A
History of Addiction and Recovery in the United States
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Book Review:
A
History of Addiction and Recovery in the United States
by Michael Lemanski (Tucson, AZ: See Sharp Press, 2001)
By Jerry
Dorsman
What
helps individuals break their addiction to alcohol? What programs have
been tried in the United States—and what works?
For
answers, read this book. In it, Michael Lemanski, a keen researcher in the
addictions treatment field and author of numerous published articles on
the topic, traces the history of addiction treatment in America. He
proceeds by peeling back layer after layer and explaining why things are
the way they are.
He
shows, for instance, that the recovery movement over the past 250 years
has been more of a religious than a scientific enterprise. He charts the
path of the early temperance movement that began in the late-1700s, to the
mid-1800s group “The Washingtonians,” to the Woman’s Christian
Temperance Union (WCTU) that started in 1874. All of these offered
recovery programs that required acceptance of religious dogma.
In the
early 20th century, not much changed. The ongoing movement to
help people who were struggling with alcohol addiction remained firmly
religious. The Salvation Army, a Christian organization offered food and
shelter along with “9 Steps” to help problem drinkers find a new life.
(As you read these 9 Steps, take a moment to compare them to AA’s 12.)
Then there was another Christian based program, the Emmanuel Movement that
interestingly included some Freudian psychoanalysis in its otherwise
spiritual approach. In addition, there were the religious and moral
activists who pushed for, and helped to bring about, “Prohibition,”
the U.S. ban on the sale of alcoholic beverages that lasted from 1920 to
1933.
But the
immediate predecessor to AA was the Oxford Group Movement/Moral
Re-Armament, a Christian based program—complete with regular
meetings—designed to help people turn their lives around by finding God
and becoming moral. Both Bill Wilson and Dr. Bob Smith were members of
Oxford Groups when they founded what was to become AA.
Lemanski
describes these early recovery programs and does so with great precision.
He then covers the entire history of AA, from its origin in 1935, through
its heyday in the 1970s and 1980s, to its leveling off in the mid- to
late-1990s and the beginning of its decline in the present day.
He also
covers the birth, and growth, of the disease concept of addiction. The
growth of this concept parallels the growth of AA and, in fact, the two
become wedded. Lemanski analyzes the reasons for the broad-based
acceptance of the disease model and also the many inconsistencies in its
application.
For
instance, if alcoholism as well as drug addiction is a disease with
obvious physical origins, then why would we recommend, as treatment, a
religious or spiritual program which encourages us to make a connection
with God and revamp our moral lives? Lemanski describes this obvious
mismatch and shows how addiction treatment in America evolved, in spite of
this, into an AA-dominated industry.
He also
includes an analysis of AA’s efficacy as a treatment program. This
analysis alone should be required reading for every treatment professional
working in the field today. It would help therapists, counselors, and
program managers to realize, first, that AA doesn’t work for everybody
(indeed it works for a surprisingly small percentage) and, second, that we
can help more clients achieve lasting recovery by offering a broader array
of treatment modalities and matching each client to the modalities that
work best for him or her.
This
latter approach, called client-treatment matching, will soon become the
gold standard of addiction treatment. As scientific research proves the
efficacy of more and more therapies and treatment modalities in treating
addictions, an increasing number of treatment professionals will begin
offering these as part of the standard fare.
What are
some of these alternative treatments? Lemanski answers this too. He gives
snapshot reviews of various treatment modalities, types of therapies, and
self-help groups, all of which have been proven successful with some
significant percentage of clients.
Today,
every treatment professional needs to know these alternative treatments
and be prepared to offer them directly to clients or to make referrals so
that clients can access these treatments elsewhere. Sadly, few
professionals do this currently. But when they become more savvy, then the
addiction treatment field will compare favorably with its sister field of
psychology. Within the past hundred years, psychology grew from one
primary psychotherapeutic intervention, Freudian psychoanalysis, to the
dozens upon dozens of successful interventions that are used today.
With
this book, Lemanski offers not only a remarkably exciting read but an
immensely important work on this topic. I feel everyone associated with
the addictions treatment industry can benefit by reading it. As Goethe
said, “Those who do not understand the past are doomed to re-live it.”
We need not re-live the nightmares of addiction treatment past. We can
move ahead. The path is clear.
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