Seth Mnookin reviews Chasing the Scream and finds its review of the science troubling. (Previous post on Hari here.)
The first tip-off that Hari might be in over his head comes when he describes how “a small band of dissident scientists” had uncovered the answers he was looking for after working “almost unnoticed, for several decades.” Hari starts with Gabor Mate, a Hungarian-born Canadian physician whose theories about how the roots of addiction (and lots of other things to boot) can almost always be found in childhood trauma are, in fact, quite well known. To support his portrayal of Mate as a fringe renegade, Hari acts as if a rigid, deterministic model of addiction as a purely physical disease is almost universally accepted; if anything, the opposite is true. Even more problematic is Hari’s wholesale acceptance of Mate’s reductionistic approach when, in fact, there’s a significant body of work demonstrating its shortcomings.
The next researcher to benefit from Hari’s credulousness is Bruce Alexander, a Canadian psychologist who believes that drugs are not the cause of drug addiction. Alexander is best known for his “Rat Park” experiments in the 1970s, which were designed to demonstrate that rats in stimulating, social environments would not become addicted to morphine while rats in cramped, metal cages would. Hari explains why Alexander’s views have not been universally embraced by making the preposterous assertion that “when we think about recovery from addiction, we see it through only one lens — the individual.”
A few pages later, Hari is talking to a Welsh psychiatrist named John Marks, who is a proponent of providing prescription narcotics to addicts. Hari supports Marks’s claims by referring to “research published in the Proceedings of the Royal College of Physicians of Edinburgh” but then buries in the notes the fact that it was Marks himself who was the author of that research. Sometimes, Hari’s unquestioning acceptance of what these researchers say is unintentionally comical: At one point, he quotes Alexander explaining that drug addicts don’t get clean because they would rather spend their time doing “exciting things like rob stores and hang around with hookers.”
Read Mnookin’s entire review here.
Addiction & Recovery News 
And there you have the future of addiction science, a giant backward leap into muddled sociology, soon to be bolstered by another Gabor Mate acolyte, Marc Lewis, with his big new book, “The Biology of Desire: Why Addiction is Not a Disease.” I admire your work, Jason, and I mourn the rearguard action you’ll be fighting over the next few years. Me, I’m taking my marbles and moving on, covering other scientific fields where the level of pointless contention and fierce pushback by social scientists does not impede progress quite as mightily as in the addiction field. Best of luck.
Wow. I hope you get drawn back in from time to time.
Louis Pasteur was also once a laughingstock for believing in “invisible animals.” The world was once considered flat and the center of the Universe, and on and on.
Be careful of how much intolerance you build for those who think differently, as we need those “crazy” people to help move the world forward. This is not to say that everyone who thinks differently is somehow going to change the world, but if the outright intolerance for other views is manifested into a general shouting down of all outlying opinions, nothing changes, and leaves us stuck in a dogmatic middle-age.
Good luck chasing your own dragon… and try not to split too many noses on along the way.
Thanks for the comment.
Other than the line, “unintentionally comical”, Mnookin avoids ad hominem attacks and examines the evidence that Hari presents. He shows how Hari misrepresents the evidence, cherry-picks evidence and uses straw men to misrepresent the social/scientific context.
I did the same thing in the previous post and showed on harm caused by his argument in the following post.
We could go through a long list of truths whose messenger was ridiculed. It’s good to be reminded to maintain a healthy dose of humility, but it’s not evidence that dissident theory is true.
Regarding the evidence, what to you object to in Mnookin’s review?
I went back, but I’ve now exceeded by NYT articles for the month.
I do believe there is value in Bruce Alexander’s work, but it seems that both sides are looking at the results in a sweeping all-or-nothing way.
The argument that the percentage of Nam-era vets that spontaneously recovered proving that it’s a disease could also be an argument that our society puts an undue level stress on a certain percentage of the population. Lies, damn lies, and statistics. All we know for certain is that those were the results, and everything else has been used by people to bolster their own set of views. To see society as a benign factor is ridiculous, and to see it as the sole blame, equally so… yet people run to these extremes and then shout across a no-man’s land.
As a bit of an aside, even to say that our society is healthy, and that people who dysfunction within it are in some way disordered is a cultural artifact, and not a “truth.” Every culture holds its normative behaviors as the picture of mental health. If you were to time-travel to the Aztec culture, I’m sure you’d be quite surprised by what was “healthy behaviors.” Someday, people will look at what we consider “healthy” and be as much in shock as we would be to be thrown into another culture. The point here is that we view it all through a cultural lens. We all define addiction by applying cultural rules; there is more agreement than is seen.
I’m merely suggesting that the “industry” as a whole stops running to these extremes, and attacking the other extreme’s villagers is probably a distraction and simply a waste of time. Invariably, it seems however, both camps blame the other for their own lack of success yet fail to even see where they agree.
After 26 years of being in and around the addiction recovery community, and performing various work in it, I still sometimes feel like a lonely resident of the middle ground… where it’s okay to say “we just don’t know that, but here’s what we do know that might be important to you…” and leaving it at that.
In application, the extremes get even worse. “You don’t believe in a supreme being? Well here’s the grease we use to fit you in…” or “You have a firm faith? Well God didn’t get you drunk now, did He?”
Treating “conditions and diseases” is not the same as helping individuals get past their difficulties with the culture they happened to be born into, their life traumas, their genetics, and so on… and I hope that someday that some people will stop making things worse in their efforts to “help.”
Should we not all hope that someone finds something that generally works, regardless of the basis they use? To root for one side or the other seems quite childish to me, and I see it as a huge issue in applied practice that people invest too heavily in theories and not the individuals they are working to help.
So, my point was to address these debate in general, and not this particular set of arguments. If you decide to delete what I have said, I certainly understand as it’s not my intention to hi-jack your blog.
In the area of drug policy in particular, I’ve blogged about the “freak show” driving the discussion in an unhelpful way.
However, when a disgraced journalist resurfaces, claiming to have discovered the cause of addiction and is getting a ton of uncritical attention, I think it makes sense to offer a rebuttal. (At least I don’t see that as killing innocent villagers.)
I made a serious attempt to acknowledge some truths in his thesis before rebutting it here:
Your comments won’t be deleted. Thoughtful dissent is welcome.
Perhaps one part of the on-going narrative that may not make sense is that there’s “a” cause? It seems (to me anyway) a fantastic leap of logic that we define a set of very loosely-related behaviors as a specific condition, assign this condition to a set of individuals, and then assume that this “it” we created must have one specific and ubiquitous root… and then go search for “it.” Am I truly alone in being absolutely baffled by this manufactured “one root cause” paradigm?
No, I didn’t see any villagers harmed here. Thanks for the thoughtful replies.