Should Addicts Be Forced Into 12-Step Rehab Programs? No (Part 2)

I would like to start this post by sharing Dr. Langan response to the first part of this post: “Should Addicts Be Forced Into 12-Step Rehab Programs? No

“The argument is often advanced that without coercion there is insufficient incentive to enter treatment and, within a medical paradigm, not wanting to enter treatment is considered a symptom of the disease. Moreover, the greater the denial of the disease is considered directly proportional to the severity of the disease. Although both of these may be true in the throes of an acute addiction, the chronic relapsing brain disease with lifelong abstinence and 12-step recovery model is being used to coerce treatment on those who do not need it as “denial” can be present. according to these folks, long after the drugs and alcohol are gone.” –-Michael L. Langan.

Comments – Jorge R. –
– I agree with Dr. Langan.
– I would like to share more information about the denial of the disease, forced treatments, and drug testing.


I. Addiction: Imaginary Gains & Real Losses

Hugh Mann. Re: Drug policy: we need brave politicians and open minds. December 12, 2014 http://www.bmj.com/content/349/bmj.g7603/rr/819519
“Addiction is a bad bargain with imaginary gains (euphoria) and real losses (sickness). Euphoria is a false, fleeting sense of well-being that makes addicts feel “high” and masks the sustained sickness of addiction. Even worse, the euphoria and sickness of addiction are polar opposites that reinforce each other and trap addicts in a vicious cycle of Jekyll & Hyde mood swings that are unique for each addition. For example:

1. Sugar creates the euphoria of feeling sweet, but the sickness of being bitter.
2. Chocolate creates the euphoria of feeling love, but the sickness of being love-starved.
3. Vanilla creates the euphoria of feeling happy, but the sickness of being sad.
4. Cola creates the euphoria of feeling hydrated, but the sickness of being dehydrated.
5. Caffeine creates the euphoria of feeling energetic, but the sickness of being lethargic.
6. Alcohol creates the euphoria of feeling relaxed, but the sickness of being uptight.
7. Tobacco creates the euphoria of feeling aerated, but the sickness of being suffocated.
8. Analgesics create the euphoria of feeling pain-free, but the sickness of being pain sensitive.
9. Hallucinogens create the euphoria of feeling wise, but the sickness of being confused.
10. Gambling creates the euphoria of feeling lucky, but the sickness of being unlucky.

Addiction is a deadly paradox. Its euphoria is a false heaven, but its sickness is a real hell. The more you know it, the more it fools you; the more you use it, the more it controls you; and the more you enjoy it, the more it hurts you. Addiction is hell you enjoy.”

II – Coercion into treatment

“…the only purpose for which power can be rightfully exercised over any member of a civilised community, against his will, is to prevent harm to others.” Mill, J.S. 1859 On Liberty

III – Drug Testing in The Workplace — IIDTW

www.jrf.org.uk sites files jrf 694.pdf (1)


“The Inquiry concludes that there is no justification for drug testing in the workplace as a means of policing the private behaviour of employees, or of improving performance and productivity. It suggests that although drug testing does have a role to play, particularly where safety is a concern, investment in management training and systems is likely to have a more positive impact and to be less costly, divisive and invasive.”




“Overall, the IIDTW concludes that there is no justification for drug testing as a way of policing the behaviour of the workforce, nor is it an appropriate tool for dealing with most performance issues. Drug testing can have an important role in safety-critical and other occupations where the public is entitled to expect especially high levels of probity, safety and security. Even here it should be approached with caution and, if the technology is available, direct testing of impairment will generally be preferable to drug testing, and the importance of the culture of an organisation cannot be overstated. Nor are drug testing systems infallible. The technology is imperfect and there are ways of subverting them. One of the strongest themes to emerge from the evidence heard by the IIDTW over an 18-month period is that good all-round management is the most effective method for achieving higher productivity, enhanced safety, low absentee rates, low staff turnover and a reliable and responsible workforce. For the majority of businesses, investment in management training and systems is likely to have more impact on safety, performance and productivity than the introduction of drug testing at work.”

  3 comments for “Should Addicts Be Forced Into 12-Step Rehab Programs? No (Part 2)

  1. January 19, 2015 at 2:19 am

    Reblogged this on Disrupted Physician.

  2. January 19, 2015 at 3:52 pm

    Reblogged this on theperfectprescription2014.

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