Tuesday, October 30, 2012

George McGovern Understood the Cost of Addiction

I once heard George McGovern speak at a meeting of addiction psychiatrists. He spoke so movingly of the futility of efforts to save his daughter from alcohol dependence. Tragically, she froze to death in a snowbank. As a father of now adult sons, I can imagine but not really understand how painful this must have been. His daughter took advantage of all available treatments. Many, many attempts at rehab. "Worked the program." All to no avail. The disease killed her. This is the reality that people avoid at all costs. Addiction kills people. And they cannot help it. And neither can we, not yet.

I've dedicated my career to developing ways to help people with severe addictions, people who often have other severe chronic illnesses. People on whom everyone else has given up , especially rehab programs and counselors, doctors and social service agencies. And yet, inevitably, if I talk about the limitations of current treatments, someone will accuse me of "giving up on them." Underlying that accusation is the assumption that "anyone can overcome addiction and recover, if they really want to."

This is arguably the cruelest thing about current treatment approaches. People are blamed for the inadequacy of available treatments. This doesn't only apply to addictions, it applies to chronic or fatal illnesses in general. Especially here in the West, we are uncomfortable with death. In the US, perhaps more than anywhere else in the world, we fear not feeling in control of our lives, or deaths. In order to maintain the illusion of control, we criticize others who have "lost control," believing that they could have prevented it, except for their laziness, moral depravity and/or lack of motivation. This helps us fend off our fears, but it is devastating to those whose lives fall apart around them, no matter what they do. Too often, when they turn to others for help, they encounter condemnation, criticism, and rejection.

Even worse, the belief that those who succumb are somehow responsible, that effective treatment was available but those affected rejected it, leads to the idea that we don't need more effective treatments. We just need more availability (and payment.) That's one reason that families and people with addictions aren't effective advocates for more research. Today, I bought something at Walgreens. After I swiped my card through the machine, I was asked if I wanted to contribute to the Susan G. Komen Foundation for breast cancer. It seems like every other week, there is some sort of "pink ribbon" campaign on this topic. And what do breast cancer advocates want? More research. They don't ask for more availability of current treatments, because they are not anywhere good enough. What's required is more research and scientific breakthroughs.

Is this what the addiction and recovery communities advocate for? No, they don't. They typically advocate for more treatment, and more support for funding available treatments. Are treatments for addiction that much better than for breast cancer, or heart disease? No they aren't. In fact, there have been very significant advances in the treatment for and survival of people with those disorders. Advances that came through scientific research.

How do you think we are going to achieve better outcomes in the treatment of addictions? If not through scientific research, then what? More 12-Step meetings? Imprisoning more addicted people? Making it even more difficult to recover by closing off access to school loans, jobs, health care, housing and other benefits? I for one believe the only way forward is through scientific research. If we are going to increase funding for research, we have to compete with the advocacy groups for autism, Alzheimers's Disease, heart disease, cancer and many others. Without the advocacy of people with addictions and their families and loved ones, we don't stand a chance. And without more research, we'll still be referring people to support groups 20 years from now, and just as many will die.

Family members: have you been satisfied with the response to addiction from available treatments? Do you just want more of the same? Who is going to organize and sponsor the first national campaign to raise funds for addiction research?



  1. This last point is incredibly important - where is the Race For The Cure for addiction?! I think there is an opportunity for a true grassroots revolution here. If half of the folks willing to walk for recovery decided to walk for research, I think we could turn some heads.
    We stand at a turning point: a new generation of addiction professionals is entering the workforce, taking the places of the counselors of the 20th century. As concepts like Evidence-Based Practices get elevated to their rightful place in counseling programs in schools around the country, we have the opportunity to enrich this paradigm shift with a body of research that prepares addiction professionals for the 21st century.

    Race for the Cure for addiction - Where do I sign up?

  2. The belief of treatment providers that if someone fails in rehab it was because they weren't motivated enough (and conversely if they succeed it's because the program works), allows providers to avoid asking themselves whether or not they're providing the most effective treatments based on scientific research. Instead they blame the patient for failures and their program for successes.


Comments are welcome.