THE POLITICS OF PSYCHOLOGY AND ADDICTION
By Fred Newman
This talk was originally presented as the annual lecture of the East Side Institute for Short Term Psychotherapy at Columbia University Teachers College, April 1990.
I think I feel a little bit defensive about this talk. Let me tell you why.
The way these talks work is that the staff members of the East Side Institute for Short Term Psychotherapy come up with a topic that they think would be important for me to talk about, to add a social therapeutic point of view to something that's hot. So this year Dr. Hugh Polk, the director of the Institute, came up to me and said, "The hot topic this year is addiction. There are big grants going out to researchers in the addiction field. Everyone's writing about it-it's the word."
And so Dr. Polk and Bette Braun, director of training, pointed me in the direction of a whole body of literature which I began to study. Well, after awhile I realized I had a certain problem which is why I feel defensive tonight.
You see, two years ago I gave a talk on depression-apparently depression was hot two years ago-and after having perused the literature, I saw that, while I didn't agree with a lot of the literature about depression, I had a critical contribution to make as a social therapeutic theoretician. While I had all sorts of criticisms of the traditional theories and attitudes about depression, after reading as much of the literature as I could, I wound up believing that there was such a thing as depression and that's what they got!
Last year I was told that the big topic was panic. I got all the literature, read through it very carefully, had severe criticism of a lot of the positions on panic and its correlate, anxiety. I gave a real radical talk on the subject-I called it "Panic in America"-but at least when I finished reading all the literature I still believed that there was something called panic and something called anxiety. So I didn't feel so bad when people came to hear me talk, because they got what they paid for!
Now here's my problem this year: I read through a huge pile of books and scholarly articles. I watched films. I read the writings of social workers, respected psychologists, distinguished psychiatrists. And here's the strange thing that happened: the more I read the more I came to believe that there is no such thing as addiction,
I notice the silence in the room! "What!!? No such thing as addiction?" you're saying to yourself. Now I know that Nancy Reagan said that there is such a thing as addiction. I know as well as you all do that there are billions of dollars made in the addiction industry. I know that the word appears all over the place. I know that lots of people including our young people, our people in the communities who are so heavily labeled, branded and stamped by that term, have themselves come to believe in addiction. But you see, I don't think it follows that there is such a thing as addiction. And that's why, as I mused over alternative titles for tonight's talk, what kept running through my mind (I am addicted to thinking up names for things!) was "The Myth of Addiction or the American Addiction to Myths."
I want to talk about how profoundly addicted to myths, mythically speaking, this addictive society is. Take a look at this big word on the banner up here on the stage-Addiction. In the language of philosophy, this big word refers to nothing. I think it damages profoundly, but it literally refers to nothing. Let me tell you why I think that, and why it's so important to clear this up and make this statement.
The Birth of the Addiction Industry
In 1968 I gave up university teaching in philosophy or, rather, university teaching gave up on me. I had been giving my students all A's because I didn't want to participate in having young people sent over to Vietnam to be cannon fodder for a bunch of people who fight all kinds of wars for mythical reasons. We know the real reasons-but they put forth mythical ones. So these young people would come into my class and I'd say something like, "OK, let's get it straight here. Everyone's got an A. You've got an A whether you come or you go or you stay or you write or you don't write. Frankly, I don't care, I'm giving everybody an A here. Now if you want to talk about some philosophical issues we can do that, and if you don't that's fine, too."
Well, I didn't do that for very long at any one school, as you might well imagine. I was fired all over the country-I think in my best year I went through seven schools. I finally walked out in 1968. Of course I didn't quite know what I was going to do-I thought I wanted to become an organizer though I hadn't the foggiest idea what that meant. So in '68 I did what a lot of people were doing-I went to a lot of rallies, I went to meetings, I tried to figure out what to do with a Ph.D. in philosophy if you didn't use it to teach at school. And of course I was broke, but I had spent a lot of my life being broke; it wasn't altogether new to me. I knew how to be broke.
But when you're broke, eventually you've got to find some work to put a few bucks in your pocket so you can get to be broke again. In early 1970 I picked up the paper looking for work. And there was an advertisement there-I think it was in the New York Times-for a "drug rehabilitation counselor." It looked like something I should apply to. New York State gave a test to become a drug rehabilitation counselor. I took the test, and I passed it with flying colors. I got a very high score, and since I knew nothing in the world about drug rehabilitation, I already knew the field was slightly suspect! I was hired by an outfit called the Narcotics Addiction Control Commission, set up by the Rockefeller Drug Program, and they sent me across the East River to the Queensboro Rehabilitation Center to be a drug rehabilitation counselor.
Well, when I got there I discovered that the Queensboro Rehabilitation Center was in fact a prison. They didn't call it a prison but it was one nonetheless. The people got to live there by copping a plea to go through a nine month program rather than spend two to three years in a prison. But the Queensboro Rehabilitation Center was a prison-it was a locked-up prison. It came complete with six by eight detention cells and beatings by guards. In short, it had all the accoutrements of a prison because it was a prison.
In the context of this prison they had something which was euphemistically called the therapeutic program. This was right before the moment when methadone came in, so they were still playing with 60s concepts like "rehabilitation." I remember those first days very, very vividly. The first day I arrived with the usual trepidation and fear of a first day on the job, not to mention the strangeness and oppressiveness of the prison environment, not to mention that I knew nothing about drug rehabilitation! I was sent up to the fifth floor and introduced to 50 African American, Latino and white working class young men, sitting around a large game room. The guards started banging and shouting out, "All right! Gather up here! The new social worker is here!" (ha! ha!), and they said to me, "Here are your men. Rehabilitate them!"
So we all sat down, and these men started checking me out-a perfectly reasonable, indeed more than responsible, thing to do. It was all happening very, very quickly. As a matter of fact they weren't even talking to me; they were talking to each other about things they knew about their shared experience-but it was transparently obvious that they were talking about me. One didn't need any training at all to figure that one out-you can tell when you're being talked about.
It became apparent after a relatively short time that one young man-a very tall, powerful looking man who was to become a very dear friend of mine and who was later killed on the streets of New York-was obviously the leader. So after about five or ten minutes, I addressed him. His name was Leonard. I said, "Leonard, how's everybody doing here?" And he answered, "We're doing great."
"Are you sure?" I said.
"Yes," Leonard said. "We're fine."
"Well, I hear what you're saying," I replied, "but-you know you're in a prison."
"Yeah, we know that."
"You know if you try to get outside this place and you get about three steps they're going to bust your head open with that bat over there?"
"Oh yes."
"You know that you'll be locked up here again and again and again because the rate of return to this place is 97%, so what you're looking at is a lifetime of being locked up here in this place, stuffed in a six by eight detention cell if you open your mouth, slugged in the head if you try to walk out of here, unable to make a move without fear of state reprisal. . .What the hell do you mean by telling me that everything's going fine? This ain't 'fine!'"
Well, in the next eight weeks we organized a workers and residents job action. We went to Albany; we went downtown to Broadway; we got the press in. We tried every kind of action to expose what the hell was happening at that place because it was a prison and a corruption pretending to be a rehabilitation center. It was a complete lie! And we failed-methadone and the whole addiction phenomenon were on their way in. The medicalization of the social problems of America had started.1 Goodbye to the old 19th century understanding of addiction as some kind of moral turpitude. No longer would it be the case that addicted people were evil people; this was going to be progress special for the 20th century! We were now going to introduce a medical model to cover over the realities of social problems.
Methadone was on its way in. Addictions were on their way in. You see, the real meaning of the story of Leonard, this very dear brother, was how rapidly everybody on that floor had become so-called "addicted" to what they were supposed to do in the therapy game. That game got picked up and learned as quickly as any other game. It wasn't addiction! It was just what people learn to do when they're in situations where they have to make certain kinds of moves in order to respond "appropriately" to the particular social oppression of a given reality!
The United States of Addiction
The addiction business is not a small business! I'm not making this up! Take a look at this stack of books I've brought here! This author, this scientist with a real Ph.D., he said it, not me. I could show you all these quotes, from all these doctor types and many of them say the same thing: this is a multi-billion dollar business! This is an addictions industry! It's well-documented. I was shocked when I found out how many folks-learned folks, experts in the field-know that there is no such thing as addiction.2 I thought I was some kind of weirdo! But it turns out that everyone knows this is a hoax, a lie. What's shocking to me is that despite the fact that folks know it's a phony sham; we don't get to hear about that out in the communities. It's a very well kept secret in America today-it's a very well kept secret that there is no such thing as addiction.
Somewhere around the tenth day of my journey into the addiction literature, I came upon a New York Times bestseller, a book that takes it all the way: "When Society Becomes an Addict."3 The thesis? Everyone is addicted to something! You're addicted to drugs, to love-there are even people who are said to be addicted to people who are addicted to something. In all the books I went through, I never found a single book that talked about people being addicted to money. But everything else is covered! They got 40 million of this particular type of addict, 30 million of these, 70 of those, 90 of this other type adding up to a figure that's three times the population of the country!
Here's an interesting item from one of the journals I read, Journal of Substance Abuse Treatment. A man named Howard Shaffer did a test called "Frequency of Disease Ratings for the Complete 80 Item List."4 He wanted to find out what things this sampling of people thought were diseases and what were addictions. The list included all kinds of bizarre things. For example, it included not only asthma, measles and muscular dystrophy, but also jogging, cubism, Taoism, metabolism-all kinds of things. Cubism got 4.2%! Yes, that's right, 4.2% of the people thought that cubism is a disease. (I think I might have been one of them actually, but that's another issue!) Muscular dystrophy won, with 94.8% of the sampling.
Here's an interesting one: 35.4% of the people took racism to be a disease. I think it's interesting because it shows how effective the medicalization of America has been. If this test has any validity at all, what it suggests is that one out of every three Americans no longer identifies racism as a fundamental social problem, but regards it as a disease, on a par with pneumonia or heart disease. What a convenient rationale for not implementing the programs necessary to do something about the social corruption that is racism!
Here's another one: 22% think that lesbianism is a disease! Homosexuality: 33.3% of the people think it's a disease. The history of the last 20 years shows quite vividly that those political, social and community leaders who have no intention of facing the hard realities of the crisis of America have been eager to find an ideological solution to what is a hard material human problem.
Someone whom I very much respect, a radical theorist named Sylvere Lotringer, said many years ago: "One does not cure neurosis Ewe could substitute addiction, or illiteracy, or poverty]; one changes a society which cannot do without it."5 On all too many occasions over the past 20 years I've been asked to speak about education in America, and I invariably begin those talks by saying something that people are initially shocked by. I point out that from the point of view of those who are responsible for it; the educational system is working just fine. In fact, it's a total success. They could not live with a more successful system! They could not turn out bright young students prepared to go on to college or to enter the labor force when there are no educational programs out there to further train them, no jobs to sustain them.
Illiteracy in America grows by leaps and bounds every day, yet there are societies in the world-indeed some very poor societies-which have cured illiteracy virtually overnight. Why can't this country cure illiteracy, or poverty, or addictions, or mental illness? The answer is that, in terms of those who have primary social control-those real people who run this society-there is no particular reason to do so!
Here's a news item about William Bennett, the drug czar, one of the real people who runs this country, about his appearance at a news conference in Orlando. The reporter said, "You talk about a stronger country, Mr. Bennett But our inner city schools, hospitals, clinics, churches are more in decline than ever before. What can we do to solve the problems of these communities?" And America's drug czar-reactionary to the core-replied, "If these institutions are failing we should take the children away, out of the community, from their families, and put them in special programs." So he pretends to be a humanist looking out for the kids who are being abused. But what about the families, the communities that are being abused? This is America's drug czar! This is America's social policy expert!
The failure of the American school system, the failure of the drug programs, the failure of the community health programs, these are not natural catastrophes. A lot of us in New York remember when they decided to remove all the people from the mental institutions and put them in the communities. That decision was the explicit creation of what is now known as "the problem of homelessness." Were there not homeless people before? Yes there were. But it never was state policy before. It was a problem before. When the people in charge closed down those institutions and brought those people into the communities but refused to fund community support programs in any serious way, homelessness was created as a social policy in New York City. And now people are making big bucks and giving big talks-some of the same people who created the mess in the first place-by saying we have to address this problem of homelessness. It's a fraud and a sham, a lie. And the worst of it is that people are suffering and dying from it. Some people like Bennett and his Democratic Party friends are saying it's a "disease" and "epidemic," a "crisis." No! You're the disease! You're an epidemic!
As I was walking up here thinking about how defensive I was going to be about this talk, I began to think about the 60s, and about people like Thomas Szasz who back in the 60s were saying things like, "There really is no such thing as mental illness."6 Szasz would argue that those terms were invented, by and large, because the insurance companies demanded them. He said that there are no scientific criteria for identifying schizophrenia or depression or lots of other diseases.
That humanistic tradition lost, for all kinds of reasons. I was part of that tradition. I didn't agree with Szasz completely; we had some debates in which I said, "Listen. I think your argument is fault. What you're saying has great merit, but the truth of the matter is that there are people who are mentally ill and it is problematic to deny that." I remember having one debate where Szasz argued that the criteria we have for identifying someone who is mentally ill could apply to virtually any person and so therefore it must be that there is no distinguishing characteristic of the mentally ill. I said to him, "Thomas, there's a little problem with that reasoning, since if everybody had cancer and therefore we couldn't distinguish between those who didn't and those who did, it wouldn't follow that nobody had cancer."
I had some problems with Szasz, but in general we walked on the same road that a lot of people walked on in those days. What we said was that there had to be a political, therapeutic, community-oriented solution to the problems that face the people of this country. We stood up tall and pointed out what everyone knows is true-that the single most effective drug rehabilitation program in the history of the United States of America was carried out almost overnight by the Black Panther Party. The Panthers and the Young Lords had a higher rate of "cure" for people who were using drugs than anybody in the entire world. Do you appreciate, when you think of the multi-billion dollar rehabilitation industry, what the figures are in terms of the number of actual people cured? Do you know that today they claim a cure rate of 6-8%? And they lie all the time-those are inflated figures. People are not being cured! Alcoholics Anonymous has become a major force in American social-political life and by its own admission it does not cure many people! It has influenced masses of people; indeed 12 step programs are one of the latest addictions.7
Myths as Social Control
I'm not saying, by the way, that people have not been helped by those programs. And I'm not saying that drugs and alcohol aren't potentially very, very harmful and destructive. No, those are real problems, disastrous problems. And we can't afford these phony, mythic explanations! The history of science, one of the fields that I have studied, is filled with the creation of mythic explanations which function as social coercion, as a way of avoiding looking at the actual social causes of human problems. And it's particularly true of societies in advanced states of decay. As Greek civilization was going under, they started increasing the activities of the Greek gods. The Greek gods during the heyday of Greece used to sit around doing pretty much nothing. They just hung out-everything was cool. But as Greece started declining, the gods got busier. If something happened down here, somebody would say, "Whoops! I think that's a big fight between Jupiter and Juno over there on the mountain." They had to account for these things going on down here.
So there's a long history of people in power creating myths to socially coerce. The other day Lenora Fulani was talking about the exciting developments going on in Zaire in central Africa. Mr. Mobutu Sese Seko, the US-installed dictator there, may be on his way out. For years and years Mobutu has accused outsiders of giving him a hard time, of "not understanding the African tradition." He'd say, "You don't appreciate that it's very different from the western tradition; our people love to be oppressed!" Addiction? Though there is no such thing as addiction, it is a very good topic to be talking about.
I know there are some people out there who are saying this is all very interesting politically speaking, but what's the scientific evidence for all this? Simply this: there is no systematic, hard evidence in any research studies anywhere in the world that there is such a thing as physio-chemical addiction.8 In fact there is no hard evidence indicating anything other than the fact that social environment is consistently a key if not the key factor in whether or not people can or can't change their habits relative to the so-called opium drugs, or anything else for that matter. That's the hard scientific evidence.
Again and again it has been established that the two dominant characteristics, the classical characteristics of addiction, particularly drug addiction, are: (1) having some kind of powerful reaction when you stop, typically identified as withdrawal; and (2) needing to take more of it in order to get the same reactions. There is evidence everywhere that many people, not just handfuls but high percentages, kick hardcore drugs by simply stopping.9 Zero withdrawal. Every major article, including the ones written by people who take the opposite position, admits that statistical studies accounting for how people actually kick drugs show that the single most frequent way is people saying, "I just stopped." There's a higher percentage of success among people who stopped because they decided to stop than any other single approach in the entire world.
This notion that addictions is a success industry is a myth; it is a money making industry! It is a failure industry! AA is not a success program, except insofar as it is major business and has major political influence. The National Council on Alcoholism, the major cover association for folks giving help and advice to alcoholics, had the American liquor industry as one of its primary sources of support until 1982.10 The liquor industry has no problem supporting AA. AA says alcoholism is a disease and that only a relative handful of people have it.
Bucks and Boondoggles: The Addiction Industry
It ends up that I share a position with Nancy Reagan. She says, "Just Say No." What does that mean, "Just Say No"? I mean, if you can just say, "No," it can't be a hell of an addiction, can it? The addictions mythology is filled with these kinds of contradictions. This whole thing is a colossal boondoggle. It was made up! I was there-in the prison known as the Queensboro Rehabilitation Center when they decided to make the move, when they decided that it was necessary and profitable and possible to introduce into this country a major social control industry, because the times they were a changing, rather profoundly.
They talk rather glibly down in Washington and at major universities like Columbia about how this is a society with a chronically poor population. What is that supposed to mean-chronically poor? I think if it means anything it means a poor population about which nothing can be done-and that came about by virtue of this country's leadership. And now they've introduced all kinds of terminology and models and paradigms to justify their doing nothing about it. You see, the meaning of calling poverty or homelessness an addiction-the meaning of addiction-is that nothing can be done about it. That's what they say. It is a reactionary and reactive model which many know to be a fraud but which is presented to the American public with a credibility that justifies billions and billions of tax dollars for programs which are utter failures, and endless amounts of money being made and being laundered, which justifies Ronald Reagan and George Bush.
So no, I'm afraid that Ann Wilson Schaaf, who says that society is addicted, is wrong. I think she's saying society is addicted so we will either accept the fact that there is no cure, or foolishly think that there is a way to cure it using, as it were, a medical point of view. Society is not addicted; society is vulgar, racist; it is oppressive and destructive. It is inhuman, it is uncaring; it generates policies that mis-educate; it generates policies that fail to respond to human needs. It does all of those things, but it's not addicted.
So I decided tonight I would raise again at this very critical moment this lost fight of the 60s and early 70s. Dr. Lenora Fulani, Rafael Mendez, Reverend Al Sharpton, young people all over the country, are beginning to raise some very old issues in some very new ways-issues which those of us who were there remember from the 60s but are not the same as the 60s, because different people are raising them, at a different stage of our history, in different ways, making different statements. There is a wisdom to those who are now rising up, to our Black and Latino youth rising up and saying, in all honesty, and with firm commitment, "No Justice, No Peace." That's the slogan, it means something-No Justice, No Peace. No Addiction. We won't buy it. Can't fool us no more. Can't feed us this kind of stuff and expect that we'll believe it. We won't enter into trivial kinds of little debates. What we're saying is the killing must stop. The drugs must stop. And we won't stop the drugs by a nonsensical explanation that it's all about addiction, because we know what it's all about! We know who puts those drugs into our communities! We know who profits from it! We know where it comes from, that there are people throughout the world making billions every day and laundering it through major banks in this country! There was a report that came out just a few days ago about the major banks in this city and the role they're playing in laundering drug money. That's why there is no book about the addiction to money, because if they had a book about the addiction to money it'd point the fingers in the right places!
Our children aren't addicted, our children aren't bad, our children aren't evil; our children are being murdered. And our children are teaching us something that we have to learn. Those of us who attempted proudly to introduce some of these things back then and who failed must learn from those who are now leading the way and saying in a militant language that cuts through all of this nonsense-No Justice, No Peace! No more of those empty words, no more of that sham science. No, we won't take addiction as your nonsensical accounting for your deadly behavior. No, it's not that I'm addicted to being poor. It's that you're a filthy rich monster!
I'm very glad to have stayed around long enough to see these fights being restructured and being redeveloped, coming out of our working class communities, our African American, our Puerto Rican, our Chicano, our Asian American, our Native American communities. Our communities are beginning to raise this issue up, and all over the world I think people are raising up issues about myths-from Eastern Europe and Tiananmen Square, to Central America, southeast Asia and Africa-people are saying we cannot afford these myths any longer! We are being murdered!
It will be good to stamp out addiction. I raise for you that political call. We must stamp out addiction because it is a fiction that is killing us. We must stamp out all of those mysteries, those myths, those rationalizations that have traditionally been used to destroy us. So, with appropriate defensiveness I hope you will not think ill of me for spending all this time and inviting you all here to hear me talk about something which doesn't exist. Thank you very much.
The Discussion
Question: I totally agree that there is no physiological basis for addiction, being in the drug-care field myself, and being around people who are on methadone and seeing how they deal with that. But what about the psychological addiction to drugs and alcohol?
Newman: Well, I don't believe there is any. Indeed, I'm very suspicious of the whole concept of psychological addiction. I'm a therapist, as you know, and I don't for a moment deny that people have emotional problems, that they have all kinds of issues they need to deal with. And I think it is appropriate and proper to have the best possible ways of supporting and helping people to deal with them. But I don't know what's supposed to be meant by a psychological addiction. The whole medical model of the 20th century grows out of the 19th century model which was the conception I said before-moral turpitude. The way you accounted for people's bad behavior was that it was in some way immoral.
I'm saying that the concept of addiction includes or is in fact the 20th century version of that same thing. I think it's a moral category; I don't think it's a psychological or physiological category. I don't think it adds anything scientifically. Without that moral platitude one can account for human behavior in terms of the circumstances and conditions that human beings have to deal with. Addiction is not only scientifically unsound, I think it's politically dangerous as hell. It leads to 33% of the American public taking homosexuality to be a disease. It's most critical that we as a people-and this is a political issue as well as a social, cultural and scientific issue-learn how to call things by their correct names and not employ the categories that are by and large handed to us.
Like many of you, I saw the addiction industry grow. It was startling. It became a major industry in only 20 years. And I think we do great harm by imposing this conception of addiction. It's the 20th century version of what used to be called the theory of dormative power. Back in the 17th century the official explanation for why wine made you sleepy was that it had dormative powers. And if you asked what that meant, they told you dormative power is the power of things to make you sleepy. People thought they had made a serious advance by understanding that wine had dormative power. But not only isn't that an advance, it's an illusion of an explanation when you don't have one and that's profoundly dangerous from a social point of view.
Question: I had another question. I heard of a study where rats would repeatedly choose cocaine to the point of death, choose it over food. Is that a bogus study?
Newman: No, not at all. For example, if you invoke the pleasure principle, which is a not unreasonable one, it might lead you to say that rats-these particular rats at least-preferred cocaine from a pleasure point of view to food. Now I don't know what food they were being fed, but I don't find that the least hit shocking. I think probably the cocaine was a whole lot better than the food that they were giving to those rats. In discussions with young people in our communities, as well as when I worked at Queensboro, people would tell me that they use crack or heroin because it's something that they find preferable to any other alternative they have in their lives! We have to face that reality! I'm not endorsing that; I think it's terrible, but I don't think that they're terrible. I think it's terrible to be in a society where the use of heroin is the most preferable thing to be doing for a certain portion of our people-middle class and working class, Black and white. I think that says a great deal about our culture!
But I don't think we can get around that by saying that these people have a certain addiction, or that they have bad taste. They don't have bad taste; they have the taste that is developed by what is in fact available in a profoundly deprived culture! You can't say to people for whom there are no jobs that they're addicted. They're not working and that's enough to drive people crazy and it does drive people crazy! You can't say to people who are getting foul, terrible education that they're addicted to dropping out. They're not addicted to dropping out, they're having perfectly comprehensible responses to the social conditions that they face.
Now I know a lot of people are saying this is the old liberal story again-it's not the old liberal story again-because it's being said in the face of 20 years of social regression. Poverty has risen 300% in this country. We're talking about a country which, far from realizing the Great Society, is now going down the Great Tube. It's no longer 1968 liberalism. We're talking about the need for profound and necessary changes because we are facing a cataclysmic social reality. And we've seen these industries growing as a function of that social system deteriorating. We didn't have an addiction myth prevalent in society when it was doing well; they had other myths for when society was doing well.
Question: I have to tell you I'm confused. Now that you say that there's no such thing as addiction, what do you think will happen to me and so many people who believe they are addicts?
Newman: "What do you think?" is the far more important question. What I think is what I've articulated and what I'm doing; trying to build such psychological, political, and cultural institutions where people don't start out from the premise that they're victimized addicts. Fundamental to social therapy is the insistence that people cannot get help and grow and develop in psychological ways if they begin from the premise that they are victimized addicts. This is not to say that people don't have things wrong with them, but it's very different to have things wrong with you for lawful reasons than to have the identity of a sick person, of a victimized person. We can't allow ourselves to be organized around our powerlessness and then attempt to do something about what's going on in our lives. I'm not saying that one can simply do that in one's head. But if people in their heads see themselves as powerless they're not going to do a lot out of their heads; they're going to stay in their heads and be permanently victimized. We've seen this happen in this country where welfare is designed to organize people into a passive and impotent position. That's not an argument against welfare; indeed I have fought for many years for tremendous increases in welfare when people don't have work because it's an obligation of our society. But a big part of what it means to put people on welfare is to regulate them; poor people on welfare are continually socially coerced.
Question: So basically it's what do you think of yourself, not taking on the role of a victim.
Newman: Right. And asking the very hard question, not only what do you think of yourself, but who got you to think that way? Where did you get that from?
Question: When that woman referenced the experiment where the rats would eat cocaine in preference to anything else, actually just about all of these animal addiction experiments are phony in the sense of their relevance. What they do is stick an animal into a very tight cage, and they stick an IV line into them. They have a tough time getting the animal to start pressing the button. The animal will usually resist quite a bit. And essentially if their choice is between food pellets and pushing the button for cocaine they will choose cocaine, under those restrictive conditions. There was a very different series of experiments done under fairly realistic conditions where the rats were given room to run around, were allowed to be with other rats, didn't have an IV line stuck to them but could just sample the material. Under those conditions they weren't addicted; as they were given fewer and fewer choices, they became so-called addicted.
Newman: I'm glad you added that. It's always important to think not only in terms of rats and other experimental animals, but that under appropriate conditions, human beings in eight weeks' time can be taught to murder women and children in foreign countries. It's important to realize that if you make the conditions coercive enough, you can get not only rats but people as well to do things that they would never think of doing under other conditions.
Question: I'm a gay man. Before going into social therapy I was involved in a 12-step group called Sexual Compulsives Anonymous. And I got some things from that group, but anything more than zero would have been something-I didn't have much before then. This group is, curiously enough, predominantly gay men at this point. I would like to know what you think of this. I think it's pretty obvious why this group is becoming more and more successful, given that it's predominantly gay men who have AIDS at this time.
Newman: Again, the addiction business is going terribly, terribly well; we have to face that fact. Groups are abounding. AA has the highest induction rate they ever had, something like a thousand new people a day. Why is it happening?-for a host of reasons. Clearly, millions upon millions of people, all kinds of people, are searching for answers. What makes this addiction sham, this industry, so pernicious, in my opinion, is the fact that it's done in the face of the desperation of our people. Our people are desperate for answers, and these programs are what's given as answers. These programs work to the extent they work not because they cure a whole lot but because of the vacuum in this society of anything resembling developmental or positive answers. There is no country in the world-western democracy or otherwise-that so completely lacks a social policy on health as does the United States of America. The general policy of this country is that it has no particular obligation to its people in this regard, that the Constitution does not give people the right to be healthy. Thirty to fifty million Americans have no health program available to them! Poor people are dying throughout our country because they literally have no hospitals which they can go to.
This country is so profoundly insensitive to the demands of its people that it creates the climate in which people go to quacks. You want to talk about the real quack industries of this country, talk about the ones that have made it! Look at some of the programs that are available for people with AIDS. Disaster programs! Now, there are truly dedicated people out there doing some humane things, but a lot of people are out there doing sham science like so-called addictions. Those kinds of programs are a national disgrace, but it's America's boom industry.
Question: Hi. I'm a drinker and a druggie. When you said I wasn't an addict, I said, boy, then I'm not powerless, maybe I should go out and smoke a joint and have a drink as soon as this meeting is over! Yet over and over again in these programs I'm told I'm powerless and I can't do that. And I think I need to have that reinforced, because I usually get myself into a hell of a lot of trouble when I drink and do drugs. Yes, I agree that NA and AA are very individualistic in that they're not talking about society, what to do to change it to a place where people don't get addicted. However, they are places where people can come together and share a common experience and perhaps keep each other from getting into trouble.
Newman: Why is it that the options in the world are using or not using? That's the mind set of the addict. I agree with you completely-it's very positive for people to come together and share their life experiences. But how come the people you choose to share life experiences with are not a group of people who have varied life experiences? What about getting support from groups of that kind? My experience is that the success rate in helping people to deal with these kinds of problems is vastly greater when the group of people who support each other do not support the addict identity but support your identity as a human being, as a Black person, a Latino person, as a member of your community, your society. And I believe that the psychologists who will not allow so-called addicts into their groups are doing a criminal thing. I have worked with groups where some of the people would normally be identified as addicts. Not only do they get a great deal of help, but equally important, they give a great deal of help. They can support others with their social problems, their emotional problems. That kind of dynamic is fundamental for the kind of support you've talked about. I don't think it is a successful model to have addicts and addicts alone coming together.
Question: First of all, I agree with you about addictions being big business. I look at that as exploitation of the persons who are victimized by addiction. I would like to add this point, however; no recovery program claims to cure everybody. But I would like to know what you consider obsessive-compulsive behavior if not addiction.
Newman: I think it's part of the sham that no recovery program claims to cure everybody. Indeed, I think it's not only true of groups like Narcotics Anonymous but of psychology in general which says, "We'll charge you lots of money but don't think that we cure anybody." I think the challenge has to be met: people have every right to demand significant change, if not cure. The only reason I agree that nobody cures anybody is that I don't think anybody is sick in the way that they're suggesting. But I don't think it meets the challenge to say that we're not going to try to change some things, some rather important things.
Obsessive behavior? Compulsive behavior? I think those categories are equally as frivolous as addiction. Where did these psychological categories come from? We look at categories of retardation, categories which abuse and identify children, particularly from many of our poor and working class communities, as belonging on certain tracks. We look at people who identify certain behavior as requiring the use of certain drugs. But there is no hard evidence that these kinds of labeling play any significant effective role in the positive development of those people, and a lot of hard evidence to the contrary. I think you can justifiably introduce labels if they're part of a process which helps somebody. But I think if you look, for example, at the educational or mental health systems what you see is a massive taxonomy, endless labeling, and then the admission that really all they can do is label and perhaps employ some drugs that have been modestly effective at changing some of the behavioral characteristics identified with the pathology.
In all of the materials that I looked at, the piece that I found most valuable was a piece called "Taxonomy and Politics" by Stephen J. Gould, which appeared in the winter 1990 issue of Dissent. Gould notes that the labeling that is done in all of these areas is not neutral; it's political through and through. They are political labels. They are designed to keep people in certain places, to track people in certain directions, and I think we have to be extremely wary of them, whether they're fancy labels with long traditions or brand new ones like "addiction." So obsessive behavior and compulsive behavior are, by and large, unscientific, not sound, and politically and socially coercive identities.
Question: Let me press this a bit. A person has been a 15-year heroin addict, shot mainline heroin for 15 years. You tell that person in that gallery or on that corner where he's getting his next hit that he doesn't have a problem.
Newman: I didn't say he doesn't have a problem! No, he's got a big problem!
Question: But it's just emotional.
Newman: No, he's got a huge problem!
Question: Is it physical?
Newman: Yes, he has a physical problem, he has a social problem, he has a chemical problem, he could be dying, but all I'm saying is: what do you think we've added by saying he's addicted? That's the question. What have we added by saying he's addicted? Except to really be saying that not only does he have all those problems, but he's a bad human being as well? That's what's added by saying he's addicted.
Question: But I still don't understand what's being offered, in terms of the person who has a physical dependency on a substance that they do day in and day out, by denying that the person has an addiction or an obsession-compulsion to use this substance even against their will and to the point of destroying themselves. To say that it's something emotional or political-sure there's politics in this shit-but this person is in the grips of something more powerful than themselves.
Newman: Absolutely! They're in the grip of something more powerful than themselves, and it's not addiction. It's the social conditions under which they are living; it's their disempowerment as human beings, and until that's transformed there's going to be no significant change in the rate of addiction in our communities. Yes, people have terrible problems-I'm not denying that! The addiction myth is the cover-u p of the fact that they have those problems!
Question: Like I said, I agree with you that the person needs to see the big picture, and that's why I'm here. At the same time, even you say that we should use whatever helps. Sure, it's big business. If people have to stand on their heads to stay clean, to stay free, that helps. So to knock anything that helps people stay clean and saves lives I think is a discredit to what people are doing.
Newman: Oh, I agree with you completely! We have to do something that helps. Should we not try to find the best things that help rather than accepting the position that anything that helps even a little is OK? Should we not seek out ways of helping that are in advance of these 7% success rates? I'm saying that we and others have discovered ways that are more successful-with illiteracy, with mental health, with drugs-and those programs are not the programs that are funded, and the reason is that they don't fit into the social control model of those other programs. We have to have helping programs that are the best programs for the people in our communities!
Question: I'm sorry, but I'm really suspect of anybody who's never been an addict or an alcoholic telling addicts or alcoholics what the problem is or what the solution is.
Newman: Every dollar of every single funded program in the United States of America, every one of the billions of dollars going into the existing programs is controlled by boards of directors, none of whom has ever had the experience that you're describing. Every single dollar! So if you're saying that you and others in this room should sit on a board, I say Right on!
Question: I still say I have gotten a tremendous amount from these programs and wouldn't be alive otherwise!
Newman: Right. And I'm sure you would agree that we have to address the 94% of the people who haven't had that experience. Because what you said right at the beginning is quite correct-you know that it's a big business. Well, if it's a big business we have to do something about how come it's a big business as opposed to a helping activity. That's what we have to do something about. You can't say it's a big business on the one hand, and on the other hand say, "But it works." Yeah, big business works, but it doesn't work for what we as a mass of people need and that's what we have to turn around.
Question: Dr. Newman, in the past 30 years I've seen the federal government on Indian reservations and state governments in prisons giving out Lithium to children, Valium and Dilantin to adults. That's a big thing. Fifteen years ago the government said they were going to stop distributing Valium in prisons when the stockpile went down. But when the stockpile went down people forgot about that promise-they replenished that pile. How do we fight something that big? I mean, that's real oppressive. Groups have come together to fight it, but they're not strong enough.
Newman: I think the issue is that we have not in fact come together. I think we've fooled ourselves into thinking we've come together. You know who comes together in this country to effect social change?-The Democratic Party. They build massive institutions with billions of dollars-that's a coming together; same thing with the Republican Party. What we've done is to come together to make our statement about this or that issue, but when it comes time to bring it all together to make a set of political demands regarding fundamental changes in social policy-that hasn't happened. We demand, for example, that a home is a right, and if it doesn't exist in the United States Constitution well then you better damn well put it there. We demand that health is a human right. But you can't demand that kind of social policy unless you build the kind of political organization which has the power to do it.
So we fool ourselves a lot. I go down to the marches too, and we say, "Hey, there are a million people down in Washington and that was really something." But then we need to raise the question of who does what with those million people. And there are political organizations that don't give a damn about our people, which make use of those million people, and we don't get the benefit of it. If we can't build a political party that gives expression to these demands then we are just wasting our breath. Until we do that we can talk a good game but it's going to mean nothing. How many limes does Governor Cuomo have to kick us in the teeth before we don't vote for him? How many meetings of Puerto Rican people will he not show up to, how many times will he insult the African American people before we say he's a bum who does nothing for us? They don't care about protest as long as you keep putting them back into power. They love protests-all it establishes is that we have a "free America." So there's going to have to be some changes at the level of political power.
Question: I've been to AA and I think it can become an addiction too. I went to meetings and people would get up and say, "I've been sober for two years now, and I'm miserable, and I wish I was dead, but hey, at least I'm sober!" I think you've got to have something better than that and this stuff ain't enough; survival ain't enough!
Newman: The point I think is not to condemn these programs. Yes, all kinds of things can help people. 12-step programs, even psychiatry occasionally helps people. The serious question is whether that's what we're willing to settle for! Why are we settling for something that is failing? The psychiatrist R.D. Laing, back in the 60s, said that psychiatry is sometimes good only because it doesn't practice what it preaches. If it did what it said it was doing it would hurt people all the time, but it periodically doesn't do that so it can help a few folks. If you look at AA and these other programs, the positive thing about them is not what they preach but that they provide a context in which human beings can at least share some of their pain. That social process is of value. But if we accept that that is all, we are feeding into the myth of addiction. The addiction myth says that the best addicts can have is an AA meeting. You can come down here year after year and confess that you've been off booze. Well, that's not the best that our young people should have. It's the same for our educational system. They say this is the best we can have for these dumb kids who don't care about learning and are addicted to stupidity and illiteracy. That's their argument! Can we tolerate that?
Question: I feel very empowered when you say there is no such thing as addiction. Could you say more about social therapy in terms of building environments that can help people?
Newman: Part of what's so pernicious about the myth of addiction is that the very people who do all the building are not identified in this culture as the people who did the building. I think it's very tough to live in a society where the folks who built the cars in Detroit have to go out and buy one in the store. What it means to build is simply to create the environment in which you can be self-conscious about the fact that what happens in groups, families, countries, is done by the people who build. This room that we're sitting in didn't come here by some act of grace of the Board of Trustees of Columbia University-it was built. And the problematic of a lot of these addictions programs is that they don't relate to people as people who can build and create and change what they need to. And until we do that people will not be empowered, they will simply be addicts. They will be addicted to a society where you let yourself believe that it was done for you. So it's not like we have to get special uniforms to be builders. We are builders! What we have to do is take off the special uniforms that tell us that we're addicts. We're wearing addicts' clothes, victims' clothes. We have to take them off; it's an undressing, not a dressing.
Question: Dr. Newman, I want to thank you and Dr. Lenora Fulani for the work that you're doing. I started using heroin in 1965 and methadone until 1983. I came off drugs through social therapy. I learned that coming off drugs wasn't the issue, but what to do after you got off drugs, because there was only drugs to go back to. There wasn't anything else to do. So I want to thank you for your work.
Question: I belong to a group of recovering addicts, which is an alumni association of a detox program in Philadelphia. I agree with that gentleman who asked, "After you're off drugs then what?" We have taken on the commitment to start a program to create an environment to develop and support the practice of leadership skills. After hearing you talk about this multi-billion dollar addiction business, I'm scared. How are we going to survive? We're not federally funded; we're simply doing something we feel the need for.
Newman: The hard answer is to go directly to the community. Win that community over to support what you're doing, because what you're doing is not coming from those multi-billionaires up there, but from the people of the community to do something for the people of the community. We have to go to our people and say, "We want to show you why this must be supported by you." Communities will support these programs if we're ready to go out and do the hard work of making the demand and organizing them to do so.
Question: I'm a single parent with two children. My one son who is 24 is not to my knowledge addicted to any drugs but he has really dropped out of society. Now, in the 60s I was an activist; I wore the turbans and I went to meetings. I was aware of how society was towards me as a Black woman. My son feels the same way, but he and about 20 kids in the neighborhood have sort of just escaped; they sit around all day and listen to rap music. He tells me that society is "beating me up and knocking me down." So how can you get these young men to come back to have the confidence in themselves and the self esteem to want to be back in society?
Newman: What you're saying is so important. The only thing that really moves people out of that kind of totally understandable cynicism we know what our young people are facing is to build something successful. I almost don't care what it is, even something little the community needs. What creates so much cynicism in our culture is that there has been massive failure. We live in a country where half the people don't vote at the federal level. The reason, apparently, is that people don't think that their participating could possibly make a difference. I don't think it's "apathy," which like "addiction" is a nonsense term. People don't do it because they don't think it makes a difference. So we have to begin to do something that makes a difference, some kind of empowerment activity-or else people will stay exactly where your son is. When I speak with people, when Dr. Fulani speaks to students on campuses or to young people in the communities, what's being said is that you've got to begin empowering yourself working with other people. I don't care what form that might take.
The social workers, psychiatrists and psychologists at the East Side Institute, whom I'm proud to be associated with, go out and ring doorbells every single day of the week and ask for support because we are building a therapy center which is independent of the big bucks so we can do the kinds of things that people actually need.
That activity is a component of building something which is different from those big buck-funded programs. And that has to be done at every single level; people must begin the work of building.
Question: I'm going to school to become a drug and alcoholism counselor. What can you tell me about these programs, since there's no such thing as addiction?
Newman: I don't think that everybody working for a drug rehab program should quit, for several reasons. One, because people need the money, and two, because people can make a difference as human being relating to human being, not because what you are doing is carrying out the mandate of some phony-baloney program with a lot of phony-baloney language. I think I made a difference at Queensboro and I think you're going to make a difference where you're going to work-because of who we are, as human beings. So because of this these programs do make a difference, though they are set up to provide far less help than what is needed. But that doesn't mean folks shouldn't make use of them if that's all we've got for the time being. I worked with welfare recipients for 20 years; you don't say to welfare recipients, "Since they're messing with you and harassing you, don't go down to pick up your welfare check." People would look at you like you're a damn fool! You pick up the check and you find out what you have to do about the fact that they're messing with you! That's what has to happen!
Question: This is wonderful! I find this whole presentation very liberating. I grew up with two thirds of the adults I knew in my life addicted to drugs or alcohol. From a very early age I've had a response to this category called "addiction," because once people are called addicted they are no longer related to as a human being, or useful. You can hardly even relate to them in any way-you kind of have to get them out of your life. It was also a way to protect yourself because there was a lot of brutality and violence and craziness that came with drug and alcohol use. So I didn't know how to balance those concerns, because in some ways I felt safe with that category.
Newman: Oh yes, it's a very safe category. Saying that two out of three people are addicted is an easier category than coming to terms with the fact that two out of three people have no jobs, aren't in a position to get the education that they need. Those are the real, hard facts, and it's hard to face the fact that this is the reality of the lives of so many of our people. But if we settle for summing all that up as "addiction," well, it's all written off, taken care of. "Oh, I got this all explained. This isn't because people are being related to in the most racist and brutal ways; this isn't because people are being put down and oppressed and stepped on and not given the programs that they need, are being murdered by the cops and so on. No, it's because they're addicted!" And that's a safe thing to say! We've got to hear it-there's a seductiveness to that! In fact, if I would ever want to use the word "addictive," that's addictive. It's addictive to buy into that kind of myth. And we all internalize that, including the people in the community who are so labeled; people explain themselves and how they're living by saying, "Well, I have an addictive personality." What the hell is an addictive personality?! You think that category isn't political? You think this 12-step book put out by AA isn't political?
Question: I was sitting up in the balcony listening to you talk and I was feeling threatened because I do follow the 12-step program. So there were a lot of conflicts going through me, because I saw a lot of things you said were true, once I really opened my mind and looked at the reality of things. Addiction is a big business, people make a lot of money at it, including our corrupted political leaders. When this brother spoke earlier and questioned what you were saying, challenged it and defended these programs, what I saw was another person going through what I was going through up there. And it scared me to see him go through it, but I understood. I had a question, but it's already been answered by you, in terms of how to build and go through the process of making people aware of what's going on.
At first when you were talking, I felt scared because I thought my program would have to go out the window, when in essence it's not really like that. I'm part of just a small percentage of the people who are getting help, but at the other end of that are a lot of people who are being condemned, being told, "You're an addict, you'll never get nowhere, you'll never be anything." So I understand where you're coming from.
Newman: Right. And they're using you to put those other people down.
Question: So I understand the need for me to go out into the community and educate around these issues.
Newman: Exactly. And when that statement is made-as you so eloquently made it just now-that's going to scare the hell out of those billionaires. When you say, "We're not doing your programs. We're doing programs that don't depend on your treating me as a victim and as an addict. We're going to deal with this drug stuff and this alcohol stuff, but not by me becoming an addict so you can use me against the other 95% of my people"-when that happens, it's going to scare the hell out of those billionaires with those phony drug programs.
Question: I agree that there is this corrupt multibillion dollar addiction industry, built around a myth, but my only conflict is with the physiological basis for addiction, which is real.
Newman: No, it doesn't exist! People use the word "physiological" and they think thereby it must give some weight or some existence or whatever to what's being talked about. It's kind of like the way people sometimes react to mathematics, or hard science. The scientific evidence doesn't support that claim. Yes, we know that people have chemical reactions. Take some arsenic and you'll have a chemical reaction. The issue is-at the risk of repeating myself-what is added by calling it an addiction? It's that label which is so pernicious.
Question: I work for Emmaus House, which is a treatment program in New York City, and after today I know there's going to be a big fight when I go back to work on Monday-and I'm down for the fight! I'm liberated by what you said, Fred, because I was organized by the addiction mentality and I kept wondering what the hell was wrong with me and why was I feeling so crazy in these places. And it's because I bought that bullshit and I don't buy it no more!
Fred Newman, the founder of social therapy, earned his Ph.D. in Philosophy at Stanford University in 1963. A practicing clinician for over 20 years, he established the New York Institute for Social Therapy and Research in 1978 and the East Side Institute for Short Term Psychotherapy-the national training center for social therapy-in 1983. He is currently a faculty member at the East Side Institute, where he leads a monthly colloquium.
Dr. Newman is the author of numerous hooks and articles on social therapy, including The Practice of Method: An Introduction to the Foundations of Social Therapy, which he coauthored with Lois Holzman in 2978. Several of his articles appear in History is the Cure: A Social Therapy Reader edited by Dr. Holzman and Hugh Polk. He is the author of The Myth of Psychology, a collection of talks he has given over the last several years on a broad range of topics (among them is "The Patient As Revolutionary, "which he delivered in Havana in 1986 to the Congress of Interamerican Society of Psychology .,l; published by Castillo International, it came out in November of 1991. He is the coauthor with Dr. Holzman of Lev Vygotsky: Revolutionary Scientist, to he published by Routledge in 1992. He has lectured extensively throughout the United States and in Europe on social therapy and the relationship between politics and psychology.
FOOTNOTES
1. The medical model of addiction is a recent concept, the development of which runs concurrent with the application of medical models to a wide range of phenomena which had hitherto been understood morally, religiously or supernaturally. Harry C. Levine (The discovery of addiction; changing conceptions of habitual drunkenness in America. Journal of Substance Abuse Treatment, vol. 2, 1985, pp. 41-57), using alcohol as a case study, traces the development of the current disease model as successor to the moral turpitude mode! of the Puritan and Temperance movements. Citing M. Foucault (Madness and civilization: A history of insanity in the age of reason, New York; Vintage, 1975) and D.J. Rothman (The discovery of the asylum: Social order and disorder in the new republic, Boston; Little Brown, 1971) on the subject of the medicalization of insanity, Levine notes that the application of the medical model was part of a trend" . the medical model of madness, first established at the end of the eighteenth and beginning of the nineteenth centuries in Europe and the U.S., was in fact a medical model of deviance in general, a part of the world view of the middle class" (p. 52). Craig MacAndrew (On the notion that certain persons who are given to frequent drunkenness suffer from a disease called alcoholism, in S.C. Plog and R. Edgerton, Changing perspectives in mental illness, New York; Holt Rinehart Winston, 1969, pp. 483-50 1) goes further, stating that the disease model is a social, not a scientific fact. " ... in officially proclaiming that 'alcoholism is a disease' whatever else the proclaimers may be doing, they are not announcing a discovery of fact" and "the success of this latest venture in medical designation is a social-historical attainment, and not a scientific achievement" (pp.495-496). See also S. Peele, The diseasing, of America: How the addiction industry captured our soul, Lexington, Mass.; Lexington Books, 1989.
The appellation "disease," however, did not remove the moral judgments inherent in pre-2Oth century conceptions. Howard J. Shaffer (The epistemology of addictive disease; The Lincoln-Douglas debate. Journal of Substance Abuse Treatment, vol. 4, 1987, pp. 103-113) astutely notes that "the contemporary disease model of addiction can be viewed as the moral model metaphorically labeled" (p. 42). The medical community, speaking out of both sides of its mouth, simultaneously says that the addict has an unfortunate disease over which he or she has no control, while the social perception and reception of addicts is that they are weak, unaesthetic, messy and to he kept away from.
2. Stanton Peele (Redefining addiction. International Journal of Health Sciences, vol. 7, 1977, pp. 103-124; and Love and addiction, New York; Signet, 1975, see esp. pp. 19-48) has compiled a comprehensive review of studies which disprove the alleged causal biochemical link for addiction. The evidence includes well documented cases of the absence of withdrawal symptoms upon cessation of administering opiates; abrupt cessation of opiate use upon change in social environment without any rehabilitation, therapy or painful withdrawal; and transfer of use from one class of drugs, e.g., opiates, to another, e.g., amphetamines. Norman E. Zinberg (Drug, set, and setting, New Haven; Yale University Press, 1984, esp. pp. 19-45) draws on research he and others conducted throughout the 1970s on drug-using populations which, while they may have been using "addictive drugs," did not exhibit the classic signs of addiction. These signs, according to the World Health Organization definition of addiction, include; i) compulsion to obtain and take the drug by any means, ii) tendency to increase the dose, iii) psychological and physical dependence, and iv) detrimental effects to the individual and society (Zinberg, p. 29). The mere existence of substantial populations which are able to use "addictive drugs" in a controlled, non-compulsive fashion itself mitigates against the concept of addiction, at least regarding those particular drugs. The best known single group of controlled drug users is that of medical doctors. Peele (1975, pp. 26-27) also cites studies of mid- die class people and professionals who are controlled heroin users, and notes that current figures estimate that one in every hundred physicians is a controlled drug user. Zinberg argues that the drug (the biochemical entity), set (the psychological profile of the user) and setting (the social setting-the whole dynamic of social expectation and social shaping of the experience of drug taking, the cessation of drug taking and withdrawal) constitute a three-way interaction which determines the particular "look" of a case of drug use. Herbert Fingarette, a professor of philosophy at the University of California at Santa Barbara who has served as a consultant on alcoholism and addiction to the World Health Organization, asserts that while "the disease concept of alcoholism not only has no basis in current science, it has never had a scientific justification," and that "there is a consensus among scientists that no single cause of alcoholism, biological or otherwise, has ever been scientifically established," nevertheless notes that "the disease model of alcoholism is a harmful myth" and "a big business." (Alcoholism; The mythical disease, originally published in The Public Interest, 1988, reprinted in Utne Reader, Nov./Dec. 1988, pp. 64-69). See also J. W. Coleman, The myth of addiction, Journal of Drug Issues, vol. 2, Spring, 1976, pp. 135-141.
3. Shaef, A .W. (1987). When society becomes an addict. New York; Harper and Row.
4. Shaffer, H.J. (1987). The epistemology of addictive disease; The Lincoln-Douglas debate. Journal of Substance Abuse Treatment, vol. 4, p. 106.
5. Lotringer, S. (1977). Libido unbound; The politics of "schizophrenia." Semiotexte, vol. 2, no. 3.
6. Szasz, T.S. (1974). The myth of mental illness: Foundations of a theory of persona! conduct. (revised edition). New York; Harper and Row.
7. See E. Herman, The twelve-step program; Cure or cover? Out/Look: National Lesbian and Gay Quarterly, Summer, 1988; L Collett, Step by step; a skeptic's encounter with the twelve step program. Mother Jones, July/August 1988; both reprinted in Utne Reader, Nov./Dec. 1988, pp. 52-63 and pp. 69-76, respectively.
8. See footnote 2.
9. The most striking example of this was provided in the early 1970s by American veterans of the war in Vietnam who, although they were 'habitual' heroin users while overseas, returned to America and simply gave up their opiate usage with success rates better than the reciprocal of success rates exhibited by formal drug treatment programs, most involving methadone. See S. Peele, A moral view of addiction; How people's values determine whether they become and remain addicts, in S. Peele (ed.), Visions of addiction: Major contemporary perspectives on addiction and alcoholism, Lexington, Mass.; Lexington Books, 1988, pp. 201-233 and 221- 222; N.E. Zinberg, Drug, set, and setting, New Haven; Yale University Press, 1984, pp. 12-14.
10. Fingarette, H. (1988). Alcoholism; The mythical disease, originally published in The Public Interest, reprinted in Utne Reader, Nov/Dec. 1988, pp. 64-69, esp. p. 66.
