The following is a transcript of a plenary talk given by Jay Renaud, longstanding editor and publisher for Guidepoints: News from NADA, and former Office Manager for NADA at the 25th Annual NADA Conference in New Orleans, March 27, 2010. Jay is recovery activist and has worked with NADA for over 20 years. He retired in 2010 and left New Orleans conference attendees with this message.
On this NADA’s 25th anniversary, my parting words are: Be careful what you pray for – – you might get it!
For decades, pro-treatment advocates agitated for recognition that alcoholism and drug addiction are not due to moral failure but are the result of an involuntary disease process. Against the concept of addiction as some type of character flaw or symptom of an underlying psychiatric disorder, our aunts and uncles in the recovery movement since the beginning have stressed the bio-physical basis and large genetic component of addiction.
However, social and medical establishment resistance to recovery movement ideas persisted long after the accumulating scientific evidence had tipped strongly to the pro-disease position. But as often with scientific truths, public policy lagged far behind. We persisted in this often uphill battle in the belief that a true understanding by the public, and by decision-makers, of the actual etiology of addiction would lead to compassion and appropriate care instead of stigma and neglect.
And, at long last, the paradigm finally shifted. We knew that a new viewpoint had risen when the National Institute on Drug Abuse adopted the slogan “addiction is a brain disease”.
But what happened to the compassion and appropriate care that were supposed to follow this revelation? Somehow, they did not appear. While NIDA acknowledged the fundamentally physiological basis of addiction, (much as the 12 Step movement had been doing for more than 70 years), they forgot to mention the equally important spiritual side of recovery.
Instead, these officials handed down a whole new set of pharmaceutical fantasies.
Their mantra became: “If it is a disease, there must be a pill for it.” Now, on the rare occasions when addiction issues make it into the major media, the story is all about the latest chemical cure for addiction.
Newsweek last year had a major illustrated feature highly skeptical of the existing “rehab” industry, which it sees as mainly benefiting celebrities who want to disappear for awhile or to get back in the good graces of their public. The lead paragraph starts out: “The time is coming – perhaps even within the decade – when doctors will treat alcoholism with a pill.”
While ever-growing scientific evidence indicates that a key component of recovery is involvement in 12 Step or similar activities, no governmental campaign blares out this news. No government funding leverage presses the treatment industry toward maximization of this existing (and cheap) resource for recovery. And NADA programs, which offer a bio-physical treatment (also cheap) boosting the spiritual resources of the addiction patient, continue to exist on minimal funding and the wits of their staffers.
Instead we see an ever-increasing flood of federal subsidy to the drug companies. In big trouble with Wall Street because of their “blockbuster” blunders such as Vioxx, big Pharma scrambles for new patentable molecules to fill its famous pipeline to profit. Thus the endless parade of press releases about pills, cocktails and vaccines to cure all the nation’s substance use disorders.
Some of these concoctions may actually play a constructive role in the recovery process. But anyone acquainted with the history of addiction treatment, or indeed that of any chronic, behaviorally mediated medical condition, will be dubious. Whether it’s diabetes, hypertension, heart disease, multiple sclerosis, schizophrenia, or many others, chemotherapy of any kind can never be the whole answer to chronic disease.
Addiction medicine at the provider level, until now at least, has been way ahead of other chronic disease disciplines in giving acknowledgement to the spiritual aspects of chronic disease management and treatment. Consider just one example: effective pharmaceutical and other bio-physical and behavioral treatments have long existed for diabetes, but many diabetic patients do not comply with their care regime. This is despite the dire likely consequences of such neglect. Their needless suffering may persist because they have no existing, independent social structure, such as the 12 Step movement, to aid them in grappling with how (and most of all why!) to live with a chronic illness.
NADA is at its strongest point as to membership, fiscal stability and clarity of mission and is moving to assert this strength in the sphere of public policy. But to succeed in its mission, NADA must not forget that, from its birth, NADA has understood the necessity of connecting firmly to the 12 Step movement, and other culturally indigenous spiritual support systems, if patients were to be given effective help in their struggle to recover. Long after the current false belief that a chemical cure for addiction is just around the corner, the spiritual groundwork that NADA has helped to lay will continue to exist for those who still suffer and seek help.