I’ve recently had reason to ponder this difference, because I belong to a professional medical organization of Addiction Medicine physicians. There is controversy in our field about how and when medications should be used. A group from that organization recently launched an effort to reemphasize psychosocial treatment in general and the 12-step approach in particular. As I think the steps are important, and not spoken of enough in mainstream circles, I joined. What I found after I joined was a little more “anti-medicine” than the original literature suggested, and was thinking about this when I saw a headline on a news site that scientists had cloned embryonic stem cells. What got me thinking was the idea that one day stem cells would be useful in curing diseases of deficiency. That got me thinking a really big “what if;” what if one day we got a cure for addiction from injection of stem cells in the midbrain. I wondered about the different responses from organized Addiction Medicine and this new sub-group of doctors.
Before I say more about this I want you to understand the entire thought experiment here. What we’re imagining is a complete cure. This is not a method for, let’s say, alcoholics not to drink, but an actual cure that would take away the illness and allow people with addiction to use just like normal people. This is because the imagined cure takes away the symptoms and the special response. They feel like normal people, and they’d have a normal person’s reaction to, say, a couple of drinks. It wouldn’t do for them what it does for the person with addiction. I’m not saying such a thing exists or that stem cells would or even could provide such a cure, but it’s my thought experiment so I get to make up anything I want.
So what would the mainstream Addiction Medicine doctor think of this? Well, to be honest, their first response would probably be fear for their job or resentment that neurosurgeons would get all their business, but after they got over that they’d realize that their greatest wish had come true; addiction would be gone. I think they’d be deliriously happy… as soon as they found another job.
But what about some of the members of the group I joined? Would they be happy? I doubt it. When discussing addiction treatment with them I heard such things as the necessity of suffering, the primacy of the spiritual experience, the necessity for gratitude for the illness as a way to a better relationship with God. I heard some of these doctors say that medication for addiction was counter to the point of recovery, because the patient would then be robbed of the opportunity to turn their pain into spiritual growth. This has really weighed on me. There are some out there that seemingly would rather 95% with the illness die of it so that 5% can achieve spiritual enlightenment than save more lives. It’s a foreign idea to me, and I was shocked to hear words associated with such a worldview from the mouths of physicians. I think these people I’m referring to would “just say no” to the idea of a one shot cure.
I think we who value the 12 steps run the risk of romanticizing this illness. Let’s be frank. This thing is a terrible killer that stands behind the top five causes of death in America. If I could wipe it off the face of the earth, I would, in a heartbeat. The world and human experience has given us many ways to enlightenment; we don’t need a disease like this to help us to the true path. I hate this disease every time I meet a child who lost a parent to it. I hate it every time I see another generation repeating the pattern. I hate it every time I see a human with great potential turned into a endless pit of need. And I hate it every day.
To some scientist out there: find a cure for this bastard of an illness. I’ll happily find another job, and another path to enlightenment.