By Matthew Kenner
“We’re crazy, going crazy,” Kurt Vonnegut said in a 2006 Rolling Stone interview, “about petroleum. It’s a drug like crack cocaine.” In April 2007, I’d just recently started a stint in inpatient rehab as part of a plea agreement related to my July, 2006 arrest, at the age of 18, for cocaine distribution, when one of my fellow addicts announced that Vonnegut had passed away.
At the heart of capitalism is addiction. But ‘addictive behavior’ is also its own thing, something framed as distinctly pathological – a disease – and ‘addicts’ (a large and ever-growing population) is its own social category. This has always been true; “the village drunk” is an archetype that’s probably older than life in civilizations. In the contemporary world, however, something new has happened: addiction itself is now an industry.
In the months since I’d seen the interview, I’d forgotten what Vonnegut said, but once I heard he’d died it immediately resurfaced. His message clicked this time in a way it hadn’t previously; perhaps partially because my mind was finally more at ease, after some of the uncertainty of my court case had dissipated; but certainly, in large part, due to my new surroundings. Something in my mind broke free: whatever it was inside me they were calling addiction wasn’t so much a disease, as a symptom. Whatever the thing was constituting this “addiction” wasn’t just something I, personally, was afflicted with. It was inhabiting everyone. My addiction was just how the disease, or disorder, call it what you want, was manifesting in me.
That moment was just a glimpse, and I lost it. The standard industry-approved disease model was the order of the day, and so I came to internalize my relationship with drugs as an illness.
“My addiction” was the problem; “my drugs of choice” were far too powerful for an addict, like me, to handle. Total abstinence was the only feasible solution.
As a 19-year-old (I celebrated my birthday the second week of rehab), the thought of a future of complete and utter sobriety was daunting, to be sure. Somehow, though, it seemed quite possible – and in any case, according to the medical professionals attending to me, it was an absolutely indispensable condition I would have to fulfill, if I was ever going to “gain control” over my life. Thus, I saw little point in doing anything besides “making the best of it”.
The glimpse, the sense that addiction was the rule for our culture rather than the exception, returned for a bit when it was time for me to do the fourth step, my personal moral inventory. I still wasn’t sure if I was truly “an addict”; but my default approach was to go through the motions anyhow. Indeed, this attitude adhered entirely to one of the program’s most steadfast recommendations: “fake it till you make it!” I was doing exactly what they told me. For the most part, my sense was: “They’re telling me I’m an addict, and so I must be.”
Primarily, my confusion arose from my ongoing attempt to understand the relationship between my depression and my abuse of drugs. Most addicts today suffer from some other mental illness as well, so this was a complication more or less all the other patients faced. On the other hand, in this context, I was in an extremely unique position compared to everyone else there: owing to the criminal case I’d gone through immediately preceding treatment, I already had nine months of sobriety under my belt. In fact, to illustrate my remorse to the prosecutors, I’d even been through treatment once, a fairly intensive outpatient program lasting four months. Thus, I now had a great deal more perspective on how my depression interacted with my drug abuse than I’d had right after I got arrested. Gradually I’d come to mostly believe that it was more so my depression driving my urge to get high, rather than the other way around.
Nevertheless, I was intrigued by what I’d heard about the fourth step: the process seemed to me to transcend any questions of “addiction” or “depression”. I started writing down everything I’d ever felt ashamed of from the earliest that I could remember. It was a terrifying exercise, especially at first, but the more routine it became to write down things I didn’t even really want to think about to begin with, the more spiritually rewarding I found it.
I had to find someone to divulge all of my information to when I was finished. Around the time I started working on step four, Yoga Dave started showing up at the rehab. Dave was an “old-timer” 12-step guy from the surrounding area, somewhere around sixty years old, a one-time photojournalist during the Vietnam War who’d been sober for over two decades. His nickname came from the three-times-a-week yoga sessions he donated to the inpatient facility when he was in town. Immediately I found the guy fascinating, mainly because he looked at least like fifteen years younger than he was.
Besides the yoga, which I was somewhat embarrassed to be participating in, Dave gave talks. He was a Buddhist, but the talks were more just about general spirituality. Although they were optional, there was really not much else to do. On one of these occasions, in the room we used for group therapy, in the middle of speaking – “the universe is an ocean of consciousness” – Dave suddenly paused and looked around for a dry-erase marker.
“Everyone in our culture today is an addict,” he said, and he started from the top of the white board, and I started to listen more intently. At the top he was writing things like ‘shopping’, and ‘TV/Internet’, making tiers, implying the increased severity of the addictions as one went further down, with me and my fellow patients contributing ideas. Below the top level we put things like ‘smoking’, ‘food’, ‘sex’, and then we got to what we all naturally assumed were “the WORST addictions”, our own, ‘drugs and alcohol’. Being within the environment of the recovery industry, it was our default response to try and rank which drugs were worse.
Dave let us all do our thing, but this wasn’t his point. After we all bragged about our own drug habits for a bit and, finally, settled down, he asked, “What’s the worst addiction of all though, the one everyone is most afflicted by?” Since no one knew anything worse than drugs and alcohol, we were all silent. He started writing something, and then stepped away so we could see. At the very bottom, Dave had written ‘THINKING’.
Our collective response manifested in a perfectly cliché cinematic moment of minds being blown. As trite as this may seem though, I’ve returned to it ever since. “We’re thinking too much all the time about everything,” Dave had said, “our minds are never at rest.” I’ve gone over this in my head quite frequently in the past ten years, so something about it must make sense to me. I just never really agreed that “thinking” was what we were all addicted to.
Anyway, for the moment, that was just another glimpse; but I picked Dave as the person to do my fourth step with. I told him all the things I was ashamed of. Aside from the main ones that I’m still basically ashamed of, I don’t really remember any of them, but the act of sharing them with another person was uniquely valuable. Other than this, I don’t recall a single other thing that happened at the institution that was meaningful for me in terms of actual recovery; although to be fair, as I said, the rehab was really meant for people just coming off drugs, not someone like me who had spent the better part of the year sober. The fact that I’d ended up there was just an accident of the courts, and of our inhumane, Rube Goldberg-machine of a “Drug War”.
This returns us to the problem, really one gigantic assortment of problems, of the industry of addiction recovery, of the very fact that recovery from addiction is treated as “an industry”, by which I most specifically mean that it is an aggregate system of a certain kind of profit-making. Profit-making introduces an entirely different element into the way tasks are performed, and I don’t believe this element has any really conducive role to play in the practice of medicine (leaving pharmacology aside), and certainly not in the treatment of addiction. A fairly radical article in the Autumn, 1985 journal of Ethos by the medical anthropologist Howard Stein, “Alcoholism as Metaphor In American Culture: Ritual Desecration as Social Integration”, argues “that our cultural models, theories, assessments, and treatments for alcoholism [and drug addiction] not only perpetuate the “disease” but are, unwittingly, part of the disease itself” (p. 221).
Stein leaves the profit motive out of it, but if the recovery industry – aside from 12-step groups, our leading “cultural model” for treating alcohol and drug addiction – “perpetuate[s] the disease”, then this must also be linked with the profit motive, which is a self-perpetuating enterprise, as well. The very nature of a system of for-profit addiction treatment assumes the creation of ever-more addicts; and/or that existing addicts will need treatment multiple times over the course of their lives, i.e., that such addicts/alcoholics will relapse. This isn’t to say that there’s a conscious incentive pushing the recovery industry towards counterproductive treatment options, so much as there’s an unconscious, structural incentive keeping it away from seeking more productive ones. Basically, at some point in the past few decades, the 12-step programs were hijacked by the recovery industry and the courts; the courts and the recovery industry, meanwhile, also inextricably merged with one another in the realm of the criminal-industrial-complex. We have a situation now in America where “addiction” is both “a disease” and “a crime”; in a given situation, moreover, whichever one of these labels gets the greater emphasis usually depends on the individual’s socioeconomic status.
Another problem – and in fact, the central one – with the current models of addiction recovery treatment: above all else, they’re part and parcel of the whole globalized capitalist system, the fundamental purpose of which is to maximize the growth of profit. While those who can afford health insurance and/or attorneys that aren’t public defenders end up in relatively cushy inpatient rehabs, poorer addicts simply end up detoxing at home or, quite often, in a jail cell. If “addiction” is truly a disease, why are jails being used as makeshift detox centers? The existing addiction recovery industry isn’t a prevailing cultural model for treating addiction because it constitutes the most effective form of treatment, but rather because it’s the preferred method of treatment within the context of globalization. Our global capitalist environment, further, in no uncertain terms depends on addiction: “Alcoholism is the socially approved way of engaging in the socially disapproved” (Stein, p. 217). That is, because alcohol plays such a vital role in so many “normal” cultural contexts, alcoholics must exist if only to set a visible, living limit for how not to use alcohol.
Again, Stein focuses on the more explicitly cultural aspects, but it’s clear that globalization depends on the perpetuation of alcohol and drug addiction just as much for politicoeconomic reasons as it does for cultural/ideological ones. Consider the “opioid epidemic” that’s so prominent in the mainstream news of late. In a culture this large and complex where the inclination towards addiction is already so rampant, how can we sustain a constantly expanding, endlessly profit-seeking pharmaceutical industry without the simultaneous emergence of such “side effects” as a constantly expanding population of opioid addicts? That expansion is shown in starkest terms by the number of fatalities it’s producing: “To put the data in perspective, opioid deaths now surpass the peak in death by car crash in 1972, AIDS deaths in 1995 and gun deaths in 1993.”
I only very recently realized: it’s not “thinking” we’re all addicted to, like Yoga Dave said; rather we’re addicted to one very specific type of thinking, or a specific type of thought-process, which pervades all the others. And this is also what Vonnegut meant when he said we’re all addicted to petroleum. Charles Eisenstein, in his brilliant 2011 work Sacred Economics, makes the very same comparison between addiction and our culture’s infinite-growth mindset: “The dynamics of usury-money are addiction dynamics, requiring an ever-greater dose (of the commons) to maintain normality, converting more and more of the basis of well-being into money for a fix” (p. 395). Endlessly-expanding petroleum supplies and endlessly-expanding debt combine into one global machine to require us all to make more and more money all the time – or perish.
Interestingly, this itself does much to explain the model of the current addiction recovery industry: the one truly rewarding experience in the whole program, as I said, was sharing my fourth step with Dave. And this is something I could’ve obtained at no cost, simply from attending a 12-step meeting, or even just sharing my thoughts with a close friend. This isn’t to say that we don’t need institutions of recovery – that addicts should be left to their own devices – but simply that the current institutions, based on a one-size fits all approach driven by the bottom line, are in no way working towards the optimization of the patient’s recovery, which of course should be their only goal.
Finally, if we’re all driven by a collective addiction in some way, and “addict” exists as a social role mainly as a boundary for defining what constitutes “acceptable addiction” and what doesn’t, what does this say about how we approach a potential transition out of the current, wholly unsustainable capitalist environment? In equal measure with public policy concerns and organizing tactics, perhaps – and this is uncomfortable for me to say, but I’m not sure how else to say it – perhaps we need to be concerned with questions of spirituality, as well.