Highly effective Teen anti-tobacco campaign gasping for funds

A few years ago, Florida's SWAT clubs (Students Working Against Tobacco) launched what many consider the most effective youth anti-smoking campaign in the nation. SWAT's edgy TV ads, many of them focused against the tobacco industry, were credited with bringing down the rate of teen smoking in Florida. Then state legislators raided the tobacco settlement account that funded SWAT, cut its budget from $70 million to practically nothing, and prohibited the clubs from running ads. From 1995 to 2003, the tobacco industry had given about $1.4 million to officials running for public office, says Common Cause of Florida. Only 10 of Florida's 160 state legislators were not recipients. Officials deny there was a connection. Now tobacco use among young teens is on the rise in the state. Read the full story from the Sarasota FL Herald-Tribune.

AA group wants exemption from smoking ban

OMAHA, Neb. -- Some people struggling with addiction are fighting Omaha's new smoking ban. A group of Alcoholics Anonymous attendees said it has been contacted by authorities and warned that attendees can't smoke during meetings, Omaha television station KETV reported. The group is talking to an attorney, hoping to create an exemption to the law.

The group contacted attorney James Martin Davis. "One of the city councilmen told me keno and smoking go hand in hand. Well, what goes hand in hand is AA meetings and smoking," Davis said, referring to the temporary exemption the city's ordinance allows for keno parlors. Source.

Teen smokers more deeply hooked

Smokers who acquire the habit as teenagers often find it far harder to kick the weed as adults. This is because nicotine alters the developing brain’s hard-wiring, Pittsburgh University researchers claimed at the Society for Neuroscience annual meeting (Oct 16). Their study found that nicotine’s formative influence is particularly strong in males. Source. Another source.

Wives of Alcoholics Screen Men for Sobriety

So serious is the effect of alcoholism on the Russian economy that an entrepreneur has started a registry of certified sober workers.

Wives of known alcoholics serve on the committee that examines the men for the certificate, because they have the necessary experience to spot the tell-tale signs.

Employers pay a fee to get access to the list of certified sober workers.

Drink has a serious impact on Russia’s economy. A 1995 study found that regular drunkenness affected as many as 60 per cent of manual and 21 per cent of white-collar staff. Source.

Get in shape, kick the habit

A new study finds that smokers who combine exercise with gum or patches are more likely to quit than those who rely on nicotine replacement therapy alone. -- Source.

Liver disease rising in UK, Ireland

The number of deaths from liver disease is rising rapidly in Ireland and Britain, Irish researchers have warned.

According to researchers at the National Liver Transplant Unit in Dublin's St Vincent's University Hospital, liver disease death rates have doubled over the past 20 years and with current trends in alcohol consumption, 'are likely to increase further'. Source.

65,000 Teens with Liver Disease: S. Korea

More than 65,500 medical treatments were given to teenagers having alcoholic liver diseases last year, indicating an education program about alcohol is needed for students, says the Korea Times. The article says that S. Korea is now fifth in the world in per capita liquor consumption. Source.

No Scientific Evidence that AA is Effective

A comprehensive meta-analysis of published effectiveness studies concerning Alcoholics Anonymous and twelve-step facilitation (TSF) treatment methods found no scientific basis for claims that these methods were effective. "No experimental studies unequivocally demonstrated the effectiveness of AA or TSF approaches for reducing alcohol dependence or problems." The study, by three Italian researchers, was published in August 2006 in the prestigious Cochrane Library journal in the UK. An abstract is available online here.

Media underreport role of alcohol in crime, accidents

COLUMBUS , Ohio – The news media seriously underreport the role alcohol plays in violent crimes, injuries and traffic accidents, according to a new national study.

While alcohol is believed to play a role in about one-third of homicides and fatal motor vehicle accidents, media reports linked alcohol to specific accidents or crimes significantly less frequently.

Some of the largest discrepancies occurred in reporting alcohol use in violent crimes, particularly for television news. Only 1.4 percent of television news stories in the sample mentioned the role of alcohol in their reporting of homicides, according to Michael Slater, co-author of the study and professor of communication at Ohio State University Source.

Slater, working on a grant from the NIAAA, doesn't ask why this underreporting happens. Might it have something to do with publishers' reluctance to risk offending alcohol industry advertisers?

Our Brains Are Wired to Connect

"Neuroscience has discovered that our brain’s very design makes it sociable, inexorably drawn into an intimate brain-to-brain linkup whenever we engage with another person. That neural bridge lets us affect the brain-and so the body-of everyone we interact with, just as they do us." -- Daniel Goleman, from his new book, Social Intelligence. Source.

It's well known that an effective way to develop some part of ourselves is to connect with others on the same frequency. That's why support groups can be effective. It's high time that this powerful process were demystified and taken out of the realm of magic. How many people still believe that the boost they experience from recovery group participation has some kind of supernatural origin or requires a supernatural presence? Daniel Goleman, whose books on Emotional Intelligence displayed his gift for translating technical, scientific research into concepts that everyone can understand and use, goes at it again with this new book.

"Empathizing with a friend, whether in grief or elation, can activate the very same circuits in our own brains as in our companion's." The fledgling field devoted to studying this kind of interaction is called social neuroscience. Virtually all the research underlying this book was published in the past ten years, after the publication of Emotional Intelligence. I've sent away for a review copy and hope to post a longer discussion in the Booktalk section of unhooked.com soon. See also the item on mirror neurons, below.

UK women worst binge drinkers in world

Women in England and Ireland are officially the world's biggest binge drinkers, according to a unique study of global alcohol consumption.

One in three 17- to 30-year-olds is now classed as a heavy drinker, bingeing on four or more drinks in one session at least once a fortnight. Source.

Book Says Faith-Based Programs Just Political Ploys

David Kuo, a conservative evangelical who was second-in command of the Bush administration's Office of Faith-Based Initiatives, has come out with a book in which he says that Bush's people privately made fun of the faith leadership and used faith-based program money mainly to gain votes.

In public, Bush and his top advisers coddled and kissed up to the born-again religious leadership, but behind their backs called them "nuts," "ridiculous," "out of control," and "goofy." Faith-based program initiatives were thinly disguised events to get out the vote for Republican candidates, and awards of faith-based funds were made mainly on the basis of loyalty to the administration. Read more. Bush's faith-based addiction treatment funding initiatives, misleadingly called Access to Treatment, can be seen as part of this cynical framework. More about that here and here.

Mirror Neurons -- Biological Basis of Group Support

Recent research into mirror neurons points to a biological basis for the effectiveness of group support. These specialized brain cells were discovered by accident when researchers studying monkey brains found that cells that fired when a monkey grasped food also fired when the monkey saw another grasping food. The cells mirrored the action of the other animal. Subsequent research discovered mirror neurons widely distributed throughout the human brain.

Mirror neurons make it possible for us to experience the actions, feelings, and intentions of others as if they were our own, without having to perform elaborate rational deductions. An article in the current Scientific American suggests that, because of mirror neurons, the common expression, "I feel your pain," can be literally true. Source. Mirror neurons are involved in imitation, one of the most important forms of learning. Mirror neurons are also thought to be the foundation of emotional resonance or empathy, a key ingredient in professional and lay psychotherapy. It follows that mirror neurons are very probably the biological basis of many of the processes that are at work in mutual aid groups. The process of sober-to-sober reinforcement that empowers the participants' sober selves plausibly rests, biologically, on mirror neurons.

In a related article, researchers explore the hypothesis that damage to mirror neurons is the cause of some of the symptoms identified in many types of autism. Lacking functioning mirror neurons, some autistic children are asocial and lack empathy. Work is being done to see what can be done to stimulate or repair mirror neurons so as to make inroads against this condition. Source.

Katherine Hepburn on Sobriety

"Cold sober...I find myself absolutely fascinating." -- Katherine Hepburn, in response to Dick Cavett's question whether she had ever had a desire to do drugs. Source. Thanks, Gillian!

New Anti-Addiction Drugs: Chantix, Vivitrol

Two new drugs to treat addiction have hit the U.S. market -- Chantix for nicotine addiction, Vivitrol for alcoholism. Read more. And more.

Two girls trampled to death in alcoholic stampede

Two high school girls were trampled to death when a group of drunk students stampeded to escape police who had come to break up their rowdy party, reports African News Dimension from Zambia. Source.

Montana adopts integrated treatment model

Substance abuse and mental illness, long treated as distant cousins, become conjoined in the latest treatment model in Montana.

Community Program Officer Mary Jane Fox with Montana’s Addictive and Mental Disorders Division came before the Kalispell Mental Health Local Advisory Council recently with a clear message.

“Individuals with co-occurring disorders need to be thought of as the expectation, not the exception,” Fox said.

To move toward integration, Montana contracted two top experts, Dr. Ken Minkoof and Dr. Chris Cline, for training and consultation.

Their model stresses screening every mental illness client for substance abuse and every substance abuse client for mental illness in a welcoming atmosphere. Success comes from “empathetic, hopeful, continuous treatment relationships.”

“There is no one correct treatment approach,” Fox said. “Everyone is an individual.” Source.

Free-base nicotine: why cigs contain ammonia

Tobacco companies add ammonia and urea to cigarettes to make them more alkaline when hot. The alkaline pH converts nicotine into its free-base form, instantly absorbed in the lungs and transmitted to the brain. Without the ammonia and urea, nicotine would remain in its natural form and go to the stomach, taking a long time to get to the brain. Researchers think that the action of free-base nicotine is key to its highly addictive properties. Read more here in the Middletown NY Times Herald-Record.

Acid and Alcohol Don't Mix

Nick Johnstone speaks for me on this topic:

"It should be obvious: giving LSD to an alcoholic in the hope of curing them is a very, very bad idea. But various newspapers this week appear not to agree. For instance, we've got the Independent claiming "LSD helps alcoholics put down the bottle" and Metro stating, "LSD can help alcoholics quit drink".

"They're alluding to the just-released findings of Erika Dyck, a professor of the history of medicine at the University of Alberta, who recently revisited the subject (and subjects) of a four decades old research study by British psychiatrist Humphrey Osmond, who experimented with giving alcoholics a single dose of LSD in a bid to cure their illness.

"Although Osmond's study was dismissed with skepticism, Dyck has now presented her findings in an academic journal, Social History of Medicine, claiming that "the LSD experience appeared to allow the patients to go through a spiritual journey that ultimately empowered them to heal themselves".

"On the eve of being twelve years sober, reading this dangerous drivel makes me shake my head in disbelief. ... " Read Nick's whole article.

LSD treatment had AA support

A set of experiments in which alcoholics were treated with LSD in the 1950s "gained support from the provincial government, local chapters of Alcoholics Anonymous and the Bureau of alcoholism," according to Dr Erika Dyck, professor of the history of medicine at the University of Alberta, Canada. Source. And not only local groups. Bill Wilson, co-founder of AA, experimented with LSD himself. (So did Chuck Dederich, founder of Synanon). See Wm. White, Slaying the Dragon, p. 229. ABC News quotes sources saying that Wilson and other AA members felt that LSD was useful in getting people to accept the "higher power" concept. Source.

Hello Faith, Goodbye Taxes

Religious employers don't have to pay into the state unemployment compensation fund, and ministers don't have to pay income tax on their housing allowances, says an article in today's New York Times. Source. In many states, religious publications are also exempt from the sales tax. The result is that religion gets a tax subsidy of at least $500 million a year -- a tax burden that's shifted to the rest of us, thank you. Among the consequences: treatment counselors working for "faith-based" agencies may not be eligible for unemployment compensation if they're laid off. See also Hello Faith, Goodbye Rights, below.

Alcohol Industry Runs Oregon

In Oregon, the alcohol industry runs the show, says an editorial in today's Oregonian. The paper points out that the excise tax on alcoholic beverages hasn't been raised in more than 30 years, thanks largely to millions of dollars the industry spends funding and entertaining state lawmakers. As a result, the state has "glaringly inadequate resources to deal with alcohol-related social ills that are largely responsible for filling our emergency rooms, jails and prisons, as well as contributing to the breakup of many families." The editorial supports an alcohol tax increase that would raise much-needed funds for addiction and mental health treatment, prevention, and education. Source.

Counselor Busted on Bribery Charges

Addiction counselors are among the most poorly compensated of all professionals. No surprise, then, to read about the indictment of Timothy J. Smith of Arapahoe County (Denver), a top level counselor, for allegedly taking bribes from clients to supply them with fake DUI class completion paperwork. In one case, says the indictment, Smith accepted payment in the form of marijuana. Source. The surprise is that there aren't more cases like this, given the overworked and underpaid status of the addiction counselor.

Terror Treatment in India

"Yes, we do beat them up when they don't listen to us. What else is there to do?" -- A staff member at the Paras Foundation addiction treatment center in Mohali, India. A Times of India investigative team found 70 "inmates" of the program sleeping on the floor in one room. Addicts are made to squat and stare at the wall for hours for minor infractions. There is no medical staff. Food is slop thrown together in a squalid kitchen. The Times says inmates "were routinely tortured and abused." Source.

Hello Faith, Goodbye Rights

Addiction professionals concerned to upgrade their salaries, benefits, and professional standing need to read "Where Faith Abides, Employees Have Few Rights" in today's New York Times. Source. Correspondent Diana Henriques details a string of court cases in which employees of faith-based institutions have been denied elementary protections that employees of secular companies take for granted: disability rights, the right to pensions and healthcare, protection against sexual or other discrimination and harassment, against arbitrary firing, and for the right to organize, and others. Typical is the case of Sister Mary Rosati (right), dismissed from her order after she was found to have cancer. Faith-based employers run roughshod over employee rights under the doctrine of "church autonomy" or "ministerial exception." The spectre of the Bush administration's heavily subsidized "faith-based treatment" spells relapse for the few protections and benefits that addiction professionals have been able to win in recent years. See also Bush Spends 2.2 Billion (September) and Bush Taking the Axe to Recovery (2004).

Faith-Based Free-Baser

The man who founded a faith-based drug rehabilitation program in Clayton [AL] after kicking his own drug addiction is now facing a felony cocaine possession charge. Keith Dohney, 42, founder of Southeast Alabama Rehabilitation Services Inc., was arrested Tuesday afternoon by the Barbour County Drug Task Force and charged with a single count of possession of a controlled substance. Source.

Foley's Alcoholism Phoney?

Directly after resigning from Congress, Mark Foley (R-FL) made a public admission of alcoholism and checked himself into an addiction rehab program.

Foley's claim of alcoholism is not convincing a lot of people who knew him. One of his own colleagues, Rep. Peter King (R-NY) told Fox the claim is "a gimmick." Source. Advocate.com, the LGBT website, quotes sources close to Foley as doubting that he had a drinking problem. Source. From this perspective, Foley's quick public entrance into an alcohol rehab clinic was a convenient exit from further public questioning about his sexual advances to underage male pages.

True, as a psychiatrist pointed out to the press, many alcoholics manage to hide their addiction for fear of being stigmatized. But Foley had other stigmas to worry about. He was a closeted gay Republican -- but his orientation was an open secret in Washington and in Florida. He was also sexually interested in the male Capitol pages -- but this fact was widely known among the pages themselves and evidently at least some in the House leadership. Does the stigma of alcoholism carry a more painful sting than homosexuality and pedophilia, such that Foley would guard the secret of his drinking more closely than his other secrets? Hard to believe. Especially in Washington.

Foley wasn't alone in taking dubious refuge in alcohol rehab. Rep. Bob Ney (R.-OH) declared himself an alcoholic and checked into rehab last month hours after pleading guilty to corruption charges in the Jack Abramoff influence-peddling scandal.

The parallel has been a feast for skeptics. The Maine Morning Sentinel's editorialist observed that "claiming an addiction becomes the last resort of the poorly behaved." Source. Another commentator thinks that checking into rehab is becoming standard procedure for cornered politicos. Source.

Writer William Saletan had fun with this emerging pattern in Slate. Politicos in trouble should follow a 10-step program, he writes, including:

4. Call yourself an alcoholic. Foley adopts the label directly: "I am an alcoholic." This is vital, because when you're also a crook, anti-Semite, or pervert, "alcoholic" sounds so much nicer. Millions of people are alcoholic or love someone who's alcoholic. Embrace the label, and they'll embrace you. Roth adds a nifty twist to this maneuver, calling Foley "a closet drinker." Everyone knows Foley had a closet. The only question is what's in it. Booze is the least shocking answer he can hope to get away with. Source.

The conservative pundit Mona Charen also wasn't buying it. She wrote: "A fly on the wall of these treatment centers would doubtless discover that some of their celebrity clients are not alcoholics at all, but simply charlatans anointing themselves with alcoholism to wring sympathy from an infinitely forgiving public." Source.

So, at least if you're a celebrity, the "alcoholism" label, far from stigmatizing you, makes you downright lovable. NCADD, are you listening?

It's a perverse world. The huge majority of alcoholics who need treatment can't get it. Source. Scarce and understaffed emergency detox centers have waiting lists. Source. But for a handful of public figures, alcoholism treatment serves as a convenient moral refuge, a beggar's cup for sympathy, and a safe harbor from public inquiry.

P.S. A number of the commentators on Foleygate are mixing up his case with Mel Gibson's. While Foley's "alcoholism" seems too convenient to be true, there's no doubt about Gibson's bona fides in this department. See earlier blog posts here and here.

Fraternities: Another Jungle

Upton Sinclair's novel The Jungle did more than any other single work to arouse public opinion against the malevolent excesses of the American meat packing industry, and to initiate its reform. Now another literary heavyweight, the prolific author Joyce Carol Oates, has come forward with a short story (Landfill in the current New Yorker, source) that ought to arouse a similar passion about the jungle of college fraternities.

Oates' fictional story describes the death of Hector Campos Jr., a Latino student at Michigan State University, who got drunk and either fell or was pushed down a trash chute into the dumpster behind the Phi Epsilon fraternity. Authorities found his body three weeks later -- three weeks of agony for his parents -- in the county landfill. Oates writes in a documentary style, sequencing factual detail after detail until the resulting tapestry becomes emotionally overwhelming.

Newspaper reports of real deaths of real college students don't seem to have made much of a dent in the college fraternity drinking scene. Source. Maybe Oates' intensely felt and written fictional piece in the New Yorker will succeed where journalism has failed. Thank you, Ms. Oates, for the effort.

Oregon Switch to Strength-Based Treatment

A huge majority of people who need treatment for ATOD (Alcohol, Tobacco, Other Drugs) problems don't want treatment, studies show. Dr. Westley Clark, keynoter at the counselors' conference in Burbank yesterday, got a big chuckle from the audience with this statistic. Practically everyone took it as proof that "denial is not a river in Egypt."

But maybe some of the people who reject treatment have a point. Maybe they've talked to people who've tried treatment and it didn't feel right. Maybe treatment made them feel powerless, and ashamed, and depressed. Maybe treatment made them feel like Bad People. And that was scary.

Dr. Karen Wheeler, addictions policy manager in the Oregon Department of Human Services, has been listening. She says that treatment shouldn't be a frightening experience, and it shouldn't make you feel more worthless than you already feel.

Wheeler has announced a new strength-based orientation for substance abuse treatment in Oregon. "We are telling state-financed treatment providers to stress people's strengths and resilience, not their symptoms and illness," she says.

"No matter how long you have been addicted, we believe you have strengths to overcome your disease. We believe in your recovery." Source.

In my opinion, Wheeler is on the right track. Seeing and working with the addict's inner power to overcome addiction is a basic tenet of the LifeRing approach. See How Was Your Week, Ch. 2, Sec. 2.4. Maybe if treatment makes you feel like there is something worthwhile inside of you, fewer people will reject treatment and more people will take advantage of it. Isn't that worth trying?

I look forward to learning more about how Oregon implements the new strength-based treatment philosophy.

Settings With the Highest Smoking Rates

BURBANK, CA: "There is probably no setting in the U.S. with higher rates of smoking than substance abuse treatment facilities and 12-step meetings, where 80-95% of people smoke." "A significant number of adult substance abusers start smoking while in treatment/recovery." -- From "Addressing Nicotine Dependence in Treatment," a presentation by Bruce Allen Jr., Joan Waddell, and Loretta Worthington (right), addiction treatment professionals specializing in nicotine cessation; at the annual addiction counselor's conference this afternoon in Burbank.

I know a hospital complex that takes up an entire city block. Nowhere in this block can you smoke, except on the deck of the addiction treatment program. I have met patients in this program who had never smoked, or who had given up smoking years earlier, and started or restarted smoking during treatment there.

This panel presentation marshaled a number of additional studies to show that alcoholics and addicts who quit smoking maintained their sobriety from alcohol and drugs more successfully than those who did not. There is more material on this topic here and here.

Dealing with Spiritual Abuse

BURBANK, CA: One of the workshops at the addiction counselors' annual conference this afternoon was Queers 101 -- What Every Addiction Counselor Should Know About Lesbian/ Gay/ Bisexual/ Transgender clients. The presenter, Joe Amico, had been booted out of his position as a successful senior minister of a mainstream Christian denomination when he came out as gay. He then became an addictions counselor, and has spoken and written widely about the topic.

Someone in the audience asked Amico to talk about the spiritual dimension of recovery for LGBT people. He said that many LGBT people had suffered what he calls spiritual abuse in the churches, in the form of sermons that brand homosexuality as a sin and tell queer people that they will burn in hell. As a result of such spiritual abuse, many LGBT people had extreme difficulty with the 12-step approach, riddled with God references as it is. Amico referred the questioner to an article Amico had written about the topic. Source.

Spiritual abuse is one more reason why it's important to have a secular option. No doubt one of the reasons why the LifeRing meeting at the LGBT Center in San Francisco is so popular is that LGBT people can work on their recoveries here without constant reminders of past painful religious experiences that filled them with shame and self-loathing.

On religious intolerance of LGBT people, read Elton John's statement with commentary, here.

"We are not 12-step sponsors for pay"

BURBANK, CA: H. Westley Clark, M.D., J.D., M.P.H, director of the Center for Substance Abuse Treatment of the federal Substance Abuse and Mental Health Services Administration (SAMHSA), gave the keynote at the annual addiction counselors' conference in Burbank this morning. In the course of reviewing the high rate of turnover, the low level of educational preparation, and the low pay scale in the addiction counseling profession, he said that some people are confused about what counselors do. "We are not 12-step sponsors for pay," Clark emphasized. "I love 12-step programs but we are not. We are driven by state of the art knowledge in a very complex field."

The remark drew vigorous applause from maybe a third or half the audience of several hundred addiction professionals in the ballroom of the Burbank Hilton. The main reason for the low pay and the low esteem in which addiction counselors are held is the constant recruitment of 12-step graduates who see the job primarily as a service opportunity, work for peanuts, and bring with them little but their own experiences. A lot of people in addiction counseling are in fact no more than "12-step sponsors for pay," and this holds back the profession.

At the start of his Powerpoint presentation, Clark showed a photo of Pres. Bush with a sentimental quote about people helping people. As a high federal employee, Clark probably had to show such a slide. Not a single person in the audience applauded.

Admitting Alcoholism So As to Keep Drinking

I've had a running argument with people who think that labeling yourself an alcoholic is essential to getting sober. I agree, the label may be useful to get some people sober, but other people use the label as an excuse to drop out of recovery. Now here's another twist: a drinker who uses his alcoholism as a reason not to get into recovery in the first place.

Rapper DMX insists he can handle alcohol better than most of his peers, because he has alcoholism in his blood. The rap star, real name EARL SIMMONS, is famous for his love of cognac and he's adamant he can still function after downing glasses of his favourite tipple, while others just pass out. He says, "I have alcoholism in my blood, in my family. My grandfather died from drinking a fifth of vodka straight. It is no problem... I am a little drunk." But DMX insists his speedy metabolism stops him from getting drunk - as long as he keeps moving. He adds, "Once I sit my a** down, it's a problem. Source.

Bottom line: admitting that you're an alcoholic doesn't necessarily help you. Identifying yourself as an alcoholic can even delay your recovery, like in this example. What's essential is not the label, but the desire to stop drinking.

Nicotine "Most Addictive Substance"

"Nicotine is the most addictive substance known on this planet," Dr. Reichert said. "It is more addictive than heroin or cocaine, it's more addictive than caffeine, it's more addictive than anything." Reichert is lead author of a new study that finds smokers succeed more often at quitting if they combine behavioral changes with group support and pharmacological aids, than if they try to quit by will power alone. Source.

Drinking Speeds AIDS progression

Heavy drinking significantly speeds the progression of AIDS, research with primates suggests. Damage to the immune system is the probable mechanism. Source.

Parents Clueless About Kids' ATOD use

You suspected this? Parents are unaware of their kids' alcohol, tobacco, and other drug (ATOD) use about half the time. Parents are so clueless that it isn't even worth asking them, researchers say. That's the finding of a study released today in Alcoholism: Clinical and Experimental Research. Source.

Should Counselors Disclose Their Recovery Status?

Should addiction counselors disclose their own recovery status to their clients? Historian William White says that this issue has been debated for more than a hundred years already (Slaying the Dragon). The issue flared when I was a client at the Kaiser Permanente Chemical Dependency Recovery Program in Oakland in the early 90s -- some clients, probably egged on by an ambitious counselor, tried to split the staff over their personal recovery status.

The freshest thing I've read on the issue recently is by Jennifer Berton (right), ethics consultant for the California Association of Alcohol and Drug Abuse Counselors (CAADAC), writing in the otherwise somniferous September issue of the organization's newsletter. Among her points, in brief:

(1) There are great counselors not in recovery and lousy ones in recovery, and vice versa. What makes a great counselor is the level of professional training and a personal inner quality of empathy. (This point is supported by research cited in the Hester/Miller Handbook of Alcoholism Treatment Approaches.)

(2) If counselors insist that their personal recovery is a professional qualification or advantage, they divide the field of addiction recovery from all other areas of psychology and medicine, and lower the esteem in which it's held. A pulmonary surgeon doesn't have to be a lung cancer survivor; a psychiatrist doesn't have to have a history of hospitalizations for schizophrenia, etc. Colleagues in other fields tend to look down on addiction counselors as really just lay people reselling their own experience, not as trained professionals.

(3) If counselors practice disclosure at their workplace, they model workplace disclosure to clients. But workplace disclosure may not be at all wise for clients, depending on the circumstances. Workplace confidentiality may be a much more prudent policy.

Berton's much longer discussion is worth reading if you're interested in this issue either as a client or a counselor.

What if Teens Tell Their Own Stories?

Parents don't get much traction shaking their index fingers at kids about the dangers of drugs. Teens notoriously tune out when parents go into preaching mode. But what if addicted teens told their own stories? That was the strategy behind a town hall meeting in Oakland MI (Detroit area) organized by the Save Our Youth Task Force. Here's a report, source. No data yet on how well it worked, but the concept has plausibility.

Don't Hold Your Breath

The Lung Cancer Alliance, a nonprofit dedicated to prevention of lung cancer and support for its victims, has sent a letter to the Securities and Exchange Commission demanding that it take action against tobacco companies for secretly upping nicotine levels in cigarettes. Source.

A federal court in August issued a sweeping judgment against the tobacco industry for conspiracy, consumer fraud, racketeering, and related wrongs. Source.

The State of Massachusetts Department of Public Health followed up with a study showing that nicotine content in major cigarette brands had increased over the past six years. Higher nicotine content makes it easier to get addicted and harder to quit. Source.

The Alliance's argument that the tobacco companies committed fraud on shareholders by secretly raising nicotine levels has abstract merit. But tobacco company shareholders stand to profit from the fraud. And the SEC under Bush isn't going to upset the apple cart. Don't hold your breath on this one.

Anonymity: Outing and Inning

A book review in this week's New York Observer observes that there is a rash of books now hitting the market in which more-or-less prominent people out themselves as AA members. Source. Cases in point: reporter Tom Sykes, Hazelden exec William Cope Moyers (son of the media icon Bill Moyers), reporter Jason Leopold, author Augusten Burroughs, and a number of others who are, in reviewer Choire Sicha's phrase, alcoholics who are "anonymous no more."

Sicha astutely observes that this small deluge of addict memoirs comes in the wake of James Frey's A Million Little Pieces, a work that was not flattering to AA or to the AA-based treatment industry. Frey's blockbuster stayed on the bestseller lists for a long time despite (or because of) Frey's grudging admission that some key points were fictitious. (Remember, "there's no such thing as bad publicity.")

Sicha sees no connection between the negative impact of Frey's bestseller and the current crop of pro-AA testimonials. He thinks the books just respond to a perceived public thirst for more addiction memoirs. He naively quotes Bill W. 's bromides about anonymity and humility, as if these had anything to do with how AA really operates. It doesn't occur to Sicha that this crop of promotionals might be a kind of P.R. campaign to counteract the shadow that Frey's book cast over some sacred cows of American recovery.

If you're a lovable celebrity, and you got sober in AA, AA itself will "out" you. You will be invited to speak at openly or covertly AA events, the press will be there, and you will be quoted about your successful recovery from alcoholism thanks to a 12-step recovery organization that you can't identify but whose abbreviated name has two identical letters which happen to fall at the beginning of the alphabet. And since there might be readers who still don't get it, you might as well, in your memoirs, name its name. As long as you remain a lovable celebrity, you will get no static from AA for bending your anonymity into a pretzel, or breaking it outright. On the contrary, you'll be lionized and in demand on the AA speaker circuit, and Hazelden may publish you.

"Outing" is a useful word. We also need a word for the opposite process, namely cloaking someone's AA affiliation after they've stopped being a lovable celebrity and become a big ugly public embarrassment. Will "inning" or "re-closeting" work? The most recent case in point is Mel Gibson, who had been attending AA religiously since 1991, and used to be a big lovable celebrity whose AA membership was a matter of public knowledge. All that changed when Gibson was caught on Aug. 28 driving drunk and spouting sexist, anti-Semitic, arrogant, belligerent and obscene remarks. Definitely not lovable. Suddenly the American press stopped referring to him as an AA member, and his story was reframed as if AA participation would be a New Thing for him and would Make a Difference. I've written about this case earlier here and here.

Anonymity? Humility? Those are only for the losers. Sicha's book review is that of an acolyte who can't or doesn't want to see through the cloud of spiritual smoke in the cathedral. Shouldn't journalists writing about others who break anonymity come out of the closet themselves?

Congress One Big AA Meeting

“If we could turn Congress into one big A.A. meeting,” he said, referring to Alcoholics Anonymous, “where people would be required to say what they mean and mean what they say, it would be a lot better Congress.” -- Representative James Ramstad, Republican from Minnesota, quoted in the NY Times today. Source.

Oh, where to start?

If Congress were one big AA meeting:

• Floor debate would consist of canned monologues, Bible readings, and speeches full of cliches and slogans
• The members with the longest tenure would run the place
• Nobody in the country would know who's really making the decisions
  
• Nothing said in Congress would become public knowledge except if leaked through the rumor mill
• A good portion of those present would be drunk or hung over
• The members would proclaim that all their decisions were inspired by God
• Funding for secular programs would be cut and diverted to faith-based programs

Wait a minute! Maybe Congress already is one big AA meeting. The Times article quotes a source saying there's "a very powerful recovering community" (read: 12-step) in the capitol, and points to an informal caucus of about 60 unnamed representatives who lobby for legislation affecting treatment for addiction and mental health. Names outed: Ramstad, Rep. Patrick Kennedy (D.-R.I.), several former members.

For a religious take on this gem of a quote from Ramstad, browse to The World Views Blog

Make them Eat Dinner

"MOSCOW. Sept 19 (Interfax) - The Russian Interior Ministry is drafting a bill requiring mandatory medical checkups of teenagers detained by police for alcohol or substance abuse.

"The problem of adolescent alcohol and substance abuse remains as acute as before. In 2006 alone, more than 12,600 crimes have been committed by teenagers after drinking or drug use," Vladimir Golubovsky, deputy head of the Interior Ministry's Public Order Department, told the press in Moscow on Tuesday." Source.

Medical checkups? Dumb idea. They should be forced to have dinner with their parents instead. See below.

Blaming the Parents

Norman Rockwell created famous Saturday Evening Post covers showing families at dinner in small-town America. I always suspected that few of the teens at THOSE dinners ever smoked, drank, or used drugs.

Now comes Joe Califano, director of CASA, the National Center on Addiction and Substance Abuse at Columbia University, with a study that proves it. Teens (ages 12-17) who have dinner with their family five or more times a week are statistically about half as likely to use nicotine, alcohol, marijuana or other drugs as other teens. Source.

That factoid fits with Califano's theme that teen substance abuse is a parent problem. The drift of CASA's work is to put the responsibility on parents to solve the nation's ATOD problem. (ATOD = Alcohol, Tobacco and Other Drugs.) If kids don't start using before they're 21, chances are they never will.

But maybe it's not so simple. When CASA's researchers asked both kids and their parents WHY they don't have dinner together more often, only ten per cent of the kids and seven per cent of the parents said it was because they chose not to. Three quarters said their schedules -- mainly, work schedules and commutes -- didn't allow it.

So, picture mom and/or dad working two jobs, or working late shifts, or commuting long hours, all to provide a home for the kids in the current economic climate of declining real wages and growing income inequality. Parents are working harder and longer hours just to keep from losing the roof over their heads, and that doesn't leave a lot of opportunity for Norman Rockwell family dinners. Think of Drey's mom in the movie Half Nelson, working two shifts as security guard, including nights and weekends.

You just don't get a sense of the real world of parenting today when you read CASA's report. A little empathy for working parents wouldn't be out of place for Califano. It seems that it's been a very long time since he was Secretary of Health, Education, and Welfare under a Democratic president.

CASA's report might also ask why there is still such a significant proportion of users among teens who do have dinner with their family five or more times per week. CASA's report says 13 per cent of the family eaters have tried cigarettes, 32 per cent have tried alcohol, 12 per cent have tried marijuana, and similar percentages are using those substances currently. Why didn't the "magic wand" of family dinner (Califano's phrase) work with these kids? Would we consider the nation's ATOD problem solved if these were the national numbers?

Astonishingly, CASA's researchers didn't ask whether families consumed alcohol at dinner, or whether parents used nicotine or other drugs inside the family home. Isn't it relevant to ask whether parents are modeling ATOD use for children inside the home?

Making a policy issue of parents who drink, smoke, or use drugs makes sense. Blaming the national drug problem on parents who are working their hearts out to make ends meet in this economy does not.

Bush spends 2.2 Billion of Our Tax Money on Religious Programs that Lower Professional Standards

The Bush administration is now spending $2.2 billion (with a B) subsidizing churches and other religious institutions to run social programs. Source. That includes addiction treatment programs. On this, see my 2004 article, "Bush Taking the Ax to Recovery." "Faith-based" is a big business now, a handy label to get fat government contracts, similar to "homeland security." (If they really rely on faith, why do they need government handouts?) No professional training or licensing is required for staff in the faith-based treatment programs. Addiction counselor organizations such as NAADAC, who have been trying to pull up the level of professional standards in treatment programs, face a gut-punch from the religious competition, and it's all being done at public expense.

Ann Richards of Texas dies

Ann Richards, the former governor of Texas and an out-front recovering alcoholic, died Sept. 16 at age 73. Richards was one of the first political figures, if not the first, to demonstrate that you can be open about your recovery from addictions and win elections.

In the 1990 gubernatorial race, polls showed Richards trailing. An opponent told the press he hoped Richards wouldn't go back to drinking because of it. The remark offended voters and Richards pulled ahead and won the election.

"Among Richards' accomplishments as governor of Texas was to add 2,000 treatment beds in state prison, with funding for a total of 14,000 beds getting legislative approval. However, when Richards lost the governor's seat to George W. Bush, he slashed the program; today, Texas has just 3,250 treatment beds for prisoners." Source.

Richards later lost her shine as a recovery hero when she went to work as a lobbyist for the tobacco industry. But she is best remembered as the politician who won the respect of the voters by being open and up-front about her addiction and her recovery.

College Recovery Speaker Available

I wish she'd been around when I was in college:

Dr. Kitty Harris is available to speak to issues involving college student substance abuse and recovery.

Harris is director of Texas Tech University’s Center for the Study of Addiction and Recovery (CSAR), the largest and one of the oldest college recovery communities in the nation.

Texas Tech’s nationally recognized program currently serves recovering students from 20 different states. CSAR offers recovery and educational assistance to students in recovery from alcohol and drug addictions and to students in recovery from eating disorders.

Now preparing to celebrate its 20th anniversary, the center has grown to nearly 100 students and has utilized federal grants to develop a curriculum for creating recovery communities on other college campuses. Harris has overseen or advised on the development of recovery communities at schools such as the University of Colorado at Boulder, the University of Texas and the University of Texas at San Antonio.

Contact: Kitty Harris, director, Center for the Study of Addiction and Recovery, Texas Tech University, (806) 742-2891, or kitty.harris@ttu.edu.

Thanks for this info, Don Phillips. More here.

See also, College is a Slippery Place, in this blog

Tony Blair's Answer to Popular Discontent

Experts warn that Britain has gone from a nation "enjoying a harmless tipple" to one developing "a dangerous alcohol addiction". The researchers say that the average UK resident's life expectancy has been reduced by ten months for men and five for women, due to drinking. Source.

This story comes less than a year after Tony Blair's government pushed through a new 24-hour drinking law, scrapping Britain's decades-old regulation of pub closing hours. When the 24-hour law went into effect last November, a critic warned:

"Thousands of prominent doctors have gone on record as saying that this is crazy and will lead to a boom in health problems among young people .... Yet the Government seems determined to press ahead ... The pretext is set to give Police more power on the streets and allow them to take more liberties with people out after 9pm.... " Source.

Oh, and people will be too wasted to worry about Blair's policies in Iraq, Lebanon, Afghanistan, etc.

Choice a Hallmark of Recovery Movement

"One of the recovery movement's hallmarks is empowering people to self-direct their services. This allows people to make their own choices, develop self-esteem and self-confidence, and to become self-determining. This involves people's accountability to live up to their potential. This same level of accountability needs to be present in the structure [of the treatment program]." -- Lori Ashcraft Ph.D. and William A. Anthony Ph.D., "Factoring in Structure -- Recovery needs a solid foundation to take root," in Behavioral Healthcare, Aug. 2006, p. 17.

Client self-direction, making choices, developing self-esteem, self-confidence, and becoming self-determining ... exactly what the Recovery by Choice workbook is built around. And yes, for clients to be able to take this road, the structure of the treatment program must permit it and support it. You won't get this kind of recovery in a treatment program structured around the postulate that clients are too (choose all that apply:) stupid, crazy, dishonest, manipulative, in denial, etc. to ever make intelligent, pro-recovery choices.

Kids Smarter Than Parents About Drugs

Parents tend to be clueless about teen alcohol and drug use, and frequently allow drinking and drug use at parties they chaperone, says a survey conducted by The National Center on Addiction and Substance Abuse (CASA) at Columbia University.

• One-third of teens and nearly half of 17-year olds attend house parties where parents are present and teens are drinking, smoking marijuana or using cocaine, Ecstasy or prescription drugs.
• 80 percent of parents believe that neither alcohol nor marijuana is usually available at parties their teens attend. BUT 50 percent of teen partygoers attend parties where alcohol, drugs or both are available.
• 98 percent of parents say they are normally present during parties they allow their teens to have at home. BUT a third of teen partygoers report that parents are rarely or never present at the parties they attend.
• More teens name drug use as their number one concern than any other issue (27 per cent). Fewer than half of their parents (12 per cent) identify drugs as teens' top concern.
  

Joe Califano, the chairman of CASA, concludes that “Teen drinking and drugging is a parent problem. Too many parents fail to fulfill their responsibility to chaperone their kids’ parties." Source. True ... but let's give credit where it's due. Despite the "denial, self-delusion and lack of awareness of these parental palookas" (Califano's phrase), the use of tobacco, alcohol and drugs among kids is declining. Source.

Bottom line: Kids today look smarter about tobacco, alcohol and drugs than their parents.

The full CASA survey report is available here.

Study: Underage Drinking Vital to Industry Profits

Underage drinking is vital to liquor industry profits in two ways, says a recent study in the Archives of Pediatric and Adolescent Medicine. Underage drinkers are a $22.5 billion market for alcoholic beverages. Moreover, underage drinkers are much more likely to turn into heavy drinkers or alcoholics when they grow up. More than 96 per cent of adult alcoholics started drinking before age 21. Adults who abuse alcohol or are dependent on it are a $25 billion market for alcoholic beverages. These two categories together -- underage drinkers and adult alcohol abusers or dependents -- make up nearly 40 per cent of the market for alcoholic beverages in the U.S. The study authors say "the alcohol industry has a compelling financial motive to attempt to maintain or increase rates of underage drinking.”
A summary of the study was published by the Center for Substance Abuse Research (CESAR) at the University of Maryland in a weekly bulletin available online here.

Survey: College is a Slippery Place

In general, people with more education tend to go lighter on tobacco, alcohol, and drugs. To this there is one important exception: booze in college. The current national survey reveals that full time college students drink more often and more heavily than their peers. This finding has held steady over the past four years.

There is no similar gap for illicit drug use; it's about the same on campus as off. Cigarette use among full time college students is much lighter (30 per cent) than among people of similar age not enrolled full time, or at all (43 per cent). But alcohol use by full time students is a solid six per cent higher.

The survey did not ask whether the colleges in question had fraternities and sororities.

Survey: Teens Wising Up About Tobacco, Drugs

Fewer kids aged 12-17 are using tobacco, alcohol, and illegal drugs, according to a government survey released Sept. 7. Cigarette smoking in this age group shows the strongest decline, from 13 per cent to 10.8 per cent between 2002 and 2005. Illicit drug use dropped from 11.6 per cent to 9.9 per cent during the same short period. Alcohol use dropped about one per cent to 16.5.

That's the good news. The bad news is that one out of ten teenagers, more or less, is still using nicotine or illegal drugs and about one out of six is using alcohol. This, despite about 80 per cent of kids having been exposed to "anti" messages in or outside of school.

There's a lot more bad news also in the full report from the Substance Abuse and Mental Health Administration (SAMHSA), available online. National averages from all age groups showed no major changes. About 126 million Americans used alcohol in the past month -- 52 per cent, up a tick from last year. About 71 million Americans used tobacco in the past month, which is about 29 per cent, down a hair from last year. About 20 million (8 per cent) used an illicit drug, unchanged.

Addiction Treatment Behind Bars

The National Institute for Drug Abuse (NIDA) has followed up its groundbreaking "Principles of Effective Drug Abuse Treatment" (1999) with a similar work that addresses issues of treatment behind bars. Titled "Principles of Drug Abuse Treatment for Criminal Justice Populations" and available online, the report is worthwhile reading for anyone concerned with the huge number of people incarcerated in connection with drug and alcohol use.

NIDA's earlier report highlighted the importance of an individualized approach to treatment. Its number one finding was: "No single treatment is appropriate for all individuals. Matching treatment settings, interventions, and services to each individual's particular problems and needs is critical to his or her ultimate success in returning to productive functioning in the family, workplace, and society. "

What holds for addiction treatment on this side of the bars is also true on the inside. The current report says, as point five, "Tailoring services to fit the needs of the individual is an important part of effective drug abuse treatment for criminal justice populations. Individuals differ in terms of age, gender, ethnicity and culture, problem severity, recovery stage, and level of supervision needed. Individuals also respond differently to different treatment approaches and treatment providers." In other words, effective treatment behind bars requires much the same basic respect for individual differences as treatment anywhere else.

Notable also is NIDA's growing recognition of the importance of patient involvement. "Effective drug abuse treatment engages participants in a therapeutic process," the report says, which suggests that getting patients involved in designing and planning their own treatment process promotes therapeutic engagement.

Although NIDA stops short of recommending any specific treatment modality, its research clearly points toward secular and broadly behaviorist approaches. The report says, "In general, drug treatment should address issues of motivation, problemsolving, skill-building for resisting drug use and criminal behavior, the replacement of drug using and criminal activities with constructive nondrug using activities, improved problemsolving, and lessons for understanding the consequences of one’s behavior."

In an accompanying op-ed piece, NIDA director Nora Volkow makes a strong case that treatment for drug-abusing offenders is more effective than incarceration without treatment, and that effective treatment, if it were available, could make a major dent in the crime rate and in the prison population. Source. Needless to add, as incumbent head of a major government department (NIDA is a part of the National Institutes of Health which is part of the Department of Health and Human Services), Volkow is silent on the issue of fading federal spending for treatment, other than faith-based approaches (see earlier blog) -- policies that run directly counter to the research that underlies NIDA's report.

Our Addiction Has Consequences for Others: Half Nelson, the Movie

Half Nelson is the story of a young white junior high school teacher in a black working class school and of a 13-year old girl student, Drey, who discovers that he is a crack addict. The screenplay, by Anna Boden and Ryan Fleck, is refreshingly free of the racial cliches that pollute most black/white dramas and sitcoms.

Dan Dunne, the teacher, has the split personality typical of many functioning addicts. In class, he is direct, honest, and empathetic with his students. He poses as something of a Marxist radical, teaching his history class “dialectics” and reviewing highlights of the civil rights, anti-war and other struggles of the past 50 years. You can see that the students, when they are not bored, like him and respect him.

But as soon as school is over he becomes a different person, scoring drugs, hanging out in clubs, lying to his family and friends, and living the life of the lumpenproletariat. It’s clear that the dialectic of life and death is at work within him, and life is losing.

When Drey finds him out, a very complicated dance begins. She has been trying to live a straight life. Her older brother is in jail for drug dealing. Her dad uses drugs and is not supportive. Her mom is clean but locked into a dead end low wage job that keeps her away from home too much. Drey tries to stay clear of the friendly neighborhood dealer and keep focused on school. The discovery that her admired teacher is a user has a powerful impact on her feelings and her life choices.

It would be unfair to give away the rest of the plot. The acting is first rate. Shareeka Epps as Drey is totally believable and honest throughout. Ryan Gosling as the young teacher turns in a devastating portrait of a manipulative addict in the grip of self-deception and on his way to self-destruction. His radical political posturing in the classroom is only a figleaf for his sick personal life and his destructive impact on the community. If you needed reminding that our addictions have consequences for other people, Half Nelson is a powerful statement, all the more so because it avoids all moralizing.

Half Nelson movie web site.

Spinning Mel Gibson's Relapse (2)

Einstein famously defined insanity as doing the same thing over and over again and expecting different results. Judge Lawrence Mira, who on August 18 gave Mel Gibson a slap on the wrist and sent him to a year’s worth of AA meetings for his drunk driving offense, should have his head examined. Mel Gibson, whose anti-Semitic, obscene, sexist, arrogant, and bellicose outbursts during his July 28 arrest on the Malibu Highway made world headlines, has been attending AA meetings for more than fifteen years already. Not only attending them, but making others attend them on the film set (see blog below). “Sentencing” Gibson to AA is a little like throwing Brer Rabbit into the briar patch. What made the judge think that another year of the Same Old Same Old is going to make any difference?

Maybe the judge is a victim of the U.S. press, which somehow managed to “miss” the fact of Gibson’s long-time AA participation almost entirely. While readers in the UK, Australia, India, and even Thailand learned of Gibson’s 15-year AA participation at the same time as they learned of his arrest and his drunken outbursts, American readers have been fed the line that Gibson is a recovery virgin and that sending him to AA will be a New Thing for him and will Make a Difference. One would like to think that the judge was better informed, but maybe prosecutors played along with the game and kept him in the dark.

Even the L.A. Times, one of the only two American print organs that noted Gibson’s prior AA participation a few days after the arrest, seems to have forgotten about it in its coverage of the hastily-called courtroom event where Judge Mira disposed of the case. The Times’ staff writer Andrew Blankstein quotes a lawyer who specializes in DUI defenses, who claims that sentencing Gibson to AA is somehow outside of standard court procedure. Source. (Where has this guy been?) But Blankstein doesn’t dig any deeper.

So, instead of stories that ask, “What do you do with an alcoholic after AA has failed him?” — a question with broad public health implications — you get pablum like this:

• An op-ed in the Baxter Bulletin (Arkansas), has Gibson’s arrest serving as the lead for an infomercial promoting the local 12-step meetings. Source.
• A guest op-ed writer in the Roanake VA Times expresses optimism that Gibson will become clean and sober now that he’s been referred to “the one program we knew worked” — Alcoholics Anonymous. Source.
• Postcards from a Pug Bus (Source), a supposedly satirical, dig-behind-the-scenes blog, indulges in an imaginary monologue in which Gibson “takes the first tottering step” on the twelve-step recovery journey. Duh.

And much more of the same.

Hats off to whoever is spinning the Mel Gibson story in the U.S. media. You’ve managed the next thing to a media miracle: turning Mel G.’s ugly recovery failure, after 15 years of AA, into a tidy advertisement for the organization. It’s like turning Chernobyl into a promo for nuclear power.

An Effective Choice-Based Treatment Approach

A client-centered recovery program that designs services to fit “clients’ individual experiences, perceptions, and needs” and where staff works with clients “on learning choice-making skills as an essential part of recovery” has scored impressive outcome improvements with a challenging dually-diagnosed populations, says an article in the July issue of Behavioral Healthcare (www.behavioral.net). The choice-based program, called CHANGES, targeted a high-risk population with multiple psychiatric hospitalization histories, including jail time. As a result of the program’s individualized approach, “clients previously considered ‘treatment avoidant’ became treatment receptive.” (p. 36)

This finding will not surprise savvy LifeRing participants (or other readers of the Recovery by Choice workbook). The traditional mental health and substance abuse approaches too often are designed to serve the interests of the providers and payors, rather than clients. Providers frequently assume as rock-bottom truth that clients are incapable of making choices, and therefore must have prefabricated solutions rammed down their throats. Instead of learning to make choices, clients are made to dwell on their moral defects and to affirm their powerlessness to change. Why are people surprised that this kind of approach produces “treatment avoidant” clients and has a dismal outcomes track record?

Millions of taxpayer dollars are wasted every month on treatment programs that are ineffective and in many instances abusive. Lonny Shavelson’s “Hooked” details many of the absurdities in the system. The CHANGES program — embodying some central tenets of the LifeRing philosophy — not only showed significant outcomes improvements, it yielded substantial cost savings. The CHANGES approach deserves consideration and creative emulation by other professionals in the mental health / substance abuse fields.

Spinning Mel Gibson's Relapse (1)

In case you’ve been on another planet, Los Angeles County sheriff’s deputies stopped actor/producer Mel Gibson’s Lexus at 2:36 a.m. last Friday going 87 in a 45 mph zone on the Malibu highway. Gibson had an open bottle of tequila on the front seat. He apparently attempted to escape, made anti-Semitic and obscene remarks, swung from the bars of his cell, and boasted that he owned Malibu and would f**k the arresting officers.

The story of Gibson’s DUI bust, first broken by the celeb-watch website tmz.com, scored more than four thousand hits in Google’s index to the world press. Gibson produced and directed the controversial religious blockbuster Passion of the Christ, which made him very rich. Many critics at the time objected to what they saw as the film’s anti-Semitic message. That background, plus the current Mideast conflagration, made Gibson’s drunken tirade newsworthy. After he sobered up and huddled with his agent and his PR people, Gibson issued an apology and checked himself into rehab.

When I entered “Mel Gibson Alcoholics Anonymous” in Google’s News search a moment ago, up came a mere 49 hits. ABC News reported that one of Gibson’s neighbors in Malibu, Chris Prentiss, said that “The center that I’ve heard he’s checked himself into follows the Alcoholics Anonymous 12-step program. And I don’t believe that will help him.” Prentiss owns a competing celebrity treatment center. The Chicago Sun-Times, the Philadelphia Daily News, and the Boston Globe carried the same bit.

The Los Angeles Times has so far been the only American print source to dig a little deeper. In a July 31 story, staff writers Robert Welkos and John Horn say, “One source said the star had already begun rehabilitation, noting that Gibson had long been a member of Alcoholics Anonymous.” Source. In other words, it appears that Gibson is not just beginning to attend AA, he is a long time AA member experiencing a spectacular relapse.

Print media outside the U.S. have been much less delicate in handling Gibson’s long time AA membership. Compare the Glasgow Daily Record’s coverage:

Recovering alcoholic Gibson was stopped on Friday on suspicion of drink-driving on the Pacific Coast Highway in Malibu, California, near his luxury mansion.

The director and actor was allegedly driving at 87mph in a 45mph area. The Alcoholics Anonymous member had a bottle of tequila in his car.

The London Daily Mail details Gibson’s background and notes that Gibson already joined AA in 1991. Source. In other words, the current relapse — the paper says it is only the most recent of many — came after fifteen years of AA membership. The Adelaide Advertiser in Australia says flatly “that Gibson has been attending meetings of the 12-step Alcoholics Anonymous program since 1991.” Source. A dozen other Australian, British, Indian, Thai, and other world press sources consider it relevant and newsworthy to print Gibson’s long-time record of AA participation.

As a recovering alcoholic myself, my heart goes out to Mel Gibson in this relapse. I don’t share his politics or his religion, but I know what addiction is and I don’t wish relapse on anybody. I hope that with the benefits of 15 years of hindsight, Gibson stops repeating the same recovery experiment expecting different results, and finds a program that will work for him.

I also wish that the U.S. press would take a hint from the world press and stop treating AA like a sacred cow. When a long-time AA member in the public eye has a spectacular relapse, the person’s membership is relevant and newsworthy. People in recovery, the general public, and lifestyle gurus like Dr. Phil and Dear Abby should become aware that no recovery program is guaranteed, that they all have their failures, and that what the recovering person needs is choices.

————————————

PS Aug. 3: Today’s Google News search on “Mel Gibson Alcoholics Anonymous” yields 138 hits … but the spin in the U.S. Press continues.

Fox gives a perfect specimen of the pro-AA media whitewash with a story today that focuses on Gibson’s selection of outpatient rather than inpatient 12-step treatment. Fox’s writer issues the usual bland promotional yadda-yadda about AA and then quotes an “anonymous” AA spokesperson stating “We only say we have found a solution that works for many of us and we are happy to share information about it with any person interested in not drinking.” Source.

As if Gibson were a newcomer to the AA concept! Not a word in the Fox story about the fact that Gibson has been attending the Malibu AA meeting since 1991 and has been following the 12-step recovery path for 15 years. The “many of us” for whom the solution works, on the evidence, doesn’t include Mel G. Fox deserves a booby prize for shutting its eyes to the obvious. (The same story is now on the AP wire and the Washington Post, which ought to know better, ran it verbatim.)

Oh, and in case you were thinking that Mel G. was just a casual AA participant, sitting behind a pole in meetings and not really working the program, consider this letter printed in the London Telegraph:

A Scottish actor who worked on Braveheart once told a director friend of mine what it was like working with Mel Gibson. “He’s off his head,” alleged the actor. “We’d all be standing there in kilts and with blue woad painted on our faces, ready to do a shot, when suddenly Mel would announce to the Alcoholics Anonymous members among us - a healthy number - that we had to have a meeting. So there we would be, behind the catering van with painted faces, reading from the Big Book and sharing our experience. You know, ‘My name’s Mel and I’m an alcoholic,’ then we’d all go back to the set and get stuck into the English.” Source.

As if to prove that some of the UK press can be dumb, too, the London Daily Mail has a story today that plays along with the wink-wink nod-nod game from America: “According to U.S. reports, Gibson, a recovering alcoholic, will now embark on the Alcoholics Anonymous 12-step programme.” Source. Will now embark! Hello!

So far, the only U.S. print media source that is filling in the background of Mel G.’s AA membership, following the L.A. Times, is the Miami Herald, which on Aug. 2 wrote, “Gibson has been a member of Alcoholics Anonymous for years.” Source.

Letter from a Woman in the UK

We received the following letter at the LifeRing Service Center yesterday. It came via air mail from a woman in the UK. I’ve edited out identifying details. She writes:

“Dear Marty and all at LifeRing,

Thank you for the e‑mail. Also thank you for saying that starting a LifeRing meeting here [in the UK] is providing a valuable service. I am not used to being valued, I am used to being undervalued.

The boss at my place of work has said that if we do the meeting within my working hours we can have the room paid by the fund. I have managed to work out how to order literature from the Internet and the next time I am paid, I will be ordering some things. Meanwhile I am downloading things such as door signs and printing them out.

I hope that this meeting gets underway. Having been in and out of AA/NA for 6 years, I feel a bit uneasy with doing it. However, at the same time I want to. I am scared, you see, to leave AA/NA. I have had it drummed into my head if I do, I will return to active drug use, live and die in my addiction; or if I manage to keep clean, I will have no spirituality and will go insane.

At present, I am seeing a psychologist on the N[ational].H[ealth].S[ervice]. who is aware of my thoughts, feelings and difficulties within the 12 step organisations. I am waiting to go into group therapy, which will last for just over a year.

When I hear of people such as yourself my first thoughts — and please don’t take this personally – are: is that person really clean? Has he/she really got and stayed clean without a 12 step programme? Is this person in a good mind state or are they insane? I can’t help this because of what has been drummed into me. I have been wishing hoping and praying for another way that will work for me — a way that has nothing to do with 12 steps and higher powers (though I have one). . A way where I am supported and befriended by others who are not out to control or abuse me in any way. And I in turn would support them without need to control or abuse.

This LifeRing may be the answer I have been looking for. I believe in the value of one person helping another in support to stay off drugs. But not when one person is out to control or use and abuse the other. And what I have found in 12 step organisations is that those who we have to listen to and stick by usually end up trying to manipulate me for their own ends. Become abusive in different ways. Controlling demanding dominating and putting me down — making me feel as if I am a bad person all the time.

I also find the god concept a bit much at times. I have a belief in god but I do not have a religion. (Or do I? Sometimes I feel like I am in one). And I do not want to talk about god all the time…

The steps also I have went through them but always relapse on the 4th one. ..I did go back once after a short relapse and picked up my 4th step from where I finished it and got it finished and shared that and then went on with the rest of them …then back to the first one to start all over again …I have never got right through all the steps without relapsing. I know that this is a requirement of 12 step organizations, to go through all the steps than start again and keep doing them. I get sick of doing them. It is time consuming and painful.

And I often wonder: if I am (as I hear at meetings) loved as I am unconditionally and accepted as I am, why is it that I have to go through a process of change for the rest of my life? I asked this question and was told because god wants me to. How does one know god wants me to?

Anyway, there are many things I find difficult in 12 step places. And all I have done since I got there is wish for a way out, as I feel trapped. Scared to leave. The same way I have done in domestic violent relationships. I do not know why I am writing to you of these things. I feel I need to explain things. I also feel the need for reassurance that there is actually a way to keep clean and sane without 12 steps and AA/NA meetings. I am sorry if I have done wrong in writing to you. About this. LifeRing seems to be quite well attended in the United States …I hope that this can happen here in Great Britain too. I am not the only person around here who is experiencing difficulties with AA/NA. I hope this will help those people too.

Thank you for all your help [Name withheld].”

Dear _______,

Thank you for your letter. It is heartening to meet a person who has the courage to speak frankly about their issues and who takes practical action to improve their situation. So many people merely complain, without doing anything. If you persevere in your efforts, I feel confident that you will rise above your present difficulties and find a new clarity and happiness.

You write that your first thought about me and other LifeRing people is to doubt that we are really clean and sober. And if we are clean, we must not be sane. I have heard this same doubt from some other 12-step participants over the years, and there are some passages in the Big Book that seem to imply that the 12-step program is the only way to sobriety and sanity.

As to being clean and sober, I can assure you that I have not put alcohol or drugs into my body for the past 13 years and 9 months today, without ever attending an AA or NA meeting. In this I am far from alone. The majority of successful recoveries from alcoholism take place without and outside of AA. The evidence for this finding comes from an unimpeachable source: George Vaillant M.D., professor at Harvard, and a Trustee of Alcoholics Anonymous. In a large, long-term study published as “The Natural History of Alcoholism,” Vaillant found that 60 per cent of alcoholics who achieve five or more years of sobriety did it without AA. You can find this fact in AA’s own Grapevine magazine in the May 2001 issue at p. 36; here is a link to the excerpt. This is, of course, not a criticism of AA. It is merely a reminder that AA does not span the whole universe of recovery. Most of the miracles of redemption from alcoholism occur outside of the 12-step tent. It is important to remember that many people in AA are well aware of this fact and have an open, welcoming attitude toward other recovery approaches.

As to proving that I and other LifeRing people are not insane, that is hard to do. How can one prove one’s own sanity? In truth, I have doubted my sanity more than once. Anyone who undertakes to change the world as it is presently constituted must have moments when the effort seems crazy. On the other hand, when I look at all the people who keep trying the same old recovery experiments over and over again with the same negative result, I wonder who is the crazy one. What’s really insane is to think that the addiction problem is going to get better if we don’t change our approach to it.

You mention that you have done the 12 steps over and over, and always relapsed on the fourth one. I have heard many people share that same experience. It doesn’t surprise me. Focusing on one’s character defects is a depressing, paralyzing occupation, ill calculated to give a person the strength and confidence required to resist cravings and build new, sober connections. In my experience, the path to recovery begins with recognizing the part of ourselves that remains sound and sober, no matter how small and hidden it may be at first. Then the task is to dwell in that place, to connect with that self in others, and so to extend — inch by inch, minute by minute — the dominion of the sober self within our own mind and body. To be sure, in that process we will come face to face with many of our shortcomings, but always in the context of building on and extending our inherent strengths.

You write that many authority figures in your 12-step organizations tried to control you and manipulate you. How is LifeRing different in this regard? It’s well to be aware that there are people everywhere who enjoy controlling and manipulating others, and that the 12-step organizations have no monopoly on that. I have met such people also in LifeRing. The important difference is that — apart from abstinence, our common denominator — LifeRing does not prescribe or suggest a capital-P Program to which all members are expected to conform. We each put together our personal recovery programs, tailor made for who we are and what we need to do. This emphasis on personal recovery programs tends to disarm the control freaks among us. There is no dogma with which to beat someone over the head. Whatever works to keep you clean and sober is a correct program, even though it may be diametrically opposed to the things that work to keep me clean and sober. The diversity of personal recovery programs that result from this emphasis forms a rich pool of experience and wisdom for all of us to draw on.

Again, I want to congratulate you for making the move from contemplation to action. You are definitely not alone in your feelings. Like every pioneer, you may encounter hardships and find yourself a target for stones and arrows. But if you persevere, you will break through to a new reality, and your friends and successors will be thanking you in the years to come.

With best wishes for your success,

Marty N.