Inkwell: Authors and Artists

    
It's too bad thta the reviewer allowed his suspicions about the 12-step 
movement to undercut his appreciation of the book, Martin. Or that he used 
your book as an opportunity to reiterate his suspicions. But in this 

 Layer onto that how a faction truly believes the "disease concept" is
 bullshit and the 12-steps a pseudo-spiritual sham that merely creates
 another form of dependence. Add to that how they resent the hell out of
 how the 12-steps have sparked a mass movement that has become
 increasingly influential. And finally, stir it with the wand of how
 they see an alliance between the treatment industry and the drug war,
 with felons being mandated into treatment that emphasize the 12-steps
 ("forced abstinence")

I have to say there is a fair amount of truth. Or at least it corresponds 
with my experience and research. The disease model of alcoholism is highly 
problematic. It was originated by Edward Jellinek at Yale Center for 
Alcohol  Studies, a group that always had a political agenda: to take 
alcoholism treatment out of the hands of the zealots. It was a worthy 
goal, to be sure, but Jellinek realized immiediately that this "disease" 
was unlike most others in that there was no pathogen, no acutal disease 
entity. But, he claimed with some justification, thta there was no real 
definition of disease in all of medicine, and "The splendid progress of 
medicine shows that that branch of the sciences can function extremely 
well without such a definition. Physicisans know what belongs in their 
realm. It comes to this, that a disease is wha tthe medical profession 
recognizes as such. The fact that they are not able to explain the nature 
of a cond9ition does not constitute proof that it is not an illness." [a 
sentence that could be translated to "abnsence of evidence is not evidence 
of absence." The disease model has succeeded in inspiring more humane 
treatment for addicts and, to a limited extent, in putting more resources 
at addicts' disposal, but it has also resulted an a fair amount of 
distortion and injustice in the treatment industry. This isn't the place 
to go into all that, but consider that the major source of addictoin 
treatment money in the US Governemtn told its grantees that they would 
lose their funding if they so much as mentioned (I'm not exaggerating; I 
have the documentation) "harm reduction" in their reports or grant 
requests or if they participated in any way in needle exchange programs 
and you will see the problem of 12-step hegemony. The 12 steps, 
and particularly their focus on Abstinence,  dovetail  nicely with some of 
the ugliest features 
of American life, like intolerance and like the ongoing effort to 
forcefully repudiate the sixties that dominates in Washington right now. 
And it's all founded on an untruth: that addiction is a disease. 

I think that abstinence, limited or global, permanent or temporary, is a 
worthy and useful practice. I know people who can't drink but can smoke 
pot, people who need to avoid xanax but do fine with acid and so on. I 
know people who just can't get high at all because the next thing you know 
they'll be selling their mother to buy Robitussin. And I think this is 
probably what you are saying, Martin--that for a certain group of drug 
abusers sobriety is the best policy--not only because it allows them to 
stay alive but also because it gives them back their consciousness. 
Actually, that strikes me as common sense. But I think it's important to 
remember that due mostly to the way it has been taken up into our 
political and cultural lives, the ignominy of the 12 steps in certain 
circles is as honestly earned as its high reputation is among recovering 
addicts. 

But speaking of truth and the 12 steps, David Crosby is one of your major 
informants on the subject of drugs and abstinence. What did you make of 
his recent arrest?
  

    
Good comment, Gary. There are cultish, religious overtones to the way
some people interpret the 12-step programs that I find creepy. i was
once pushed against the wall by the ex-wife of a friend who needed to
atone for all the wrong she'd done me, and all I could say is, hey, I
only met you once and you spent the whole time frying chicken. Of
course, I never *got* any of the chicken, but her husband and I had an
appointment we had to keep. 

That said, I'm not going to gainsay the great work it's done for lots
of folks. 
  

    
Gary, I have no thoughts about David Crosby's recent arrest in New
York for marijuana  at all because I don't know what really happened.
For all I know, he could have been carrying the weed for someone in his
band, and without any knowledge of the details, it would be dumb to
conjecture anything about it. 

I do, however, have plenty of thoughts about your thoughts. The debate
about whether addiction is a disease or not can go on forever; it's a
fascinating and significant argument and we can have it or not. But I
think your whole notion of "12-step hegemony" is misnamed and
misdirected, if not downright paranoid. 

If anything defines the 12-steps, its the recovery fellowships
themselves, and how they actually work in people's lives, not anyone or
any organization even remotely connected to any aspect of profit,
policy, or politics. I direct your attention to the Traditions of AA: 

Tradition Eight--"Alcoholics Anonymous should remain forever
non-professional..."

Tradition Ten--"AA has no opinion on outside issues..."

Tradition Ten--"Our public relations policy is based on attraction
rather than promotion..."

I don't have to tell you that the people in recovery fellowships are
as varied, politically and culturally, as the population at large. The
bible thumping fundamentalists in a small town AA group in Mississippi
are as different in this regard as the Rodeo Drive group in Beverly
Hills, who are as different as the Zen Buddhists who go to meetings in
Marin. Anyone in any of these groups who professes to speak for or
represent the fellowship and the steps in any way, is in violation of
these traditions.  Someone like Mitchell Rosembloom is no more a
spokesmen or lobbyist for the steps themselves than a representative of
the drug testing industry. So the very idea that the "12 steps, and
particularly their focus on abstinence, dovetail nicely with with some
of the ugliest features of American life, like intolerance and the
ongoing effort to forcefully repudiate the Sixties," etc.--not only is
it inaccurate and wildly hyperbolic, but it's just not useful. Are
there plenty of recovering fundamentalist types who disagree with harm
reduction and needle exchange programs? You bet, just as there are
plenty of us who agree with them. But the ones who disagree, if they do
so publically, or in some organizational manner that embodies any kind
of agenda whatsoever, do NOT represent the steps or the fellowships,
because they CAN'T. Of course, I wouldn't presume to deny that a
significant faction of recovering addicts who themselves have become
addiction "professionals" may be in league with organizations like the
Family Research Council on an issue like needle exchange, and that such
an association incorporates an agenda of policy and/ or profit, but
you could easily find plenty of addicts in recovery fellowships who
would stand up very vocally for needle exchange. But they wouldn't be
representing anyone but themselves.

In sum, then, the idea of the 12-steps being associated with any
political or cultural attempt to "forcefully repudiate the 60s" is no
more accurate than associating the steps with an attempt to affirm the
60s. That's why I don't think the "ignominy of the 12-steps in certain
circles" is "honestly earned" at all. I think it's an example of
ideological bias, and like any bias, it's based on preconceived beliefs
and ignorance.  




  
  

    
AA grew out of the Oxford Group, a quasi-evangelical (but not 
fundamentalist) Christian organization that stresses confession in the 
context of fellowship and acceptance. The intersection of the two occurred 
in about 1935, when Bill W. was adopted by an Oxford cell or when he 
decided to apply Oxford principles he'd already adopted to his ongoing 
attempts to stay sober, depending on which version you believe. The date 
is interesting--a couple of years after 
end of Prohbition (itself largely the work of Christian crusaders), the 
church finds itself again involved with alcohol, only now ministering in a 
whole new way to the drinker. THe Yale Center got started in the nexst ten 
years, and was already committed to the AA model of alcoholism, which more 
or less conceptualized it as an allergy to alcohol. So the hypothesis that 
alcoholism was a disease followed from the need of the movement to see it 
that way. Without that notion, the fact that "we became powerless" is no 
more than what it was when Jonathan Edwards was preaching about hellfire: 
a symptom of the depravity of the will. AA requires that alcoholism be 
shifted from a sin to a pathology, and Jellinek provided the auothority 
for this shift--all, of course, without a shred of evidence. And this has 
in turn given legitimacy for what is indeed a discipline of compulsory 
sobriety. You see it in the way that clean urine specimens are a condition 
of probation, of employment, of school sports participation, etc. and that 
when you fail the piss test youir only alternative to jail or 
joblessness or what have you is to participate in a 12-step group. It 
would be much harder to pull this off if we didn't all believe that 
addiction was a diseaser for which AA is the cure.

But here's another way to look at it: Diseases surely aren't simply what 
doctors say they are; otherwise homosexuality, to cite the most obnoxious 
example, would still be an illness. But they are also perhaps not 
"natural" phenomena. ONe theorist, Peter Berger, says that diseases are 
all soocially constructed, that from the point of view of nature there is 
little or no difference betweeen the snapping of a femur and the snapping 
of a tree limb, but that this is actually good news. Because the function 
of calling something a disaease is that it allows the sick people to make 
demands on their society. (Berger wrote this in 1972, long before people 
actually started to do this.) An honest disease model of addiction would, 
then, not insist that either AA or sobriety was the cure for addiction and 
that society's resources shoujld be expended only on those cures
but rather that addcition is a complex, idiosyncratic phenomenon that 
requires multiple resources, including harm reduction measures, etc. In 
other wrods, sobriety is the tail that wags the dog of both treatment of 
and theorizing about addiction.

This puts a hair across the ass of libertarians and some drug users. 
Sounds like one of them reviewed Martin;s book.
  

    
last response was not in response to Mart5in's 53, although I suppose it 
could have been.

What I am saying about AA is not about the people who practice it, but 
about the institution./ Which is an interesting thing, becasue the 
institution in many ways doesn't exist, just as you say, Martin. That is, 
there is no AA central HQ or anthying like that, no conspiracy to own the 
field of addiction treatment or to enforce sobriety on the unwitting 
masses. 

But it is not paranoid at all to assert that AA has hegemony over both the 
professional and the layperson's understanding and experience of addiction 
and treatment. I would be willing to bet you, for example, that more than 
90 per cent of 
the addiction treatment facilities in this country are 12-step oriented, 
that they conduct their treatment on the 12 step model, and that their 
aftercare program consists of refeerral to a 12-step pgroup. I'd say theat 
virtually 100 per cent of law enforcement referrals for addiction are to
12-step groups, that prison treatment, where it is available at all, is 
12-step groups, that parolees and probationers are routinely ordered to 
12-step groups as a conmdtion of freedom, that corporate drug-testing 
programs routinely (here I'm not so sure of the nuimbers, but it's got to 
be a majority) result in referrals to 12-step groups and that attendance 
is sometimes a requrirement. I would also say that if you are a community 
mental health treatment program and you want to get government money, then 
you have to have a 12-step model in place. AS for laypeople, I think if 
you asked the average joe on the street, he ouwld tell you that addiction 
ios a disease and that AA is the cure, although I will admit I've never 
done this and I could be wrong. This is what I mean by hegemony--no 
conspiracies, just a fortuitous coming together ofo a powerful idea and a 
receptive culture. To use a term popular on the Well, it's a meme.
  

    
None of which is to say that the 12 steps don't work. (Although they don't 
work with the kind of regularity that one might think.) Or that they are 
bad. But another problem with what I am calling their hegemony is that it 
forecloses other possibilities, some of which might be at leastas 
effective.

Ibogaine is a good example. Here's a drug that is at least potentially 
effective against addiction, and for good pharmacolgical reasons. Now the 
reason that NIDA won't fund ibogaine research is not that NIDA is somehow 
in thrall to the 12-step movement whbich is in turn run by an evil cabal 
of Nazi doctors. That would be a paranoid assertion. But 
its refusal is surely related to the fact that ibogaine treatment is so 
far outside the paradigm, and also to the fadct that NIDA can say that we 
laready have a cure for addiction, which is AA.
  

    
The Washington Post review:
http://www.washingtonpost.com/wp-dyn/articles/A42448-2004May20.html
  

    
From David Gans' into on Gary Greenberg:

"Gary writes on drugs whenever he can."

Way to go, Gary.
  

    
I blame Gans.
  

    
Good idea. Everyone else does.

I've ordered the book, hope to make some less inane posts once it is
delivered.
  

    
Ok, just a few more comments about so-called "12 step hegemony." Just
remember one thing: the 12-steps are AA's "suggested" program of
recovery. "The only requirement for AA membership is a desire to stop
drinking." It doesn't say jackshit about the steps in the Preamble! 
Nor does it even say anything about abstinence in the steps. You don't
even need the steps to stay sober, for chrissakes. You can go to a
meeting and drink every night and come back the next day for the rest
of your life and nobody can ever deny your right to be there. But
people use the steps because they realize their utility in how to
really change their lives once they quit drinking or drugging. And,
again, they're SUGGESTED. There are people in AA who make a big deal
about how they've been sober for 20 years and never worked a damn step,
just like there are people who make a big deal about how they're
atheists. And, remember, all this stuff about God in the steps that
makes people queasy that AA is some quasi-evangelical religious cult or
something--it's a GOD OF YOUR UNDERSTANDING. People literally invent
their own Higher Power. So for all the seeming dogmatism of the steps,
they really encourage a unique kind of spiritual creativity. 

The plain fact is that the steps work--not for everyone, but they've
helped more people deal with alcoholism and addiction than any other
philosophy or program. 

Why have they caught on? It's very complex, and a lot deeper than AA,
the lobbying of the National Council on Alcoholism, the treatment
industry, or the criminal justice system being in cahoots. In fact you
can blame Oprah Winfrey as much. Yes, as Gary points out, they've
evolved out of a tradition of protestant temperance, but the real
reason they work, their real power, lies in the fact that they
incorporate elements of all the great wisdom traditions--meditation,
service. self-examination, fellowship--confession being only a part.

Nuff, lest people think I'm trying to promote. Personally, I have a
problem with all kinds of fundamentalism; I deeply distrust it, whether
religious, cultural, or political. I lay many of the worst problems in
the history of the human experience at the feet of fundamentalism. Are
there 12 step fundamentalists? Hell, yes. Call them AA Nazis. Big Book
thumpers. Some drunks and addicts, of course, are desperate and need
this kind of fundamentalism to survive. It becomes a life saver. They
never let go and they can get downright messianic about it. But never
forget that one of the most attractive things that make 12-step
recovery fellowships work is this slogan: Take what you can use and
leave the rest. Personally I find the steps to be ingenious, and when
all is said and done, I think people will look back and see them, in
their pure form and practice, as one of more significant American
contributions to world culture in the 20th cent.--right up there with
jazz, blues, and rock and roll, in my book. And that's another reason
why I think that, no matter how "hegemonistic" or self-aggrandizing the
organizations that practice them may appear, the whole
rationalist/intellctual crtitique of them is, ultimately, like farting
up a rope.  
  
  

    
Your chapter on Noveau Psychedelics is a sort of coda to the book, coming 
after the disaster of cocaine and the description of recovery. And it has 
a different trajectory than earlier chapters, no arc from discovery to 
excess to disaster. YOu also manage to talk about one of the areas of the 
culture whose debt to psychedelics is rarely mentioned--the 
computer/cyberpunk/post(trans)humanist nexus. (For those of you who 
haven't got there yet, this is the chapter that features, among others, RU 
SIrius.) "in this cultural configuration, freedom of information and 
ulimited access to computers were the imperatives; cyberpubnks should 
always mistrust Authority, Promote Decentralization, Do It Yourself, Fight 
the POwer, Feed the NOise Back into the System, and Surf the Edges." It's 
a fascinating discussion, and it ties in with something that is very au 
courant: the question of biotechnological enhancement, e.g., brain 
implants, steroids, Prozac, etc. The enhancement enthusiasts that you 
interview are attracted to 
the idea of drugs as much as to drugs themselves--as something that 
perturbs consensus reality, "an objective correlative for being weird 
and different," as Rudy Rucker put it. 

Questions of the ultimate fate of drug taking aiside, you seem to give 
credit to drugs for being able to wreak transformations at a very deep 
level--something that makes the transhumanist project not only plausible 
but in some ways, at least potentially, attractive. So I was wondering as 
I read this chapter what you think of this idea of remaking ourselves by 
getting at the source code.
  

    
Martin, your comments and responses to the 12 Step issues are spot on.
 Thank you.
  

    
Yes indeed. Put them online somewhere, if you haven't already. (Of course,
they will live on here.)
  

    
The freedom and autonomy of the 12 Step programs can probably be
brought into greater focus if contrasted to something seriously
structured, like say Scientology's Narconon.
  

    
"The idea of drugs as much as the drugs themselves..."

I do give credit to drugs to be able to wreak "transformations at a
deep level," as you call it. One of the great pleasures of the entire
experience of researching this book has been learning about the quality
and depth of some of the conceptual thinking that has come about as a
result of the whole experiment of altered consciousness that took place
around the rediscovery of psychedelic substances like peyote and
psilocybin mushrooms, and around the discovery of LSD and the
phenetylamines. 

Fortunately there have been some excellent books about the psychedelic
theorists like Huxley and the whole secret history of the government
involvement with psychedelics like Acid Dreams and Storming Heaven. At
some point I had to make some hard decisions about the book because of
length and scope, and one of them was to where to fade in with the
psychedelic story. As fascinated as I was by Huxley and Wasson and
Schultes et al, I decided to fade this story in where it most impacted
on my own generation. 

The two most powerful strains were the Leary-Alpert scene at Harvard,
and the Kesey-Prankster experience. This meant merely alluding to
pre-1960s psychedelic history where appropriate. It wasn't an easy
decision, but as I became more aware of the Nouveau Psychedelia of the
80s and 90s and how remarkable and rich it was with MDMA, the Shulgins,
rave, cyberpunk, the ongoing re-invention of Tim Leary in his 70s, and
especially the emergence of Terrence McKenna as one of the most unique
philosophers of the 20th century, I realized that the story would be
perfectly bookended because it seemed not only to come full circle but
signify and affirm with stunning clarity the ongoing relevance of drugs
in our culture. 

What the Nouveau Psychedelia made obvious was that despite the
brutality of the war on drugs as the ultimate personification of the
right wing counter-reaction to the psychedelic 60s, it had never, and
would never, go away. The genie was out of the bottle (out out out!)
never to be fully put back inside. And it was also obvious that to some
folks drugs were every bit as cutting edge in the 90s as they;d been
thirty years earlier (nobody said it better than Wavy: "The 90s are the
60s turned upside down"). I think Sirius and his crowd deserve a lot
of credit as the chroniclers of the sensibility; they merchadised it in
Mondo  in a way that was very clever and fun. But nobody was more
influential in his sheer weird brilliance (or brilliant weirdness) than
McKenna, whose very obsession, of course, was the "idea of remaking
ourselves by the source code," as you put it...McKenna, who had the
balls to smoke DMT and try and figure out why, despite scientific and
technological advances that seemed to be occurring  at the speed of
light, we can't seem to stop hating and slaughtering each other. And
posited a pharmacological thesis and solution! 
  

    
That was remarkable, and his delivery was spellbinding. I firts 
encountered McKenna via a tape of True Hallucinations, which I listened to 
in my care over the period of a couple of weeks. I can still hear him 
reeling off those plant names--banisteriopsis and yage and so on--in that 
nasally deadpan. That was during the time that my wife was doing her 
dissertation on people who had been abducted by extraterrestrials, ande 
for a few months there I really believed in all that stuff--that mushrooms 
were UFOs, that we were rapidly hurtling toward some kind of psychedelic 
armageddon, etc. It was all held together, somehow , by McKenna's voice. 

Too bad he died.

I think you did the right thing, focusing on the two psychedelic scenes 
that you did. No point in reinventing the wheel. 

But let's talk about drugs as medicine for a second, because that's what 
the Nouveau Psychedelics chapter made me think about, especially the part 
about MDMA. I think Rick Doblin is onto something in his attempt to 
medicalize MDMA. When I work with couples who are held back by fear, and 
when I think about the way that MDMA can provide an experience of the 
other in the absence of that fear, and all the good that can come of that, 
I really wish that MDMA wqas legal for medical use.  But I wonder what you 
think. Is bringing some of these drugs into the official pharmacoepia a 
worthwhile effort? 
  

    
It makes me furious that MDMA is not being researched and licensed for
therapeutic use. It's nothing less than criminal that the population
is allowed free access to massive amounts of anti-depressants through
medicine and psychiatry but can't make use of MDMA. I only did it one
time and it was packaged to me as a whole candle-crystal mineral bath
New Age experience by this wonderfully witchy lady named Frances, but
once was more than enough for me to see that every single claim made
about its potential therapeutic application deserves serious
consideration. I don't know Doblin personally but of course I know of
him and his work and he deserves tremendous credit for his dedication
and tenacity. So there's no doubt in my mind that the substance could
be enormously useful; the questions would be how to best use them, and
we've really lost a lot by not being able to freely work in this area
to truly ascertain their potential as well as their limitations. Never
having had ibogaine, I can't remark about it, but unlike many abstinent
people in 12-step recovery fellowships, I even see the potential value
of MDMA in the treatment of addiction (heresy!). I mean, so many
recovering alcoholics and addicts are also the victims of the most
horrendous kinds of abuse, especially sexual, which becomes a paramount
issue for them, and they just fall into an abyss of pain where they
get stuck. I think that with the right treatment, some of them might
benefit from MDMA. 
  

    
Thank you, Martin.  That's the way it looks to me, too.
  

    
Some of your remarks earlier make me think that you are pessimistic about 
the prospects for the end of prohibition. In your chapter on the subject, 
you mention two conditions that maight be necessary to reform. "Reformers 
would have to address the ideology of abstinence itself..." and, quoting 
Ethan Nadelmann, "If we win the battle over kids and drugs, we win drug 
policy reform." 

Can you expand on this here? What is "the ideology of abstinence." Do you 
think  it is a problem or are you relaying what reformers think? I'm 
assuming that there is a difference between abstinence itself and the 
ideology of abstinence, but I'm not sure what the latter is. (Heck, maybe 
I don't even know what the former is.) ANd what way of addressing it would 
bring us to reform?

And what is this battle over kids and drugs?
  

    
isn't the prohibition at least as far as marijuana is concerned being
encouraged / payed for largely by the liquor lobby who I believe know
full well that pot is a better high and doen't kill you ( as booze
definately does ) and worst of all for them ....is free ...you can grow
it in your back yard ....a terrifying proposition to them ?......
  

    
"...payed for largely by the liquor lobby".

Worse than that, David.   Almost all of the funding for the "Partnership for
a Drug-Free America" comes from the three pillars of legal drugs.
Alcohol, tobacco, and pharmaceuticals.      And that's the way they control
the debate in such a way that the damage they do to society doesn't even get
brought up, much less compared to that done by the prohibited drugs.
  

    
This is true, but the reasons the prohibition continues are more
complex than the funding/funders of its propaganda machine.
  

    
Yes, no doubt it is a useful component of the control apparatus as
well.
  

    
>Almost all of the funding for the "Partnership for
a Drug-Free America" comes from the three pillars of legal drugs.

Not anymore. That was true when PDFA started up, and it was always a
project of the RW Johnson Foundation, whose money comes from Johnson &
Johnson. (Incidentally, no one was supposed to know that PDFA was
funded this way. Cynthia Cotts, a Village Voice reporter, made a
routine request for their NY State tax return and was sent the entire
thing, including the list of contributors and what they gave,. which
she promptly pubioshed in, I believe, the Nation. A big embarrassment.)
But PDFA runs differently now. They still get corporate money,
although after Cott's article ran they but they have entered into an
unholy alliance  with the Office of National Drug Control Policy
(ONDCP), better known as the drug czar's office. ONDCP provides the
money--around 165 million dollars this year--for media buys, and ad
agencies supply the creative force on a volunteer basis. The overall
PDFA advertising effort, they say, makes them the second or third
largest ad buyer in the country.

The best historical comparison to the PDFA is the War Bond drive of
WWII, which was conceived as a propaganda tool that had as an almost
incidental outcome the squirreling away of insignificant amounts of
money. Like that effort, the PDFA allows corporations, especially the
media, to get pr points and viewers/readers to feel good about the war
on drugs, to feel like something is being done.

Now, I really don't mean this as a conspiracy theory, but this effort
is undoubtedly related to the way that the media cover the drug war.
Here's an example. I pitched a story to a big magazine with which I
have a good relationship and a good track record, and which prides
itself on taking on the powers that be. It was the MDMA bogus science
story, which for various reasons I had long before it was public. I was
turned down because the magazine didn't want to expend any of its
"liberal chits" on such a story. The PDFA ads are devastatingly
effective, not so much in changing people's minds as in disclosing and
reinforcing the consensus. It is very hard for an editor to want to
take on this kind of juggernaut.