Excellent piece as always and you covered a lot of ground. A few things that you said reflect many of my thoughts and specifically reminded me of matters that I raised in my essay on the root causes of addiction, https://medium.com/recovery-cultures/drilling-down-to-the-root-cause-of-addiction-7c57c5a3fd6c , and the follow up essay, https://medium.com/recovery-cultures/drilling-further-down-into-the-root-cause-of-addiction-d8fe8414390.
In describing my essay in a short form, I wrote:
"Is substance abuse a personal failure of willpower or a disease that deserves medical treatment — the answer does not matter. The problem affects all of society so society must stop the binary assignment-of-blame-approach and simply accept that the problem affects millions of people touching the lives of all and costs society hundreds of billions of dollars annually. Substance abusers have the ultimate accountability for their actions and a duty to do what they can to recover. Society needs to do its part to understand addiction, remove the stigma, and make proper care affordable not only for addiction but for mental health generally. 12-step programs and rehabs are salves between relapses. A new paradigm is required. Until we destigmatize substance abuse, the cycle of failure will never end."
In my first essay I wrote:
"Even AA’s self-reported statistics are abysmal. I will write in detail at a later date about how and why a program that preaches humility has such hubris to refuse to alter its ways in the face of lousy success rates. The short answer is a 42 BILLION DOLLAR industry has grown out of AA. The treatment centers preach AA as the only game in town so they keep sending people to AA and doctors keep sending patients to treatment and it’s a never-ending cycle. I am not blaming AA. I blame the centers, which even if not-for-profit, are paying executives what would be profits in salaries; and the doctors with addiction specialties who seem satisfied with results below the Mendoza line (a baseball reference to a batting average under .200).
I blame them for complacency; I blame them for profiteering. I blame the perversion of capitalism that cares more about profit and the resultant concentration of wealth than societal benefit at the expense of the workers and the middle class; in this instance, I blame the system that allows a few to get rich on the backs of the sick."
