Addiction

Perhaps you know that I’ve been trying to help folks with addiction. You can read about how I taught critical thinking and non-violence to the inmates in the local jail (there’s a link to “Teaching Addicts” on the homepage of the Advanced Reasoning Forum, http://www.AdvancedReasoningForum.org). Alex Raffi and I have written a draft of a comic book about addiction, “Addiction in the Body—Too Good Is Just Awful” (also on the ARF homepage).

There is much we can do to help. We can teach critical thinking. We can lead people to see a better life through our understanding not of theoretical ethics but of a way of non-violence. You can find how I teach a way of non-violence in my translation of “The BARK of DOG” (the Introduction of that is on the website TheBARKofDOG.org).

Though many people have approved of the essay “Teaching Addicts” and have told me that the approach is excellent and I should continue, I found that I couldn’t take the program into prisons and rehabilitation centers because they accept only “evidence-based” programs. Catch 22: you can’t teach it because there’s no evidence it works, but you can’t get evidence because you can’t teach it. Yet, the more I considered it, that wasn’t the problem. The problem is what is meant by “evidence-based program”.

So I set out to find what was meant, reading some papers and books. Then I set those aside and asked what we could do in evaluating treatment programs for addicts. First, there is the large problem of deciding what is meant by saying that a treatment program is “effective”. This involves values and goals, an analysis to make clear the assumptions behind various prescriptive claims. Some programs are deemed in need of evidence, others not, and the criteria for whether a program requires evidence are not made explicit. For example, it seems that administrators do not ask for evidence that teaching reading helps addicts. Nor do they ask for evidence that Bible classes help addicts.

Second, administrators want objective data as evidence. Yet that is rarely linked to the unstated subjective conclusions that are hidden in the objective conclusions. Ending addiction is not ending just certain behaviors, because all definitions of addiction use subjective criteria.

Third, any evaluation is an attempt to establish causal relations: this program helped this person, or this program–via a cause-in-population study–is likely to help these people. Just going from basic observations about what is meant to be studied, I found that there is very little, perhaps almost nothing that can be established in the way of causal claims about the effectiveness of any addiction treatment
program. I’ve written up a draft of that analysis, which you can get from me if you like. But it needs a lot more research to show how the analysis plays out in specific evaluations that have been done, and for that I would need funding.

Then I read the book Heavy Drinking: The Myth of Alcoholism as a Disease  by Herbert Fingarette, written in 1988. It is a superb analysis of just the issues I was worried about, though only for alcohol addiction. Fingarette uses the best of the skills of critical thinking and philosophy to piece out what we do or should consider in treating
alcohol addiction. He shows that the programs for treating “heavy drinking” have not been shown to be “effective”. The work is a masterpiece we can all learn from.

There is much that we can do to help. We can teach addicts. We can encourage addicts to find a better way. We can learn and then teach others about the nature of addiction and what can be done to lessen the problems of addiction.

To do this, we use our skills in reasoning and in philosophy, and theology and ethics. I have based my work on the analysis of cause and effect in my critical thinking books, which I have set out in scholarly form in my book of essays Cause and Effect, Conditionals, Explanation”.  I have drawn on the analysis of how to reason with\ subjective claims that Fred Kroon, Bill Robinson, and I have given in
the essay “Subjective Claims” in my book of essays The Fundamentals of Argument Analysis. And essential also is knowing how to reason with prescriptive claims, which I describe in my book Prescriptive Reasoning.  But don’t wait to read all those before you start.  Begin now, so that you can integrate your experience with what you study.

There is little that works in helping addicts quit. But some does. We need to help those who are addicted, those who are hurt by the addiction of their family or friends, and help those who must decide how to spend money on addiction programs to understand and make good decisions.

Critical thinking is not a theoretical skill but a practical guide to reasoning that should, indeed must, have an ethical basis and good goals. And for that, we need virtue.

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