Okay, So It's Not a Disease?

I dunno.

The other day I was expounding here about the theory that one's predisposition to addiction may have a genetic component. I'm not a scientist, I just play one on the internet, and I should probably state this at the top of everything I post on addiction. Fact is, my posts are simply reflections of my own experience, because fuck it, this is my shitty blog. That post was really little more than speculative rambling on my part, and I knew I was treading into troubled waters by comparing the experience of acknowledging my addiction (not healthy, not normal) with the acknowledgement many years ago that I am gay (healthy, normal.) That distinction (not healthy vs. healthy) is why I've always said that coming out as a drunk was harder for me than coming out as gay. Reasonable minds can agree to disagree with the point I was making there, whatever it was.   

Anyhoo, I recently stumbled across the Baldwin Research Institute, an organization focused on addiction treatment methodologies and best practices. From their website: 

Founded in 1989, the Baldwin Research Institute's mission is to research cutting edge drug and alcohol issues, educational methodology, and best practices for drug and alcohol problems and related issues, to guide the drug and alcohol treatment industry and recovery society as a force for change, and to honestly and objectively educate the public as to the effectiveness of treatment and prevention programs with respect to drug and alcohol use. 

 The people at Baldwin are not big fans of Alcoholics Anonymous, or of what they call the "recovery industry." One of the first things that caught my eye was the article "Alcoholism Is Not A Disease," which demolishes the whole disease model of addiction. A snippet: 

History and science have shown us that the existence of the disease of alcoholism is pure speculation. Just saying alcoholism is a disease, doesn't make it true. Nevertheless, medical professionals and American culture enthusiastically embraced the disease concept and quickly applied it to every possible behavior from alcohol abuse to compulsive lecturing and nail biting. The disease concept was a panacea for many failing medical institutions and pharmaceutical companies, adding billions of dollars to the industry and leading to a prompt evolution of pop-psychology. Research has shown that alcoholism is a choice, not a disease, and stripping alcohol abusers of their choice, by applying the disease concept, is a threat to the health of the individual. 

The disease concept oozes into every crevice of our society perpetuating harmful misinformation that hurts the very people it was intended to help. Remarkably, the assumptions of a few were accepted as fact by the medical profession, devoid of any scientific study or supporting evidence. And soon after, the disease concept was accepted by the general public. With this said, visiting the history of the disease concept gives us all a better understanding of how and why all of this happened.

It's a long article, but well worth the read. While I'm not sure where they fall on genetic predispositions to addiction, they do echo many of the suspicions I've long held about the Recovery Industrial Complex and the industry's rather self-perpetuating message that addiction is a chronic illness, which requires not only eternal vigilance but also eternal treatment that rehab facilities are only too happy to provide for a hefty fee.

My own experience with rehab was positive, as far as it went, even though it was very much predicated on the disease model of treatment. It was pointedly not based on the precepts of AA, higher powers, or the antiquated writings of Bill Wilson -- which was a huge relief -- but it did push graduates of the program into AA, or the far better (IMO) SMART Recovery, but I can't really fault them for this; what else is there? 

It was also very expensive. I could never have afforded it without the cadillac healthcare coverage I had at the time. And its costs were nothing compared to the soaring fees of the opulent spas in exotic destinations where the beautiful people go to dry out. 

Anyway, I found the ideas being put forward by the Baldwin people thought provoking and challenging to the widely held assumptions surrounding addiction. I haven't spent enough time there yet to know what I agree or disagree with, but I find data driven arguments hard to argue with. Hit the links above if you're so inclined, and let me know what you think.