The problem of wanting to "cure" addiction by using drastic measures like cold turkey or rehab is that it may not be the best course of action. Perhaps it is better for many people to acknowledge that the addiction is in fact "just a phase", and that a proper way of dealing with it would be to accompany the addiction so that the person wouldn't be harmful to himself and others, until the person reaches the point where they "outgrow" it naturally.
I agree that rehab is not always the best solution, because it does not teach the user to wilingly bot use drugs, just forces them not too.
You can't just group all "hard" (what exactly does this mean anyway? Is diamorphine "hard" but morphine not? Codeine? Tramadol?) drugs under one umbrella. You ESPECIALLY need the appreciate the differences between, for example, benzodiazepine (are these "hard"?) withdrawals and crack withdrawals. An addict withdrawing from crack/coke mainly needs sleep and nourishment, "cold Turkey" is a realistic option. An addict who is physically dependent on benzodiazepines will have a grand mal seizure and die if you attempted to force them to "cold Turkey". Gabaergic withdrawal (alcohol/ benzodiazepines/barbiturates/GHB) is a death sentence, opioid withdrawal (diamorphine/morphine/ methadone) sincerely feels like a death sentence but is very rarely lethal (and then almost always a result of dehydration), stimulant withdrawal (meth/coke) is never lethal. I've oversimplified greatly, but I think you get the point.
Also note how alcohol withdrawals are often lethal. Very few people classify alcohol as a "hard" drug comparable in seriousness to heroin, but from a physiological perspective alone, alcohol dependency is far more damaging to the user than heroin dependency. A dependent user could use opioids every day of their life and die at a normal age, completely healthy (the negative health effects from opioids are almost entirely a result of users being forced to turn to a black market). This cannot be said for alcohol.
Before advocating for any policy in regards to a serious public health issue, please at minimum read up on the literature regarding physical drug dependency, the differences between the major classes of commonly abused drugs, and which (humane) approaches other countries have tried which have yielded positive results.
The article is essentially asserting that of the people who clinically qualify as addicts earlier in their lives, about half of those people don't by the time they are in their 30's, and that the pursuit of treatment doesn't necessarily correlate to that outcome.
That isn't to say that there are people who absolutely need to treat addiction as a disease, and that viewing the next drink as an existential threat isn't an important part to their recovery.
When I was a teenager and in my 20's, my drinking and drug use was out of control, and I did enter treatment including 12 step programs. Those weren't particularly effective at keeping me sober in part because of the mantra that "hey, you have a disease, and you don't have control". That's sort of a self-fulfilling prophecy to a younger brain.
What ultimately happened to me was that the life I wanted wasn't compatible with drug and alcohol abuse, and I moved on in my mid-20's.
I do occasionally drink now (in my 40's), but there's no fathomable way that I could see myself going back to what I did when I was young, and no clinician would diagnose me as an addict or alcoholic today.
So yes, the article is dangerous if you are part of the subset to which it doesn't apply. The question is whether we should be treating all addicts in the same way. One answer might be "use the disease model on all addicts because it may apply". Another might be to try to treat this as a leaning disorder.
Right now, we don't know the answer, so I agree with much of your practical advice: if you need help, it's out there, in the form of free communities of 12 step programs, as well as medical treatment programs.
But it's just as dangerous to propose that simply because you have issues in your life that some religiously-motivated program like AA is the way to go.
We should provide people with help that's scientifically developed and proved to be effective, and AA and its various sister programs are neither of those. They're just "get the drunks to worship god instead" programs. In recent years they've gained the thin veneer of talking about a "higher power" instead of "god", without becoming any more scientific or empirically-supported as a result.
If you have a problem with addiction start by talking to your physician, not a church group.
I go to Agnostic meetings that don't involve any prayer or spiritual aspect, just a group of drunks gathered together helping each other to stay sober. So if the whole religious or spiritual aspect of the program leaves a bad taste in your mouth, try finding a secular meeting in your area: https://secularaa.org/tsml_meeting/
In any case, the motivation for my comment was to point out that many of these "xA" programs are inspired by the 12-step "AA" program. That program is not scientific, or even amenable to change as new evidence about the efficacy of sobriety comes in.
Rather, it's dogma. Whatever white-washing of AA's mention of "God" over the years as "higher power" doesn't change the fact that it's not science-based.
Does that mean it's completely useless? No, but as others have pointed out studies of its effectiveness are rather damning[1]. It just bears pointing out when treatments for addiction are discussed that AA is a dogma-based therapy, because many people suffering from addiction think AA is just what you're supposed to do.
1. https://en.wikipedia.org/wiki/Effectiveness_of_Alcoholics_An...
It works for some, but anyone who says its not a christian organization is absolutely lying - its like taking the caramel coloring out of cola - its still cola, it still tastes like cola, you just took away the color that reminds people that its cola.
Physicians aren't a cure-all, because there's no guarantee they've been trained in addiction medicine. After a few doctor visits and them hearing the word "anxiety", you might just leave with a new prescription to Xanax or some other benzo, which could be a virtual death-sentence for someone with a dual-diagnosis.
That is not to say that AA is for everyone, but this advice to just “talk to a physician” as if that is the only fix is absurd. Look at how many people are hooked on opioids after “talking to their physician.”
For what it's worth, my wife, son, parents, siblings and co-workers all would say that 12 step has improved our relationships.
The anecdotes are meaningless. AA can work for a small subset of individuals, but It makes no sense for America to push AA as a first line treatment. AA is not a treatment, it’s a self-help group with poor results.
Pardon my disdain, but promoting AA over other solutions is frustrating for this formerly silent family in America who are fed up with the 12 step answer.
I am pretty skeptical of a claim like that.
It works for some people. It's also completely free, which you can't say about medical intervention. Around here, detox and rehab facilities have 6 month long waiting lists and cost tens of thousands of dollars.
I am skeptical about that too. I'd be surprised if both rehab and AA don't have a statistically significant effect on addiction treatment.
People tend to expect that rehab will cure addiction, and become disillusioned with the reality that addiction is a chronic illness. Relapse rates are high in chronic illnesses, like diabetes and hypertension, the latter having a relapse rate of 50%-75% according to the NIH. Addiction is no different, and its relapse rates are between 40%-60%, even with ongoing treatment. Efficacy rates will reflect this harsh (and often very expensive or deadly) truth.
Also instead of taking the time to write out multiple comments expressing your doubt as to the efficacy of AA, you could've found the information you needed in a single google search.
"Dr. Maté's approach to addiction focuses on the trauma his patients have suffered and looks to address this in their recovery"
>if we don't end up in jail first
The former statement does not work because of the latter. Any additional person that knows about it is a risk to your freedom.
Never had someone tweeted one my comments before :)
YES I'm sure some of us can quit on our own or can "grow out" of our addiction if we don't end up dead or in jail first. I'm sure there cancer patients out there who are cured and have never had a single treatment, but you can bet that most people with cancer get some sort of treatment and help.
Bottom line is, YOU DON'T HAVE TO GO AT IT ALONE. There is help available, so why not use it? AA, NA, HA ,CA, Wellbriety, going to therapy, medical professional, it's all there to help so use it. You doesn't HAVE to take 15 years to "grow out" of alcoholism if you can get the support you need to help you quit sooner.
Tonight I'm speaking at a DETOX and I suggest that they go through the 60 day RIT program that it offers so they have a better chance of beating their addiction. Again, please don't wait to get help. You don't have to fight this battle alone.