A Final Conversation with Addiction Professionals
Bruce K. Alexander
Simon Fraser University
This is a written version of a webinar presentation organized by the Addiction Theory Network on April 19, 2022
By compiling the best evidence pro and con, the new edited book Evaluating the Brain Disease Model of Addiction(Heather, Field, Moss & Satel, 2022) shows that the Brain Disease Model of Addiction is a weakly supported, largely fruitless theory. This despite its authoritative endorsement by governmental agencies and professional societies, and despite its extensive data base in advanced neuroscience.
In the context of this game-changing new book, I want to make some very strong statements about addiction myself. My justification for this outburst today is that I have been working in this field for more than half a century and am now 82 years old. I will not be doing a lot more public speaking. I want to state what I have learned in my long career as emphatically as possible before I quit. I do not claim to have the final answers, but I do credit myself with having examined the most difficult issues from many directions. Here are seven conclusions that I have reached:
Read more: A Final Conversation with Addiction Professionals
Alexander, B. (2020). [Special issue]. International Journal of Existential Positive Psychology, 9(1), 1-8. Retrieved from https://www.meaning.ca/ijepp/special-issue-2018-proceedings-of-the-meaning-conference/
Creating Healing Communities in a Toxic Society: Viktor Frankl and Jordan Peterson
Bruce Alexander, Ph.D.
Existential therapy can be a wonderful gift to addicted people and will help some to improve their lives in tangible ways. However, no combination of existential treatment, other psychological and medical treatments, personal courage, harm reduction, and recovery groups can stem the rising tide of addiction in Canada or in the world. As Victor Frankl and many others have shown, the psychological environment of late modernity is too toxic for most people to handle without an intolerably high risk of psychological disasters. Nothing short of epochal social change will restore us to a reasonable level of psychological health. To face that daunting truth, as Frankl did, opens the way towards a new level of psychological realism. Perhaps realism is the greatest gift we have to offer at this point.
Read more: Creating Healing Communities in a Toxic Society: Viktor Frankl and Jordan Peterson
Presentation to Leeds and York Partnership, NHS Foundation Trust, March 23 2018
Bruce K. Alexander, Professor Emeritus, Simon Fraser University
Latest revision May 28 2018
We are meeting today amidst a crisis of opioid overdose deaths in the US and Canada. We are all doing our best to end this crisis, but the death toll keeps rising. Historically, the current opioid crisis is not an isolated event, but only the latest tsunami to blow in across a rising global tide of addiction to many drugs and other habits. We are not doing well with the larger problem either.
I believe that I know why we are not doing better. Almost all of our interventions are based, at least partially, on a very old narrative about drugs that has outlived its usefulness, but stubbornly refuses to release its hold on our thinking. I will propose a paradigm shift from this played-out “old story” to a “new story.” I will show at the end of this presentation how the new story can help us to respond better to the current crisis and to the rising tide of addiction to which it belongs. Along the way, I will show why the old story is so very hard to leave behind.
Read more: Treatment for Addiction: Why Aren’t We Doing Better?
A Review of Addiction and Devotion in Early Modern England
by Rebecca Lemon, University of Pennsylvania Press, 2018.
Early modern literary scholar Rebecca Lemon calls the word “addiction” a “semantic palimpsest.” I had to look it up. A “palimpsest” is either an erased parchment or a stone surface from which carved writing has been effaced. Although it has been written over, traces of the earlier writing show through. This metaphor works beautifully because the meanings of the English word “addiction” have been both diverse and changeable from the age of Shakespeare to the present. Can addiction professionals, like myself, fully understand the “addict” who appears before us in our office if we overlook the barely erased cultural meanings that are still legible beneath that label?
Read more: What Shakespeare Knew About Addiction, But We Have Forgotten:
Expanded version of a Presentation to the Rational Drug Regulation Conference, Brno, Czech Republic, Oct 4-6 2017
Bruce K. Alexander, Professor Emeritus, Simon Fraser University, Vancouver, Canada
We are here today because of a global drug addiction problem. We are failing to solve this problem everywhere. No matter what we do, it seems, more people are becoming dependent or addicted. I hope to show you today why we are not doing better. The primary reason is that almost all of our interventions are based on a very old and very popular narrative about drugs that has outlived its usefulness. I will propose a paradigm shift from this “old story” to a “new story.” I will concentrate on showing how the new story can help us to envision a productive future for Rational Drug Regulation, which is the topic of this conference.
Read more: How to Regulate a Demon Drug
Bruce K. Alexander
April 19, 2017
Revised September 9, 2017
Expanded version of a presentation to the “New Directions in the Study of Alcohol Group,” Fortieth annual meeting, Bradford, UK, April 24 2016. However, this written version was not completed until a year after the speech was given because, as I neared the end of delivering the speech, I realized I could not fully believe what I was planning to say! I had to end the speech on a minor point (Alexander, 2016a). The new ending is a more fully developed and considered version of what I wanted to say out loud in Bradford, but couldn’t.
Read more: Addiction: Hopeful Prophecy From a Time of Despair
Healing Addiction Through Community: A Much Longer Road Than it Seems?
Bruce K. Alexander
Revised Version of Keynote Address at the “Creating Caring Communities” Conference
Selkirk College, May 14, 2015
The winds of change are blowing in the field of addiction. I sense the change in the discourse of the most stimulating scholars and the discussions of the audiences when I give public presentations. Both the moralistic view of addiction as wilful evil and the disease/medical model of addiction have lost much of the impregnable power they once had (Pickard, 2012; Ahmed, Lenoir, & Guillem, 2013; Levy, 2013; Satel & Lilienfeld, 2013; Hall, Carter, & Forlini, 2014). A new understanding is gradually emerging in their place: Addiction is a way that needy people respond to what is missing or traumatic in their own lives and communities (Maté, 2008; Hart, 2013; Peele & Thompson, 2014, esp. pp. 197-200; Lewis, 2015). Along with this understanding comes a much greater emphasis on attempting to establish addicted people in a welcoming community, thereby reducing their need for addictive compensations. This expanding trend is associated with googleable phrases like “building community”, “restoring community”, “recovery houses”, and “support groups”.
Read more: Healing Addiction Through Community: A Much Longer Road Than it Seems?
Addiction, Environmental Crisis, and Global Capitalism
Bruce K. Alexander
Presented at the College of Sustainability, Dalhousie University
February 26 and 27, 2015
On good days, I can still feel optimistic about the future of Planet Earth. On such days, I rejoice in the amazing worldwide environmental and social justice movements whose members I encounter everywhere I go. Tonight, I am pretty sure that many active members of the environmental movement are in the audience. I am truly honoured to be able to speak with you as well as to those whose connections to the environmental movement have been more limited, as mine were for most of my professional life.
I devoted the major portion of my professional lifetime to studying the psychology of addiction. However, over the decades, I gradually came to see addiction not only as an agonizing psychological problem that certain individuals must deal with, but also as a kind of a window onto modern society. I have come to believe that looking through this addiction-window can provide useful insights into social problems of all kinds. Tonight I hope you will look with me through this window at the current environmental crisis, as it relates to global capitalism.
I believe that this unique viewpoint will help us to understand more fully not only why there is an ecological crisis at this time in history, but also what we can do about it.
Read more: Addiction, Environmental Crisis, and Global Capitalism
Rat Park versus The New York Times
Bruce K. Alexander
Rat Park closed forever more than 30 years ago. In its heyday, it was a very large plywood box on the floor of my addiction laboratory at Simon Fraser University. The box was fitted out to serve as a happy home and playground for groups of rats. My colleagues and I found that rats that lived together in this approximation of a natural environment had much less appetite for morphine than rats housed in solitary confinement in the tiny metal cages that were standard in those days.
Who could be surprised by this finding? The only people who acted surprised at the time – and a bit offended – were those addiction researchers who believed that the great appetite for morphine, heroin, and cocaine that earlier experiments had demonstrated in rats housed in the tiny solitary confinement cages proved that these drugs were irresistible to all mammals, including human beings. I call this idea the “Myth of the Demon Drug.” This myth was the backbone of mainstream theories of addiction in those days.
Read more: Rat Park versus The New York Times
The Rise and Fall of the Official View of Addiction
Bruce K. Alexander, Professor Emeritus
Simon Fraser University
Revised July 3 2014
Confession and Plea to the High Court in the Field of Addiction:
Herewith, I confess to the charge of attempted murder. My intended victim was – and still is – the Official View of Addiction, sometimes known in the field by its aliases including, “the brain disease model of addiction” or “The NIDA model”. The presentation below contains irrefutable evidence of my guilt. However, it also expresses my plea to the High Court that ridding the world of the Official View of Addiction is justifiable and that its useful aspects can be preserved within a different paradigm.
Read more: Rise and Fall of the Official View of Addiction
2 February 2011
Nick Reding’s book, Methland, is a fascinating, new study of addiction. It focuses on the town of Olewein, Iowa, which has been stricken by methamphetamine addiction in the past few decades. Methamphetamine is an infamous stimulant drug with many aliases. It is also known as “meth” “crank” “crystal,” and, most ominously, “ice.”
Beyond Olewein, the book tells the story of a huge area of the rural United States, which Reding christens “Methland”. As Nick Reding defines it, “Methland,” is the rural center of the US -- the 28 landlocked American states. Obviously, Methland has more familiar names too, such as “Middle America,” but Reding renames it Methland because at the end of the 20th century it became notorious for its rampant meth use, meth addiction, and amateur meth manufacturing or “cooking”. Reding was determined to figure out why.
Read more: A Train Trip through Methland