Diseasing of America: Addiction Treatment Out of Control

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Diseasing of America: Addiction Treatment Out of Control

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By Stanton Peele

Lexington Press, MA, D.C. Heath and Co., 1989, 321 pages, $19.95

The most compelling social problem facing the United States is abuse of drugs including alcohol. Peele Joins Fingarette (Heavy Drinking, the myth of Alcoholism as a Disease), Marlatt and Gordon (Relapse Prevention) and others who persuasively challenge the popular "disease concept" approach. Without scientific evidence, alcohol abuse was designated a disease. As other similar social problems developed the disease terminology was also applied to them. Examples include gambling, food, love or sex, and drug abuse. Stanton Peele examines the historical, and sometimes hysteria, progression of these "diseases" as well as the development of the treatment industry.

The text is footnoted with references of published research from refereed journals, however Peele's treatment of the topic is easily understood by the lay person. He has succeeded in making scientific research on a complex issue understandable. An historical synopsis of alcohol use is provided which highlights how attitudes toward alcohol changed from a highly regarded social behavior to an evil controlling addictive substance.

An interesting chapter is devoted to the coventional wisdom of alcoholism. The "truths" include the notions that all alcoholism results in loss of control, the disease of alcoholism is progressive; alcoholism is the "primary disease" and is not caused by environmental or social concerns; and alcoholism affects all social strata equally. Peele discusses research which question these "truths" as well as the social and political trends which have validated them as "truths". Conclusions may be drawn that national alcohol and drug policies will continue to be minimally effective since the underlying causes of abuse are not considered.

Peele's discussion of how the individual learns to define themselves as an addict and the impact of the label is thought provoking especially for those professionals who work with children and adolescents. Most educators will agree that labeling sets up a self-fulfilling prophecy. Peele cites examples of treatments which mandate that the individuals label themselves an addict and the potential difficulty of the label especially for the young.

Obviously, since Peele feels the "truths" of alcohol and drug addictions are false, he also feels that there are significant problems in the treatment industry. For example, Peele contends that disease based therapy which requires constant attendance in therapy results in a permanent addict identity and does not allow the person to forge new values and Behaviors based on being a well person. This results in a continued addict identity and prohibits positive growth and development. Additionally, Peele cites research which suggests that doing nothing is as effective, if not more effective, than conventional treatment. Conventional treatment was defined as Alcoholics Anonymous, Alcoholism education, confrontation, disulfiram, and group therapy. Treatments which have proven effective such as behavioral self-control training, community reinforcement, social skills training, and stress management are explained.

Peele concludes his text with a chapter devoted to a discussion of the components needed to impact on addiction rates. According to Peele, the causes of addiction are basic social situations and in order to impact on addiction rates the real sources of the problems must be addressed. The necessary social components include: work opportunities, family and community supports, and morals and values in people's lives.

Drug and alcohol abuse is caused by a constellation of factors within an individual's life. However, if we as a society are going to prevent and intervene effectively programs, policy and education must be based on correct information, much of what the average American believes about addiction is refuted in Peele's text. The sheer abundance of articles written in support of the disease orientation and the extent to which it has been institutionalized in the United States suggests how difficult it will be to overcome the misinformation. As well, it is very advantageous and socially acceptable to have a "disease" while it is not to be considered lacking in values, work opportunities, family supports, etc. The "recovery" field ts currently controlled by "disease" oriented individuals will be extremely resistant to the conclusions of Peele, Fingarette, Marlatt, etc. since their identity and careers are based on the perpetuation of the "disease" approach. Peele presents evidence which suggests that schools, communities, states and commonwealths, and the federal government need to critically review the information on which prevention programs and treatment programs are based.

PNG Publications.

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By Stanton Peele

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