Treatment of addictions isn’t working… there I said it!
Over the past 4 months, I’ve shared a lot of my own personal experiences as it relates to my history with traditional 12-step treatment models and alcoholism. The more research I gather, and the more conversations I have with people in the ‘business of treatment’, the more obvious it becomes to me that there’s a larger problem at work and what's being offered up as the standard of treatment isn’t working.
Before I share some ideas worth talking about, let me back up a few steps, and share some information I’ve learned. In sharing some of this information, my hopes are that you begin to question the current things as they are as it relates to the businesses of treatment and recovery. Please keep an open mind, recognizing I’m not trying to be antagonistic, or dogmatic, I’m only looking to stimulate a conversation away from treatment and recovery, towards one of the lifestyle changes, empowering transformations, and personal choice.
So, what’s the problem with the business of addiction treatment and recovery?
Treatments of addictions is BIG business. In the United States alone, the addiction treatment industry has grown to a staggering tune of $34 billion dollars a year, meanwhile, overdose death rates have tripled in the past two and a half decades.
While the growth is staggering, it pales in the scope of the human cost associated with excessive alcohol consumption and drug overdoses, which jointly accounts for nearly 127,000 deaths per year.
There are more drug treatment facilities than ever before – over 14,500 of them in the United States – and countless alcohol treatment facilities, with more being opened year after year. This is a tell-tale sign that more and more people are seeking treatment, more and more money is being spent on said treatments, and yet, more and more people are overdosing and dying from substance abuse. At what point do we stop, give our cultural head a shake and scream from the rooftops, “WTF is going on here!?”
[highlight color=”yellow”]It would seem that the treatment solutions being offered up are not working.[/highlight]
The Disease Model of Addiction and Where the Wheels Fell off the Treatment Bus
According to the disease model, ‘addiction is very much a brain disease’. It is reported that brain abnormalities cause people with the disease to become addicted to substances or activities once exposure to these stimuli occurs. This model considers addiction IRREVERSIBLE once acquired.
The ONLY way one diseased with addiction can recover ‘consists of developing and maintaining complete abstinence from all addictive substances and activities. Abstinence arrests the disease.’
Many of the treatment facilities and organizations that accept this model own the fact that complete abstinence is difficult to achieve and as such the model stresses the importance of peer group support and attendance at regular meetings.
“People are active agents in – not passive victims of – their addictions.” Stanton PeeleTweet This!
What I found extremely interesting was the fact that many of the websites and literature surrounding the disease model of addiction and recovery, often compare alcohol or drug addiction to cancer.
One example from a very prominent site reads:
‘Cancer survivors share with the group their personal experiences of the disease and of recovery. Similarly, addicts and alcoholics support each other in groups such as Alcoholics Anonymous. They share their personal experiences of addiction and recovery and provide hope and inspiration to each other. When people support each other in this manner, they become more hopeful. Therefore, they are more motivated to take the necessary steps toward recovery.’
And here’s the crazy thing, if addiction is a disease like cancer, stroke and heart disease, and large amounts of money are continually invested in the study of these diseases, at what point do we demand results?
Not sure where I’m going with this? Bear with me a second.
Here are some figures to chew on:
Between 2008 to 2012, $735,985,000,000 of taxpayer’s money was allocated by the National Institute of Health to study diseases. These diseases included heart disease ($12 billion), Cancer ($55 billion), stroke ($2.2 billion) as well, $9.7 billion was spent to study the ‘disease’ of drug addiction.
Wondering what all these dollars in research studies have to report back from an ROI standpoint?
Here are the stats…
The $1.76 billion per year investment in Heart Disease Research has returned:
- 38% reduction in deaths from heart disease (2003 – 2013)
- 30 to 40% reduction in hospitalizations resulting from heart failure, heart attack and stroke (1999 – 2011)
- 83% reduction in hospitalization rates for people suffering from unstable angina, a leading symptom of coronary heart disease. (1999 – 2011)
The $7.94 billion invested yearly into Cancer Research has returned:
- 20% reduction in cancer rates over the past 20 years
- This reduction translates to 1.3 million lives saved
- Survival rates for nearly all types of cancer are climbing
The $325 million invested annually into Stroke Research has returned:
- a 35.8% reduction in annual deaths from stroke (2000 – 2010)
- a 50% decrease in the incidence of stroke in a Johns Hopkins study from 1987 to 2011.
Now what about the $1.38 billion per year (2008 – 2012) that is being allocated to Drug Addiction Research has returned a:
- 10.33% increase in deaths from prescription drug abuse
- 35% increase in deaths by illicit drug abuse
- 8.1% increase in deaths by opioid pain relievers
- 30.2% increase in deaths from benzodiazepine
- 95% increase in deaths caused by heroin
The numbers are staggering! Clearly money invested in the research and treatment of diseases yields a positive return, so why isn’t the money being thrown at addiction research providing the same results?
Maybe, just maybe, addiction isn’t a disease.
If you are a visual learner like me, you’ll appreciate the well laid out, researched infographic produced by Saint Jude Retreats. (see below)
What’s the ‘Business of Recovery’?
With all this money being spent within the treatment industry – remember to a tune of $35 billion according to the Substance Abuse and Mental Health Services Administration – we have to wonder, why we don’t have more scientific-based evidence supporting the efficacy of programs like Alcoholics Anonymous or similarly designed 12 step programs.
‘The Business of Recovery’ is a documentary that sheds a light on many of the problems within the treatment industries. An article worth exploring, ‘Inside the $35 billion addiction treatment industry’ by Dan Munro appeared on Forbes.com makes great mention of a few of the startling statistics and findings shared by the film.
Ruben Baler, a health scientist at the National Institute on Drug Abuse, addresses the key concerns head on when he states:
12 Step programs are very popular, but if you’re looking for figures and randomized trials and scientifically rigorous studies of how they work and for how many people they work ‒ you will not find those studies. You will find anecdotal evidence ‒ for people who it did work [for] ‒ but unfortunately we don’t have the scientific basis to say how many of all those people who tried a 12 Step program ‒ how many of those failed.
The film is definitely an eye opener and puts our status quo beliefs about treatment in question. Not sure? Finding this a bit incredulous? Fair enough. Do you own due diligence and see what you come up with.
I feel you’ll come to a similar conclusion and find that ‘treatment doesn’t work!’
Defining is THE problem: Labeling of Addictions and the Pokémon Go Connection
Throughout this process of researching addictions, I find that much of the misinformation appears to stem from the definition itself. The labeling of substance abuse and/or addiction as a disease is quite absurd when you look at any other behavior in place of the substance or habit being defined as ‘the abuse’.
As an example, let’s look at the well-accepted definition of addiction (or substance dependence) and compare it to the global phenomenon that’s taking millions by storm — that is Pokémon Go.
First, let’s look at how the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association) defines addiction or substance abuse as a disease:
- The substance is often taken in larger amounts or over a longer period than was intended.
- There is a persistent desire or unsuccessful effort to cut down or control the use of the substance.
- A great deal of time is spent in activities necessary to obtain the substance, use the substance, or recover from its effects.
- Craving, or a strong desire or urge to use the substance.
- Recurrent use of the substance resulting in a failure to fulfill major role obligations at work, school, or home.
- Continued use of the substance despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of its use.
- Important social, occupational, or recreational activities are given up or reduced because of use of the substance.
- Recurrent use of the substance in situations where it is physically hazardous.
- Use of the substance is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance.
- Tolerance, as defined by either of the following:
- A need for markedly increased amounts of the substance to achieve intoxication or desired effect.
- A markedly diminished effect with continued use of the same amount of the substance.
- Withdrawal, as manifested by either of the following:
- The characteristic withdrawal syndrome for that substance (as specified in the DSM-5 for each substance).
- The substance (or a closely related substance) is taken to relieve or avoid withdrawal symptoms.
Now let’s take this defined criteria and insert Pokeman Go as the behavior or action in question:
- Pokemon Go is often played in large amounts of time or over a longer period than was intended.
- There is a persistent desire or unsuccessful effort to cut down or control playing of Pokémon Go.
- A great deal of time is spent in activities necessary to download Pokémon Go, play Pokémon Go, or recover from its effects.
- Craving, or a strong desire or urge to play Pokémon Go.
- The recurrent playing of Pokémon Go resulting in a failure to fulfill major role obligations at work, school, or home.
- The continued playing of Pokémon Go despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the playing the game.
- Important social, occupational, or recreational activities are given up or reduced because of playing Pokemon Go.
- The recurrent playing of Pokémon Go in situations where it is physically hazardous, such as driving a car, or while operating machinery.
- Playing of Pokémon Go is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by Pokeman Go, such as dreaming of Pokémon characters.
- Tolerance, as defined by either of the following:
- A need for markedly increased amounts of playing Pokeman Go to achieve balls and hunt characters for desired effect or achievement.
- A markedly diminished effect with the continued playing of Pokémon Go, hence the game begins to get less fun after playing it for 2 weeks straight.
- Withdrawal, as manifested by either of the following:
- The characteristic withdrawal syndrome for that substance (as specified in the DSM- 5 for each substance)…..Whatever the hell that means…just another lame catch-all.
- Pokemon Go (or a closely related game) is played to relieve or avoid withdrawal symptoms from lack of playing Pokemon Go.
This is just one example of how you can literally put any behavior to fit the definition and label anything as a disease. And there lies a big problem with labeling any chosen behaviors as diseases and taking the control away from the person.
A Non-Treatment Approach to Dealing with Substance Abuse and Addiction
Common knowledge among the North American culture is that if we suffer from an addiction, we have to ‘join’ the treatment industry and subject ourselves to a great deal of misinformation which is largely unproven.
While there exist several nontraditional treatment options, the only truly non-treatment based option is that of the Saint Jude Retreats, which help people overcome an unwanted habit or unwanted behavior. Or, even better, they go about helping those dealing with substance issues by helping them see how they can improve their lives and in turn leave the unwanted baggage behind them.
In writing this article, I had the opportunity to interview Ryan Schwantes, president of Baldwin Research Institute (the parent company of Saint Jude Retreats). Over fifteen years ago Ryan committed his life to help others realize there are alternative methods to achieving new habits, establishing lifestyle habits that are geared to building lives on happiness first. He believes no one should allow themselves to give up on their dreams and everyone has the power within themselves to build the life they want and absolutely no one has the right to tell them they can’t or won’t be successful and happy!
Below is Ryan’s recounting of a conversation he shared long ago which forever affected the trajectory of his life’s path.
Gerald Brown (Jer), one of the [Saint Jude Retreats] Co-Founders, once told me “Ryan, nothing is wrong with you, and you’re going to be fine”.
As simple as that sounds, it was so powerful because up to that point I had learned I was diseased and I was pretty much doomed for the rest of my life. All my dreams and goals were out the window because I was forever going to be dealing with my disease of addiction.
I have always been a person with extreme pride, self-determination, strong-willed and motivated individual with strong principles, and well-grounded moral values. I always had an overabundance of energy and I was able to overcome adversity in my life by mentally and physically working through pretty much anything that came my way. I guess I considered myself a pretty tough nut to crack but I have to say I was holding on by a shred at that point to not succumb to the nonsense.
I was not a person that was easily intimidated, but I was literally scared shitless that I wasn’t going to be able to beat this disease. When Jer told me that I was going to be fine and I had nothing wrong with me, I immediately thought… I knew it… I knew I wasn’t nuts and now here was this wise Yoda type guy confirming what I was thinking in my head for the past several years. It was literally like I was injected with all the old drive, determination, and energy I once had, and the fire within me began to explode again!
Ever since then I haven’t looked back and have strived to achieve every goal I set out to carry out and I vowed to never let anyone or anything tell me I can’t do something or tell me to believe or think a certain way because I was “supposed” to. Never again!
And I have vowed to do everything I can to help others see that despite what they have been told, and what they are expected to believe, they aren’t doomed and they aren’t sick and diseased. I want them to know there’s nothing wrong with them and they’re going to be fine.
I shared a similar experience as Ryan.
My wife Christie was my Jer. I shared that moment when I made a personal choice to change a habit that was not in alignment with who I wanted to be. Sometimes the simplest choice is the right choice, and all it takes is one person to believe in you, as Christie and Jer believed in us.
I recognize the treatments of addiction and the industry of recovery are anything but perfect. Many of our accepted norms are based on antiquated teachings and beliefs. Many want to quote ‘evidence-based science’ as the gold standard of proof. But there comes a point when we have to question what evidence is based on beliefs and what evidence is based on fact.
The fact is that if you or anyone you know want to change a self-defeating habit that isn’t serving you, such as a compulsion to drink or use other substances, there exist options outside of the disease treatment system. And the solution lies in non-treatment!
You can change anything you choose to change, and sometimes it just takes a conversation to target your specific challenges, needs, concerns, hopes, goals, and dreams. Help you remember what it is you want most from your life.
For what it is worth, if you are reading this article and something in you is driving you to seek a change, I want you to know I believe in you. There’s nothing wrong with you and you’re going to be fine.
Don't stop here, check out the other articles from the Addiction for Life series