Psychology Today Blogs - Addiction in Society

Harry Houdini Had Too Much Integrity to Do Therapy on TV

Stanton Peele — Thu, 15 May 2008 13:22:56 -0700

A fellow PT blogger speaks of the many hats worn by therapists. How about the hat of "psychic?"

I was amazed on catching one respected psychiatrist with a television show (he no longer has it, but appears regularly as an expert on other news programs) presenting psychic twins to his audience. The audience peppered the two youthful, attractive women with questions, for which they had instantaneous answers - about dead relatives, illnesses, life decisions - all of which it would be inappropriate for a licensed therapist to provide. I was stunned that a psychiatrist would jeopardize his audience with this kind of BS.

This celebrated psychiatrist showed no self-consciousness about putting such pernicious crap out there. I contrasted this in my mind with Harry Houdini. Houdini early in his career performed spiritualist tricks. Once he came to a town and learned that a couple had just lost a baby. Judging them to be young and fertile, he shouted out to the couple in the audience that their dead son said he was glad his mother was with child again - which she had told no one. The woman and her husband, of course, dissolved into hysterical tears.

This image never left Houdini's mind. Years later, when he had made his name as the world's greatest escape artist (and was the best-known celebrity in the Western World), Houdini contacted these people to let him know the trick he had played on them. He simply could not rest having foisted irrationality and terror on the world.

But you can get this madness around the clock on American TV, often bearing the imprimatur of therapy. Dr. Phil today had on a woman whose life has been ruined by the spirit of a ten-year-old boy who she says is constantly with her, causing her perpetual anguish, to leave her job, and to cease all outside relationships. What to do? Why, call in ubiquitous ghost buster James van Praagh.

Van Praagh divined that it wasn't a ten-year-old tormenting this poor woman, but another man she knew who had been murdered (how's that for differential diagnosis?). Dr. Phil asked, reassuringly, could van Praagh help the woman - van Praagh assured Dr. Phil that he had a spirit protection package ready to put in place for this therapy -- or is it seer -- client.

We know Dr. Phil is beyond licensure action - this was revealed when he went to Britney Spears' hospital room at the request of her parents, but instead recruited her for his TV show. Many people - including Spears' parents - were appalled at this conflict of interest, violation of confidentiality, and self-serving behavior. But it turns out that Dr. Phil doesn't hold a license, so no one can bring an action against it.

The aforementioned psychiatrist I assume must be licensed, as well as being a member of the American Psychiatric Association. But I imagine no one complained about his psychic twin therapy. Why would they - mental illness is, after all, a ghost in the machine.

How to Tell Kooky Nuts in the Addiction Field

Stanton Peele — Tue, 13 May 2008 15:42:26 -0700

1. When you say, "Wine reduces heart disease," kooky nut says, "Grape juice does too."

No it doesn't. All forms of alcohol prolong life for most groups (those at risk to die of heart disease). All forms of beverage made from the genus Vitis (grape plants) do not have this effect - just the alcoholic ones. Religious variation: Jesus didn't drink wine at the Last Supper (like every other Jew in the bible did for Passover) - he preferred grape juice, like the kooky nut telling you this story.

2. Kooky nut says: "If you take heroin long enough, you MUST be addicted."

And what about all those people in hospitals taking narcotics more concentrated than street heroin for weeks and months at a time, who then eventually reduce self-administered doses of analgesia (the standard response)? This myth, unfortunately, is sold at the highest levels of drug research (e.g., by Nora Volkow of the NIDA) because they know their jobs depend on their endorsement of zero-tolerance science.

3. If you have any kind of a drinking problem, kooky AA nut says, "You're in the early stages of alcoholism."

Let's see - you can either have blackouts, loss of control, and all those other things AAers say prove you're an alcoholic, or else you don't have them, which likewise proves you're an alcoholic, because you're going to get them. This is a favorite argument of alcohol counselors who are themselves alcoholics, who use the irrefutable logic - "That's what happened to me!" (Warning: Never argue with a kooky nut - it can be dangerous for your health and for their mental health.)

4. Kooky nut says, "No alcoholic ever succeeds at reducing their drinking. If someone does do so, then they were misdiagnosed as an alcoholic (see pt. 3)."

In the most famous kooky nut study ever published (in Science yet), Mary Pendery showed that alcoholic patients who received controlled drinking (CD) treatment had relapses. However, the original study of these patients indicated that CD patients fared better than those receiving abstinence treatment at the same facility, whom Pendery neglected to examine (although admitting they did very poorly). With one patient everyone agreed became a moderate drinker, Pendery endeavored mightily to prove he wasn't really an alcoholic originally, despite ending up in a VA alcoholism ward. At a national conference, Mary Pendery attacked my article in PT pointing this out. (Warning: Being a kooky nut can be dangerous to your health - Pendery took up with an alcoholic patient who underwent abstinence treatment at this facility, and he killed Pendery and himself while extremely intoxicated.)

5. Kooky nut says, "If AA helps even one patient, then I'm for forcing people into it."

Well, apricot pits have cured some cancer victims. The way we usually test clinical efficacy is to assign people with a problem randomly to different treatments, perhaps including no treatment, and compare their outcomes. This has been done several times with AA - in every case, AA participants fared worse than other subjects, including those receiving no treatment! Moreover, coerced AA patients may suffer significant negative events - up to and including suicide - as well as having their personal integrity violated. But who cares when you're a kooky nut?

PT Readers’ Drug Abuse Prevention Policy – I couldn’t have done better myself

Stanton Peele — Sun, 11 May 2008 18:17:24 -0700

San Diego State University (SDSU) administrators permitted Drug Enforcement Administration (DEA) agents to infiltrate fraternity drug distribution rings after two students on campus died from drug use. After several months' investigation, DEA agents arrested 75 students, whose lives will be forever altered for the worse.

I posed five questions to PT readers in my post, "Go Ahead - Write My Blog," and this column summarizes their answers. The responses were extremely good, giving answers I can modestly say are as good as - or better than - I could have given. Moreover, they provide two views of the operation - the side which reacted negatively to the intrusion on campus life of federal agents to fight drug use that has been going on for a half century, and the side that says the school had to act and that such retribution for drug use tilts the scale away from drug use in students' minds (sort of).

Here are the quiz questions and the summary of your responses:

1. Will the raid and arrests reduce drug use on SDSU campus? If so, for how long?

The consensus was, not, as expressed by JDB:

Most people don't expect to be arrested for the consensual use of drugs, so in most cases punitive threats will not work to reduce drug use. To reduce or eliminate drug use on the SDSU campus would require arresting everyone currently doing drugs on the SDSU campus, something that by now is clearly more difficult thanks to the DEA's recent, high-profile drug raid.

The positive position, on the other hand, from Anonymous, was:

Yes, temporarily. There is no telling how long. When you remove key movers and shakers, dependent buyers may find it harder to find suppliers. You have to consider that prior to the bust, these students did not have to venture
into dangerous territory to "score." Getting the drugs they craved was literally a text message away. The consequence of reducing the ease of acquiring illicit drugs will be a temporary hiatus on drug use. But let's not be so arrogant
as to think that this effect will last long. Dr. FeelGood is as cunning as he is consistent. He'll be back.

NOTE, however, that even this supporter of the raids doesn't really think it's an effective way to reduce use.

2. Will the raid reduce negative drug use consequences? That is, because of the sting and arrests, will fewer students use drugs in dangerous ways? Why or why not?

The breakdown was similar here, with most saying "no," and Anonymous once again giving the pro-raid position - however, once again, almost wistfully:

We would like to hope that the selling of illegal drugs by fraternities was like a social drug in itself to students who may otherwise not have ever become users. I say this because if Starbucks started putting crack into their espressos, not everyone would abstain in horror. Some would buy just because of the Starbucks brand. The effective branding of these drugs as fraternity promoted may have reduced the urge to abstain for some students. "It can't be that wrong."
The second hope is that by relaying the message to students that selling drugs has consequences, students may be reminded of the "wrongness" of doing drugs, thereby reducing consumption with a psychological tweaking on how they view drug use in the future. I do believe that occurrences like overdose may be reduced due to the limitations on ease of scoring and resocialization casting drug-use back into the "wrongness" category.

3. If your answers to (1) and (2) are "no" (or "yes, but not long" for 1), WHY did the DEA and University conduct the operation?

Eugene was funny on this one (Superman does laundry?):

The DEA seeks out opportunities to make high profile seizures as to justify their own existence. Universities under the slightest federal pressure fold faster than Superman on laundry day.

I thought Peter Guither was right on with his "money is at the root" response:

They both did it to protect their budgets. The DEA, because they have to justify their budget with lots of arrests and seizures, and the University out of fear of appearing soft on drugs and thereby jeopardizing state money and/or parents' tuition.

4. If you answer "no" to (2), what could the university have actually done to reduce negative drug and alcohol consequences?

JDB says:

To get students to use drugs in less dangerous ways would require them to take a college course or its high school equivalent in toxicology and pharmacology aimed at drug users-a reality-based science course, as opposed to subjecting the students to some half-witted monument to failure such as the DARE program.

Pete reiterated:

Reality-based drug education combined with harm reduction programs (medical amnesty policy, free treatment for those who need it).

The keys in these answers are to provide honest information - that drugs can be used in more or less harmful ways - and making it easier for those needing assistance to get it. ("Medical amnesty" is like the so-called Good Samaritan law in New Mexico, where those bringing someone for help to an emergency room won't be prosecuted. As it is, instead, drug users often leave fellow users where they drop.)

5. If a Democrat is elected president, will such drug raids and similar activities become more or less frequent, or remain the same?

Eugene doesn't think things will change:

Regardless of the election's outcome investigative operations like this one will continue for a number of reasons. It makes politicians appear "tough on crime." Modern surveillance legislation aids this type of investigation. Also, for the DEA this investigation has been a huge success, meaning that they
will continue investigations similar to this one.

JDB is more sanguine:

The Democratic president will be getting a great deal of grassroots feedback that will help this president understand that these types of drug raids on otherwise law-abiding citizens require major reform. And with the latest phalanx
of evidence emerging from New York of race-based enforcement of the marijuana laws,
there's already sufficient information available to demand that police tactics nationwide be reviewed and modified.

All right, let's summarize: drug use by the young will remain with us and our approach will remain to ban such use and punish it legally, and - no matter who's elected - honest discussion of reducing harmful drug use won't be permitted in the United States. Well, if we could eliminate drug problems and the cultural problem we have in responding to the original problems, there wouldn't be problems, would there? Then, no PT blogs - and we can't have that.

How First Nations People Cure Their Own Addictions

Stanton Peele — Sat, 10 May 2008 06:15:53 -0700

I partner with a recovered addict named Scott Gallagher in presenting addiction-prevention programs to high school kids and their parents. Last week we met in a far north region of British Columbia to present at a secondary school in an indescribably beautiful river valley where a group of First Nations People have several villages.

Substance abuse is rife. Some people believe the situation is actually worsening as young First Nation People seemingly become more alienated from the mainstream culture while being attracted to its darker and superficial (e.g., pop entertainment) values.

They are still searching for a balance between traditional cultural values and participaton in the white world. How do you strengthen family and community ties while arming young people to get constructively involved in the broader economy and culture?

Alcoholics Anonymous is certainly not a good fit (although some peope try to give it a native hue). Convincing native peoples overpowered by the white culture that they are powerless and need to follow the white man's god reeks of the residential schools where native children were previously sent to be shorn of their tribal identities.

It seems ironic to many that First Nations communities and families are often quite potent, and yet they don't work to enforce values of sobriety. Perhaps this is due to a cultural attitude that can only be called "live-and-let-live."

Scott and I have struck on the chord of reinforcing these community institutions in order to combat addiction. When one woman described her heartbreak because a brother was again turning towards alcoholism despite a number of successes, we discussed utilizing a reinforcement approach in which she could deny him any help for dealing with the consequnces of his drinking, but offer him all of her resources when he pursued the opportunites he has been rejecting.

At the village level, we spoke with an elder about a process of community outing of drug dealers and bootlegers (alcohol sales are illegal in these communities). But First Peoples are slow to turn their members over to the Royal Candian Mounted Police. Instead, this process involves making violators aware of the negative impact they are having on the community -- which no ones likes to admit to -- and turning them instead towards helping their brethren.

We spoke with one woman, a drug ealer and an addict who didn't live with her four children who said she wanted to reject her past, about becoming involved with her youngest daughter's school and contributing her skills as community resources in other ways.

It is hard to know how the 21st Century will pan out for the First Nations. I only know this -- it is with rediscovery of their own potency that they wll survive and thrive.

Go Ahead -- Write My Blog!

Stanton Peele — Wed, 07 May 2008 14:16:44 -0700

Reading readers' comments, it's occurred to me that it doesn't really matter what I say about drugs and alcohol -- people just maintain their basic biases no matter what.

Thus, readers should have their own clear reactions to a sting perpetrated at San Diego State University by the DEA with the cooperation of SDSU officials. The DEA and University justified the five-month operation and the life implications for the 75 students arrested on various charges (e.g., losing all chance at federal loans) because of two earlier drug-use deaths on campus.

So, PT readers, please answer the following quiz:

1. Will the raid and arrests reduce drug use on SDSU campus? If so, for how long?

2. Will the raid reduce negative drug use consequences? That is, because of the sting and arrests, will fewer students use drugs in dangerous ways? Why or why not?

3. If your answers to (1) and (2) are "no" (or "yes, but not long" for 1), WHY did the DEA and University conduct the operation?

4. If you answer "no" to (2), what could the university have actually done to reduce negative drug and alcohol consequences?

5. If a Democrat is elected president, will such drug raids and similar activities become more or less frequent, or remain the same?

All right, go ahead and write my blog. Answers will be summarized in a few days.

I Kid Because I Love - I Didn't Really Mean We Should Bomb Spain!

Stanton Peele — Mon, 05 May 2008 08:31:56 -0700

I wrote a post titled, End Alcoholism - Bomb Spain, focusing on the different attitudes Americans and Southern Europeans have towards alcohol. They allow kids to drink, while we believe youthful drinking causes alcoholism.

Fundamental cultural differences like that prove to me that attitudes influence psychological reality. But Americans don't believe that - we figure that what happens here is ordained in heaven, or in the science lab, which is pretty much the same thing to us.

I pointed up this solecism by playing the ugly American in my post and suggesting Europeans were dumb. Since I didn't think anyone would believe I would seriously propose blowing up Spain in a blog for Psychology Today, I thought people would find my post funny. And there were my additional recommendations, like that people not let their kids talk to Italians and Greeks to avoid being corrupted.

Wrong. Ten comments were posted expressing various reactions. The first anonymous comment expressed total confusion: "Is this a joke? Maybe I missed the point."

When the second came in "You Go Stanton!" I figured I was out of the woods. Wrong again. The next post, rather than focusing on my harebrained scheme to bomb Europe, focused on my hare brain. (No offense to rabbit lovers intended!) Gentle Path noted that, while in treatment, he or she learned that sarcasm was deflected anger. And although Gentle found my book "helpful at a difficult time in my life," he or she was now reconsidering this in light of my dubious mental health.

But worse was yet to come. Paco, who IS Spanish, really took offense, titling his comment "You are ignorant." I responded that Paco must have misunderstood me - I didn't want to drop anti-personnel bombs on Spain, just to defoliate the country to prevent their growing grapes.

Despite my addiction to sarcasm, Paco caught my humor, and forgave me: "I laugh now with your sarcasm sharing with my little 16-year sister a big cup of red wine. Grapes will resist your radiactives nukes and next harvest I will send you a bottle." (Note to Paco - still waiting for that bottle.)

Okay, now surely I was home free. Wrong, oh so wrong. The latest comment arrived from Sophie, titled, "I am shocked by what I just read!" Sophie then recapitulated the argument I actually thought I was making, that cultural variations disprove the reductive reality Americans attribute to our own prejudices, and that the Southern European style of teaching kids to drink is actually superior to our own.

She went on to take my ugly American persona literally, declaring at the end of four lengthy paragraphs, "But of course all this coming from a 19 year old British university student of British/French heritage who regularly drinks won't matter to you at all [in my blog I described drinking with my 20-year-old college-student daughter], I need to 'get with the programme', I'm just too 'dumb' to understand."

Sophie - I love you! I hereby, with the power vested in me as a PT blogger, declare you Director of the U.S. National Institute on Alcohol Abuse and Alcoholism.* I also promise to share the wine Paco sends me with you when we meet!**

• Note to NIAAA: This is a joke.
• Note to Bureau of Alcohol, Tobacco and Firearms - I'm not really going to accept illegally imported alcohol.
• Note to INS - I don't really plan to facilitate an underage foreign national's consumption of alcohol.
• Note to everyone else I have offended without even knowing it - I'm entering sarcasm rehab next month!

War of the Generations

Stanton Peele — Sun, 04 May 2008 12:34:42 -0700

I seem to be in a pivotal cultural position in re old age.

I just turned 62, first year of eligibility for Social Security benefits (I was born January 8, 1946 - the baby boom generation is reckoned to have begun January 1 of that year).

Remember the old days, when people looked after their aged parents? (Or, if you don't remember those days, did you ever see a movie about them?) You still see sixty-year-olds looking after 80-90-year-old parents sometimes on TV specials. But I worked in senior care facilities and, as guilty as it made people, they generally ended up warehousing their parents there.

I also live in New Jersey, the state with the greatest indebtedness. We currently have over $30 billion in debt. What is more alarming is the $50+ billion in unfunded pension obligations for state employees courtesy of the last two governors, Whitman and McGreevey.

We elected as governor Jon Corzine, a liberal democrat of my era whose qualifications include formerly chairing investment firm Goldman Sachs. Unlike me and my fellow New Jerseyeans, Corzine can comprehend a billion dollars - he made a few of them for his firm and himself.

Corzine proposed doubling tolls on state roads every few years as a way to attack our debt obligations. Neither fellow Democrats nor Republicans supported him and his approval ratings are at historically low levels. So he recently abandoned this effort - which other politicians and citizens don't seem to be as worried about as he is (which worries me even more).

When I talk to younger adults, their typical response is, "Why should I pay for the wasteful expenditures and failure to pay for them of past generations?" Why indeed - to do so will reduce their own standard of living as a result of decisions they didn't make and benefits they didn't receive.

Which returns us to my being the crest of the baby boomers moving into Social Security and Medicare ages (no, I haven't applied!). According to Roger Lowenstein of the New York Times, this will mean a doubling of the number of people claiming such benefits, with a smaller number than at present of people working and paying into the system. Projections are that Medicare and Social Security benefits will at some point consume the entire budget. The problem is, according to one analyst, so "overwhelming, none of the candidates feel they can tackle it."

Now we're beginning to talk about real conflict! With incredible real estate costs, taxes (New Jersey, for example, has the highest property taxes in the nation), food and fuel prices rising in never-ending spirals, and what not, things might get tough down the road! And what do you think the younger generation will think about carrying us oldsters on their backs?

Could get ugly, you know.

No Pill Can Cure Addiction

Stanton Peele — Tue, 29 Apr 2008 08:14:26 -0700

A remarkable article by Marilynn Marchione in last week's (April 23) Washington Post announced the death knell for an addictive fantasy - that we will find a chemical cure for addiction. The article summarized negative clinical outcomes--including frequent cases of depression and even some suicides--from drugs prescribed for smoking and obesity.

At first blush, the NIDA seems focused on the chemical rewards produced in the brain by specific drugs, notably cocaine. But, as I announced in Psychology Today 35 years ago, this model is illusory. Addiction is not the result of a drug molecule binding with specific receptors. For one thing, too many drugs with widely varying chemical structures can be addictive.

Actually, Nora Volkow and other NIDA theorists have moved beyond that model to identify general reward paths in the brain which many different substances impact. Of course, this immediately calls into question the NIDA's mandate - if we're mucking about among general reward mechanisms in the brain, why are they limiting their research to illicit substances? The answer is, of course, the government hates these drugs and wants to label them addictive to alarm Congresspeople and scare school children and their parents.

Thus, the obesity and nicotine drugs the Post discussed were not strictly in the NIDA's realm (although several have been touted for alcoholism and drug addiction). But the therapies rely on the same approach of blocking pleasure signals that underlies NIDA strategizing. The only problem is, since the mechanisms involved are so global, pleasurable experience is defused in general--walla, people become depressed.

Some key players have been struck by this lesson, including the man (Mark Egli) in charge of chemical cures at the NIDA's sister agency, the National Institute on Alcohol Abuse and Alcoholism. His chastened conclusion: "It certainly diminishes my enthusiasm."

This is actually reminiscent of the reactions of key genetic researchers when simple-minded hopes of finding a single gene for schizophrenia and bipolar disorder were no sooner announced than they were immediately dashed, as I described in Psychology Today. (We won't go into Ken Blum's "discovery" of the gene for alcoholism, which he then claimed explained all of addiction.)

As is now occurring for serious students of addiction, real geneticists announced they were recasting their entire model of how human behavior and mental illness arises. It cannot be the result of a single inheritance, or solely of genetics altogether. Nor, we now see, can addiction be resolved and dealt with as one uniform biochemical process.

Dying of Thirst

Stanton Peele — Sun, 27 Apr 2008 03:50:21 -0700

A New York Times article this weekend revealed widening gaps in life expectancy according to income, race, sex, education and geography. All of the demographics associated with declining life expectancy gains are also associated with abstinence from alcohol.

According to the article, researchers "found that life expectancy actually declined in a substantial number of counties." Worst off are poor Southern women, who are the Americans least likely to drink. They can't match the continued health gains among better-off men and women in New England states, the Americans most likely to drink.

According to the National Survey on Drug Use and Health, demographics of those 18 and older show that men (62%), whites (60%), and college grads (67%!) are most likely to drink along with, geographically, New Englanders (64%) and urbanites (58%).

At the opposite end of the spectrum, women (48%), African Americans (45%), and those without a high school diploma (36%!), along with those residing in East South Central (42%) and rural regions (48%), are least likely to drink.

Let's review the United Health Foundation's state-by-state compilation, America's Health Rankings. Four of the five healthiest states are among the leaders in precentage of drinkers, starting with the healthiest, Vermont (64%) and including Minnesota (#2 in health, 60% drinkers), New Hampshire (#4, 64%), and Connecticut (#5, 66%).

Likewise, four of the five least healthy states - Mississippi (#50, 38%), Arkansas (#48, 40%), Oklahoma (#47, 41%), and Tennessee (#46, 33%) - are at the low end of the imbibing rankings. In all of the healthiest five states, a majority drinks. In all the unhealthiest states, a minority does. The average percentage of drinkers in the healthiest states is 61 percent, the average in the least healthy, 40 percent.

Epidemiologists have long known that regular moderate drinkers live longer than abstainers. Virtually all accept that alcohol itself (all forms of beverage alcohol) prolongs life. A handful of contrarians argue that it is not alcohol per se that makes people live longer - it is the fact that drinkers eat better, exercise, control their weight, and don't smoke that accounts for their longer lives. But even this minority view is that studious drinkers are the healthiest Amerians overall.

The ratings for percentages of drinkers by states comes from the Behavioral Risk Factor Surveillance System. I'm confused - it seems as though drinking is the risk factor they are tracking. But this runs counter to the data showing that a higher prevalence of drinkers in a state predicts greater longevity and healthfulness in the state.

People who believe public health admonitions that alcohol is a dangerous substance to be avoided actually suffer the poorest health outcomes. Shouldn't public health agencies be warning about abstinence insetad?

It just shows - you can't always swallow what you are told.

(I toast Ron Roizen's health for pointing these data out to me.)

Answers to Addiction Quiz: Homage to Uncle Ozzie

Stanton Peele — Thu, 24 Apr 2008 10:42:49 -0700

For all of you who have been clamoring for them, here are the answers to the quiz on Uncle Ozzie's successfully quitting a 25-year-four-pack-a-day cigarette habit when someone said he was a sucker for the tobacco companies.

1. Why did Ozzie quit smoking that day, based on a few words from a co-worker?

Everyone caught this - as in Yvonne's comment that he would be allowing "the powers he fought against" to control him. But Dr. Martin put it most brilliantly:

He was a militant union man being ridiculed by a co-worker for being a corporate pawn of the tobacco companies. And, he saw that the co-worker was right! Co-workers were important to him. I believe it was an epiphany! That's why he told the story in the first place.

2. How can a simple thought overcome a powerful quarter-century addiction?

Anonymous put this well: "Quitters are prompted by one impressive line of reasoning: the one that dictates how they see themselves and how they want others to see them." The juxtaposition of these images with how they actually appear can be intolerable, as they were for Ozzie.

My point is that, with the right leverage, you can move a mighty addiction. As Becky put it in her comment entitled, "Whatever strikes a chord,": "If we could readily identify those chords in other addicts we may be a lot closer to helping them quit harmful habits." But she is pessimistic about doing this: "The frustrating part is that the addicts themselves can't usually tell you what would make them quit because they don't know. Ozzie didn't know that comment would be the end of his smoking days."

3. Ozzie had a small daughter and a teen son, but he didn't quit smoking because of them, even though he was a good father. Why didn't he?

Good therapy encourages the addict to discover for himself a motivator to quit, rather than imposing the therapy's or counselor's values on the addict. As Becky put it in re Ozzie's attitude towards his kids: "We harp on the ‘do it for your kids' statements because we think those have universal appeal. The truth seems to be that even the most devoted father might not. . . . It doesn't make the addict a bad father, it's just not the right chord to play." Just like militant unionism wouldn't be the cure for everyone's addiction.

At the same time we should remember, per Dr. Martin: "At the time he quit smoking, there was no publicized evidence that second hand cigarette smoke could hurt his family. None. It was not considered dangerous." Given Ozzie's devotion to his family, I agree he would likely have quit on these grounds as well at a later point.

4. What about Ozzie's withdrawal?

Anonymous was great on this one: "The chemical dependency alone would have provided at least two weeks of withdrawal. That said, Ozzie was apparently a very busy, very determined man. Once he heard the tobacco companies were laughing at every nickel he gave them, every withdrawal symptom was probably paltry compared to his desire to get back at the bad guys. (It was his life, after all.)"

This gets to the idea of reframing cravings as symbols of virtue. When I asked Ozzie how hard it was to stay off the cigs, he told me, "For a few days I woke up in the middle of the night and thought, ‘I can just go down and get a cigarette.' But I didn't."

You might say Ozzie had superhuman determination and self-control. But he didn't seem that way when he was standing there incessantly puffing on Pall Malls while he worked so that he constantly smelled of tobacco. He was just waiting for his better side - the true Ozzie - to appear.

5. Describe Ozzie's behavior from the framework that addiction is a chronic brain disease.

This one gets everybody's hobby horses (especially mine). For Yvonne, whose answer to the last question was, "What withdrawal.....it was just a decision," the answer here is "It is chronic indecision, that is all." Yvonne apparently belongs to that school of thought which dislikes the idea of addiction as a disease (as I do), but then substitutes the non-sequitur that "addiction is a choice." That's just not true to lived experience: when you say someone is addicted to something and can't quit despite harming themselves, everyone knows what you mean.

Anonymous is at the other extreme, insinuating that Ozzie's resolve was the only time in history a person ceased an addiction on their own: "Now, if only the rest of us could kick our habits so easily." All right, so maybe Anonymous isn't Nora Volkow. But the fact is, people do what Ozzie did all the time - half of all addicted smokers quit, ninety percent of those without treatment - that's 40 million people right there. And a HIGHER percentage of heroin, crack, cocaine, and alcohol addicts (although this involves smaller absolute numbers of people) self-cure their habits.

If there is an overall point for Nora Volkow to incorporate down at the NIDA, it is that Ozzie's life could never be captured in an MRI. Was Ozzie's unionism visible in his brain, could neurology tell us how he would interpret and respond to his co-worker's chance remarks, what was it about Ozzie that made sure he didn't relapse? Addiction is so fundamentally human and experiential that it can never be reduced to - and certainly not predicted by - a brain scan.

But you blogees gave great answers. And my obvious love and admiration for Ozzie seemed to come through. Per Yvonne: "he was a caring man." According to Dr. Martin, who met Ozzie: "He was a kind and considerate Dad. None better." And from Joyce C. Hamilton: "Thank you for reminding me what a unique and fine person Ozzie was!"

Uh, excuse me . . . I've got to sign off. . . I've got something in my eye.