![]() ![]() It refers to a tendency to think that the patients you see in a clinical setting fully represent all people with that condition. This is called the "clinical illusion," and it applies to all medical conditions. Most research is done on people in a treatment program, so by definition you've already got a skewed population. People who come to treatment tend to have concurrent psychiatric illness, and they also tend to be less responsive to treatment. This recognition is very important for designing personalized therapies.ĭon't most studies show that addicts do better with professional help? That, as destructive as they are, drugs also serve a purpose. It also overlooks the enormously important truth that addicts use drugs to help them cope in some manner. Naturally, every behavior is mediated by the brain, but the language "brain disease" carries the connotation that the afflicted person is helpless before his own brain chemistry. I'm critical of the standard view promoted by the National Institute on Drug Abuse that addiction is a brain disease. Most experts regard drug addiction as a brain disease. You might get methadone for withdrawal and medications for an underlying psychiatric problem. You get instruction in formal relapse prevention therapy. Even for court-ordered treatment, people often internalize the decision as their own. If you're already in treatment, you've made a big step. ![]() What do professional drug addiction programs offer that is difficult to replicate on one's own? True, some people decide they can't do it on their own and decide to go into treatment-that's taking matters into one's own hands, too. People will put obstacles in front of themselves. They can make it harder to access drugs, perhaps by never carrying cash with them. For example, they change whom they associate with. If not, there are lots of recovery strategies that users figure out themselves. But I've had a number of patients in the clinic whose six-year-old says, "Why don't you ever come to my ball games?" This can prompt a crisis of identity causing the addict to ask himself, "Is this the type of father I want to be?" The subtext isn't that they just "walk away" from the addiction. It takes the realization that their family, their future, their employment-all these-are becoming severely compromised. The implicit message isn't that treatment isn't important for many-in fact it should probably be made more accessible-but it is simply a fact that most people cure themselves. It is even possible that those who quit on their own could have quit earlier if they sought professional help. That's in no way saying that everyone should be expected to quit on their own and in no way denies that quitting is a hard thing to do. Most people recover and most people do it on their own. Is it possible to cure yourself of addiction without professional help? How often does that happen? Satel was formerly a staff psychiatrist at the Oasis Clinic in Washington, D.C., where she worked with substance abuse patients. Scientific American spoke with Sally Satel, a resident scholar at the American Enterprise Institute for Public Policy Research and lecturer in psychiatry at the Yale University School of Medicine, about quitting drugs without professional treatment. Other studies on Vietnam War veterans suggest that the majority of soldiers who became addicted to narcotics overseas later stopped using them without therapy. ![]() A survey by Gene Heyman, a research psychologist at McLean Hospital in Massachusetts, found that between 60 to 80 percent of people who were addicted in their teens and 20s were substance-free by their 30s, and they avoided addiction in subsequent decades. ![]() Because these changes make it much harder for the addict to control substance use, health experts recommend professional treatment and complete abstinence.īut some in the field point out that many if not most addicts successfully recover without professional help. The model attributes addiction largely to changes in brain structure and function. His claims of quitting a serious drug habit on his own, however, is perhaps one of his least eccentric statements.Ī prevailing view of substance abuse, supported by both the National Institute on Drug Abuse and Alcoholics Anonymous, is the disease model of addiction. After the rest of his season's shows were canceled by producers, Sheen has gone on an interview tear with many bizarre statements, including that he is on a "winning" streak. Until last month, he was the highest paid actor on TV, despite his well-known bad-boy lifestyle and persistent problems with alcohol and cocaine. When asked recently on The Today Show how he cured himself of his addiction, Two and a Half Men sitcom star Charlie Sheen replied, "I closed my eyes and made it so with the power of my mind." ![]()
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