April 16, 2015

Josh Hamilton and the 'disease theory' of addiction

Josh Hamilton, neither
'good' nor 'bad" but possible
'ugly' of addiction.
Now that Los Angeles Angels former star outfielder Josh Hamilton will officially get no suspension for an alcohol and cocaine relapse, both the moral scolds and the "there, there" folks are coming out in force.

The scolds say that Hamilton just needs to "man up" or whatever. The "there, there" types usually talk about addiction as a "disease" where Hamilton just can't help himself.

The moral scolds? They've been a thorn in the side to addicts long before Alcoholic Anonymous as the first 20th-century addiction recovery support. They're generally off base, and often of the type to selectively apply their "man up" ideas.

That said, note that I called AA "20th-century." I did NOT call it "modern."

Second, for the "there there" folks, outside of 12-step circles, the "disease theory" of addiction does not have universal support.

Given that it came from a non-medical organization, and is also decades old, and that things like the "neurotransmitter theory" has been shown to be incomplete at best on depression and serotonin and, more directyl to this issue, on "rewards" and dopamine, we probably should back off on a broad-brush use of the idea, even more so when you add in that we still don't know a lot about consciousness or free will and volition.

(And, if a person on Hardball Talk thinks that his HMO disagrees with me, and that article, for any other reason than money, namely meds being cheaper than talk therapy, they're stupid indeed. Or, at a minimum, simplistic.)

Beyond that, nobody is "powerless over alcohol," nor over an illicit drug. If so, nobody would ever quit.

Of course, the 12-step movement solves this with the injection of god, then adds irrational insult to irrational injury by claiming it's not religious.

This is like the Lutheran "single predestination," one even more illogical than Calvinist double predestination. People get blamed for their addiction, but not credited for stopping it.

Again, nobody is "powerless" over alcohol or other addictive substances. One may become close enough to powerless after starting addictive use again to never quit for good, but that's why this has more than two sides.

Beyond that, "good liberals" should note what this piece says: promulgating the disease theory may be harmful to addicts. Take that with a grain of salt, though; a BIG grain of salt. It's by Stanton Peele, who pushes "moderation" for and to too many people, in my opinion.

That said, a 20-year-old kid with his first DWI shouldn't be force to attend AA; neither should he be forced to attend a secular alternative. In many cases, moderating one's behavior should be the first approach.

And, on both that issue, and understandings of addiction in general, that's why, once again, we need to quote the Iranian philsopher Idries Shah:
“To 'see both sides' of a problem is the surest way to prevent its complete solution. Because there are always more than two sides.”

Exactly.

Often people want to see only one other side not just because it's easier to think in black-and-white than shades of gray, but also because it's easier to "win" an argument if there's only one other "side." Hey, I can still be like that myself.

Now, the situation at hand, since an arbitrator has ruled Hamilton did not break league drug policy?

I'm not looking for MLB to throw the book at Hamilton. Nor am I looking at MLB or the Angels to treat him with kid clubs. I expect both, beyond their business interests and legal restraints, to treat him in the best way possible for him.

Related to the legal angle, I have to disagree with Craig Calcaterra of Hardball Talk. It's possible that at least part of the leaks in all of this were NOT by the Angels, but rather by Hamilton trying to stay ahead of the story. "Goes to motive," as the old legal saying avers — an old legal saying which Calcaterra, a formerly practicing lawyer, knows. And, with Hamilton, I believe he has the mindset to do that.

That said, it's more likely that the Angels were the leakers. I suspect that GM Jerry DiPoto is "venting" anger he'd really like to direct at owner Are Moreno for pushing for the Hamilton signing. DiPoto, let's not forget, at the time Hamilton was a free agent, wanted to resign then-Angel Zack Greinke rather than letting him walk in free agency. Survey shows that would have been a MUCH smarter move. Sabermetrics shows that, outside of one fantastic year in 2010, adjusting for The Ballpark's hitter friendliness, Hamilton was good to very good, but not great, otherwise, with the Rangers. (That said, Greinke, if we compare ERA+ to OPS+, straight up, has been throughout his career what the non-2010 Hamilton was in Texas.)

Steve Howe, with his seven suspensions and still not "learning," shows that, just like Christians talk about "why some and not others" on "being saved," that addiction is a mysterious issue. It also shows that it's not the business of MLB, or the Angels, to, well, to go beyond business. They will help him to the degree it accords with best business practices first, and true sympathy second. They will cut him off at the pass to the degree they can to the degree it accords with best business practices.

(For those who can't remember, Howe died in a one-vehicle rollover where he was the driver, and toxicology reports show he had meth in his system.)

Speaking of, one person has a good perspective on this: Angels manager Mike Scioscia, who played with Howe on the Dodgers.

Of Howe, at his death, Scioscia noted:
"Clearly, he was a kid who never reached his potential, but for a short time he did. The feeling of regret, he never expressed, as far as I know."

That second sentence, especially, is noteworthy.

Of Hamilton, he said last week
“(A)ddiction is a terrible thing, and he’s trying to deal with that.”
 “I don't know if there is any use looking back, whether surprised or relieved or whatever,” Scioscia said. “I could go either way, but most important is for Josh to pick up the pieces and get himself where he needs to be first with these issues and then we'll see where he goes from there as far as getting to baseball activities. So we’ll see.”
Scioscia may not even remember what he said about Howe. But, the idea is important. Hamilton’s not too likely to be going down the same road if he’s regretful.

As for “problems”? Howe, if not “born to be wild,” was certainly determined to be that way.

Hamilton? I think, per his Wiki page, his car accident, a small determination to be a little wild, and perhaps smothering parents that he wanted to escape, are all factors.

One point in common so far? Evangelical Christianity didn't "save" Steve Howe from his addiction; so far, it's not been a magic cure for Hamilton, either. That's not to claim it's all Christianity's failure, but it is to note above that the 12-step movement's "god deal" ain't so totally true, again.

Meanwhile, back to addiction in general.

Alcohol is not that strongly addictive physically. And, even many illicit drugs, without repeated administration on a regular basis, are less physically addictive than the nicotine in cigarettes.

This all gets back to the medieval "cur alii, non alii?" question. In English, that's "why some, not others?" In other words, whether for salvation or overcoming addiction, why do some "get it" but not others.

As for addiction in general? I still lean toward the idea that, if you've crossed some invisible barrier into "abuse," to use the professional phrase, abstinence is almost surely the best option. But, that's not set in stone yet, either.

And, let me take this as a chance to say that AA and NA, and the 12-step movement in general aren't the best answer for many, and, as we enter into the world of evidence-based medicine, aren't the scientifically proven be-all, on average, for anybody.

There are secular — non-religious but NOT anti-religious — options out there. I recommend one called Lifering Secular Recovery.

(Meanwhile, on the baseball-playing front, Commissioner Corleone, aka Rob Manfred, seems determined to risk a repeat of the 1994 lockout.)

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