The future of Addiction – Stanton Peele

The future of Addiction – Stanton Peele

I have long been a fan of Stanton Peele’s writing and he has certainly helped me recover with his ideas which have often questioned old ideas that have become accepted parts of addiction life that actually hinder many in recovery. The first book I read of his, was the  “Diseasing of America”, which was a real eye opener on how groups such as AA grew in the USA.

Stanton Peele

Stanton Peele

His first book was called Love and Addiction and this has recently been re published. It was written in 1975 and was way ahead of its time. It is really worth reading today and comes across as up to date, which is pretty impressive and a good reason to take Stanton’s views about recovery in the future seriously. I wrote about it here.

He also wrote Recover which is his most recent book which has a great new program that could help many.

Here is a great post by Stanton about how he sees the future of addiction on

I thought it was a good piece and was particularly impressed by this section which questions the “disease theory” which is a view often held in America but not so much elsewhere.

“Key question: Will we successfully challenge the disease meme—while reversing the constant increase in addiction?

Although it is true we are looking in more places for addiction, it is nonetheless also true that addiction is genuinely increasing. Aside from the ever-roiling heroin, painkiller, pick-your-new-drug scares, just look at people staring at their iPhones who are gaming, texting and otherwise compulsively absorbing their attention all around you.

The American Psychiatric Association publishes its bible, the Diagnostic and Statistical Manual of Mental Disorders (DSM), every decade or two to tell us what’s wrong with us. The fifth edition was released in 2013. For the first time it recognized non-substance addictions—a mere 40 years after Archie and I detailed this phenomenon in Love and Addiction.

First (are you ready?)—DSM-5 doesn’t label substances as addictive or dependence-producing. There are simply mild, moderate, and severe Substance Use Disorders (SUDs). Only activities are “addictive” in DSM-5. Actually, only a single activity, gambling, is called addictive—sex and love were notably denied this status. Still, who would have guessed in 1975 that in 2013 psychiatry would eliminate addiction regarding drug effects, but decide that there were “behavioral addictions”?

Meditate on our confusion: Addiction is a scientific term whose meaning was considered nailed down in 1975, but has been in constant flux since then. The inadequacy, inconsistency and illogic of DSM-5 were instantly apparent. Who believes that addiction doesn’t exist, except in behavioral form? Who can believe that there is one—and only one—such behavioral addiction, gambling, and not eating, sex, love, video games, etc.? To artificially distinguish one behavior amid the entire welter of human existence is patently absurd.

DSM justifies this ridiculous conclusion by playing to our neurochemical fetish. DSM-5’s authors had to make the case, however crazy, that gambling alone of all behaviors taps into the same brain reward system as drugs (which, and I repeat myself, are no longer themselves reckoned to be addictive).

Thus they cast among the shifting evidence about what exactly this reward system comprises and, voila, arbitrarily found it characterizes gambling. Without question, more such behavioral addictions will be “discovered” in the years to come. Indeed, one development over the last 30-40 years has been the official decision that one drug after another previously not considered addictive—nicotine, cocaine, amphetamines, marijuana—actually is addictive. None of the 10 types of drugs DSM-5 recognizes can be distinguished from the others because it produces, or doesn’t produce, addiction.

Our neurochemistry fetish is not new. It is only the latest version of our long, futile effort to translate addiction into biochemistry. The Harrison Act of 1914 officially declared narcotics to be singularly addictive like nothing else—and a century later, this mistake still corrupts scientific and popular thinking. We need to reverse this thinking, and the idea that neuroscience can reveal the true nature and the cure for addiction. Instead, the validity of the biochemical, now neuroscientific, approach to addiction has been disproven time and again.

Key question: Will we come to our senses, rebel against Nora Volkow of NIDA and rely on the plain sense addictive behavior patterns make?

Addiction exists and is important and is not a drug or a biochemical phenomenon. If addiction applies as a concept to gambling, then it can’t be due to specific chemical properties of drugs, nor to a specific brain-reward pathway, except in as much as any human activity can be said to involve such pathways. Addiction can only be understood at the level of human experience.

DSM-5 defines SUDs on a more-or-less scale in terms of how seriously drug use impairs users’ lives—not as an on-or-off disease. DSM-5’s SUD criteria are based on how badly a person’s life is going due to their substance use—a description of lived human experience. At some arbitrary point along the scale of dysfunction—a scale that can be applied to any involvement—we may say that someone is addicted. No brain scan or neurological measure can tell us this.

It is scientifically and clinically possible—and useful—to say that some people are addicted and to use addiction therapy techniques to address their problem. But, contrary to the constricting, self-fulfilling 12-step ideology, addiction is not a fixed personal trait. “Addicted” does not describe a person’s character in a meaningful way—it is a characteristic of an involvement that they have formed at a particular time. As Ilse Thompson and I make clear in my latest book, Recover! Stop Thinking Like an Addict:

Addiction is not who people are. Addiction manifests differently in everyone, and for different reasons. Addiction includes a wide range of involvements, whether with substances or behaviors. It can be more or less severe. It can be an acute condition, limited in time and place, or one that stretches though a longer period of a person’s life.”

I would strongly urge people who are interested in recovery and addiction to read Stanton’s work.

I have just noticed that he has a new piece on the fix which is about not pushing everyone towards AA




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