Friday, June 10, 2011

Anonymous Anonymous

Today is the 76th anniversary of the founding of Alcoholics Anonymous. While there is considerable debate in the public health community about its efficacy, the model has been applied to virtually all other forms of addiciton, from Narcotics Anonymous to Gamblers Anonymous, from Sexaholics Anonymous to Workaholics Anonymous. So ubiquitous is this approach that some are considering beginning Anonymous Anonymous for those addicted to attending 12-step meetings. The first step is admitting that you are powerless over you ability to stop admitting that you are powerless about admitting that you are powerless.

You have some like psychiatrist Thomas Szasz who question the very category of addiction. While that's a good conversation to have, I want to assume that addiction is a real psychological problem, but ask whether it ought to be seen as a psychological or sociological concern.

Given that certain substances and activities cause changes in brain chemistry that lead some people to alter their behavior in irrational and undesirable ways, are there social structures and institutions that create an environment where we would expect an increasing number of addicts to be created? Since there is a significant amount of profit to be made from the sources of addiction, whether it be nicotine, slot machines, alcohol, or cocaine, and since we live in a culture where money is equated with political speech and influence, should we be sending individuals to programs or should we be starting a regulatory 12-step program to a healthier society? Are there things that we could do to create a culture that is less likely to create addicts? We say that this is the land of the free and that we love liberty, but with fast food chains and sugared cereals advertising to our children, with payday loan sharks and liquor stores populating our poorest neighborhoods, with Starbucks as the go to hangout for the cool and busy, aren't we setting ourselves up to make all of us dependent on this or that? Is addiction a foreseeable and preventable tragedy of modern cultural structure?