Gary Greenberg (gberg) Tue 25 May 04 04:09
It's too bad thta the reviewer allowed his suspicions about the 12-step movement to undercut his appreciation of the book, Martin. Or that he used your book as an opportunity to reiterate his suspicions. But in this Layer onto that how a faction truly believes the "disease concept" is bullshit and the 12-steps a pseudo-spiritual sham that merely creates another form of dependence. Add to that how they resent the hell out of how the 12-steps have sparked a mass movement that has become increasingly influential. And finally, stir it with the wand of how they see an alliance between the treatment industry and the drug war, with felons being mandated into treatment that emphasize the 12-steps ("forced abstinence") I have to say there is a fair amount of truth. Or at least it corresponds with my experience and research. The disease model of alcoholism is highly problematic. It was originated by Edward Jellinek at Yale Center for Alcohol Studies, a group that always had a political agenda: to take alcoholism treatment out of the hands of the zealots. It was a worthy goal, to be sure, but Jellinek realized immiediately that this "disease" was unlike most others in that there was no pathogen, no acutal disease entity. But, he claimed with some justification, thta there was no real definition of disease in all of medicine, and "The splendid progress of medicine shows that that branch of the sciences can function extremely well without such a definition. Physicisans know what belongs in their realm. It comes to this, that a disease is wha tthe medical profession recognizes as such. The fact that they are not able to explain the nature of a cond9ition does not constitute proof that it is not an illness." [a sentence that could be translated to "abnsence of evidence is not evidence of absence." The disease model has succeeded in inspiring more humane treatment for addicts and, to a limited extent, in putting more resources at addicts' disposal, but it has also resulted an a fair amount of distortion and injustice in the treatment industry. This isn't the place to go into all that, but consider that the major source of addictoin treatment money in the US Governemtn told its grantees that they would lose their funding if they so much as mentioned (I'm not exaggerating; I have the documentation) "harm reduction" in their reports or grant requests or if they participated in any way in needle exchange programs and you will see the problem of 12-step hegemony. The 12 steps, and particularly their focus on Abstinence, dovetail nicely with some of the ugliest features of American life, like intolerance and like the ongoing effort to forcefully repudiate the sixties that dominates in Washington right now. And it's all founded on an untruth: that addiction is a disease. I think that abstinence, limited or global, permanent or temporary, is a worthy and useful practice. I know people who can't drink but can smoke pot, people who need to avoid xanax but do fine with acid and so on. I know people who just can't get high at all because the next thing you know they'll be selling their mother to buy Robitussin. And I think this is probably what you are saying, Martin--that for a certain group of drug abusers sobriety is the best policy--not only because it allows them to stay alive but also because it gives them back their consciousness. Actually, that strikes me as common sense. But I think it's important to remember that due mostly to the way it has been taken up into our political and cultural lives, the ignominy of the 12 steps in certain circles is as honestly earned as its high reputation is among recovering addicts. But speaking of truth and the 12 steps, David Crosby is one of your major informants on the subject of drugs and abstinence. What did you make of his recent arrest?
Berliner (captward) Tue 25 May 04 05:33
Good comment, Gary. There are cultish, religious overtones to the way some people interpret the 12-step programs that I find creepy. i was once pushed against the wall by the ex-wife of a friend who needed to atone for all the wrong she'd done me, and all I could say is, hey, I only met you once and you spent the whole time frying chicken. Of course, I never *got* any of the chicken, but her husband and I had an appointment we had to keep. That said, I'm not going to gainsay the great work it's done for lots of folks.
Martin Torgoff (martintorgoff) Tue 25 May 04 06:35
Gary, I have no thoughts about David Crosby's recent arrest in New York for marijuana at all because I don't know what really happened. For all I know, he could have been carrying the weed for someone in his band, and without any knowledge of the details, it would be dumb to conjecture anything about it. I do, however, have plenty of thoughts about your thoughts. The debate about whether addiction is a disease or not can go on forever; it's a fascinating and significant argument and we can have it or not. But I think your whole notion of "12-step hegemony" is misnamed and misdirected, if not downright paranoid. If anything defines the 12-steps, its the recovery fellowships themselves, and how they actually work in people's lives, not anyone or any organization even remotely connected to any aspect of profit, policy, or politics. I direct your attention to the Traditions of AA: Tradition Eight--"Alcoholics Anonymous should remain forever non-professional..." Tradition Ten--"AA has no opinion on outside issues..." Tradition Ten--"Our public relations policy is based on attraction rather than promotion..." I don't have to tell you that the people in recovery fellowships are as varied, politically and culturally, as the population at large. The bible thumping fundamentalists in a small town AA group in Mississippi are as different in this regard as the Rodeo Drive group in Beverly Hills, who are as different as the Zen Buddhists who go to meetings in Marin. Anyone in any of these groups who professes to speak for or represent the fellowship and the steps in any way, is in violation of these traditions. Someone like Mitchell Rosembloom is no more a spokesmen or lobbyist for the steps themselves than a representative of the drug testing industry. So the very idea that the "12 steps, and particularly their focus on abstinence, dovetail nicely with with some of the ugliest features of American life, like intolerance and the ongoing effort to forcefully repudiate the Sixties," etc.--not only is it inaccurate and wildly hyperbolic, but it's just not useful. Are there plenty of recovering fundamentalist types who disagree with harm reduction and needle exchange programs? You bet, just as there are plenty of us who agree with them. But the ones who disagree, if they do so publically, or in some organizational manner that embodies any kind of agenda whatsoever, do NOT represent the steps or the fellowships, because they CAN'T. Of course, I wouldn't presume to deny that a significant faction of recovering addicts who themselves have become addiction "professionals" may be in league with organizations like the Family Research Council on an issue like needle exchange, and that such an association incorporates an agenda of policy and/ or profit, but you could easily find plenty of addicts in recovery fellowships who would stand up very vocally for needle exchange. But they wouldn't be representing anyone but themselves. In sum, then, the idea of the 12-steps being associated with any political or cultural attempt to "forcefully repudiate the 60s" is no more accurate than associating the steps with an attempt to affirm the 60s. That's why I don't think the "ignominy of the 12-steps in certain circles" is "honestly earned" at all. I think it's an example of ideological bias, and like any bias, it's based on preconceived beliefs and ignorance.
Gary Greenberg (gberg) Tue 25 May 04 06:42
AA grew out of the Oxford Group, a quasi-evangelical (but not fundamentalist) Christian organization that stresses confession in the context of fellowship and acceptance. The intersection of the two occurred in about 1935, when Bill W. was adopted by an Oxford cell or when he decided to apply Oxford principles he'd already adopted to his ongoing attempts to stay sober, depending on which version you believe. The date is interesting--a couple of years after end of Prohbition (itself largely the work of Christian crusaders), the church finds itself again involved with alcohol, only now ministering in a whole new way to the drinker. THe Yale Center got started in the nexst ten years, and was already committed to the AA model of alcoholism, which more or less conceptualized it as an allergy to alcohol. So the hypothesis that alcoholism was a disease followed from the need of the movement to see it that way. Without that notion, the fact that "we became powerless" is no more than what it was when Jonathan Edwards was preaching about hellfire: a symptom of the depravity of the will. AA requires that alcoholism be shifted from a sin to a pathology, and Jellinek provided the auothority for this shift--all, of course, without a shred of evidence. And this has in turn given legitimacy for what is indeed a discipline of compulsory sobriety. You see it in the way that clean urine specimens are a condition of probation, of employment, of school sports participation, etc. and that when you fail the piss test youir only alternative to jail or joblessness or what have you is to participate in a 12-step group. It would be much harder to pull this off if we didn't all believe that addiction was a diseaser for which AA is the cure. But here's another way to look at it: Diseases surely aren't simply what doctors say they are; otherwise homosexuality, to cite the most obnoxious example, would still be an illness. But they are also perhaps not "natural" phenomena. ONe theorist, Peter Berger, says that diseases are all soocially constructed, that from the point of view of nature there is little or no difference betweeen the snapping of a femur and the snapping of a tree limb, but that this is actually good news. Because the function of calling something a disaease is that it allows the sick people to make demands on their society. (Berger wrote this in 1972, long before people actually started to do this.) An honest disease model of addiction would, then, not insist that either AA or sobriety was the cure for addiction and that society's resources shoujld be expended only on those cures but rather that addcition is a complex, idiosyncratic phenomenon that requires multiple resources, including harm reduction measures, etc. In other wrods, sobriety is the tail that wags the dog of both treatment of and theorizing about addiction. This puts a hair across the ass of libertarians and some drug users. Sounds like one of them reviewed Martin;s book.
Gary Greenberg (gberg) Tue 25 May 04 06:52
last response was not in response to Mart5in's 53, although I suppose it could have been. What I am saying about AA is not about the people who practice it, but about the institution./ Which is an interesting thing, becasue the institution in many ways doesn't exist, just as you say, Martin. That is, there is no AA central HQ or anthying like that, no conspiracy to own the field of addiction treatment or to enforce sobriety on the unwitting masses. But it is not paranoid at all to assert that AA has hegemony over both the professional and the layperson's understanding and experience of addiction and treatment. I would be willing to bet you, for example, that more than 90 per cent of the addiction treatment facilities in this country are 12-step oriented, that they conduct their treatment on the 12 step model, and that their aftercare program consists of refeerral to a 12-step pgroup. I'd say theat virtually 100 per cent of law enforcement referrals for addiction are to 12-step groups, that prison treatment, where it is available at all, is 12-step groups, that parolees and probationers are routinely ordered to 12-step groups as a conmdtion of freedom, that corporate drug-testing programs routinely (here I'm not so sure of the nuimbers, but it's got to be a majority) result in referrals to 12-step groups and that attendance is sometimes a requrirement. I would also say that if you are a community mental health treatment program and you want to get government money, then you have to have a 12-step model in place. AS for laypeople, I think if you asked the average joe on the street, he ouwld tell you that addiction ios a disease and that AA is the cure, although I will admit I've never done this and I could be wrong. This is what I mean by hegemony--no conspiracies, just a fortuitous coming together ofo a powerful idea and a receptive culture. To use a term popular on the Well, it's a meme.
Gary Greenberg (gberg) Tue 25 May 04 06:59
None of which is to say that the 12 steps don't work. (Although they don't work with the kind of regularity that one might think.) Or that they are bad. But another problem with what I am calling their hegemony is that it forecloses other possibilities, some of which might be at leastas effective. Ibogaine is a good example. Here's a drug that is at least potentially effective against addiction, and for good pharmacolgical reasons. Now the reason that NIDA won't fund ibogaine research is not that NIDA is somehow in thrall to the 12-step movement whbich is in turn run by an evil cabal of Nazi doctors. That would be a paranoid assertion. But its refusal is surely related to the fact that ibogaine treatment is so far outside the paradigm, and also to the fadct that NIDA can say that we laready have a cure for addiction, which is AA.
Gary Greenberg (gberg) Tue 25 May 04 07:14
The Washington Post review: http://www.washingtonpost.com/wp-dyn/articles/A42448-2004May20.html
Robin Russell (rrussell8) Tue 25 May 04 08:15
From David Gans' into on Gary Greenberg: "Gary writes on drugs whenever he can." Way to go, Gary.
Gary Greenberg (gberg) Tue 25 May 04 09:37
I blame Gans.
Robin Russell (rrussell8) Tue 25 May 04 09:48
Good idea. Everyone else does. I've ordered the book, hope to make some less inane posts once it is delivered.
Martin Torgoff (martintorgoff) Tue 25 May 04 19:27
Ok, just a few more comments about so-called "12 step hegemony." Just remember one thing: the 12-steps are AA's "suggested" program of recovery. "The only requirement for AA membership is a desire to stop drinking." It doesn't say jackshit about the steps in the Preamble! Nor does it even say anything about abstinence in the steps. You don't even need the steps to stay sober, for chrissakes. You can go to a meeting and drink every night and come back the next day for the rest of your life and nobody can ever deny your right to be there. But people use the steps because they realize their utility in how to really change their lives once they quit drinking or drugging. And, again, they're SUGGESTED. There are people in AA who make a big deal about how they've been sober for 20 years and never worked a damn step, just like there are people who make a big deal about how they're atheists. And, remember, all this stuff about God in the steps that makes people queasy that AA is some quasi-evangelical religious cult or something--it's a GOD OF YOUR UNDERSTANDING. People literally invent their own Higher Power. So for all the seeming dogmatism of the steps, they really encourage a unique kind of spiritual creativity. The plain fact is that the steps work--not for everyone, but they've helped more people deal with alcoholism and addiction than any other philosophy or program. Why have they caught on? It's very complex, and a lot deeper than AA, the lobbying of the National Council on Alcoholism, the treatment industry, or the criminal justice system being in cahoots. In fact you can blame Oprah Winfrey as much. Yes, as Gary points out, they've evolved out of a tradition of protestant temperance, but the real reason they work, their real power, lies in the fact that they incorporate elements of all the great wisdom traditions--meditation, service. self-examination, fellowship--confession being only a part. Nuff, lest people think I'm trying to promote. Personally, I have a problem with all kinds of fundamentalism; I deeply distrust it, whether religious, cultural, or political. I lay many of the worst problems in the history of the human experience at the feet of fundamentalism. Are there 12 step fundamentalists? Hell, yes. Call them AA Nazis. Big Book thumpers. Some drunks and addicts, of course, are desperate and need this kind of fundamentalism to survive. It becomes a life saver. They never let go and they can get downright messianic about it. But never forget that one of the most attractive things that make 12-step recovery fellowships work is this slogan: Take what you can use and leave the rest. Personally I find the steps to be ingenious, and when all is said and done, I think people will look back and see them, in their pure form and practice, as one of more significant American contributions to world culture in the 20th cent.--right up there with jazz, blues, and rock and roll, in my book. And that's another reason why I think that, no matter how "hegemonistic" or self-aggrandizing the organizations that practice them may appear, the whole rationalist/intellctual crtitique of them is, ultimately, like farting up a rope.
Gary Greenberg (gberg) Wed 26 May 04 04:04
Your chapter on Noveau Psychedelics is a sort of coda to the book, coming after the disaster of cocaine and the description of recovery. And it has a different trajectory than earlier chapters, no arc from discovery to excess to disaster. YOu also manage to talk about one of the areas of the culture whose debt to psychedelics is rarely mentioned--the computer/cyberpunk/post(trans)humanist nexus. (For those of you who haven't got there yet, this is the chapter that features, among others, RU SIrius.) "in this cultural configuration, freedom of information and ulimited access to computers were the imperatives; cyberpubnks should always mistrust Authority, Promote Decentralization, Do It Yourself, Fight the POwer, Feed the NOise Back into the System, and Surf the Edges." It's a fascinating discussion, and it ties in with something that is very au courant: the question of biotechnological enhancement, e.g., brain implants, steroids, Prozac, etc. The enhancement enthusiasts that you interview are attracted to the idea of drugs as much as to drugs themselves--as something that perturbs consensus reality, "an objective correlative for being weird and different," as Rudy Rucker put it. Questions of the ultimate fate of drug taking aiside, you seem to give credit to drugs for being able to wreak transformations at a very deep level--something that makes the transhumanist project not only plausible but in some ways, at least potentially, attractive. So I was wondering as I read this chapter what you think of this idea of remaking ourselves by getting at the source code.
Of course this can get a little solipsistic (pjm) Wed 26 May 04 09:05
Martin, your comments and responses to the 12 Step issues are spot on. Thank you.
Andrew Alden (alden) Wed 26 May 04 12:46
Yes indeed. Put them online somewhere, if you haven't already. (Of course, they will live on here.)
the Conoisseurship of Stonation (bratwood) Wed 26 May 04 16:11
The freedom and autonomy of the 12 Step programs can probably be brought into greater focus if contrasted to something seriously structured, like say Scientology's Narconon.
Martin Torgoff (martintorgoff) Wed 26 May 04 16:38
"The idea of drugs as much as the drugs themselves..." I do give credit to drugs to be able to wreak "transformations at a deep level," as you call it. One of the great pleasures of the entire experience of researching this book has been learning about the quality and depth of some of the conceptual thinking that has come about as a result of the whole experiment of altered consciousness that took place around the rediscovery of psychedelic substances like peyote and psilocybin mushrooms, and around the discovery of LSD and the phenetylamines. Fortunately there have been some excellent books about the psychedelic theorists like Huxley and the whole secret history of the government involvement with psychedelics like Acid Dreams and Storming Heaven. At some point I had to make some hard decisions about the book because of length and scope, and one of them was to where to fade in with the psychedelic story. As fascinated as I was by Huxley and Wasson and Schultes et al, I decided to fade this story in where it most impacted on my own generation. The two most powerful strains were the Leary-Alpert scene at Harvard, and the Kesey-Prankster experience. This meant merely alluding to pre-1960s psychedelic history where appropriate. It wasn't an easy decision, but as I became more aware of the Nouveau Psychedelia of the 80s and 90s and how remarkable and rich it was with MDMA, the Shulgins, rave, cyberpunk, the ongoing re-invention of Tim Leary in his 70s, and especially the emergence of Terrence McKenna as one of the most unique philosophers of the 20th century, I realized that the story would be perfectly bookended because it seemed not only to come full circle but signify and affirm with stunning clarity the ongoing relevance of drugs in our culture. What the Nouveau Psychedelia made obvious was that despite the brutality of the war on drugs as the ultimate personification of the right wing counter-reaction to the psychedelic 60s, it had never, and would never, go away. The genie was out of the bottle (out out out!) never to be fully put back inside. And it was also obvious that to some folks drugs were every bit as cutting edge in the 90s as they;d been thirty years earlier (nobody said it better than Wavy: "The 90s are the 60s turned upside down"). I think Sirius and his crowd deserve a lot of credit as the chroniclers of the sensibility; they merchadised it in Mondo in a way that was very clever and fun. But nobody was more influential in his sheer weird brilliance (or brilliant weirdness) than McKenna, whose very obsession, of course, was the "idea of remaking ourselves by the source code," as you put it...McKenna, who had the balls to smoke DMT and try and figure out why, despite scientific and technological advances that seemed to be occurring at the speed of light, we can't seem to stop hating and slaughtering each other. And posited a pharmacological thesis and solution!
Gary Greenberg (gberg) Wed 26 May 04 17:23
That was remarkable, and his delivery was spellbinding. I firts encountered McKenna via a tape of True Hallucinations, which I listened to in my care over the period of a couple of weeks. I can still hear him reeling off those plant names--banisteriopsis and yage and so on--in that nasally deadpan. That was during the time that my wife was doing her dissertation on people who had been abducted by extraterrestrials, ande for a few months there I really believed in all that stuff--that mushrooms were UFOs, that we were rapidly hurtling toward some kind of psychedelic armageddon, etc. It was all held together, somehow , by McKenna's voice. Too bad he died. I think you did the right thing, focusing on the two psychedelic scenes that you did. No point in reinventing the wheel. But let's talk about drugs as medicine for a second, because that's what the Nouveau Psychedelics chapter made me think about, especially the part about MDMA. I think Rick Doblin is onto something in his attempt to medicalize MDMA. When I work with couples who are held back by fear, and when I think about the way that MDMA can provide an experience of the other in the absence of that fear, and all the good that can come of that, I really wish that MDMA wqas legal for medical use. But I wonder what you think. Is bringing some of these drugs into the official pharmacoepia a worthwhile effort?
Martin Torgoff (martintorgoff) Wed 26 May 04 18:16
It makes me furious that MDMA is not being researched and licensed for therapeutic use. It's nothing less than criminal that the population is allowed free access to massive amounts of anti-depressants through medicine and psychiatry but can't make use of MDMA. I only did it one time and it was packaged to me as a whole candle-crystal mineral bath New Age experience by this wonderfully witchy lady named Frances, but once was more than enough for me to see that every single claim made about its potential therapeutic application deserves serious consideration. I don't know Doblin personally but of course I know of him and his work and he deserves tremendous credit for his dedication and tenacity. So there's no doubt in my mind that the substance could be enormously useful; the questions would be how to best use them, and we've really lost a lot by not being able to freely work in this area to truly ascertain their potential as well as their limitations. Never having had ibogaine, I can't remark about it, but unlike many abstinent people in 12-step recovery fellowships, I even see the potential value of MDMA in the treatment of addiction (heresy!). I mean, so many recovering alcoholics and addicts are also the victims of the most horrendous kinds of abuse, especially sexual, which becomes a paramount issue for them, and they just fall into an abyss of pain where they get stuck. I think that with the right treatment, some of them might benefit from MDMA.
I'm on the Chet Atkins Diet. Pass the BBQ, please. (rik) Wed 26 May 04 18:56
Thank you, Martin. That's the way it looks to me, too.
Gary Greenberg (gberg) Thu 27 May 04 05:44
Some of your remarks earlier make me think that you are pessimistic about the prospects for the end of prohibition. In your chapter on the subject, you mention two conditions that maight be necessary to reform. "Reformers would have to address the ideology of abstinence itself..." and, quoting Ethan Nadelmann, "If we win the battle over kids and drugs, we win drug policy reform." Can you expand on this here? What is "the ideology of abstinence." Do you think it is a problem or are you relaying what reformers think? I'm assuming that there is a difference between abstinence itself and the ideology of abstinence, but I'm not sure what the latter is. (Heck, maybe I don't even know what the former is.) ANd what way of addressing it would bring us to reform? And what is this battle over kids and drugs?
David Crosby (croz) Thu 27 May 04 09:30
isn't the prohibition at least as far as marijuana is concerned being encouraged / payed for largely by the liquor lobby who I believe know full well that pot is a better high and doen't kill you ( as booze definately does ) and worst of all for them ....is free ...you can grow it in your back yard ....a terrifying proposition to them ?......
I'm on the Chet Atkins Diet. Pass the BBQ, please. (rik) Thu 27 May 04 09:36
"...payed for largely by the liquor lobby". Worse than that, David. Almost all of the funding for the "Partnership for a Drug-Free America" comes from the three pillars of legal drugs. Alcohol, tobacco, and pharmaceuticals. And that's the way they control the debate in such a way that the damage they do to society doesn't even get brought up, much less compared to that done by the prohibited drugs.
Uncle Jax (jax) Thu 27 May 04 12:00
This is true, but the reasons the prohibition continues are more complex than the funding/funders of its propaganda machine.
Robin Russell (rrussell8) Thu 27 May 04 12:37
Yes, no doubt it is a useful component of the control apparatus as well.
Gary Greenberg (gberg) Thu 27 May 04 16:16
>Almost all of the funding for the "Partnership for a Drug-Free America" comes from the three pillars of legal drugs. Not anymore. That was true when PDFA started up, and it was always a project of the RW Johnson Foundation, whose money comes from Johnson & Johnson. (Incidentally, no one was supposed to know that PDFA was funded this way. Cynthia Cotts, a Village Voice reporter, made a routine request for their NY State tax return and was sent the entire thing, including the list of contributors and what they gave,. which she promptly pubioshed in, I believe, the Nation. A big embarrassment.) But PDFA runs differently now. They still get corporate money, although after Cott's article ran they but they have entered into an unholy alliance with the Office of National Drug Control Policy (ONDCP), better known as the drug czar's office. ONDCP provides the money--around 165 million dollars this year--for media buys, and ad agencies supply the creative force on a volunteer basis. The overall PDFA advertising effort, they say, makes them the second or third largest ad buyer in the country. The best historical comparison to the PDFA is the War Bond drive of WWII, which was conceived as a propaganda tool that had as an almost incidental outcome the squirreling away of insignificant amounts of money. Like that effort, the PDFA allows corporations, especially the media, to get pr points and viewers/readers to feel good about the war on drugs, to feel like something is being done. Now, I really don't mean this as a conspiracy theory, but this effort is undoubtedly related to the way that the media cover the drug war. Here's an example. I pitched a story to a big magazine with which I have a good relationship and a good track record, and which prides itself on taking on the powers that be. It was the MDMA bogus science story, which for various reasons I had long before it was public. I was turned down because the magazine didn't want to expend any of its "liberal chits" on such a story. The PDFA ads are devastatingly effective, not so much in changing people's minds as in disclosing and reinforcing the consensus. It is very hard for an editor to want to take on this kind of juggernaut.
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