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Category: Disease

Addict nation

May 25th, 2012 · Posted by: One comment

My essay based on The Fix is the Spectator’s cover story this week:

When future generations look back at the early 21st century, they may well decide that its political turmoil — the collapse of the euro, the spread of Islam, the rise of China — pales into insignificance next to a far more important development: a fundamental change in the relationship between human beings and their social environment.

This was the moment in history, they may conclude, when our species mastered the art of manipulating its brain chemistry to produce intense bursts of short-term pleasure. As a result, billions of people began to have more fun than their minds and bodies could handle — and developed insidious, life-sapping addictions.

Already, the distinction between ‘addicts’ and ordinary people is far less clear than it was even 20 years ago. The line between consumption, habit and addiction is becoming dangerously blurred.

It’s not difficult to find evidence that appetites are spinning out of control. At Victoria Station, young commuters pant like elderly spaniels after rushing to catch their train. Many of them are clutching over-filled baguettes; they have to lick the mayonnaise off their fingers before fishing for their ­tickets.

Other travellers are hovering over a gigantic free-standing food counter loaded with thousands of pieces of loose candy: jelly beans, toffee, bonbons, liquorice sticks, fudge and lollipops, all glistening with artificial colouring. These sugar addicts look furtive as they scoop the sweets into the paper bags. Anyone would think they were buying pornography, from the way their shoulders hunch and their eyes dart sideways.

Not that many of today’s porn connoisseurs have to go through the ordeal of scanning the top shelf in the newsagents. That embarrassment has been made redundant by technology. More than 150 million people visit porn sites every year, and the figure will soon rise into the hundreds of millions as the developing world hooks up to the internet.

The numbers tell only part of the story, however. It’s not just that digital technology creates unprecedented desire for pornography; the images themselves are shockingly explicit compared with most pre-digital porn. Never before have so many nice people discovered that they have depraved sexual tastes. Husbands who would once have retreated to their dens to pore over car magazines now download videos of ‘teen sluts’ being violently penetrated and gasping for more.

The difference between old-fashioned porn and internet porn is a bit like the difference between wine and spirits. After hundreds of years as a mild intoxicant, erotica has undergone a sudden distillation. Digital porn is the equivalent of cheap gin in Georgian England: a reliable if unhygienic hit that relieves misery and boredom. And, unlike the old ‘dirty mags’, it is available in limitless quantities.

You can read the rest free of charge on the Speccie’s website here.


Posted in: Disease, Eating, Porn, The Fix

The Fix: How Addiction Is Invading Our Lives And Taking Over Your World is OUT NOW, published by Collins. Click here to buy your copy in hardcover or on Kindle.

Sexual predators in Alcoholics Anonymous: the dangers of the ’13th step’

May 24th, 2012 · Posted by: No comments

Here’s a brave article about sexual predators in Alcoholics Anonymous. A young woman is talking about her experiences of “the rooms” and of the older men who may have kicked their addiction to alcohol but can’t keep their hands off vulnerable girls:

The young people’s meetings I went to all over Los Angeles featured a revolving cast of men that I would call perverts. They weren’t the obvious kind of creeps, either, with windowless white vans and long trench coats. They looked like everyone else at the meetings: tattooed and cool and smoking cigarettes.

These men swarmed me, as they did every other newcomer too young and inexperienced to distinguish between the loving hand of AA and the clammy hand of a predator. They welcomed me to the meetings, they gave me over-long hugs, they offered me smokes when I was still too young to buy my own. I felt absolutely enveloped by the program. I had never had so many people pay attention to me in my life.

But what I thought of as harmless flirting—and all flirting is harmless when you’re 17 and your curfew is 10 pm—these men rightly interpreted as vulnerability.

There was J, who asked me to his house to “read the Big Book.” When I arrived and asked what we were going to read, he laughed and showed me to his bedroom. I let him kiss me and grope me because I didn’t know I was allowed to say no. He was a grown-up; I was a kid. He’d been sober 15 years; I’d been sober a few months. He was in his 30s; I was 17. My parents had taught me to respect adults, and that’s what I thought I was doing. It can’t be wrong or immoral if J is doing it, I thought; he has a million sponsees and he’s a grown-up.

There was C, who was 36 and also had double-digit sobriety. He had a daughter a few years younger than me. It’s strange to look back and call it rape—because I’ve been assaulted under much less ambiguous circumstances—but that’s absolutely what it was.

I heard about this sort of problem when I started attending 12-step meetings in London in the mid-1990s. Sexual advances were known as “the 13th step” and one very famous rock musician was notorious for trying it on with female AA members. Obviously this type of behaviour wasn’t unique to AA: you also find it in other moralistic groups where older people wield spiritual power over younger ones – evangelical churches, for example. And I need hardly mention the Catholic Church’s record in this respect. Still, I can’t recall reading an article on 12-step predators before, so all credit to thefix.com (no relation to this website) for running it.

 

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Posted in: Disease

The Fix: How Addiction Is Invading Our Lives And Taking Over Your World is OUT NOW, published by Collins. Click here to buy your copy in hardcover or on Kindle.

We are all addicts now, says DSM-V. That’s really good news for therapists

May 22nd, 2012 · Posted by: No comments

There’s a real storm brewing over DSM-V’s inclusion of behavioural addictions in next year’s manual. On the one hand, it’s clear that some “process” addictions – to gambling and internet porn, for example – have a compulsive quality that can ruin lives. But there’s no getting around it: the wider you cast your net, the more the addiction therapy industry stands to gain. Here’s a sceptical report from Pittsburgh Post-Gazette:

It is often said, on everything from oil to junk food, that we’re a nation of addicts. That adage will have greater meaning if the American Psychiatric Association adopts broad new definitions of addiction next year in the manual that shapes the nation’s approach to mental illness

The Diagnostic and Statistical Manual of Mental Disorders is undergoing revision, and one part to come under fire is a proposed expansion of the list of symptoms for drug and alcohol addiction. Critics fear that the looser language could mean millions more people being classified as addicts, thereby creating expensive consequences for health insurers and the public.

The association would be wise to reconsider its proposals.

The New York Times reported that the new manual, which will be published in May 2013, would list gambling as an addiction for the first time and might include the broad new category of “behavioral addiction — not otherwise specified.” Some public health experts, according to the Times, fear that classification could be overused by doctors to diagnose patients with addictions to the Internet, video games, shopping or sex.

The biggest controversy, however, is over how the proposal recasts drug and alcohol addiction. The current definition requires serious outcomes like being arrested, driving under the influence or missing work or school for a person to be diagnosed with alcohol abuse. The new approach views addiction as a continuum, with those displaying at least two less-problematic behaviors, such as craving alcohol or drinking more than they should, being seen as mild addicts.

One study says this could result in 60 percent more people being classified as addicted to alcohol. A Stanford psychology professor who was a White House drug policy adviser believes up to 20 million people could be newly tagged as substance abusers.

All these new diagnoses will carry a price tag. The association argues they could get abusers into treatment earlier while critics fear they will only raise medical and insurance costs.

Although costlier, late-stage medical intervention for any affliction can be headed off by early treatment, we fear a different kind of financial consequence: a flood of new low-level diagnoses overwhelming the health care system and resulting in a shift of dollars away from patients who really need help.

Brent Robbins, an associate professor of psychology at Point State Park University, gave this sensible assessment to Post-Gazette reporter Anya Sostek for a story published Friday:

“Everyone who goes to frat parties at age 19 and drinks too much doesn’t have an addiction. They are abusing the substance, clearly, but that’s very different from someone who has an addiction. The difference between substance dependent and substance abuse is being lost, and that’s not a good thing.”

Other professionals agree, hence the controversy. If the psychiatric association wants its new manual to garner respect and have integrity, it should reconsider its proposed changes and weigh their far-reaching impact.

The Fix argues that addictive behaviour is one of the most serious challenges facing humanity – but it’s also critical of 12-step entrepreneurs who slap addiction diagnoses on basically healthy people and encourage them to define themselves by their “issues”. As the report above says, “all these new diagnoses will carry a price tag”. And not a cheap one, either.


Posted in: Disease

The Fix: How Addiction Is Invading Our Lives And Taking Over Your World is OUT NOW, published by Collins. Click here to buy your copy in hardcover or on Kindle.

‘The Wire’ showed us that drug addiction isn’t a disease

May 8th, 2012 · Posted by: 2 comments

If you want evidence of how drug-saturated the streets of Baltimore are, consider this: last year the actress who played one of The Wire’s most memorable characters pleaded guilty to conspiracy to distribute heroin. Felicia Pearson – known as “Snoop” on the show and in real life – was caught on a wiretap conspiring with two others, who bought heroin in bulk from New York and distributed the drugs in Baltimore.

David Simon, who created the show, reacted to Pearson’s arrest by telling Slate:

The war on drugs has devolved into a war on the underclass, that in places like West and East Baltimore, where the drug economy is now the only factory still hiring and where the educational system is so crippled that the vast majority of children are trained only for the corners, a legal campaign to imprison our most vulnerable and damaged citizens is little more than amoral.

Let’s leave aside – for the moment – Simon’s campaign to change US drug policy. I’m interested in his statement that “the drug economy is now the only factory still hiring”. That touches on one of the major themes of The Fix – that availability of drugs is the main factor in how many people take them, NOT their susceptibility to a “disease”.

The vast majority of Baltimore kids are trained only for the corners, says Simon. And they’re not like the classic drug dealers of legend, selling junk but never touching it themselves. As The Wire’s five seasons made clear, getting high was their favourite recreation. Only having sex rivalled it – but sex while high, of course.

Drug-taking in Baltimore doesn’t spread like the plague: it spreads like other self-destructive habits. It has more in common with stuffing yourself with junk food than with a disease. More on this in the book, but if you want a historical analogy, look at the picture below.

 

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Posted in: Disease, Drugs

The Fix: How Addiction Is Invading Our Lives And Taking Over Your World is OUT NOW, published by Collins. Click here to buy your copy in hardcover or on Kindle.

The mystery of America’s Vietnam junkies

April 23rd, 2012 · Posted by: 6 comments

Experts who argue that addiction is a chronic, relapsing, incurable disease should try speaking to some veterans from the Vietnam War. If the disease model really worked, America should be full of ageing smackheads who haven’t been able to stop taking heroin since ‘Nam. But it isn’t. From The Fix:

In 1970 there was a shockingly sudden burst of heroin addiction among GIs in Vietnam. As Alfred McCoy describes in his book The Politics of Heroin, until 1969 the ‘Golden Triangle’ of south-east Asia was harvesting nearly a thousand tons of raw opium annually – but there were no laboratories capable of turning it into high-grade heroin. That changed when Chinese master chemists from Hong Kong arrived in the region. Suddenly South Vietnam was full of fine-grained No. 4 heroin instead of the impure, chunky No. 3 grade.

‘Heroin addiction spread like the plague,’ writes McCoy. ‘Fourteen- year old girls were selling heroin at roadside stands on the main high- way from Saigon to the US army base at Long Binh; Saigon street peddlers stuffed plastic vials of 95 percent pure heroin into the pockets of GIs as they strolled through downtown Saigon; and ‘mama-sans’, or Vietnamese barracks’ maids, started carrying a few vials to work for sale to on-duty GIs.

Between 15 and 20 per cent of GIs in the Mekong Delta were snorting or smoking heroin. Panicky headlines about the ‘GI epidemic’ started appearing in American newspapers. The Nixon administration was terrified of a crime wave caused by the return of thousands of desperate junkies to American cities. But it never materialised. Instead, the addicted soldiers cleaned up their act – fast.

They didn’t all join 12-step groups. They didn’t check into rehab. They cured themselves. How?

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Posted in: Disease, Drugs

The Fix: How Addiction Is Invading Our Lives And Taking Over Your World is OUT NOW, published by Collins. Click here to buy your copy in hardcover or on Kindle.

If you think addiction is an incurable disease, answer this question

April 19th, 2012 · Posted by: 15 comments

Addicts love, just love, being told they have a disease. Or, better still, in the words of the American Society of Addiction Medicine:

…a primary, chronic disease of brain reward, motivation, memory and related circuitry.

And it’s incurable. So if that’s what you’re suffering from, no wonder you say ‘Okay, I’ll have another pint/line/cupcake’ when temptation rears its head. How can you be expected to say no when all that ‘related circuitry’ is kicking in?

Here’s my rough and ready translation of ‘primary, chronic disease of brain reward, motivation, memory and related circuitry’: This is not your fault. Your ‘disease’ left you no choice, whether you’re addicted to bourbon, crystal meth or Krispy Kreme. That’s what you’ll be told if you attend Alcoholics Anonymous, Narcotics Anonymous, Overeaters Anonymous or any other 12-step group.

But there’s a problem here. Many of the people in ‘the rooms’ have stopped drinking, taking drugs, binge eating or whatever without any medical intervention whatsoever. And lots of them don’t relapse. (Me, for example: gave up booze 18 years ago, haven’t gone back to it.)

So here’s my question: is there any other ‘primary, chronic disease’ whose sufferers can cure themselves without medical intervention?

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Posted in: Booze, Cupcakes, Disease, Drugs, Eating, Gaming, Pills, Porn, Shopping, Tech

The Fix: How Addiction Is Invading Our Lives And Taking Over Your World is OUT NOW, published by Collins. Click here to buy your copy in hardcover or on Kindle.