What's Inside

Chapter 1. Is Addiction a Disease

Introduction. The value of understanding. A little story about understanding.

Powerlessness: the essential experience of addiction. The control conundrum.

Automaticity: re-thinking the disease concept of addiction. Relapse. Progression. Summing up.

Chapter 2. Why Me?

Resistance and susceptibility. Risk factors for developing an addiction. Biological factors. Sociological factors. Psychological factors. The spectrum of addiction. Summing up.

Chapter 3. Does Treatment “Work”?

The problem of diagnosis. What is treatment? The problem of measuring treatment outcome. Abstinence: necessary but insufficient. Beyond abstinence: the goal of treatment. The dimensions of treatment: Biological. The dimensions of treatment: Emotional. The dimensions of treatment: Cognitive. The dimensions of treatment: Spiritual. Why medical science can’t “cure” addiction. Summing up.

Chapter 4. Is a Spiritual Awakening Necessary for Recovery?

Some definitions: “Meaning.” “Spiritual.” “Recovery.”

Addiction: a new metaphor for human suffering. Why a new metaphor? Thinking about a Higher Power. Are science and spirituality compatible? “As above, so below.” Something from nowhere: mind, brain, and a higher dimension. Evidence of a higher dimension: the Present Moment.

This re-formulation of the disease concept of addiction explains why, despite the promises made by some in the medical and treatment communities, addictions cannot be cured, why relapse is so common, and why the work of recovery never ends. It should also enable family members and treatment providers who have not had the experience of addiction themselves to better understand those who have. And, for addicts and alcoholics themselves, it provides a foundation for understanding that the road to a stable and joyful recovery includes the search for the meaning of human suffering.

Despite all that’s been said and written about alcoholism and drug addiction, many people remain seriously confused about some of the most basic aspects of these problems. It’s not surprising – the field itself is characterized by strongly held opinions and long-standing disagreements. On one side is academic medicine, daily discovering new complexities in the chemistry and psychology of addiction, endlessly promising cures, and yet never quite delivering the goods. On the other side are the spiritually-based 12-step groups, AA and its kin, offering an effective method of recovery – but only for those who are able and/or willing to embrace its tenets. At best, the two sides are often only in a state of peaceful co-existence. Meanwhile, individual alcoholics and addicts remain baffled, and the people who deal with them become exasperated. Public policy suffers from unrealistic goals and inadvertently creates new problems as a result of attempts to solve old ones.

“The experience of powerlessness gives the key for a new approach to the disease concept of addictions as disorders of automaticity – conditions which, once acquired, cannot be eliminated, but can be made dormant through abstinence.”