It seems like you can’t open a newspaper these days or visit a news site without reading some mention of the newest looming “crisis.” Today that's the so-called “opioid epidemic.” Now, I’m not here to give an opinion on whether there really is an “epidemic” or not. I say “so-called” because we’re fed panic-stricken stories about some new “epidemic” on a regular basis. Is this one legitimate? I don't know. And it doesn't matter.
It doesn't matter because I don’t want to talk about whether painkiller addiction is a real issue. What I want to talk about is the subtle effect this laser-like news focus is having. It’s changing the way we think about addiction—whether it’s to painkillers, alcohol, cigarettes or something entirely different. And it’s not a good change.
But what does this have to do with your brain? It's that the Big Guys would like us to believe that addiction is a "brain disease."
There's little if any evidence to support this idea. There's much more evidence that it's merely a symptom. But one thing is for sure: if we call it a brain disease, the medical complex stands to make money. And the media focus is designed to convince us of just that: that addiction is a brain disease, and that medicine can cure it.
Addiction treatment is Big Business
Not so long ago, no one would have dreamed of calling addiction a “disease.” It was viewed as a moral failing. It was considered a character flaw—a weakness of will. Addicts were seen as simply too weak-willed and lacking in “moral fiber” to overcome their addiction, too self-centered to take responsibility for their own action and change their ways.
Then came the “disease” model of addiction. It tells us that addicts are suffering from a “brain disease” rather than a character flaw, lack of willpower, or psychiatric problem. And while I’d never want to see us go back to the earlier attitudes, an honest look shows that this disease model does little more than put a feel-good spin on the same basic ideas. And although the addiction treatment business would like us to believe differently, there’s no hard scientific evidence for this model.
Nor is there any consensus even among professionals. There are half a dozen different theories about addiction, and the “brain disease” supporters are just the most vocal.
While the disease model is credited with “de-stigmatizing” addiction, I would argue that it’s done no such thing. It’s simply changed the name of the stigma. Instead of treating addicts as human beings with the ability to change their circumstances, the “disease” model positions them squarely as helpless victims. Victims who are at the mercy of their “disease” and thus need…you guessed it…healthcare.
Addiction treatment is a massive industry. It’s also an extremely lucrative industry, and the more medicalized it can become, the more cash it will rake in. Yet for every professional addiction treatment center out there, there are also groups out there working quietly, for free, to help addicts help themselves. And in fact these quiet little groups are some of the oldest and most successful treatment programs in existence.
The panic over the “opioid crisis” has brought addiction treatment into the spotlight as never before. And critics are saying that we should get rid of these low-profile 12-step programs—even though they’re as successful as any other treatment. Hundreds of thousands of people have used programs like Alcoholics Anonymous to turn their lives around. And in fact, may “treatment centers” revolve around a 12-step program. Nevertheless, critics are using the “opioid epidemic” as a soapbox to preach a different message.
They claim that 12-step programs aren’t really treatment—no matter how successful they are. They claim they “stigmatize” addicts. They decry the idea that they’re “moral rather than medical.” They say we should give up 12-step programs and look to medicine instead. (Nevermind the fact that opioid addiction is the only area where medicine has had any success.)
But what it really boils down to this: they don’t like the idea of a “higher power.” They don’t like the idea of taking personal responsibility. And they really, really don’t like the idea of the industry losing money to free programs like Alcoholics Anonymous.
Do you need a “higher power” to overcome addiction?
One of the most fundamental tenets of 12-step programs is believing that there is a power greater than yourself—whether you call it God, the universe, or the great marshmallow. They’re also firmly rooted in personal responsibility. In fact the first five steps are these:
Step 1: Acknowledging that your life is out of hand. Admitting that you can’t control your use of whatever it is you’re addicted to.
Step 2: Believing that there is a force bigger than yourself that can help you get your life back on track—a higher power.
Step 3: In a nutshell: “Letting go and letting God.” You have to be willing to put your fate in the hands of this higher power.
Step 4: Taking a long, honest look at yourself. This step asks you to face up to past guilt, embarrassment, regret and anger.
Step 5: Confession. Once you have identified these negative issues you must admit them to yourself. And to God. And last of all, to another person.
In later steps, you’re asked to make amends to anyone you’ve harmed. To forgive those you’re angry with—including yourself. You’re instructed to continually take stock and admit it when you’re wrong. You're encouraged to develop a spiritual life and a closer relationship with your higher power, whatever face you choose to put on it.
It’s these foundational requirements—belief, confession, and atonement—that have secular critics up in arms. They say we should put our faith in Big Pharma instead of a Higher Power. They say admitting our faults somehow “stigmatizes” us. And they see no need for making amends—unless it involves a prison sentence as “payment to society.” Addiction, they claim, is a disease. Period. And they say that explicitly “moral” solutions like these have no place in treatment.
If we were talking about “mental health” here instead of addiction, we would call this kind of program talk therapy rather than moral stigmatism. Here’s the thing: Every single person who gets help from a free program such as AA represents lost revenue for the treatment industry. And opting out of paid programs also keeps people out of the medical and psychiatric systems. More lost revenue.
But most of all, it puts control over and responsibility for their recovery where it belongs—firmly in their own hands. Instead of reinforcing the idea that they’re victims, it empowers them. And instead of keeping them dependent on the system, it asks them to take responsibility for themselves.
So don’t let the media lie to you: if you or someone you care about has an addiction, a 12-step program is treatment. The critics are just afraid of that little three-letter word.