Nadine knew she was in trouble after six months of weekend binge drinking. She also drank until she blacked out many week nights. She had been off-and-on the wagon with booze (and drugs as well) in many periods of her life, beginning in college. In fact, she had been in rehab twice, and had attended many Alcoholics Anonymous meetings. But somehow, none of this had stuck, as she hadn’t with the programs. She wasn't trying to be difficult, but Nadine was naturally a questioning person. (Nadine is not her real name, and some non-essential facts were altered to shield her identity.)
Nadine remembered the first lecture she and her fellow residents heard in rehab: “You all have been born with a genetic disposition to be alcoholics, from which you can never fully recover,” announced the official-looking man at the front of the room backed by large, sun-filled windows that hurt Nadine’s eyes.
Nadine raised her hand.
“Yes?” The man was astounded anyone was questioning him.
“Is there any test that shows we all have this gene?” Nadine asked sincerely. “Because I haven’t had a medical examination yet.”
The group leader no doubt marked Nadine down as a tough case at that moment. The idea of biological determination of alcoholism and addiction is a given in American culture, inside of treatment and out. And, yet, Nadine was 100 percent right. There was not a shred of evidence that she had any particular gene configuration. Neither of her parents, none of her grandparents, none of her cousins or her brother was an alcoholic. But, more importantly, there was no test for either her genes or her brain that would prove Nadine was one. And there never will be such a test. She was an alcoholic because she had begun missing work, had gotten in a traffic accident, and often was either drunk or suffering a hangover—everyone knew she was an alcoholic, or becoming one.
Well after her rehab experiences, at age 27, and following a long period of alcoholic binge-drinking, Nadine awoke after a very bad night with bruises all over her face and body. She decided to quit drinking. It’s true that she had said that before—and done so for months at a time. Then she always started drinking again.
Ironically, what had most kept Nadine from deciding to quit and staying quit—and what frightened her most—was what she had heard in rehab and what she had seen on television. She had a brain disease, everyone said. What did that mean? Was she incapable of quitting drinking, at least without joining an AA group or returning to rehab? Nadine couldn’t understand that. After all, what was going on when somebody quit drinking, in AA, or rehab, or out? You have to stop drinking one way or the other. Wasn’t that just common sense?
The truth is, the vast majority of people quit addictions on their own. Every population study (that is, research with people not in treatment) tells us this. There is no ambiguity, no doubt, no scientific questioning of this truth. Only the neuroscientific, “chronic brain disease” crowd—represented by the new official medical subspecialty, the American Board of Addiction Medicine (ABAM)—strives to convince us of the opposite, even as a never-ending flood of data tells us otherwise.
The marketing rubric “chronic brain disease” originated with Alan Leshner, the former head of the National Institute on Drug Abuse (NIDA). Leshner’s announcement in an article in Science that “Addiction is a Brain Disease, and It Matters” cast the die for all that was to follow. As Leshner said elsewhere, “It’s a myth that millions of people get better by themselves.”
After Leshner came Nora Volkow, who doubled-down on everything Leshner claimed about addiction, the brain disease, when she replaced him as NIDA’s director. Volkow’s role at the ostensibly scientific NIDA was correctly termed by the New York Times to be “A General in the Drug War.” The NIDA wants us to know that drugs (and alcohol) are so inherently dangerous that human beings can never be trusted to manage these substances or recover from an addiction to them.
Arguably Volkow’s greatest triumph has been to gain official American Medical Association acceptance for addiction medicine through ABAM, whose mission is to explain why people never overcome addiction:
Armed with that understanding, “the management of folks with addiction becomes very much like the management of other chronic diseases, such as asthma, hypertension or diabetes,” said Dr. Daniel Alford, who oversees the program at Boston University Medical Center. “It’s hard necessarily to cure people, but you can certainly manage the problem to the point where they are able to function” through a combination of pharmaceuticals and therapy.
Like the roach motel, once you’re in the hands of ABAM and addiction medicine, you can’t escape.
But what they tell us doesn’t happen to be true. People recover from addiction all the time. How do I know? Government research conducted by the NIDA and its sister agency (with which it is soon to be combined) the National Institute on Alcohol Abuse and Alcoholism (NIAAA) tells us that. In the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), a massive national study involving face-to-face interviews with over 43,000 Americans in 2001-2002 about their lifetime drinking and drug use, the NIAAA revealed that, “twenty years after the onset of alcohol dependence, three-fourths of individuals are in full recovery; more than half of those who have fully recovered drink at low-risk levels without symptoms of alcohol dependence.”