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Whose Way of Dealing With Addiction is Better?

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Much is being made of the Russians' style of dealing with their growing addiction problem, reportedly due to flooding of the marketplace with the drugs from Afghanistan. They lock down addicts -- handcuffing them to their beds -- until the urge to consume the drug passes.

The objections to this approach are pretty standard (and I agree with them):

Most experts in drug treatment condemn this approach as a primitive, brutal and ineffective way to address the problem, saying that addiction is a much more complex and intractable challenge and that simply drying out cannot bring a lasting cure.

"What they present as drug treatment has absolutely no basis in evidence," said Diederik Lohman, a senior researcher at the monitoring group Human Rights Watch.

So why, then, do Russian authorities insist this approach is overwhelmingly effective?

Despite the outward dissimilarities between Russian methods and the approach taken in the United States -- where we regard addiction as a disease, not a bad habit or way of life to be stripped off of people -- there are actually quite a few similarities between our Russian comrades and us in this area:

  1. We both seek simplistic answers that fail to grasp the enormity of the life challenges faced by many addicts, who lack job skills and productive engagement, who don't have social connections to the non-addict world, and who can't see a path on which to retrack their lives away from their addictions.
  2. Neither the Russians' nor our most popular treatment modalities -- the Russian one just mentioned or the 12 steps that dominate American treatment -- has demonstrated clinical success. How could they? If they were as successful as their advocates in both countries claimed, addiction would go the way of tuberculosis, instead of being the intractable problem it is for both of us.
  3. Each nation's dominant method plays into cultural memes -- the Russian one of heavy-handed repression of people's behavior, and ours of spiritual redemption.
  4. The Russian monkey is heroin, a readily available painkiller flooding over its border with an impoverished neighboring country. But our fastest growing monkey is pharmaceutical painkillers manufactured domestically that are widely distributed right here at home.

  5. We both react with the same, what-me-worry-if-addiction-never-decreases shrug when our unshakeable belief in the infallibility of our core method for dealing with addiction faces contrary epidemiological evidence, such as that indicating that the treated do no better than those who go untreated. What, do you expect Dr. Drew to step back after yet another celeb fails at rehab and say, "We really have no idea how to crack this puzzle."

To bring things full circle, it's sort of like how leaders in each country remained convinced that their unique and superior methods of conducting war in Afghanistan meant that they would emerge victorious in that domain too, despite all the evidence proving them wrong.

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