Speaker 1for most of history we didn't treat addiction we punished it prayed over it or locked it away today we're going to talk about how we used to handle addiction 100 200 years ago and how we handle it today hopefully this episode will give you some insight and maybe perspective and gratitude on the way we have it today it's it's a pretty good time to be struggling with addiction and if it doesn't feel like that and that makes you angry that's okay hopefully you find your recovery and you find your healing but I think after this episode you'll have some gratitude with our system as imperfect as it is whether you live in the U.S. or Canada and we're doing pretty well comparatively so this is what it would have been like if you were a drug addict alcoholic 100 200 years ago let's get into it the history of addiction treatment here's some perspective for you the 12 steps are younger than the telephone methadone is younger than television almost everything we call treatment was invented inside living memory today we're going to walk through the whole arc moral failing to disease to medicine to harm reduction and what it means for us as people in recovery so why does history matter why should we care about all this the way a society explains addiction decides how it treats people who have it every model will cover today is still alive today you can meet all of them in one 12-step room one hospital one comment section this is a pure podcast not medical advice if you're struggling there's some resources in the show notes below and my name is Anthony I'm an alcoholic addict in recovery been in recovery since 2015 this is recovering out loud podcast I'm glad you're here before treatment the moral model and the first crack not just the first crack but the moral model and the first crack not that type of crack the default setting was moral failure so pre-1800s heavy drinking equaled sin weakness a character defect response to that was shame church jail the alms house which is essentially a place they locked people away for struggling who struggled with alcohol and drug addiction 1784 dr benjamin rush breaks ranks russ was a singer of the declaration a signer sorry rush was a signer of the declaration of independence he publishes an inquiry into the effects of ardent spirits arguably the first american text to call chronic drunkenness a disease rather than a vice he described loss of control as the core problem pushed abstinence as the cure and called for a special sober house to care for people a treatment facility two centuries earlier russ was a singer of the declaration a signer sorry russ was a signer of the declaration of independence he publishes an inquiry into the effects of ardent spirits arguably the first american text to call chronic drunkenness a disease rather than advice he described loss of control as the core problem pushed abstinence as the cure and called for a special sober house to care for people a treatment facility two centuries earlier the idea was radical and incomplete he still framed it as a disease induced by a vice the stigma and the science were tangled from day one loss of control comes back again and again for the next 240 years so this was sort of the defining factor of an alcoholic is i i've lost control and choice whether i drink but mainly control whether i drink or not drink and when i start i lose control in stopping the 1800s temperance the first fellowships the asylums so 1840 the washingtonians washingtonians were a group of recovering people helping each other a century before alcoholics anonymous it started with a handful of drinkers in baltimore in a baltimore tavern and it grew to a reported 600 000 members before collapsing in a few years the dna of pure recovery one drunk so sorry funny story on how the washingtonians started there was a bunch of guys drinking at a bar in baltimore and they went out to make fun of a temperance movement movement that was happening outside temperance rally they were heckling the people in two guys were heckling the people in the rally and making fun of them and then they came back from that rally changed and the idea had sunken in about temperance and they wanted to start this this group called the washingtonians and this is how it all started so it's kind of funny how the the group started from two guys making fun of sober people essentially and then they would make a pact to never drink again the dna of pure recovery one drunk talking to another this is the first time it shows up in history and this would later evolve into different forms of pure recovery groups including this podcast one alcoholic helping another
Speaker 2ultra running shoes are all about space the space to go further to feel better to do something you never thought possible and this space starts with ultra fit unlike traditional running shoes ultra fit gives toes more room to move naturally so every step is strong balanced and comfortable whatever you're lacing up for stay out there with ultra shop now at ultrarunning.com that's a-l-t-r-a running.com 1849 the word alcoholism is born a swedish physician
Speaker 1magnus huss coins alcohol alcoholism chronicus naming it as a medical condition the inebriate asylums so mid to late 1800s dedicated inebriate homes and asylums open for the first time the first institutions built specifically to treat addiction the honest so almost none of it was evidence-based they had good intentions dubious methods and plenty of coercion prohibition and the treatment vacuum the first institutions built specifically to treat addiction the honest so almost none of it was evidence-based they had good intentions dubious methods and plenty of coercion next we go to 1920 to 1933 america tries to tries to solve addiction by deleting the supply supply prohibition reframes the problem as legal criminal not medical if we ban all alcohol this will solve the problem the inebriate asylum movement withers medical interest in treating alcoholism nearly dies off everybody's focused now on the supply of alcohol being the problem and i think we can all agree this doesn't work you take away drugs alcohol people are going to find other ways to do it it's just the nature of alcohol and drug abuse when you criminalize a health problem the health infrastructure evaporates so prohibition ends in 1933 millions still can't stop drinking and there's almost nowhere to send them 1935 the birth of modern recovery into that vacuum walks alcoholics anonymous 1935 akron ohio bill wilson a new york stockbroker meets dr bob smith a surgeon two hopeless drinkers discover they can stay sober together when they couldn't do it alone the founding date is march marked as june 10 1935 dr bob's last drink and this grew out of the christian oxford group and then it's split off to focus only on alcoholism and they took the religion out of it 1939 the big book names the movement alcoholics anonymous is published lays out the 12 steps tells the story of its early members the nickname comes from the thick paper of that first edition the original name was almost the way out and then they all decided to call it alcoholics anonymous instead well a lot of people don't know this but the the book alcoholics the big book was published with a few hundred people and bill wilson wrote the majority of it but it was all it was a group of people that proofread it and approved it so why this was a revolution not a hospital not a jail not a church it was a fellowship free anonymous run by the people who served it the people it served aa reframed the sufferer from patient or sinner into a member institutionalizing the disease model the disease idea goes into mainstream 1949 hazelden opens in minnesota the treatment center that i went to out of the hospital i went to a hospital that i went to and i went to a hospital out of it grows the minnesota model mixing aa's 12 steps with professional clinical staff which becomes the blueprint for the modern 28-day rehab in 1956 the american medical association formerly calls alcoholism an illness in 1960 a guy named em jelinek publishes the disease concept of alcoholism the book that puts the disease model on a scientific sounding footing his phrases and typologies of drinkers then we have a harder darker experiment the therapeutic community so this is an interesting story that i posted a reel about but there's a group in 1958 called synanon they're from california and it was the first big residential therapeutic community it pioneered peer-run residential treatment and curdled into coercive cult-like group a real cautionary tale about power inside recovery spaces this group eventually would turn into a cult and the leader i forget his name now but was later arrested they would do things like put snakes in former members mailboxes and essentially they wouldn't let you leave which is the definition of a cult from a high level this is what happens when alcoholics take over things and make them about themselves the disease model reduced some stigma and opened medical funding but it was contested from the start and still is next we have the medicine and science wars so 1964-65 Addiction gets its first real medication medication vincent dole and marie neiswander with the help of mary gianne creek at rockefeller develop methadone maintenance for heroin addiction the fda approves it for maintenance in the early 1970s this was a huge conceptual leap you could treat a drug problem with a medication and manage addiction like a chronic condition not a moral emergency next we have the 1970s controlled drinking wars researchers challenge aa's total abstinence orthodoxy by asking whether some people can moderate this ignites a decades-long still unresolved fight about goals of treatment do we become abstinent or do we moderate and become harm reduction this is the great debate of today this is really a fight about who gets to define recovery abstinence versus reduction relevant to every debate in the field today then we move to 1997 addiction is now a brain disease and it matters alan leshner the head of u.s national institute on drug abuse publishes it in science brain imaging era cements the brain disease framing plenty of serious researchers push back you can't reduce a whole life to neurons they present it as a live debate not gospel so this is the idea of the bio psychosocial model that the environment plays a bigger factor in the fight against drug abuse than we probably realized. The growing up, the childhood, there's a lot more factors than just my brain's different than your brain. Next, we move to 2000 to 2013. Treatment comes out of the clinic. So data in the year 2000 lets regular doctors prescribe addiction meds for the first time in decades. In October of 8th of 2002, buprenorphine or Suboxone gets FDA approval. Opioid treatment can now happen at a doctor's office, not just a methadone clinic. In 2013, the DSM-5 merges abuse and dependence into one spectrum. Substance use disorder, mild to severe. The old hard line between abuser and addict is gone. Harm reduction and the Canadian story. A different question. What if the first goal is just keeping people alive? Harm reduction stops requiring abstinence as the price of admission to care. In September of 2003, Insight opens in Vancouver's downtown Eastside, North America's first legal supervised injection site under a health Canadian exemption. It survived court challenges and government turnovers. The arc of one breath. So from sin, we move to disease, to medicine, to keeping people alive. Each model didn't replace the last. They're still in the room arguing. What this history gives us. Every model we inherited was somebody's attempt to answer, what is wrong with this person? And how do we help? And everyone got part of it right and part of it wrong. Recovery is not one thing. And it never has been. There's multiple factors involved in everyone's addiction and recovery. Whatever door worked for you, 12 steps, medication, harm reduction, a fellowship. It exists because people before us refuse to accept moral failure. They refuse to accept moral failure. They refuse to accept moral failure as the final word. And what a gift, what a blessing that is. Thank God for these people. Thank God for people constantly trying to challenge and change the medical norm and societal norm and trying to help recovering people into recovery. And that recovery can look like California sober. Recovery can look like harm reduction. Recovery doesn't have to be abstinence. It is for me and it has to be for me, but it's not the case for everybody. Maybe moderation works for you. Maybe moderation works for you. Maybe moderation works for you. Maybe California sober works for you. Maybe just drinking and not doing heroin works for you. That's great. Whatever works, whatever makes you happy. So today you're not just in recovery. You're standing in a 240 year old conversation and you get to add to it. What does recovery mean for you? For me, it is progress. It is goals. It is growth. It is change. It is doing right. Being a giver. Rather than a taker in my life today. That's what recovery means to me. Amending the past and not repeating the behavior, staying sober and accepting the fact that I have lost my right to chemical peace of mind. I cannot afford to alter the way my brain works with emotions. I have to do the work from inside. I cannot use any outside thing to change my inside effectively. It just doesn't work. I have lost right power and choice in my life today. And that's okay. Because on the other side of that is growth and a gift and beauty and recovery and happiness and joy and freedom. But it was a long winding path to get there. And thanks to all these people over the years that have brought recovery to where it is today. So whatever your recovery group, whatever your recovery looks like, I think we can all agree that the opposite of addiction is connection. And I need people to hold me accountable. I need people that are like me, minded in my life that won't judge me for my thoughts and my behaviors and try to help me do better and our role models in my life and have what I want. And if you want what we have, you got to do what we did. Simple as that. Whether you believe addiction is a disease or.
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Speaker 1I don't know an environment issue or your trauma and your past or pain that you're trying to heal. It's important to know what your addiction did for you, what your drugs and alcohol did for you, and that they were about a symptom of the disease and that you don't need drugs and alcohol to be a good person, to be the best version of yourself. I hope you understand that today. And I can't tell that to you. I can't tell that to anybody. I can't, I can't convince anyone of that. And nor do I want to, but on the other side of this addiction is a beautiful life. If you choose to see it that way, it can be the greatest gift in your life, or it could be the greatest curse. It's all in your perception, your reframe of your addiction. Was I trying to escape myself, my environment, or was I just trying to heal pain and feel okay in my own skin? Only you can decide that by listening to others talk about their addiction. And say, yeah, me too. Yeah, I get that. I relate to that. That makes sense. Because then when you understand why you can treat the how and work on the how, and I know how I got sober. I followed somebody else's direction. I did what they did. And I continue to do that. So if no one has told you this yet today, I love you. And remember recovery is simple.
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Speaker 1Not easy.
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