on May 21, 2004
I have known people to sober up with 12 Step Programs. And without them. I have been sober for over 20 years and I did not avail myself of AA. According to AA, this is not possible. But AA does not see those of us who simply didn't buy into the disease model - one that oddly enough finds treatment in peer groups - disparaged by one 12 stepper below. Umm - 12 step programs ARE peer groups - nothing more happens than listening and talking - both of which can be quite magical. I just am living proof that you don't need Bill W. to do it. I didn't want to "keep coming back" to rooms of people who only had my "disease" in common. So I surrounded myself with "healthy" people. It was hard. I didn't have the excuse of "my disease talking" because I had to take responsibility for the garbage coming from my mouth. I had to take responsibility for my actions. And I did it all at once. Stanton Peele is not against AA - if it works for you. But there is precious little scientific evidence pertaining to AA (it IS an anonymous program, after all) and when a friend started in AA and worried about the "sick and suffering alcoholics" who left the program, I sought them out and found more than a few - NOT drinking. They were busy holding jobs and being in families and friendships and pursuing interests and did not want AA to be one of those interests. Of course, that is just anecdotal evidence. But it's mine and good enough for me. Just like the AA "evidence" is anecdotal. Good to see somebody not just blinding swallowing the party line.
on February 20, 2008
I just finished a nine month stint in alcohol recovery. I entered voluntarily, which I'm glad for, but of course I was in the company of many who had been forced by the legal system into the same treatment. As is pretty much always the case, when you get a DUI or some other form of alcohol- or drug-related charge, the legal system thinks your "best" choice is treatment.
So I've been there. And I did the required reading and the required AA meetings. (In fact I'm the secretary of my home AA meeting.) I read "Under the Influence" by Milam and Ketchum. That book of course is reviewed here on Amazon.com, lauded for its brilliance and comprehensiveness, and its followers no doubt enjoy Milam's pokes at the members of the establishment who reject his Disease Model.
I have been saying "I'm and alcoholic" for ten months now. My wife would tell you unequivocally that, sadly, her husband is an alcoholic, but the good thing is he has a disease, so the prognosis can be good. The odd part of this is that I only drank on weekends. I have never heard of a disease that afflicts its host every Friday and goes into remission the following Sunday.
So "The Truth About Addiction" was like a long needed breath of fresh air. Finally, here was a guy saying the kind of things that I had been feeling for months. Interestingly, in the same manner that alcoholics who find for the first time they have a disease are relieved to realize they aren't moral degenerates, I was relieved to realize that I was not the only one who thinks Milam is full of crap.
I'm mixed on the effectiveness of the Twelve-Step model. There are definitely benefits. I personally believe that the greatest benefit of AA is "the fellowship." You get a bunch of people together talking about their problems and supporting each other, invariably good things are going to happen.
And, in fact, despite Peele's assertions that AA doesn't work, he does make a point to say point blank: If AA works for you, then that's good, do what you need to do. His point is NOT that people should not adopt the Twelve Step model -- it's that the Twelve Step model has been shown to be ineffective and we need to consider alternatives.
on October 27, 1998
This is NOT a book for people who are perfectly happy in AA; there are plenty of books out there for you. This book is GREAT, however, for those of us who have ended up feeling as though AA has outlived it's usefulness, or those who wonder if they ever really belonged in "the Program" at all. I spent nearly five years in AA, and that it saved my life at the time I joined I cannot deny. Eventually, I had to leave--I simply couldn't stand it any more. I began to wonder: was I truly diseased,or had I just been an immature, insecure person who drank to drown a mountain of fear? I began looking for alternatives, and found this book. I've been drinking again for five years, with no dire consequences; nobody would guess I ever needed AA! I can't recommend this book enough. There are NO miracles here, NO faith-healing, NO catchy little phrases--just lots of good, rational common sense for those who want to move on--whether you choose to drink again or not.
Flying in the face of conventional thought, "The Truth about Addiction and Recovery" encourages the reader to challenge the contention that addiction is a disease. The authors' contention is that addiction is a coping mechanism that people develop to deal with life's stressful situations. Instead of doing the 12-step program the solution is to develop alternative coping skills.
Addiction is a symptom and not the disease.
Peale argues that treatment for addiction should be based on learning skills that allow the addicted person to cope better, communicate easier and relate to others better.
One of the more interesting points of the book is the analysis of people who try to kick an addiction without going through a 12-step type program. Statistically, untreated people have the same or better success rate as those in treatment. The author make a very strong case and argues it well. This should be required reading for anyone dealing with an addiction or who knows someone dealing with an addiction whether it is drugs, sex, food, shopping or whatever other addictive behavior they may have.
on April 13, 1999
This book trounces the idea that addiction is a biologically determined disease that requires 12 step treatment. Even herion addicts say that cigarrettes are the most addictive substance -- and most people quit smoking on their own.
Most people who use cocaine (and other drugs) do not use it regularly, those who use it regularly do not become addicted and those who become addicted recover on their own. Sound outrageous? Citing several thorough sociological studies, this statement becomes more and more believable as you read this book.
I used to think that behavioral compulsions, like addictions to sex and food, were different from substance abuse. Surely shooting heroin involves a chemical dependency, whereas overeating or spending all your money on porn and peep shows is a sign of psychological escape, right? Some say that all such behaviors are biological, but that sounded preposterous to me. This book drove home the idea that ALL addiction, be it abusing credit cards or smoking crack cocaine, is a symptom of a life out of control, not the cause. The book clearly illustrates how people become addicted when their lives lack meaning and hope, during painful transitions, and when they don't have the life skills or coping skills to ride out the rough edges of life.
Why is smoking crack considered more addictive than sniffing powder? People who smoke crack are generally people who live in the desperation of the inner cities, so they have less *motivation* to overcome their addiction, not a stronger drug.
Any serious student of sociology or psychology should read this book
on July 14, 2005
The Truth About Addiction and Recovery has to be the best, most comprehensive book on the subject. The book is cogent and intelligently written. It's impeccably sourced. It was a delight to read and EVERY single question and doubt I've had was answered somewhere in this volume.
I'm troubled by the reviewer who titles his review, Disturbing, and states, "Any work that claims to be THE definitive answer to an enormously complex problem should be approached with caution." That sounds like a rational statement. However, Stanton Peele's research isn't based on feeling, like the AA model. It's based on numerous studies by many different scientists done over the past several decades that have drawn the same conclusion OVER and OVER again. And, the conclusion is that it's NOT a disease-- despite the AMA and despite AA and despite every single organization that says it is. The proof lies in this point-- that there hasn't been even ONE successful study that has proven otherwise-- even when the study was created to PROVE that it was a disease.
AA ADMITS in it's own data that only 5% of AA members remain alcohol abstinent. The data that has been proven over and over again is that this number is LESS than those that quit drinking without AA. Additionally, a recent Harvard University Study stated that 80% of those that have quit drinking did it on their own. This goes against the disease model and AA approach. Many can moderate their drinking successfully or quit successfully altogether. This goes against the disease model and AA approach, too. Stanton Peele's book shows us the studies and data that support that once addicted DOES NOT MEAN ALWAYS ADDICTED. Unless, of course, one has bought into the AA philosophy and has now accepted that they are permanently sick and out of control. This is the crux of this argument. Studies have shown that those that have bought into this philosophy wind up having a lower self-image than those that have not, and they wind up believing they are permanently sick and completely unable to manage their lives-- thereby buying into the belief that they are "out of control". The focus is never about getting better in AA (I know they say otherwise)-- the focus is on STAYING 'sick', STAYING in AA, and STAYING permanently in a "RECOVERY" state. The focus, truthfully, is in keeping old folkwisdom alive even though every bit of evidence shows us that there are proven better ways. To add insult to injury, anyone who doubts this model is accused of being in denial, and everyone who remains alcohol abstinent without AA is accused of being a dry drunk (not "sober" according to AAspeak). Hello? Isn't this supposed to be a quit-drinking program?
The problem AAers have (such as the reviewer I quoted before) is that this proof (that is shown so coherently here) completely pulls their chairs out from underneath them. I understand this, too. If everything I believed was taken away from me and proven to be false, it would certainly undermine my own confidence in my ability to make decisions. And, so far, although the twelve-step "treatment" (although why we continue to call it treatment when it hasn't successfully treated anything) philosophy has continued to permeate our culture, there is absolutely no evidence at all to suggest that it is beneficial. On the contrary. The evidence proves it hasn't been and that there are better ways that have been proven to work (for instance, Community Resource and Family Training, Rational Emotive Behavioral Therapy, and Cognitive Therapy, as well as other approaches) scientifically.
on March 27, 2002
This book was very helpful to me years ago when I was dealing with my own drinking and drug problems. It seemed that the cure (AA) was worse than the disease, from my standpoint. The cultishness, the massive cigarette smoking, not to mention the horrid coffee... Did I really need this? I had given up cigarettes on my own. Couldn't I lick this thing, too? With the help of a gifted counselor, and a good physician, I cleaned myself up, and have been clean now for over 6 years. Not that that makes me an expert or anything. But I do wholeheartedly recommend this book. Don't trade one addiction for another, folks.
on April 27, 1999
Stanton Peele has a controversial view of addictions, be it to substances or behaviors. The question he asks of those who believe that the drug itself hooks people is, "Even if the substance is incredibly euphoric or blocks pain, what makes the person favor that experience over other rewarding experiences?" He strongly disputes that addiction is biological disease and that the 12 Steps are the only treatment - indeed they may be worse than no treatment at all.
I've always disputed that things like sex, food, and shopping could be addictions, without denying that people can clearly go overboard with such things to ignore inner turmoil or avoid responsibilities they can't cope with, or because they lack relationship skills. Peele's view is that this characterizes *all* addiction, and treatment should involve learning coping, communication and interpersonal skills. The biggest controversy surrounding Peele, however, is his assertion that most people gain life skills naturally as they mature -- when people get jobs or find something they care for and have better things to do then get smashed -- making clinical treatment unnecessary for addictions in young people. He sites sociological studies that show that most drug users "mature out" of drug use, even if the drug use involved drug binges or other obvious addictive behavior.
Still think that some drugs are just more "addictive" than others? Is it the drug or the person taking them? What makes a person take a hard-hitting drug to begin with? I had never really thought before what it meant that crack was more "addictive" than cocaine. As crack is mostly consumed in poor, degraded environments leading most into dead-end lives, what motivation - what opportunity - does one have to put down the pipe get a life? This book makes a strong case for looking at environment, sociological and psychological factors in addiction, not brain chemistry.
This book also opened my eyes to what happens to people who don't go through therapy or drug treatment. I only looked at the statistics that evaluated people *in* treatment, not those who never went! When you consider how most therapy, especially the 12-steps do not address life skills and in fact hinder them with their rhetoric of powerlessness and doomed childhood, its not really a surprise that untreated people have the same or better outcome as people in treatment.
on April 27, 2000
Stanton Peele has made a career out of a single issue: a serious ax to grind with the "alcoholism is a disease and only AA and its related 12 Step program will put the disease into remission" school of thought. Certainly those who believe AA and its canards are unassailable will cling to this belief. And those for whom AA was NOT a viable solution will pronounce Dr. Peele a genius and declare his work a revolutionary advance in the treatment and understanding of addiction.
But what if the answer is in between these two poles of thought?
I certainly had MAJOR reservations before I opened this book. Any work that claims to be THE definitive answer to an enormously complex problem should be approached with caution.
Peele raises some critically important issues surrounding current thought on addiction. Foremost is the "disease" model itself. As Peele indicates, this allows people to abdicate personal responsibility for their addiction, a claim Peele says that is the backbone of AA--and the problems with the AA approach to addiction. But a careful reading of "Alcoholics Anonymous" and related literature published under the auspices of AA is more complicated than Peele acknowledges. It is not simply a matter of learned helplessness. On the contrary, AA literature stresses that the individual must take personal responsibility for their actions: no one forced an alcoholic to drink. It is not enough to "turn one's life over to a higher power" and wait for the miracle to happen. That is a simplistic reading of the AA program--one critics of the program seem to make again and again. On the contrary, the addict must take a proactive approach to recovery. Praying and meditating are all very helpful, yes, but only a small part of the total recovery process. And Peele does not, I believe, properly acknowledge that. Perhaps a more reasonable approach to the problem of alcoholism is to say that whether or not it is a chronic, lifelong "disease," it certainly acts like one. And then to discuss the ramifications of that. Simply dismissing it wholesale as Peele does again and again does no one any service.
Peele's answer to this can be similarly reduced to the "pull up those socks and get a move on" approach to recovery. For example, certainly environment plays a factor in addiction, but Peele gives it too much weight. If environment were so all-determining a factor, why does addiction remain a problem at *all* socio-economic levels and environments? I agree that addictive behavior is the symptom of a life out of control. But then again, so does AA. But to state that crack is considered more addictive than powder cocaine because typical crack users live in poor environments with little chance of bettering their lives is a questionable conclusion. Furthermore, to state that most people who become addicted grow out it (oh it's just a stage), is as disturbing to me as the disease model is to Peele. Shall I use and use and use until, by some magical process of maturity, I don't have the desire anymore? According to Peele, I would have a better chance of recovery doing that than if I followed a 12-Step Program.
Certainly there is much to criticize with the current AA and disease-approaches to addiction. And lumping in other behaviors like shopping and sex trivializes the problem. AA's insistence on it being the only effective approach to addiction is equally questionable. But AA does one thing Peele does not: it allows the individual to take what is useful *and to leave the rest behind.* As I stated earlier, I think the answer will eventually be found in between these two poles of thought. Peele's approach, while raising some issues that must be reconsidered, is not THE answer; it is just one answer, and a disturbing one at that.
on June 29, 2004
I gave this 4 stars since it was written in 1992 and no updates since (but maybe what was said is all that needed to be said)
I found the chapter "Life Skills: If you don't have them, get them!" That chapter alone will help people to maintain recovery...it is part of what going to 12 Step meetings do... they help you to sociolize with others in recovery (ie. Water seeks it's own level) so learning to stop hanging out with the addicts who are using and hanging out with non users and recovering people will help you to stay sober even better... but there is far more to that chapter and the others. I grow tired of 12 Step programs and how they teach you about being helpless (you are helpless about the feeling of wanting to go use/slip...but you are not helpless) Your drug of choice does not tie strings to you like a marianate and when you feel like using...it has no power to make you stand up, make that call to your dealer or make you walk over to the store/dealer and reach down and get that money out...it does not make you use it... YOU did all that...it just made you feel good (or distract you from what you were running from for awhile...that is all it does) Remember when addiction use to be refered to as a 'habit'...it is, just really well engrained. Time to learn better and newer habits (they do that in 12-Step already...don't believe me? When you feel like using, use the phone, go to a meeting, journal, do your step work, exercise, help another addict, use phrases...all alternative habits to learn and distract yourself.) Most cravings last about 15 minutes maximum if you just wait it out and concentrate on other stuff... according to studies as of late (and yest studies do change) But learning you are not helpless is a bigger start. After all, if the drug was that powerful don't you think it could do something to stop you from going to a meeting...like calling a pizza delivery guy or something to stand in your way?)