1. Why Addiction is Not a Disease: Into the Debate Lecture 4

2. Why Addiction is Not a Disease! One of the main proponents Stanton Peele http://www.peele.net/ http://www.youtube.com/watch?v= 5BLCVTU6J4A&feature=related http://www.youtube.com/watch?v= 5BLCVTU6J4A&feature=related

3. When Behavior is a Disease: Around the Water Cooler 1. The disease is marked by loss of control of an involvement or behavior 2. The sufferer cannot recognize the disease in the absence of education by disease sufferers, especially other sufferers 3. Disease exists in of itself and cannot be traced back to childhood rearing practices or other environmental causes 4. Disease progresses inexorably no matter what effort or life choice is made unless they receive treatment aimed at containing or eliminating the behavior that defines the disease 5. Disease is a permanent trait must accommodate it the rest of their lives 6. Because of the inherent tendency for the sufferers and society to deny presence of disease, it is remarkably prevalent, yet frequently undetected, calling for more aggressive identification and treatment of sufferers

4. Main Messages A host of addictions may be understood as disease, but they are not diseases “Addiction is an experience people can get caught up in but that still expresses their values, skills at living, and personal resolve – or lack of it”. Upon stopping use – peoples’ problems don’t disappear Addiction has become a marketplace

5. Sit with this… We will never, ever treat away drug abuse, alcoholism, and the host of other behaviors that are now called addictive behaviors…

6. Main Messages (cont.) No biological urge to form addictions that will one day be found under the microscope We are creating more addictions ever year / generation (who we often tell will never get better) CHILD OF A PERSON WITH A DISEASE OF ALCOHOLISM Mix up moral responsibility with disease diagnosis

7. Peele’s idea of treatment / helping Nurturing communities can protect and support the individual and family reduce an entire range of illness Here people learn that can control their destinies = Self Efficacy But we have not capitalized on self-efficacy, connection, support, and education instead we find it easier to…

8. The Disease Timeline

9. Specific Microbes Preventative Inoculations Measureable Physical effects First Generation Diseases: AIDS Clearly connected with the functioning of the body

10. Derived from what we are told Disordered thinking / feeling No Brain Scan / No Microbe Second Generation Diseases: Mental Disorders

11. Known by behaviors they describe Disease = compulsively seek DOC If I stop behaviors(s) no disease Third Generation: Addictions

12. Convincing Ourselves the Impossible Mental problems as “diseases” broadly accepted by 1950’s Mentally people are sick like those suffering from sore throats…Medical science knows neither specific causes…nor specific ways of preventing them (World Book Encyclopedia, 1961) Are we closer today?

13. Szasz, Foucault, Bateson, Laing Middle Class Morality Presumed disease because declared so Control behavior we don’t like Demand conformity Medical Garb A problem does exist – but it's misunderstood

14. Szasz, Foucault, Bateson, Laing: Explanations / Answers Family and the double bind Community Deep Understanding / Safety and Support Spiritual Journey Accountability Taking responsibility Today for good and bad, greater public seduced by enthusiasm in neurosciences.

15. No doubt great increased understanding of brain, which has helped reduce suffering from 1 st generation diseases… But why then have 1 st and 2 nd generation disease rates climbed? Why so many pills? Why are a great deal of “so called” addicts now dually diagnosed? It is obvious that medical and pharmaceutical breakthroughs for first- generation diseases have not been forthcoming in dealing with our second and more noticeably 3 rd generation diseases. Medical community has itself contributed to increase in addiction?

16. AA Becomes Institutionalized Private fellowship now co-opted into mainstream medicine and psychotherapy (1970s) Linchpin for services (widespread in U.S. and Canada) We become convinced (lay public) millions of people are in need of services (just not acknowledging) Thus AA moved away from an anonymous program; one where law, medicine and the like now coerce people into a one size fits all approach. An approach that suggests once and alcoholic always an alcoholic

17. Diseasing of America AA/Medical view is popular and is being applied to every-kind of behavioral problem o Gambling o Overeaters o Compulsive shoppers o Relationships addicts, love addicts, and sex addicts o Suffers from agoraphobia to severe anxiety to eating paint chips o ADCOA o Depression o PMS o Video Game Addicts

18. Can We Escape Being Diseased? Worse yet, disease according to its own tenets - is biological in nature, and yet sufferer(s) are told they are incurable!

19. Conclusions: Peele’s Final Stand Disease conceptions are bad science Biology is not behavior People’s belief that they have a disease makes it less likely that they will outgrow the problem We also most guaranteeing relapse Lastly, the pseudo-medical and treatments of new diseases increasingly determine our feelings, our self-concepts, and our world views – defining our culture and who we are.

20. Draw Backs: Unpeeling Peele Let’s Chat!