The Stanton Peele Addiction Website, September 14, 2009.
Convincing Ourselves We're Okay
The new Time magazine has an optimistic piece on promising vaccines against cancer. The timing of the article is, of course, linked to Ted Kennedy's death from brain cancer this past week. His illness, like most cancers, has the same survival rate as it had in 1972, when Richard Nixon announced America's War on Cancer. Between then and now, any number of news and magazine articles have announced the inroads America has made combating this frightening disease.
When Republicans claim our health system is the best in the world, they are riffing off a cultural mind set about health care, of remarkable new medical discoveries that have conquered, or are near conquering, all the diseases that confront us and our children. This sense of inevitable progress is essential to our collective feeling of well-being. If all of our medical expertise can't ward off diseases, some of them ancient, some of them, like cancer (now our number-one killer) peculiarly modern, then where are we? The model for a modern disease is autism, which we can't understand nor cure, and which arouses cultural wars over causes and treatments. Meanwhile, it's hard to argue that adult and adolescent mental health are improving, despite our overwhelming reliance on modern psychopharmaceuticals.
If there is one malady that Time and other magazines have announced over and over again we are on the verge of curing, it is addiction. And most Americans have a sense that we are almost there in unlocking the secrets of the addictive brain. Why wouldn't they, with the HBO series on Addiction: The Brain Disease (which is used as a curriculum in schools throughout the U.S.), and myriad articles with diagrams depicting chemicals flowing through the addictive brain.
But a funny thing occurred in the HBO series, if you were paying attention. The primary treatments it reviewed were so-called cognitive-behavioral therapies (CBTs), which work on people's motivation to change, on their ways of thinking about their problem, and on how they cope with their worlds: "Most addiction treatments," the HBO series announced, "focus on getting addicted people to change their lifestyle and even their core life values as a way of preventing return of the problems." And, here's the real irony - such CBTs tend to downplay the disease nature of addiction - since accepting the disease view reduces people's belief they can combat their addictive habits.
The United States government conducts a massive study of alcohol and drug use every decade. In 2002, the study (abbreviated NESARC) interviewed 43,000 Americans. Concerning alcohol abuse (by far the largest source of intoxicant addiction), the study made this alarming discovery: there were more clinically defined alcohol abusers than there were ten years earlier - even though alcohol consumption itself has gone down. For those of you who feel we have made great strides in curing addiction, 25+ percent more of those who had ever been diagnosed as alcoholic during their lifetimes were still alcoholic in 2002 compared with that figure for 1992.
The National Survey on Drug Use and Health is another massive government survey of our drug use and drinking. In 2007, 25 percent of 21-year-olds qualified for a clinical diagnosis of substance abuse or dependence - although young people themselves are also drinking somewhat less. Somehow, not only do we not have effective cures for addiction, but our very ways of thinking about it coincide with - not to say encourage - increasing addiction.
Cancer, autism, and addiction are different things, of course. That we can't conquer cancer has to do with its convoluted and evolving nature, our health habits, and our environments. Autism we just throw our hands up in the air over or bicker among ourselves about. Addiction is a cultural malady involving a good deal of self-definition and increasing feelings of youthful powerlessness - feelings which, ironically, our conceptions of addiction contribute to. In oh so many ways we're not making headway - we're traveling downstream.
Note: Watch for kooky comments saying AA is the cure for everything, as though somehow the reason we have more alcoholics and addicts is because not enough people accept 12-step philosophy or treatment, which evolved out of revival Protestantism in 1935 and replicated the significant features of Temperance. And, oh - please none of those, "Here's the real cause and cure for autism - I expect to win the Nobel Prize for my remarkable discovery."