Words still mean things
A bill in Congress – sponsored by Joe Biden – is attempting to change the National Institute on Drug Abuse to something kinder and gentler: the National Institute on Diseases of Addiction. Two therapists – a psychologist and a psychiatrist – say they don’t like the focus moving from “abuse” to “disease”:
We have chafed at the “brain disease” rhetoric since it was first promulgated by NIDA in 1995. Granted, the rationale behind it is well-intentioned. Nevertheless, we believe that the brain disease concept is bad for the public’s mental health literacy.Characterizing addiction as a brain disease misappropriates language more properly used to describe conditions such as multiple sclerosis or schizophrenia—afflictions that are neither brought on by sufferers themselves nor modifiable by their desire to be well. Also, the brain disease rhetoric is fatalistic, implying that users can never fully free themselves of their drug or alcohol problems. Finally, and most important, it threatens to obscure the vast role personal agency plays in perpetuating the cycle of use and relapse to drugs and alcohol.
This is not in some nutball Christian magazine, either. It’s in Slate. Read the rest here.




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back to top56 Comments to “Words still mean things”
“This is not in some nutball Christian magazine, either”.
Well, it is now.
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You have to admit, that was an easy opportunity to take. How about a comment on the content? I suppose you like the idea of “brain disease” to describe drug addiction, Erasmus?
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trr please tell me more about myself.
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Wow, Erasmus, you’re sooo witty…
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This is just another opportunity for people to lie to themselves and avoid taking responsibility for their choices. We’re all “addicted” to something — if not cocaine or alcohol, then shopping, food, chocolate or whatever. This makes it easier to say “I can’t help it; that’s the way I am.” Joe Biden is wrong.
Will the liberals include my shopping addiction in their universal health care coverage plan? I think not, so I’ll continue staying away from shopping malls and watching my diet in a responsible manner.
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Whether the name change would be good or bad depends on what changes accompany it. There is addictive behavior that is not a physical dependence on a controlled substance, so if the NIDA is widening its scope to cover those areas then some kind of name change makes sense. As to whether the word “disease” is going to give people the idea that they have no control over it, that depends on how the messages that come from the NIDA are presented.
It is not true that all diseases, even using the traditional sense of the word, are neither brought on by sufferers nor modifiable by behavior (motivated by the desire to be well). Some are, some aren’t.
Diabetes is an example of a disease that can often be prevented by healthy eating and exercise, so to some extent sufferers (of the adult form of the disease) often have brought it on themselves. And if it is caught early enough, sometimes modified behavior can keep the person from having to become dependent on medication.
To some extent, mental illness is affected by a person’s choices. My mother might never have been “normal” (whether due to genetics or poor upbringing – her mother was in an institution and killed herself when my mother was young) but I think that the small choices she made over the years (usually choosing *not* to make decisions, and making other people take responsibility for her), steadily degraded her ability to take responsibility for herself, until she was a basket case bouncing between the psychiatric hospital and the nursing home, and diagnosed with paranoia and psychosis and who knows what else.
I don’t think that everything that happens to a person is a result of their choices (as my mother did – she said even if you got hit by a drunk driver you had somehow brought it on yourself by negative thinking). But it’s well known that attitude does have a lot to do with physical health, and that doctors can sometimes see no medical reason why one patient does so much better than another, other than attitude.
So calling addiction a disease does not put it in a class of “something that happens to me that I can’t do anything about except take medicine.”
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There are two current anthropologies:
1. We are chemical accidents of nature and our behavior is the mere product of external stimulus from nature and nurture. We are not good or evil, but just cogs in a system trying to survive and thrive as long as possible (simply for survival’s sake). Undesirable behavior is the result of material or external factors working in or on us beyond our esential control. Thus, the abuse of substances is a disease that is controling us.
2. We are here by design and intention, as a result of the creative will and action of a transcendent and intelligent designer (God). And He invested us with a free capacity for design and intention ourselves by making us in His image. This allows us to make active or willful choices in a purposeful universe. Good and evil are missional concepts and we can point our hearts and lives toward one or the other by intention, and we can seek essential help from our Creator as we pursue His will. Undesirable and abusive behavior can be purposefully chosen and we are responsible for our decisions.
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A third “anthropology” is: we are people who describe all the dilemmas and mysteries of life in terms of two “greatly oversimplified so they make great blog bites.”
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I love anonymous trolls who pop up out of their mud puddles from time to time to jab little toothpick insults at passersby engaged in legitimate conversations.
This is what comes of having computers in middle schools, I guess.
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What I find interesting is that this is presented as some sort of “either/or” dichotomy. Pauline has made some very good points – there are elements of truth on both sides.
I don’t think the two anthropologies Joel presents are mutually exclusive, rather it is a “both/and” scenario.
There are components both of choice and of internal and external material factors, both controllable and non-controllable, at work. Approaching complex problems like addiction and substance abuse as though they are all one or all the other ignores reality, and makes progress very difficult.
Here where I live, the Reasearch Institute on Addictions has been helping lead the fight against casino gambling coming to our town. Although I don’t believe it’s immoral per se, there are a host of problems and social pathologies such that I don’t think it’s a good basis for economic improvement of our city.
But the interesting thing, based on their studies, RIA can predict quite accurately how many new gambling addicts there will be in any given area, based on demographics and casino location.
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The article concludes with this key observation:
You would think Congress has better things to do than legislate name changes.
Better things to do? No, no, this is what Congress does best, especially a Democrat Congress. Senator Biden (D-DE) seeks to define a whole new class of voters: helpless addicts, the unfortunate victims of brain diseases. They will be included in subsequent government programs, again sponsored by liberal Democrats, to bring them salvation from their afflictions.
Another block of state dependent wards, eagerly looking for Democrat handouts is on the drawing boards here. There is great potential for all sorts of follow-on, caring programs. It’s a political gold mine of new problems for the government to solve with new programs. This translates into votes for the self-serving politicians who will buy political support with your tax dollars.
Better things to do? Politicians like Senator Biden have no higher priority than the continual cultivation of their power base.
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Michael,
Good posts lately, here and under the Ward Churchill thread. Keep up the good work.
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Roy,
Thank you for your thoughtful post.
The two anthropologies I generalized about are simply intended to highlight two basic worldviews. The complexities of actual human beings and of life itself should be affirmed (and they are humbling). But to seek clarity of thought is not necessarily to deny life’s complexities. We just need frameworks for our thinking, just to make progress toward understanding.
I agree that the two anthropologies are not mutually exclusive. I just want to point out possible philosophical origins for why some of us go in different directions in the words we choose to explain ourselves and our lives.
I do NOT think that the complexities of all the factors that come together in certain addictions should be seen as making victory over addictions and abuses an unrealistic goal (not that you said otherwise). The power of God is greater than all our complexities. OUr churches and other caring loved-ones who support us are also a profound resource of strength,.
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#3 You don’t appear to know the meaning of the word “suppose”. How’s that?
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I thought it interesting that the 21-year-old actress who was arrested recently for an OWI claims innocence — while her attorney says she’s the victim of the disease of addiction.
No one likes to be held responsible for their actions anymore (not that they ever did in the first place — just look at Adam and Eve and the snake), so we have leftists like Senator Biden redefining terms so no one ever has to feel guilty again.
And imagine, Biden would love to occupy the White House someday — scary!
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#8 is me. I was using a different computer than my usual one, in a hurry, so I didn’t bother to put my “name” on it.
However, although I am 63 years old, I am also an anonymous troll popping out of my middle school puddle.
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LOL! David has stepped in it yet again, hasn’t he…
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I think “drug abuse” is definitely the preferred term here, as opposed to “addiction,” for it speaks of personal irresponsibility rather than victimhood. Indeed, I prefer the term “drunk” to “alcoholic” for precisely the same reason.
But regardless of what we call it, it’s long past time for the federal government to admit that it has lost the “war on drugs,” and return the discussion of the criminalization of drugs to the state or local level, where it has always belonged.
The GWOD has only served to restrict our liberties and aggrandize the State.
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If David steps in anything it’s just because a troll dropped it and doesn’t clean up after himself.
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HAHAHA!!!!
TEll it too Cindy LOhan!!!!
She just gout out the jail for DUI and now she going back. And no racist sherriff going to let her out early this time!!!! He learned his lessson last time!!!!
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Random,
Not that your comment wasn’t a legitimate one. I just tire of people not owning up to their opinions and ideas around here. Way too much ugly sniping from the shadows around here lately. Speaking of which…
#17 – “yet again”? You must have me confused with someone else.
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Michael – “It’s a political gold mine of new problems for the government to solve with new programs. This translates into votes for the self-serving politicians who will buy political support with your tax dollars.”
I would change “solve” to “address”. Government programs don’t generally solve problems, they institutionalize them, if relatively bengign they are perpetuated, if bad they are exacerbated.
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Outkast calling Randoom Name a troll? Now that’s rich!
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EXacerbated
WHat kind of laguage is that for a socalled “Chistian” website? Could the monderator kindly please keap this kind of FILTH of the boards? There is children redding this stuff!!!!
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I agree with NJ Lawyer and Outkast. Nobody wants to be held accountable for their actions- they like to pretend they don’t have a choice, that they were either forced into addiction or couldn’t resist. The last thing we need is some democrat inventing a disease so those people can feel better.
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#25 “Nobody wants to be held accountable for their actions”
Logical,
I don’t think that’s true. No one enjoys being held accountable for their (destructive) actions, because the consequences hurt, but there are people who recognize that continuing their actions also has bad consequences, and would like to change, but aren’t able to change without help. (My brother-in-law was once a cocaine addict and quit cold turkey, in part due to the “tough love” his family showed him – but he is pretty unusual in his success at that.)
I’ve already explained above my view of why the word “disease” does not mean people have no responsibility for their actions. People with all kinds of diseases – even ones they had no part in getting to begin with – have a responsibility for following through with the required treatment. I agree that people need to take responsibility. I just don’t see that the word “disease” necessarily detracts from that.
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This is mostly a comedy of errors. See my last comment in Whirled Views about people taking on line communication too seriously.
My original “anonymous” comment was a disagrement or criticism of Joel’s comment. I don’t perceive any ill will with Joel. We just disagree greatly on truths and values.
We may be on as good terms as two people can be under those conditions, though I can’t speak for him.
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#25 I have to disagree with you.For years I have
been suffering from addictions of my own.If I go
4 to five days without eating I feel as if I’ll
die.And don’t get me started on the water cravings
because they can be real torture.I have suffered
from “food & water” addictive disorder from before I can remember.It didn’t help that my
mother used food and got me hooked as well.This is
a disease,and I’m going to”self medicicate”as my
dealer “Ronald” is in town.Good day sir!
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NJ writes:
Will the liberals include my shopping addiction in their universal health care coverage plan?
Sure, however, we liberals suspect that a shopping addiction isn’t the only thing on your shopping list. But it’s a start. Go on. We’re listening…
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I think NJLawyer has it right at #5. Dishonesty with oneself often lies at the root of some addictions. Case in point: “I can’t help it!”
This does not explain all addictions but spinning words around like this does make it easier to say, “I can’t help it.” It puts self-pity where legitimate guilt belongs.
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Random Name, thanks for your compliment on my blog bite. My comments are not often called “great” (#8). Even I didn’t think it was THAT good.
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Well, to be honest about this whole entire issue, I personally reject the disease concept. To say that I was genetically infused, or inherited a trait that is non-characteristic to either (a) my survival, or (b) my moral standards and behaviors, takes both sides of the spectrum and fuses them together. I would say that it is quite simplistic in nature when it comes to man’s sinfulness and his rebellion against God. I am more than willing to say that those same pleasure centers that light up when you show me a needle and a spoon (being 3 years clean) are the same ones that light up if I were to look at pornographic images. Either way, I am only helpless when I am in full abandon to the control and compulsion of the chemicals control. Other than that, I always made a decision to get high. Narcotics Anonymous, yet another help program I have participated in not only embraces the disease concept, therefore becoming a drug itself creating a need for the “program” as you will die without it, and rejecting the truth of “One” God, as you can choose your own god, leaves many clean, but eternally damned.
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Seeing how everything that precedes this post is partisan blather, I’ll simply ignore it and state the obvious.
I agree with Slate.
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A lot of issues are common sense issues. This is certainly one of them. The difficulty breaking addictions has nothing to do with morals. Starting the addiction in the first place is the only place when “morals” are even a question. This is why it’s important to teach “prevention”. When prevention isn’t taught, then that is “immoral”. Too many parents think teaching sex education or drug prevention is actually a “green light” to “wild, immoral” behavior. Wrong.
Once someone is addicted, breaking the addiction is in no way a test of “morals”. That’s ‘tarded. It makes the person, who already has an addiction, feel that they do not deserve to “make it” because they have a lack of morals if they have a relapse. Another factor is that the addiction may be difficult just because their physiology makes them more susceptible to the addiction in the first place.
When politicians do these shenanigans, it’s because they are looking for some spotlight. What it does is make me less likely to vote for them. When you change institutions wording, they have to spend millions sending out new brochures and literature as well as pay people to write those new brochures and distribute it. The money is just being thrown away. It could be used for prevention. It makes me made.
Ooh, ooh, could this be a Utube question?
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It looks like the Dems are simply catching up with the medical community, at least so far as alcoholism goes:
From Physicians News Digest
During the past 35 years, numerous studies by behavioral and social scientists have supported Jellinek’s contentions about alcoholism as a disease. The American Medical Association endorsed the concept in 1957. The American Psychiatric Association, the American Hospital Association, the American Public Health Association, the National Association of Social Workers, the World Health Organization and the American College of Physicians have also classified alcoholism as a disease. In addition, the findings of investigators in the late 1970s led to explicit criteria for an “alcohol dependence syndrome” which are now listed in the DSM IIR, DSM IV, and the ICD manual. In a 1992 JAMA article, the Joint Committee of the National Council on Alcoholism and Drug Dependence and the American Society of Addiction Medicine published this definition for alcoholism: “Alcoholism is a primary chronic disease with genetic, psychosocial, and environmental factors influencing its development and manifestations. The disease is often progressive and fatal. It is characterized by impaired control over drinking, preoccupation with the drug alcohol, use of alcohol despite adverse consequences, and distortions in thinking, mostly denial. Each of these symptoms may be continuous or periodic.”
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Yeah, the Dems have caught up with the libs in the medical community — just as they’ve joined at the hip with those in the liberal science community and liberal religious community.
Just naming something a disease, Anony, does not make it so.
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See where Lindsy LOhan now tyring to blame a black man for her crime? She claims she wasn’t driving a black kid was.
http://www.tmz.com/2007/07/27/lindsay-i-wasnt-driving-the-black-kid-was/
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“Just naming something a disease, Anony, does not make it so.”
Outkast, I am not trying to name anything. I was simply pointing out that the medical terminology going back to the 50’s has termed alcoholism a disease. The AMA classified it as such within 3 years after “One nation under God” was added to the Pledge of Allegiance, if that gives you any perspective on how pervasive those villainous “libs” were at the time
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No name, no game.
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Amen, #39.
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I don’t need a game. I showed where the term origiinated and Outkast now knows it has nothing to do with liberalism
Nuff said. Thanks for playing!
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#31
I hope coyote blue is taking notes. I was providing examples of how to flame without seeming to flame, but I am always willing to defer to others who do a fine job.
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I wrote something like this a while back, but this seems to be a day for repeating myself. The following is a thought exercise. It’s just an opinion, and not subject to any testing, much less proof. It’s meant to disturb, but may only demonstrate the writer’s disturbance.
If I had sufficient resources and freedom to do as I please, my expectation is that I could raise (that is, supervise the raising) of 100 infants so as adults at least 80% would be sociopaths willing to kill. They could be programmed to kill in the name of Communism or fascism or Islamic terrorism or a similar ideology.
If I had sufficient resources and freedom to do as I please, I could raise (that is, supervise the raising) of 100 infants so as adults at least 60% as adults would be reasonably well-behaved, law-abiding, constructively-employed adults in any reasonably well-performing modern society, such as North America, Western Europe, Japan, Australia, etc. They could be programmed to “justify” (perhaps inspire would be a better word) their decent behavior in terms of some sects of Christianity, Judaism, and some varieties of secular humanism.
I estimate the lower success rate in that it is harder to inspire people to be good than it is to inspire them to be evil. Also, the art of controlling human beings, although highly developed, is not yet fully developed to the point of fully deserving to be called a science.
My underlying point (which I expect no one here to accept) is that the ideas of “free choice” and “responsibility” while difficult to resist, are to some extent myths and fallacies. I don’t like the idea either, though I just wrote a mini-essay on it.
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The AMA has been liberal since BEFORE the ’50s, Anony, so you’ve proven nothing except that you’re a coward by remaining totally anonymous.
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Outkast, could you provide some examples of the AMA being “liberal” prior to the 50’s? You really crack me up, btw
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Outkast? Ouuuutkaaaast…? Where’d ja go? No sources for this claim either? When am I finally going to learn you never bring the ball to the game?
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No support. Just name calling and run. The usual MO. sheesh…
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#45-47–Outkast is accused of avoiding the question because he hasn’t answered within 45 minutes of your asking it on a day-old thread? Huh?
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Sorry, I went out to dinner tonight. Unlike certain anonymous losers on this blog, my life does NOT revolve around this blog 24/7 every day.
My support, #45-47, is contained in your own post 38: I was simply pointing out that the medical terminology going back to the 50’s has termed alcoholism a disease.
The AMA is liberal institution, and has been since at least the 1950s.
Hello . . . ?
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#44
I was alive in the 50s. (I was born in 1944.) There aren’t many perks to being old, but one is being able to say, “I remember when, sunnyeee” (delivered in creaky, “old geezer” voice).
My parents were very liberal. They were health food fanatics and alternative medicine fanatics, as was most of my family.
As a child, I was exposed to many rants and diatribes about how conservative the American Medical Association was.
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Cheryl, weekie and I were talking there. Look at the time stamps. (he left for dinner at 2pm?) I know you feel sorry for him, but you really should let the boy standon his own lest he appear to be a loser.
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Outkast,
you wrote: The AMA has been liberal since BEFORE the ’50s, Anony, so you’ve proven nothing except that you’re a coward by remaining totally anonymous.
I wrote back: Outkast, could you provide some examples of the AMA being “liberal” prior to the 50’s?
Outkast, you are being very dishonest and irresponsible. Have you no integrity whatsoever? Making a claim and then obfustacting is not honorable. Where is Joel Mark when I need him!!?
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Anony #52: Can you read? I gave a perfect example of YOUR OWN CLAIM of the AMA being liberal in my post that referred back to your very own posts #45-47.
Blah, blah, blah . . .
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Such twisitng and wanking, Outkast. I never said the AMA was liberal. Just run along now. You briing nothing to the discussion.
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You didn’t have to SAY the AMA was (and since the ’50s always has been) liberal, Anony. The quotes you posted above PROVE the fact.
BTW, I’m not going to “run along,” but once WMB finally mandates registration for all posters you will be H-I-S-T-O-R-Y.
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Outie, you just run yourself in circles time after time…and you’re not even quoting yourself correctly now
You said “BEFORE the 50’s.” (emphasis yours) re-read your posts. They make no sense.
Nothing I quoted implies political leanings whatsoever. Just a factual quote from a medical publication. You never did offer a source for your jibberish. Not surprising IME of chatting with you.
And just so you don’t have to worry, I promise to register when required. I’d miss you if I didn’t. Until then, I’m just following the rules.
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