AA in Addiction Treatment, two articles by Maia Szalavitz

    I like Maia Szalavitz, not only is she a former junkie who consistently advocates against the stigmatization and criminalization of illicit drug users, but she also has an open mind about what constitutes recovery.  Below are two interesting papers along with some choice quotes.

Do the 12 Steps Belong in Addiction Treatment? by Maia Szalavitz

"For no other medical disorder is meeting and praying considered reimbursable treatment: if a doctor recommended these religious or spiritual practices for the primary treatment of cancer or depression, you would be able to sue successfully for malpractice. Similarly, people who have those medical conditions and recover from them may have valuable experience and information to share. But they have not graduated from medical school and would never escape legal scrutiny if they decided to set up a medical practice."

"Nor do I think discussions of spirituality have any more place in professional addiction treatment than they do in psychological counseling for depression or other disorders...in cancer care or in hospices, pastoral care should be an adjunct to treatment for those who want it, not a substitute or requirement."

"The idea that spirituality is the only way to meaning is also troubling."

"Finally, when we emphasize addiction as a uniquely spiritual problem, I think we not only subtly reinforce the idea that it’s not a medical issue, but, in fact, suggest that it is a sin."

Addiction: Medical Disease or Moral Defect? by Maia Szalavitz

"Here’s the problem. Several studies find that teaching people that addiction is a brain disease increases rather than reduces stigma. Why should the “scientific” or “medical” model trigger such a seemingly irrational response? Basically, it's because people see those who are “brain diseased” as permanently damaged and scarily out of control. As a result, they want to lock them up (whether or not they get treatment) even if the problem 'isn’t their fault.'"

"The fewer “aspects of mind” you attribute to someone—like being able to freely make choices, feel pain and pleasure, and form intentions and plans—the more you dehumanize at person, research finds. And the more you dehumanize a certain group of people, the more you support measures like incarceration or treatment that is coercive and infantilizing. After all, the treatment is intended to fix those whose behavior is child- or animal-like in being uncontrollable."

"However way you slice it, it seems, addicts lose. Either we are deliberately making bad choices and must be locked up…or we are mindlessly driven by compulsions and must be locked up. The middle way offers an alternative to this dead end—the idea that it is not your fault that you are at high risk for addiction but you are responsible for dealing appropriately with the issue."

Also see:

Does AA Really Work? A Round-Up of Recent Studies