Addiction Treatment: A Professional Review©
Kenneth G. Wilson, Ph.D.
“One size does not fit all”
This sight is dedicated to providing evidence based information on what treatments for addiction are available and how to choose among them and to demystify and critique current beliefs regarding what addiction is.Â
“The hottest places in hell are reserved for those who, in a period of moral crisis, maintain their neutrality”
-John F Kennedy
When I begin my book in 2015 the annual death rate from Nicotine, Alcohol and other Drugs (NAD’s) were right at half a million. After completing my research and finishing the book in 2017 it had climbed to over 600,000 and is expected to continue to climb. It is during this election cycle that our elected representatives finally publicly acknowledged that we had an epidemic. It was in part the addition of those in the breadbasket and rust belt of the United States turning to drugs for relief that finally got their attention. However, they don’t have an explanation of how those that previously had a moral compass or whose addiction gene had somehow become activated through epigenetics, went astray and succumbed to addiction? I contend that it is the impoverished “Brain Disease Model of Addiction” (BDMA) that impedes our understanding of the true nature of addiction which is;
the need to quiet an agitated brain whose job it is to maintain equilibrium. The real culprits are trauma and stress and ineffective and inappropriate strategies designed to deal with them.
What is the official position of the governmental entities that allocate funds for research on and the treatment of addiction, officially, a Substance Use Disorder (SUD)? The entities are the National Institute of Health (NIH) and its departments specifically charged with addressing addiction; the National Institute of Alcohol Addiction and Abuse (NIAAA) and the National Institute of Drug Addiction (NIDA). The American Medical Association (AMA) has a division comprised of approximately 600 physicians who define themselves as addiction specialists. They are the American Society of Addiction Specialists (ASAM). The American Psychological Association (APA) agrees with the BDMA. The official position of these organizations is as follows;
Addiction is defined as; a chronically relapsing brain disease characterized by a hijacked brain, compulsive drug seeking and accompanied by self-harm.
Obviously if we are treating a biological disease it is the job of “real medicine” to treat it. That is why the majority of money that is allocated goes to neuroimaging, brain scans and the search for a pharmacological solution to modify the action of neurotransmitters rather than an explanation of how stress activates the fight or flight syndrome which creates disequilibrium and the need to self medicate.
It is not my position that neuroimaging and the search for pharmaceutical interventions have not provided us with much-needed information about the neural pathways, the connections between reward centers and the sites that psychoactive street drugs affect sections of the brain. The problem is the promise of investing the majority of our funds in the search for improvements in the amelioration of this disorder have not lived up to their promise and expectation. Wayne Hall* and his colleagues critique the BDMA in the following way: “The BDMA is not supported by animal and neuroimaging evidence to the extent its advocates suggest: it has not helped to deliver more effective treatments for addiction: and its effect on public policies towards drugs and people with addiction has been modest. The focus of the BDMA is on disordered neurobiology in a minority of severely addicted individuals, which undermines the implementation of effective and cost-effective…”
The use of the terms addicts and addiction is not meant to be pejorative it is simply part of the lexicon understood by the general public. Substance Use Disorder (SUD) is the term that is now accepted by the professional community.
Therefore, this blog is being created to provide; a presentation of the existing research, my own psychometric assessments of addicts and my experience treating addicts. These data provide accurate and updated information regarding the real causes and appropriate treatments for addiction. It is being created by Dr. Kenneth G Wilson. My initial interest was physiological psychology (neuroanatomy and neurophysiology) the brain until it was brought to my attention that to study the mind at a cellular level was reductionist. I turned instead to personality and social psychology. I am a licensed psychologist primarily trained as a scientist. I have spent the last 40 + years of my life studying and treating mental disorders with a specialty in addiction. However, since I’m not a real doctor I cannot belong to the American Society of Addiction Medicine, (ASAM) and cannot present to them an alternative hypothesis regarding the multiple causes of addiction. ASAM is the official voice of the American Medical Association on what addiction is and how it should be treated. I turned instead to addicts who have conquered their chronically relapsing brain disease with their mind and the treatment professionals who know that addictive behavior is ultimately a decision. This is neither a Nancy Reagan “Just Say No” position; I acknowledge there are psychological reasons that a segment of the population has not been capable of using substances recreationally. Nor is it to suggest that using the MIND to control the BRAIN is a simple proposition. The treatment of the chronic/intermittent drug user versus the time limited is a complicated process best practiced in a relatively long term therapeutic community such as The Stout Street Foundation Inc.
The book that this blog represents is designed to address the current belief system, paradigm, which ignores the ability of the human organism to choose rather than be slavishly driven by the basic biology of the brain. With the current paradigm the brain is dominant over the mind. The appropriate paradigm would acknowledge that the mind can in fact establish and make peace with the events which created the initial disequilibrium and find another way to accomplish the brain’s desire for quiescence.
Wayne Hall, et. al., The brain disease model of addiction: is it supported by the evidence and has it delivered on its promises? Lancet Psychiatry 2015 Volume 2: 105-10.www.thelancet.com/psychiatry Vol 2 January 2015