Coming Soon: The Soul of an Addict
My first non-fiction book is coming soon. The Soul of an Addict: Unlocking the Complex Nature of Addiction argues that addiction is far more complex than most models accept. Is it a disease? A choice? Yes. But it’s also more than either of these. In fact, addiction has the sociological characteristics of a religion.
The book is supported by statistics, anecdotes from my work with addicts, and stories from my own struggle with addiction. It will be available in two weeks.
Here’s an excerpt from Chapter Twelve, “What Is Recovery?”
Jenna was in her fifth round at a treatment facility when I met her. She dropped out before the end of the program and went back to using drugs.
Nate got clean and sober the first time he went to treatment and never used again.
Ben was sentenced to treatment by the court after his fifth conviction for DUI. He went to avoid prison, yet he got clean and stayed clean for many years.
Vivian had a spiritual experience after an alcoholic binge, attended Twelve Step meetings and never drank again.
Dan found sobriety in a church run by a pastor in recovery.
Al got sober through Twelve Step meetings while in prison for vehicular manslaughter.
Vern failed at treatment facilities and methadone clinics for years, but after doing some time in jail and living in his car for a year, he finally got clean in a Twelve Step program.
Treatment takes many forms, and has varying rates of success. But, whether an expensive rehab facility, a publicly funded treatment center, a church-based support group, or a cost-free Twelve Step meeting, some form of support is usually necessary to help us get out and stay out of our addiction. The reason is simple: If we knew how to stay clean and sober without treatment, if we could envision a way of life sufficient to replace addiction, we would have given up drugs already.
Treatment for drug and alcohol addiction is big business in the United States. In 2017, nearly three million people underwent treatment. It’s estimated that Americans spend $30-35 billion a year attending rehabilitation centers for drug and alcohol abuse.
That doesn’t include the nation’s largest single “treatment” system: prison. According to researchers Wendy Sawyer and Peter Wagner, nearly half of all federal prisoners, about 100,000 people, are incarcerated for nonviolent drug offenses. It’s estimated that half a million nonviolent drug offenders are incarcerated in state and local prison systems.  At an estimated $30,000 per prisoner per year, that’s another $15 billion expense that falls to the taxpayers.
In 2016, some 168,000 people on parole or probation were returned behind bars not because they committed a new crime but because of technical violations such as staying out past curfew. Sawyer and Wagner argue that the justice system is structured to promote failure, not to reward success.
It’s worth noting that those who go through treatment are more likely to be white (about 80%). Those who go to prison are more likely not to be white (about 70%). The rate of addiction does vary slightly between races, but perhaps not as expected. Of the three most populous races, whites lead in substance abuse problems with 7.7%. Blacks have a rate of 6.8%, and 6.6% of Hispanics struggle with substance abuse. Yet blacks are six times more likely to be incarcerated for drug offenses than whites.
Jacob, a young African-American man, was arrested for drug-related offenses. While represented by a public defender, he was sentenced to four years in prison. Later, he managed to pay an attorney several thousand dollars to have the judge reconsider the sentence. It was reduced to one year followed by a court-ordered drug treatment program. Financial resources clearly make a huge difference in the outcome of drug offenses in the criminal justice system.
There’s another troubling statistic. In 2017, more than 20 million Americans sought treatment for a substance abuse problem. Only 12% of them actually received treatment. That’s a huge improvement over prior years. In 2014, for example, only 7.5% of those seeking treatment actually received it. But still: out of every eight people who seek treatment, seven do not receive it. The most common reason cited, by almost half of those who could not obtain treatment, was lack of insurance coverage. They couldn’t afford the cost.
 Bose, Table 5.10A.
“What America Spends on Drug Addictions,” Addiction-Resources.com, 2005 (https://www.addiction-treatment.com/in-depth/what-america-spends-on-drug-addictions/, accessed August 14, 2019). There are many more recent estimates on what Americans spend on the substances themselves, but I was unable to find a more current estimate of the cost of rehab. Gabrielle Glaser, “The Irrationality of Alcoholics Anonymous,” Atlantic Feb 2015 (https://www.theatlantic.com/magazine/archive/2015/04/the-irrationality-of-alcoholics-anonymous/386255/, accessed August 15, 2019). “Offenses,” Federal Bureau of Prisons, Aug 9, 2019 (https://www.bop.gov/about/statistics/statistics_inmate_offenses.jsp, accessed August 14, 2019).
 Bose, “Results from the 2017 National Survey on Drug Use and Health: Detailed Tables, 2018 (https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHDetailedTabs2017/NSDUHDetailedTabs2017.pdf, accessed May 15, 2020).
 NAACP, “Criminal Justice Fact Sheet” (https://www.naacp.org/criminal-justice-fact-sheet/, accessed May 15, 2020). Numbers for Hispanics were not included. Also see Alana Rosenburg, et. al., “Comparing Black and White Drug Offenders: Implications for Racial Disparities in Criminal Justice and Reentry Policy and Programming,” J Drug Issues 2017 47(1), 132-142 (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5614457/, accessed May 15, 2020): Blacks are more likely to be incarcerated for smaller offenses; 49% of Blacks and only 10% of whites in the study were convicted of marijuana possession compared with 7% of Blacks and 50% of whites convicted for heroin possession.
 Rachel N. Lipari and Struther L. Van Horn, “Trends in Substance Abuse Disorders among Adults Aged 18 or Older,” The CBHSQ Report, SAMHSA, Jun 29 2017 (https://www.samhsa.gov/data/sites/default/files/report_2790/ShortReport-2790.html, accessed August 15, 2019). Compare Rachel N. Lipari, Eunice Park-Lee, and Struther Van Horn, “America’s Need For and Receipt Of Substance Abuse Treatment in 2015,” The CBHSQ Report, SAMHSA, Sep 16 2016 (https://www.samhsa.gov/data/sites/default/files/report_2716/ShortReport-2716.html, accessed August 15, 2019) reports that 10.6% of those who sought treatment received it in 2015. The percentage receiving treatment has
 Bose, Table 5.50A, shows 421 of 1,033 (41%) surveyed either didn’t have health insurance, or had health insurance that didn’t cover treatment.