more than rehabilitation."
Habilitation Can Save Lives
By habilitation, Kleber means developing life skills, life structures, and constructive communities to support people in life. But if the ability to function free of drugs depends on job training, social skills, and pro-social attitudes, why do so many Americans fail to acquire these in the first place? For every person who can possibly be cured in therapy, many more young addicts will appear. What successful therapy actually demonstrates is the need, not for more or better therapy, but programs to strengthen families, communities, education, housing, and job training. Indeed, assisting people to acquire these things could itself be termed therapy — a kind of reality therapy — as opposed to therapy that involves people sitting around in groups talking about their powerlessness and making amends for their lives. Such therapy directed at redressing real-world deficiencies is productive and sane. Incarceration and forced spiritual treatment are not.
Unfortunately, the trend towards forced treatment as an adjunct to the criminal justice system will most affect lower level, recreational, and casual users, such as Johnny and Paul, because there are simply more people who fit this profile than there are addicts. Also, since their lives are more manageable they are more easily recruited into treatment. The end result? Millions of otherwise productive citizens will be saddled with inappropriately broad clinical diagnoses. In this way, so-called addiction treatment will simply be another coercive technique to enforce unrealistic zero-tolerance goals. In the meantime, by sinking our resources into these ineffective programs, we'll have no resources for building the programs and approaches that can cure hard-core addicts — or prevent addiction in the first place.
next: The New Consensus "Treat 'em or Jail 'em" Is Worse than the Old
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