Protecting the brand of addiction as a medical condition and its payoffs required that the story change from a genetic cause – never supported by evidence – to current messaging of diseased brains “hijacked” by drugs. But the facts and research have never changed: the behavior of compulsive substance use concocted as a medical condition is falsified by all relevant lines of evidence.
In a previous post, some of those lines of evidence were examined: whether decades and $billions in medical model funding and research have led to evidence of gains in identified physical cause, in development of effective treatments, of slowing or reversing of trends in population substance use problems.
1. Does the phenomenon of “addiction” fit with our conception of “disease”
2. Is there an identified disease (biological) etiology, pathology?
3. Is the epidemiology of substance use congruent with a chronic disease or medical condition course?
4. Are medical model explanations logically coherent?
5. Are predictions for causes, patterns and course of relapse based on the “hijacked brain” model supported by the evidence?
6. Are there alternative conceptualizations supported by evidence that are incongruent with a medical condition model?
7. Are the course, epidemiology, and population patterns of the most pervasive and costly substance use problem – Food Use Disorder – congruent with a disease, or “hijacked brain” model?
It turns out that evidence – all lines of relevant evidence – is congruent and clear.
There is no disease, no disease of the brain, and there are no medications to treat the fabricated disease, never will be.
Because compulsive substance use is not remotely a medical condition – on any critical examination, the “evidence” for the fictional brain disease model dissolves, is invalidated by all longstanding lines of relevant evidence and reasoning.
The outcomes of the fabricated medical model and medical approach – just as for the runaway prescription of addictive opioid medications for common chronic pain, an entirely non-medical condition with no biomedical treatments – were predictable from the start: no gains, no signs of benefit in epidemiological data, instead continuously worsening epidemics as higher and higher doses of the cures are enthusiastically provided by the manufacturers and dispensers.
While there are no bodies of validating evidence (replicated randomized controlled trials, RCTs) to support clinically significant benefit from medications for compulsive substance use, common chronic pain, or depression, despite decades and billions of dollars of public healthcare resources successfully diverted, research is not required to invalidate the constructed fictions of medical treatments for the non-medical conditions.
Because the fictions are absurd on their face. Millions and millions of deaths, of lives impaired or ruined by substance use, by impairing depression, suicide, related physical illness and discomfort – those costs mounting, over decades of promises and assertions of medical treatments.
And all it would have taken, for the vulnerable Americans and their families, to avoid all that pain and loss, the impaired lives and lost lives, was to take a prescribed pill. From any doctor. Who wouldn’t? Why not? The medications are widely available, the economics are on the side of even the more expensive ones.
America’s collective brain has been dosed with these medical fixes for decades now, with the predictable result that demands repeating: no gains, no signs of benefit in epidemiological data, instead continuously worsening epidemics as higher and higher doses of the cures are enthusiastically provided by the manufacturers and dispensers.
Just as the evidence-free, medical/pharmaceutical industry constructed lie that common (centralized) chronic pain is a biomedical condition that could be medicated effectively has led to enormous harms in the form of the Opioid Crisis, longstanding worsening substance abuse epidemics are driven by diversion of healthcare resources to promised medical fixes for the entirely non-medical condition of compulsive substance use, with no bodies of evidence to support medical treatments, instead for longstanding evidence-based psychotherapies and psychosocial supports.
Every visit to a medical office or provider for a substance use problem causes harm by instilling and reinforcing false belief in a passive, ineffective medication, a pill for a complex, individualized inner reality of potent early experiences, psychological injury, distress, distorted beliefs and associated mood states – an individualized inner reality with only collaborative, extended work in psychotherapies as indicated treatments – disincentivizing patients engaged in a potentially lethal compulsive behavior (the symptom of that inner reality) away from engaging in the more intensive, active work of counseling and behavioral changes. Predicting continued distress, illness and harm.
Every medical visit and “treatment” robs vulnerable patients of a factor strongly supported by extensive research as protective against relapse and required generally for change: self-efficacy, or sense of confidence in one’s own choices, abilities, and effectiveness to make the changes needed to resolve a problem or regain health and safety.
Self-efficacy is developed, reinforced, experienced and strengthened in a process of interaction with skilled therapists over which experiences that include active changes (not passive changes like taking a pill) are experienced as effecting positive changes in the patient’s life and resolution of problems.
That is, a key factor established by research as required to stop and protect against return to problem substance use requires work in therapy over time in order for patients to internalize, own, and self-affirm personal agency and effectiveness, control, in behavioral and other changes that protect against problem substance use.
Medical visits and the sham “treatments” are a barrier to self-efficacy, that is a barrier to healing and wellness. That process is subverted when vulnerable patients are reinforced, by medical visits for a non-medical problem – in the false belief of a passive fix for substance use, a pill.
The trained belief in a non-existent condition “addiction” as a medical condition with medical treatments was predicted, all along, to generate illness, “treatment” failures, ultimately lethal epidemics.
American Media love to “fact check” the statements of politicians and political candidates, individuals a jaded public rarely view as trustworthy or authentic in any case. That fact checking appearing to constitute, more than anything, a ritual and exercise meant to create a sheen of competence and aggressive investigative journalism in the absence of that role and in a postfactual cultural/media matrix in which repetition creates meaning and elects a pathological liar as a president.
The craven abdication of competent medical fact checking allowed a lethal opioid crisis to unfold with media along for the ride, now allows continuation of overtly unsupported lethal medical misinformation driving public health epidemics in substance use, depression, suicide, obesity.
If there had been in operation that critical watchdog, evaluative role of a free and uncowardly press in a democracy, unbeholden, providing competent challenge and critical discourse, how many lives . . .