THE June 4 column I
wrote disputing the
disease theory of addic-
tion, in which I relied
on Dr. Stanton Peele’s
work in the field,
prompted readers to
request that I revisit
the topic, and how bet-
ter to do so than with
an interview with Dr.
Peele?

Dr. Peele is a psychologist,
an attorney and an addiction
expert with an international
reputation.

A recipient of the Mark
Keller Award from the
Rutgers Centre for Alcohol
Studies and the Lindesmith
Award for Carcer
Achievement in Scholarship
from the American Drug
Policy Foundation, Dr. Peele
is the author cf 120 articles
and seven books about chem-
ical and relational addiction.

QO: Dr. Peele, do you believe
addiction is a disease?

A: “No. Most emphatical-
ly not. tt has become the
style ta call negative behav-
iours, which people often
experience as compclling
motivation, “discases.” As
though nail-biting, overeating
and wife-beating were like
the malignant growth of can-
cer cells.

“Much self-defeating and
anti-social behaviour has a
common thread. People
engage in it because they feel
degraded and disapproved of,
which feeds into their moti-
vation to continue the nega-
tive behaviour.

“But how ultimately do
people stop drinking too
much, overeating, and biting
their nails?

“They feel, internally, that
the balance of their desires
and rewards is not to act this
way; people make positive
choices when they fecl they

scounti

comment

have the opportunity to
engage — and are supported
— in more positive choices.
The toughest addiction to
quit is smoking. Right now
about 50 million Americans
have quit smoking, over 90%
without a patch or formal
therapy.”

Q: How have we progressed
to thinking about addiction as
a disease?

A; “We have developed a
faith in medical advances that
is steeped in the legend of
the ‘microbe hunters,’ the
generation of researchers and

hysicians who identified the
bugs that cause many of the
major killers of humans

“This worship of medicine
has become a fetish in North
America. If we can describe a
malady in medical terms, we
feel we have somchow con-
quered it.

“Yer with psychological
disorders and problems of
behaviour — namely, addic-
tions — such labelling and
accompanying medical
mumbo-jumbo have not fed
to improvement in treatment
outcomes.

“In many ways, in fact,
turning our sensc of ourselves
over to medicine seems to be
making things worse. Surveys
repeatedly confirm that a
generation of education
about addiction has led to
people’s spiralling out of con-
trol now more than ever,”

What is the science upon
which the disense proponents of
addiction base their demand
for considering addiction a
diseuse?

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A: “There is no inherited
mechanism that leads a per-
son to be unable to control
their substance use, to go on
tremendous binges, or to
leave off their connection to
people and environments in
order to consume a sub-
stance.

“Genetic theories, being
the modest things they are,
can never explain the experi-
ence of loss of control, An
overview of the research on
alcohol and drugs never sup-
ports the wild claims made by
some proponents of the dis-
case model.

“These claims reflect fun-
damentally anti-scientific atti-
tudes and a lack of under-
standing of the confluence of
human motivation in
response to experience, biolo-
gy and external stimuli.

“Consider this example: A
1996 headline in The New
York Times declared that
brain images of addiction in
action show its neural basis.

“The article reviewed
research showing that many
different drugs — namely
heroin, alcohol, ampheta-
mines or nicotine — activate
common neural pathways. its

mailbox

diction as a

author surmised that these
deugs bathe the neurons ar
these sites so as to reduce
natural supplies of dopamine,
and thus stimulate a craving
for more of the drugs to
compensate for this depleted
supply of the neurotransmit-
ter.

And this was taken to
mean that addiction is purely
brain-driven. In my critique
of this folly I explain that the
wide range of activities that
stimulate the pleasure centres
of the brain — including sex,
eating, working, chocolate —
should alert us that these
brain theories tell us nothing
about differences in behav-
jour, let alone addiction.

“Apparently, stimulation
of a pleasure centre is only
one small component in the

¢ addiction syndro

‘Moreover, if any activity
can be pleasurable — from
work, to sex, to parenting
and so on — identifying
activities as stimulating the
pleasure centre simply begs
the questions: why do peaple
find different things pleas
able and why do different
people react in destructive,
addictive ways to some of

Friday, July 16, 1999 — North Shore News — 7

these things, while others
incorporate them into a bal-
anced overall lifestyle?”

Dr. Peele’s position is at
odds with that of the drug
reform movement.

While being a proponent
of harm reduction policies
such as needle exchange, he
views treatment as part of the
coercive state since most of
those attending treatment are
forced to do so.

Here’s something to mull
over: Vanconver Sun colum-
nist Patrick Nagel offered the
alleged resumption of
Stephen Reid’s career as a
bank robber as proof that
addiction is a disease com-
pletely separate from “the
man’s morality.”

Believe this leap of
abstraction if you like but
consider this: if addiction is a
disease of the mind, then its
behavioural manifestations
are still an extension of the
person’s character.

Progressives espouse a
holistic view of human moti-
vation. This means that
behaviour needs to be seen as
a consequence of every facet
of our biopsychosocial
beings. But at the same time

Searching for Canadian justice

politically correct Canadian legal authorities

Dear Editor:
Subject

umn.

Congratulations to Ms. Ilana Mercer for
her refreshingly iogical views on the Ludwig
affair (by the way, his first name is spelled

icbo” not “Weibo”).

The hidden irony of this column’s title is

that Mr. Ludwig seems to be
receiving the Canadian jus-
tice as codified and propa-

gated by the fashionable,

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Re “Wicbo Ludwig deserves
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and the media. ;
What Mr. Ludwig truly needs is the real

justice, and this may be hard to find in

vanada,

Mariusz T, Wesolowski

North Vancouver

rapier@direct.ca

isease

progressives are so unclear as
to what holism means that

dual’s behaviour by
reducing it to biology alonc.

This demonstrates a flaw
in thinking. Hence, you can-
not separate Reid’s penchant
for drugs from his choice of
robbery as an outlet.

In a deluge of liquor,
some people will do their
best writing; some will go
bungee jumping; and others
will choose to break the law.

— gnome@attcanada.net

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