Author Archives: Steve S

Looking to start LR on Florida’s “space coast”

Dale B. is looking to get Lifering started on the “Space Coast” area of east central Florida, which includes Orlando and the area directly east of it. Here’s his regional Lifering website, already set up. If you live in the area, or know someone who does, please alert them.

New book hits hard at fundamentals of 12-step based sobriety support

In a book that’s getting plenty of discussion around the Internet, including multiple reviews, “The Sober Truth: Debunking the Bad Science Behind 12-Step Programs and the Rehab Industry,” is one of the hardest-hitting and most direct critiques yet of the 12-step ideas, structure and model for sobriety support. Per the subtitle, it’s about more than just Alcoholics Anonymous and Narcotics Anonymous. Authors Lance Dodes and Zachary Dodes, the former with  35 years of psychiatric experience, tackle how the 12-step model has become accepted by the rehab industry, and also the courts, including noting, of additional importance to LifeRing, legal rulings that 12-step programs are a religion in terms of First Amendment views. and therefore mandatory  orders to AA or NA meetings are not allowed.

From the review on Amazon:

In The Sober Truth, acclaimed addiction specialist Dr. Lance Dodes exposes the deeply flawed science that the 12-step industry has used to support its programs. Dr. Dodes analyzes dozens of studies to reveal a startling pattern of errors, misjudgments, and biases. He also pores over the research to highlight the best peer-reviewed studies available and discovers that they reach a grim consensus on the program’s overall success.

But The Sober Truth is more than a book about addiction. It is also a book about science and how and why AA and rehab became so popular, despite the discouraging data. Dr. Dodes explores the entire story of AA’s rise, from its origins in early fundamentalist religious and mystical beliefs to its present-day place of privilege in politics and media.

The Sober Truth includes true stories from Dr. Dodes’s thirty-five years of clinical practice, as well as firsthand accounts submitted by addicts through an open invitation on the Psychology Today website. These stories vividly reveal the experience of walking the steps and attending some of the nation’s most famous rehabilitation centers.

The Sober Truth builds a powerful response to the monopoly of the 12-step program and explodes the myth that these programs offer an acceptable or universal solution to the deeply personal problem of addiction. This book offers new and actionable information for addicts, their families, and medical providers, and lays out better ways to understand addiction for those seeking a more effective and compassionate approach to this treatable problem.

To many LifeRingers who came to LifeRing from 12-step programs, these critiques may already be known. But, as Dr. Dodes notes, they’re still not well known in either the court system or his own profession.

Some, based on the first major media review of the book, in Salon, an excerpt from the book by the authors, may fear this book engages in “AA bashing.” However, Dodes does note that the 12-step methodology does work for some people. Rather, to me, the book seems to be what flows from his observations of “medical best practice” based on his 35 years as a psychiatrist.

In one earlier book, per a review on Amazon, he labels as “myth”:

  • Addictions are fundamentally a physical problem.
  • People with addictions are different from other people.
  • You have to hit bottom before you can get well.
  • You are wasting your time if you ask “why” you have an addiction.

In other words, he seems to discuss issues of addiction from a variety of medically and psychologically informed angles. In that book, these issues seem to be related to what he presents in his current book, namely that addiction is a psychological issue as much as anything, and that while addictive substances affect brain chemicals, that’s not the most productive way, or the right level of approach, to address this situation. I do know that neuroscientist Carl Hart, in his new book, “High Price,” is more explicit about ideas about how addiction boils down to dopamine problems are more and more panning out as not true. (I’ll have a review of that book in a couple of days.)

Per the informational angle, this book is gaining “traction” nationally, and aside from any possible concerns about “tone” on Dodes’ discussion of 12-step methodology, raises important issues from a medical stance. Besides Salon, it’s now also been reviewed in The Atlantic and at NPR, as part of an author interview.

There is one thing that is a bit eyebrow-raising, that I noticed most at his NPR interview. He talks about “managing” addiction. I don’t know if “moderation” is under his “management” ideas or not.

You can learn more about Dodes, including a blog he maintains on addiction issues, at his website.

Note: This post h as been lightly edited since its original posting to drop most references to other Liferingers’ opinions and to add a reference to another new book about addiction, that of Hart.

The psychology of quitting, and quitting drinking

Getting sober means quitting, quitting drinking. In the “can-do” and “rugged individualism” that seems part and parcel of American society, the idea of “quitting” often has other attendant psychological issues. Like, if you quit something, that means you were a failure. You didn’t do something successfully.

And, that can be seen as applying to the need for sobriety, too. A person “failed” at being a successful drinker. We even have semi-jokey stereotyped statements about people “not being able to handle their liquor” and similar.

The book, “Mastering the Art of Quitting” has nothing specific to sobriety. But, as a self-help book that isn’t overly laden with blind-rosy optimism, and that talks about goal strategies and similar ideas, a person embarking on the journey of sobriety can surely mine nuggets from this issue, not only about sobriety itself, but, for many people, earlier life issues that may have contributed to eventual addictive alcohol drinking or drug use.

The good points of this book are that it says we shouldn’t be afraid to quit something. Nor should we see shame or a sense of failure in doing so.

Personality factors that affect this, strategies for planning quitting, etc., all get discussed.

Philip Seymour Hoffman: A caution, about triggers

Philip Seymour Hoffman, via Slate

Science writer Seth Mnookin has a very good piece about Hoffman’s death.

First, there’s the scary part. Now, in recovery, we want to grow to the point where fear isn’t our primary motivator, but, we should still have a healthy fear for addiction. That’s why this scary part is of the “healthy fear” type:

I cried when I heard about Philip Seymour Hoffman. The news scared me: He got sober when he was 22 and didn’t drink or use drugs for the next 23 years. During that time, he won an Academy Award, was nominated for three more, and was widely cited as the most talented actor of his generation. He also became a father to three children. Then, one day in 2012, he began popping prescription pain pills. And now he’s dead.

Why he started back, we don’t yet know, and maybe never will. But, he did.

And, contra some recent columns that tout how much “moderation” may be able to help people, it usually doesn’t. Hoffman’s addiction progressed until he died with a heroin needle in his arm, and heroin dangerously “cut” with the narcotic fentanyl. (Updated, Feb. 13 — Although fentanyl from new “cuts” of heroin was under suspicion at the time this was written, none was found in Hoffman’s case.)

Mnookin goes on, to reveal his own background:

My first attempt at recovery came in 1991, when I was 19 years old. Almost exactly two years later, I decided to have a drink. Two years after that, I was addicted to heroin. There’s a lot we don’t know about alcoholism and drug addiction, but one thing is clear: Regardless of how much time clean you have, relapsing is always as easy as moving your hand to your mouth.

He got and stayed sober after that, but later got “reminders” himself. What we might call “triggers”:

Being back in Boston was a visceral reminder that there’s an important part of my past that isn’t on the bio page of my website: From 1995 to 1997, the last time I’d lived in the area, I’d been an IV drug addict. Living here again made me acknowledge that past every day: The drive to my son’s preschool took me within blocks of the apartment that I’d lived in during those years; my route from his school to my office went past the free acupuncture clinic where I’d sought relief from withdrawal pangs. One afternoon, I looked up and realized I was in front of the emergency room I’d been taken to after overdosing on a batch of dope laced with PCP. I did a double take and looked to my wife, but, of course, that wasn’t a memory we shared. We met in 2004, when I’d been sober for more than six years.

One truism of addiction science is that long-term abuse rewires your brain and changes its chemistry, which is why triggers (or “associated stimuli,” in scientific parlance) are major risk factors for relapse. But these changes can be reversed over time. Walking past the apartment where my dealer used to live didn’t make me want to score; it made me feel as if I was in a phantasmagoria of two crosshatched worlds—but I was the only person who could see both realities.

Give the whole thing a read. It’s worth it.

And, although Lifering has no formal “program” of recovery, talk like Mnookin’s is why many in Lifering talk about the issue of “triggers.”

Yet another “false dichotomy” story

Just a couple of weeks after the New York Times, in a column by a person pushing a book, presents a false dichotomy between Alcoholics Anonymous and science-based moderation as the only alternatives on the table, Slate does the same thing. And, it’s story author is a Slate staffer who doesn’t even have the excuse of publishing a book. You can comment on the page or Tweet Brian Palmer here.

The story’s good otherwise; Palmer knows the history of AA’s semi-official opposition to medical assistance for addiction, counseling and more. But, there’s not a single word in there about secular sobriety organizations. Only by people like us contacting people like Palmer to get the full story out there, can we get the full story out there.

And, whether Palmer’s analysis of AA is close to correct or not is not the primary point of this blog post. (That said, I do think he is broadly correct.)