Substance Abuse vs. Self Abuse

by Les Smith, CFO
Oasis Mountain "OM" Wellness Center

Alcoholics Anonymous is a powerful force. Few can resist the charms of AA and few can truly break its embrace. AA thrives on the sadistic pleasure of a collective mentality. AA is the sirens that entice the wandering traveler with songs of sobriety and, once successful, turns the mind into a complete void. AA is a Venus Fly Trap. AA's attraction is like that of religion to the lost soul who, wishing to be free and happy, becomes trapped and miserable in constant prayer. Alcoholics become addicted to Alcoholics Anonymous.

But the saddest part of the dependency is the fact that most participants are willing victims. They think that they are happy, but just one day at a time. They believe that AA has kept its promises and have no desire to search elsewhere. They are deeply in love with the 12 steps and have been blinded by that love to the point of unquestioning sacrifice. They become smiling drones that can automatically regurgitate the dogma that they are fed without a glance... And for the unfortunate first timers, "Resistance is futile".

The answer is not to replace your love of alcohol with a higher power; but to just give it up purposely. The answer is to let the motivation that drove you into that relationship be the same one that drives you out of it. The answer is to allow the "transformation from the unquenchable to the enlightened" to happen without the crutch of a sponsor. The answer is to achieve the "higher awareness of self-empowerment" as opposed to attending an oblivious lifetime of meetings. The answer is to awaken from the unconsciousness of the rituals and to realize the beauty of your place in the unfurling. The answer is in the unaltered process of simply becoming you.

Given that habits can become compulsions and later addictions are simply semantics. The problem at hand is the "condition". If resignation to an omnipotent being will achieve the desired results for the masses, so be it for them. The intellectual "freethinking" elite need more to resolve a misunderstand of the world from an altered state or an "outside of the self" frame of reference.

There is an element of those that reach for the "above and beyond" that is not understood by the proponents of most governments and religions. Regardless of a process theology, an ontological constant, or a metaphysical reawakening, the "song remains the same". One can choose to be in a constant haze, or to revel in a "higher awareness". Beauty is in the eye of the beholder; however, the beholder must understand the difference between "what is pretty" and "what is good" for it to really make sense. The jaundiced eye of aestheticians can do more for the ethical unworthy than history can ever extrapolate.

Ronald R. Parks, MPH, MD, PLLC, Integrative Medicine and Psychiatry Consultant at Oasis Mountain Wellness Center, feels that substance abuse can result from the cycle of cravings that are triggered by environmental toxins such as pesticides on your food. In his recent article, "Addictions - Breaking the Cycle", Ron writes:

"A high degree of other co-existing problems ... may need addressing before addiction treatment can be successful or sustained. This includes many common nutritional, hormonal, allergy/immune and metabolic problems, or other medical and psychiatric conditions.

Proper nutrition and diet can be critical especially if signs of deficiencies and hypoglycemia exist. Imbalance or deficiencies of minerals such as magnesium, copper, and zinc; amino acids; essential fatty acids; vitamins such as B6, B12 or folic acid; related nutritional and digestive factors; and hormonal deficiencies (as thyroid problems) all can be corrected if appropriate assessment is done.

Another dilemma that faces individuals trying to understand their cravings is the unrealistic expectation for many that if they ever take another drink of alcohol, then they will automatically be transformed into a stark raving lunatic and wind up on skid-row. The guilt factor, the shame and blame that is the second most manipulative tool of 12-step programs (next to religious brainwashing) creates immeasurable stress for participants because they are led to believe that alcohol is evil in and of itself. The beverages does not jump to your lips - you have to make a conscious choice to raise the glass. If you can make that choice without a "higher power", you can also "self-empower" either not to drink at all, or drink responsibly.

"Moderation Management" through methadone is the norm for heroin addicts. I continue to be amazed that anyone sees the only indicator of success following alcohol treatment as being "complete" abstinence. For no other chronic disease do we see "complete" cure as the only indicator of treatment success.

Let's assume that after your pneumonia was treated with antibiotics and you no longer showed any symptoms, you were told that as long as you had any moisture in your lungs you were still sick. You could never really be cured of pneumonia and must keep all moisture out of your lungs for the rest of your life. Alcohol consumption in the absence of any symptoms of abuse or dependence is not alcoholism, just as moisture in the lungs is not pneumonia except when it is producing symptoms of pneumonia.

The goal of treatment research is to identify treatments that cure people. Curing alcoholism does not require abstinence. The goal of treatment should be eliminating the disease. If a person no longer shows any symptoms of alcohol dependence, then they no longer are alcohol dependent. That doesn't require abstinence. Look carefully at studies of treatment - if the requirement for success is to have remained totally abstinent from alcohol from day one, only about 10% succeed "for life" (which you obviously can only examine after they have died).

Success in moderating is more common than success in abstaining. Epidemiological studies of the population show very large numbers of former alcoholics who are now moderate drinkers -- more than are abstainers. Follow-up studies of treatment show that almost as many "graduates" of abstinence-oriented treatment are succeeding at moderate drinking as are abstaining. The available evidence all shows that the moderation parachute is at least as reliable as the abstinence parachute and very likely more reliable. "Moderation is harder" has become a popular slogan but I know of nothing that shows it to be true. There is excellent evidence that abstinence as a goal increases the risk of relapse and makes relapses more likely to be severe and/or permanent. The convenience of abstinence as a "measuring stick" should not justify the means.

Yes, there might be as many as hundreds of thousands who have achieved abstinence without relapse, although most who achieve abstinence do so after repeated relapses. There certainly are at least hundreds of thousands who have failed repeatedly in their attempts at abstinence and who never succeed in achieving it. A person who has returned to moderate drinking HAS succeeded in eliminating all harm from alcohol use. Moderate drinking is NOT harmful; but is sometimes beneficial. Recent medical research confirms this. Small amounts of alcohol can have cardiac benefits and possibly delay the onset of Alzheimer's.

Not only are the effects of moderate alcohol consumption on heart health very well established, but their are also benefits in preventing ischemic stroke (but not hemorrhagic stroke), type 2 diabetes, and gallstones. Alcohol also lowers the incidence of rheumatoid arthritis in women and perhaps in men as well. Two studies have shown that moderate drinkers are less susceptible to the common cold. Moderate alcohol consumption is also associated with better mental health and better self-reported general health. You can find a good summary of the research in the American Council on Science and Health publication Moderate Alcohol Consumption and Health.

We stigmatize the very people who successfully reduce use to levels where no problems are present and keep them continually under suspicion rather than the object of praise. Abstinence becomes a goal that you feel they should be pursuing. Not necessarily their goal, and not a goal that has any merit greater than the goal of moderation, except from the perspective of a moralistic view of drinking as evil.

I even assert that this discussion has somewhat gotten the cart before the horse. Why would anybody spend enormous amounts of energy worrying about how much he "doesn't" drink? If you don't have a problem, you don't think about drinking too much. There is nothing wrong with drinking -- nothing at all. Many people do it. Many people ski. Many people don't. For those of us with little sense of balance on a pair of waxed slats to expend time and energy on trying to learn to moderate our skiing, is ludicrous. We'd be better off exercising in a manner that is more suited to our physiology; however, I bet I could find someone who doesn't have a problem skiing who would be willing to teach me how to ski -- even if I killed myself trying.

I wonder when the professionals will discover what the rest of the world already knows: If someone can moderate without undo attention on moderation and sustain that moderation over time, they aren't moderating. If we ever got this simple truth clear in our conversations, we could then define an alcoholic simply as someone who cannot drink moderately.

The "Addiction is a Disease" argument for total abstinence is also an exponent of the 12-Step Hazelton "Minnesota Model" that over the past 50+ years has rooted itself into medical school dogma and the criminal justice system. They are the same organization that has based the now standard duration of treatment on what insurance reimbursement will allow, i.e. "28 days because it pays". Stanton Peele, Ph.D., J.D., a licensed Psychologist and Pool Attorney in the Public Defender's Office of Morris County, New Jersey, is a strong supporter of "Moderation Management" and outspoken adversary of the "Disease" concept. Peele, in his book "Diseasing of America" writes:

"THE PARADOX of the American addiction treatment industry is the tremendous growth it maintains without demonstrating that it works. In the case of alcoholism, the treatment industry first convinced us that alcoholism is a major problem and now persuades us that the problem is ubiquitous. This problem augmentation-and not any evidence the industry has offered that it can stem alcoholism or treat it effectively-serves as the justification for the entire industry. The alcoholism industry thus presents a model of growth for any other industry that would carve out a niche in the mental health marketplace. The drug abuse industry is another case of the success of futility. We have spent successive fortunes on campaigns against drug use-yet inner-city addiction and drug degradation achieved their major gains in urban ghettos only after we targeted drug abuse as a major social problem.

"The addiction treatment industry is an expression of larger trends in American society. The principal trend has been our failure to stanch every social problem associated with the underclass that has evolved in the United States. Rather than address the fundamental social issues underlying ghetto deterioration, addiction policies speak to primarily middle-class anxieties. Problems rooted in ghetto life, in addition to substance abuse, include violence, childhood obesity, and the poor health of the fetus and newborn in America relative to every other industrialized nation in the world. And although these problems are worst in the ghetto, middle-class America also suffers from a version of each problem more severe than those found in other economically advanced countries.

"Moreover, the addiction industry expresses the sense of loss of control we have developed as a society, an anxiety brought on by our utter incapacity to alter the trends over which we are so distraught. We have simply proved incapable of identifying correctly the sources of our most dire problems, and our tendency instead is to respond to our anxieties. Our fears themselves have now absorbed our attention to the point where they endanger our individual mental health and our health as a society. Our fears for our children, among other fears, affect us so much that we can no longer carry on a community life in the United States. Yet the failure of community leads to greater alienation, health problems, and the kind of violent and addictive relationships we examined in the previous chapter. Americans as a group now share some of the traits said to characterize mental illness, such as a terror at something nameless that we cannot shake.

"Why is it that America has now entered the age of addiction? Why have we become so afraid that addiction is everywhere and that we are out of control of our eating, shopping, lovemaking, gambling, smoking, drug taking, menstrual cramps, feelings after birth, anxieties and depressions, and moods of all kinds? What characterizes modern-day Americans and American society that can possibly explain the out-of-control growth of the experience of being out of control? Let me list what I believe to be the main dimensions of this problem:

"1. We have marketed loss-of-control conceptions to a fare-thee-well.

We so often believe we have lost control because we are told so constantly about the danger that we will lose control, about the prevalence of loss of control, and about the signs that indicate we have lost control. It is only to be expected that so many people would take up the cues from the media and everywhere else around them that maybe they, too, are out of control of something in their lives, and that this is a disease requiring a kind of medical attention. It is also a natural by-product of the marketing of loss-of-control ideas and treatments that we increasingly see the world as an uncontrollable place.

"2. We are alienated from many of our basic emotional and physical experiences.

Among technological societies, we in the United States are the most alienated from basic emotional and physical experiences. In our efforts to protect ourselves from accident and assault, we have built up our fears of our physical and social environment to the point that dealing with our fearfulness is frequently our most pressing problem. As a result, we worry incessantly that no matter how sensibly we act; we can be hurt by the world around us, by the people around us, and by our own bodies and behavior.

"3. America is the most medicalized of all societies.

Americans rely more on medical technology for solutions to both sickness and ordinary life problems than any other society. Americans invariably seek more medical treatment, and American doctors and other professionals seek to provide this treatment, whereas Europeans more often allow healing to take its course and recognize that every medical intervention has its own risks. Indeed, Europeans more readily accept that every problem does not have a solution and that life has a good deal of uncertainty and imperfection about it. The American credo, in contrast, is that medicine can ultimately fix everything that is wrong with us. This reliance on medicine extends to our attacks on our largest, most complex social problems.

"4. We are preoccupied with our innermost feelings but are oblivious to how these feelings stem from our social relationships.

Americans are famous for their self-improvement programs, particularly those geared toward emotional well-being. At times it seems that, as a nation, we are all involved in the constant contemplation of our neuroses. Yet although we spend so much mental energy examining what is wrong with us and our relationships, we refuse to consider how our emotional states and patterns of interacting are linked to social structures like family, work, and community. We prefer to make individual resolutions to change or to consult with private physicians or therapists or to join self-help groups rather than to strive to change our families, our work, and our communities.



"5. Americans are not comfortable in communal arrangements.

One great paradox in America is that so many of us are willing to join self-help groups and movements, and yet are reluctant to be part of our own communities. Americans live and love isolated suburban existences. We don't meet in pubs, cafés, and boulevards like those in some countries, or join with neighbors or extended families in sharing meals and household space. In fact, "making it," means not having to do these things. As a result, for most Americans, the concept of community is moribund. The condo "community" of transients is the model for American life today.

"6. Americans are ambivalent about alcohol, drugs, and intoxication.

From temperance to Prohibition to the modern drug era, an awful lot of American history has focused on efforts to regulate Americans' pursuit of intoxication. Why is this? Americans are both prudish and idealistic, so that we believe we can be perfect and that intoxication and bad behavior should and can be eliminated. At the same time, like people everywhere else, many Americans welcome intoxication. Only for Americans, our drive for intoxication conflicts so greatly with the value we place on self-control. It is, of course, our constant disappointment at failing to live up to this value-a value many cultures don't share-that makes us so preoccupied with loss of control.

"7. Temperance and AA have radically affected the American sensibility.

The historical facts of temperance, Prohibition, and AA-while they spring from the depths of American culture-have also had a tremendous impact on how we conceptualize our social and personal problems. The mission of temperance adherents and AA proselytizers has been to convey the beliefs that alcoholism is a disease and that alcohol exercises an alluring but destructive power over our bodies and minds-our souls, in fact. And these preachers and businesspeople have done a passionately successful job in selling Americans this view of the world. One of the most successful aspects of this sales job has been the convincing of liberal-minded Americans that it is most humane and helpful to regard drunkenness and other misbehavior as being out of people's control.

"8. Disease conceptions have come to stand for all of our fears.

We in America congratulate ourselves on discovering so many things that can addict us (a list that grows never-endingly), at the same time that we never gain a sense that we can control the sources of our fears. These two themes interact addictively-that is, more of the one creates more of the other. In this addictive cycle, we feel temporarily relieved when we can claim some unwanted behavior (our own, our children's, a stranger's) is due to some new disease. But the longer-term consequence of this process is to make us more frightened and impotent and more likely to identify new diseases. Addiction then becomes the all-purpose explanation for the control of our worlds and ourselves that constantly eludes us."

So, the point that I raise is the concept of "Substance Abuse" is actually a misnomer. In fact, the problem at hand is "Self-Abuse", and the way to deal with it is not to consider anyone as "diseased". This allows the individual to skirt moral responsibility, i.e., "I killed my friend while driving drunk, but I am sick, so it is not my fault". Also, to label someone "Once an alcoholic, Always and Alcoholic" is to label them as "Mentally Ill". Soon, they will come to believe that they are "incurable" and will continue to behave it that fashion. If a patient's cancer goes into remission, then should they continue with radical chemotherapy? If someone learns to control their drinking, should they continue to attend AA meetings for life? The stress and depression that results from a feeling of "powerlessness" is rabidly more detrimental to health than any alcoholic beverage. And how can one actually "Abuse" a "Substance" anyway? If "guns don't kill people, but people kill people", then People don't "Abuse Substances", they "Abuse Themselves".

Les Smith is CFO of Oasis Mountain Wellness Center in Weaverville, NC, near Asheville. The center has announced a unique, non-sectarian holistic substance abuse treatment program to begin in December 2002. The integrative techniques will offer an alternative to traditional 28-day, “12-step” methods. Some of the unique processes to detoxify the body, clarify the mind, and reawaken the spirit include stress management techniques, nutrition, yoga, meditation, acupressure, bodywork, breathwork, exercise, and other non-invasive methods. All activities are under the direction of licensed and certified practitioners. OM will also allow pre-trial enrollment to avoid mandatory jail time for pending convictions. Because this approach is not part of a court sentence, it helps the client to design their substance abuse treatment around employment and other concerns. Also, as a "voluntary" vs. "court ordered" program, the clients can qualify for health insurance reimbursement. Photos and additional information can be found at website: www.oasismountain.org

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