Milam - Ending the Drug Addiction Pandemic: Discovering the Liberating Truth

ENDING THE DRUG ADDICTION
PANDEMIC

Discovering the Liberating Truth

by
James R. Milam, PhD

Strategic Book Publishing and Rights Co.

E-book Edition 2014
Print Edition 2013 James R. Milam, PhD. ISBN: 978-1-62857-209-4

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No part of this book may be reproduced or transmitted in any form or by any means, graphic, electronic, or mechanical, including photocopying, recording, taping, or by any information storage retrieval system, without the permission, in writing, of the publisher.

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Table of Contents

Chapter 1: Introduction

Since its first publication in 1981 I have been best known for my book, Under the Influence (UI) , coauthored with Catherine Ketcham. It was soon recognized as a classic and the indispensable guide to recovery in effective AA oriented treatment programs. In 1983 it became a Bantam paperback and now 3 decades later it is still a top seller in the field. Millions of alcoholics and drug addicts owe their recovery at least in part to this remarkable practical guide to treatment and recovery. Nevertheless, my first book, The Emergent Comprehensive Concept of Alcoholism (ECCA), self-published in 1970, was the more generic and exciting of the two.

The opening sentence of ECCA stated simply and unequivocally that The most important phenomenon in alcoholism since the founding of Alcoholics Anonymous in 1935, and the least understood by the general public, is the fact that the long awaited scientific and technological breakthrough has already occurred. The rest of the ECCA then explained the new concept, documented it with scientific and clinical research evidence, and contrasted it with the defunct psychiatric view of alcoholism that it is destined to replace.

The truth is that alcoholism is a genetic predisposition, a biological susceptibility. It is activated by simply drinking beverage alcohol regardless of the psychological characteristics of drinkers or why, when, how, or how much they initially drink. Aside from the invisible genetic predisposition, before they first start drinking and during the early adaptation phase of their alcoholism alcoholics are biologically, socially, and psychologically normal and indistinguishable from nonalcoholics. Early adaptation and rising tolerance requires the increasingly heavier alcohol intake that in turn causes the progressive brain syndrome and the neuropsychological symptoms that are then wrongly diagnosed as a preexisting functional psychiatric problem. This is why most alcoholics are still being destructively treated with psychotherapy and/or cross addicting psychoactive drugs. The recovery rate is worse than zero as the deterioration is compounded and accelerated by the synergism of the toxic metabolites of alcohol and drugs.

Although I was excited about the discovery and expected that ECCA would be warmly received, I was unprepared for the enthusiasm of the response and the surge in demand on my time that soon followed its publication. Because I had already been extremely busy with consulting, public lectures, and helping to start new treatment programs incorporating the new understanding, I had written ECCA in my spare time over a period of about 6 weekends. And although it was initially promoted only locally in my public lectures in and around Seattle, it soon flashed across the nation in the grass roots alcoholism reform movement that was just starting to captivate the country in the early 1970s. It revealed the decisive role of psychiatry in keeping society blinded and paralyzed within the inverted view of alcoholism. It was that little book that suddenly catapulted me onto the national scene as a leading authority on addiction, and that created the initial demand for me on the national lecture circuit.

I soon discovered in Thomas Kuhns The Structure of Scientific Revolutions (1962) that the newly emerging comprehensive concept qualifies as a new scientific paradigm. Kuhn explained that in a shift from an old to a new paradigm compromise is not possible. The two paradigms are mutually exclusive. It is essential to discovering a new paradigm to realize at the outset that it cannot be reached as a modification or linear extension of the old. It is an alternative, a wholly new gestalt.

Kuhns explanations helped to gather up the loose ends and complete the delineation of the boundary between the old false beliefs about alcoholism and the new factual information. I renamed what I had called the emergent concept the accurately descriptive name, the biogenic paradigm of addiction, and the false view that it replaced the descriptive name, the psychogenic paradigm .

The contrast between the two paradigms can be illustrated by Robert Louis Stevensons classic parable of addiction, Dr. Jekyll and Mr. Hyde. In the psychogenic view, the insane, murderous Hyde is the real person, with Jekyll merely a facade. It taps deep currents in American thoughtthe notions of original sin and the Freudian Idthat beneath the inhibiting veneer of civilization man is inherently evil. Alcoholism merely releases this deeper ugliness by removing the inhibitions. In vino veritas [in wine is truth]. The task of therapy is to engage and civilize Hyde. Treatment fails because the contemptible Hyde is willfully incorrigible. He deserves the stigma and scorn of society.

Within the biogenic paradigm Jekyll is the real person, Hyde a neuropsychological distortion created by the addictive chemical. Hyde exhibits the same kind of deterioration of personality and character as victims of such other progressive brain pathologies as brain syphilis or a brain tumor. Body, mind, and spirit (including willpower) are biologically compromised and subverted to serve the addiction. Given time for healing, in alcoholism the brain syndrome is reversible. The task of therapy is to restore Jekyll to sanity and selfhood, and to start him on a path that will preclude a return to the addictive, transforming chemical.

It also became evident that according to Kuhns criteria what I had called the psychogenic paradigm was pre-scientific thinking. But in this instance the recognition of it as such was complicated by the fact that for over a century two conflicting versions of the same pre-scientific thinking have prevailed, represented by the Drys responsible for Prohibition, and the Wets who flouted the law and got it repealed. Widely as they differed in their conclusions and agendas, they were both born of the same historic frustration, disgust and contempt for the drunkard for not controlling his drinking like everyone else soon learns to do.

The unspoken universally shared premise has always been that alcohol affects everyone the same biologically and that therefore only a serious character defect could possibly account for such wanton self indulgence and lack of normal self control. It is this shared premise that permits only the two possible alternatives represented by the Drys and the Wets: For the Drys alcohol is addictive and alcoholics are those without the strength of character to resist or overcome the addiction. For the Wets alcohol is not addictive, and alcoholics are those who shamefully overindulge, who abuse alcohol. Either way, the 10 percent of drinkers who are alcoholic are culpable for failing to control their drinking like the other 90 percent of drinkers do.

Virtually everyone has sided with either the Drys or the Wets without realizing that both are blindly committed to ignorance of alcoholism. Therefore even when legitimate scientific and clinical evidence has been reported it has been brushed aside by everyone as inexplicable and anomalous. Through the first half of the 20 th Century, legitimate scientific and clinical knowledge accumulated in the shadows, ignored by psychiatry and the establishment and therefore by the public.