The Best Cures for Addiction are Desire and Purpose
Many neuroscientists claim that we have made great advances in addiction—that we have discovered its chemical sources in the brain and are on the verge of a cure. Recently, the Wall Street Journal published “A Pill to Cure Addiction?” (based on a JAMA Internal Medicine study). The article trumpets the cure for addiction by “transforming” the brain’s “chemical architecture.”
But that view of addiction reveals a basic misunderstanding of why—and how—people are able to overcome addictions. Worse, it makes it less likely that they will do so.
Contrary to the idea that withdrawal is the hardest part of quitting, people kick drugs and alcohol all the time. Most rehab patients abstain in treatment, only to relapse afterwards. The real task is not to quit, but to stay quit. This study, which measured the drinking of alcoholics treated with the drug gabapentin for only the twelve weeks of the study, doesn’t tell us that. Its results were that just 17 percent of alcoholics who received the highest dosage of the drug abstained in that time. A larger group, 28 percent, drank without bingeing.
Consider one study participant, Kathy Selman, described by the Journal. She didn’t actually know if she was on gabapentin, which means she may have experienced a placebo effect. She felt that she was taking the drug because she became depressed after completing the 12-week course of capsules. But becoming depressed after ceasing the medication would be a prompt for her to resume drinking. According to Ms. Selman, she relapsed in the past whenever she tried to quit but faced economic stress.
Let’s examine some of the major insights research on addiction has yielded over the years. In a study of Vietnam vets addicted to heroin in Asia, fewer than 10 percent remained addicted stateside—even though a third used a narcotic here. It isn’t really surprising to learn that soldiers addicted in a war zone ceased relying on the drug when they returned home. Unless, that is, you are one of the anointed addiction “experts” who claim that a person, once addicted, can never escape this fate.
The National Institute on Alcohol Abuse and Alcoholism (NIAAA), which funded the research reported in the WSJ, conducted its own research that confounds the JAMA study. Called NESARC (National Epidemiologic Survey on Alcohol and Related Conditions), the study interviewed more than 43,000 Americans about their lifetime drinking. The NIAAA reported: “Twenty years after onset of alcohol dependence, about three-fourths of individuals are in full recovery.” Moreover, the large majority of these were never treated for alcoholism nor joined AA! Also surprising to those anointed experts, as in the JAMA study, a majority of those who recovered in NESARC drank at “low-risk levels without symptoms of dependence.”
And, yet, the neurochemical thrust is infiltrating our society with the notion that all of our addictions (which now go far beyond drugs and alcohol) are diseases that only medicine can cure.
Despite this popular notion, most people quit smoking (along with alcoholism and drug addiction) on their own. They do so primarily due to their desire to quit. This desire is marked sometimes by previous failures—the CDC lists frequency of attempts to quit smoking as a primary predictor of ultimate success, since these efforts bespeak the intensity of the smoker’s motivation.