It is said that drugs and alcohol chemically trigger some people to drink/drug uncontrollably once they’ve had a single drink or hit. This theoretical inability to stop (referred to as loss of control, or powerlessness) is the central concept in the mythical disease model of addiction/alcoholism (MacAndrew, 1969). This is summed up in the phrase “one drink equals a drunk” or some people’s belief that “once I start I can’t stop.” For these people, a single dose of a drug or alcohol equals guaranteed disaster. Let us address this facet of addiction mythology.
The popular strategy for dealing with “addiction”, logically enough then, caters to this supposed loss of control. “Addicts” and “alcoholics” (and their helpers) must do all they can to make sure they don’t take that first drink or hit. This means avoiding places where alcohol is served and the people who use substances. It means becoming part of a subculture made up of abstinent peers and special abstinent social events – to insulate you from the dangerous temptations. And most importantly, it means generating and maintaining a consistent fear of substances, a process that is initially kicked off by identifying as an “addict” or “alcoholic” (one who lacks control over their intake of drugs and alcohol), then maintained by a steady stream of the proper messaging from the recovery culture.
In most treatment programs, a single use of a substance is called a “relapse”, and therefore seen as a major failure, and it is expected that heavy uncontrolled use will quickly follow it. Whether the individual chooses further heavy use or not, a new cost is nonetheless imposed upon them by their “support” group – they lose respect and status within the group, and must go back to step one of “recovery.” More fear; more deterrence based “help.” In the supposedly more progressive treatment programs, a single drink or hit is called a “slip” – again implying that you’ll fall hard quickly unless you get some support. This support often consists of being reminded of all you stand to lose by using substances, or in plainer language, being scared straight.
An aura of fear surrounds all substances in this approach, to the point that it’s believed that products containing small amounts of alcohol, such as mouthwash, perfume, or even hand sanitizer, can chemically trigger a relapse. It’s also believed that foods containing or cooked in alcohol can do the same. Many painkilling drugs are avoided by people using this approach, even after major injuries and surgeries, for fear that they’ll trigger uncontrolled use.
In group counseling sessions and support group meetings it’s not uncommon to hear stories about how someone thought they could handle one drink or hit, and then “lost control.” Other scary tales, like that of someone who relapsed because they ate Tiramisu (a dessert containing a small amount of alcohol) are routinely told in these settings as well. The thing all of these stories have in common is that they end tragically, and so the lesson is simple: be very afraid of drugs and alcohol. Thus the choice presented in the recovery culture is a binary one – either stay fearful and vigilant to avoid even the sight or mention of any drugs or alcohol, or fall off the cliff into the abyss of addiction – with a promise of incarceration, madness, or untimely death.
Without the concept of loss of control, all substance use would be considered voluntary (freely chosen). Our culture’s concept of substance addiction would fall apart, as would the fear-oriented approach to changing a substance use habit outlined above. Frankly then, it’s extremely important to know whether people really lose control or not, since it would have a profound impact on how to approach a substance use problem. Does the concept of loss of control really hold up?
The most basic logic and examination of experience say no.
What is meant by uncontrolled drug and alcohol use? What is meant by loss of control? Imagine a set of dominos. Once you knock down the first one, there’s no turning back; an irreversible chain reaction has been triggered. This is what supposedly happens to those labeled as addicts or alcoholics. It is said that their brains have been wired to give substance use top priority over all other activities and to generate overpowering impulses to use (NIDA, 2008). The first drink sets off a chain reaction of substance use that the individual is physically incapable of stopping.
Think of the danger posed by a single drink or drug if you really lost control after a single dose. After one drink, you would proceed to drink non-stop until you either passed out or died from alcohol poisoning every time you have a single drink. This is the important point here. Loss of control means loss of control every time you drink or drug. Not loss of control when it serves a purpose or is convenient. Not loss of control when you have a stressful day, or when you hear of your spouse’s infidelity, or when you lose your job, or when you got the promotion and want to celebrate, or when you are depressed, or when you have a panic attack, or when you are feeling the first nip of withdrawal. Sure, each of these may be a reason to get drunk or high, and they may even be reasons you find totally acceptable. But regardless, each of these reasons are just that; choices based on the power of mental reasoning. Loss of control cannot be intermittent or based on choice or it isn’t loss of control! Anything short of this all or nothing condition is classified as having control. It is the fundamental belief in total lack of power over substances and their use that builds the foundation of the loss of control theory being peddled by the likes of treatment centers, NIDA, NIAAA and 12 step groups across the globe. They cannot have it both ways. They cannot say you have a loss of control…well…sometimes. That would be oxymoronic.
In the loss of control theory, if you ran out of alcohol before passing out or dying, then you’d do whatever you had to do to acquire more alcohol – including potentially driving drunk to a store; breaking into a store or bar if it’s after hours; committing robberies to acquire more alcohol, etc. Again, it would play out in these extreme ways every time you had a drink if we really believe in a genuine loss of control.
So what exactly are these loss of control theorists implying? Let us examine their theory in logical steps.
First, in order to examine the possible validity (or lack thereof) of the loss of control theory in real detail, we must describe the opposite of loss of control first. The opposite of loss of control is obviously the idea that humans CAN control their sphere of influence including substance use habits. So what gives human’s the power to guide their lives? The answer is three aspects to the human mind that provide this mental and emotional power. They are:
1. The Positive Drive Principle® – That all individuals are motivated by a desire for more satisfaction, fulfillment and happiness.
2. Freewill – All people possess the power of free choice and the mental capacity to change their minds about any topic at any given moment in time.
3. Autonomy – That all people are separate and unique individuals who possess their own thoughts, values, drives and goals.
At St. Jude’s we call this trio of naturally inherited human gifts the Freedom Model Triad®.
We know that every human is endowed with these three indisputable mind-based gifts that make up the Freedom Model Triad: freewill, autonomy, and the positive drive principle (PDP). In concert, these three components that constitute the human mind allow an individual to guide their life, their behavior and their choices including substance use habits.
Loss of Control = Substance-Will Possession
But in the loss of control theory one must come to the conclusion that freewill, autonomy, and even the PDP are taken over by the will of another; in this case the will of a substance. Think about that carefully. In the loss of control theory, substances are endowed with a metaphysical life force of their own that is more powerful than the human mind. To understand this mystical substance-will in more detail we must look at the differences between the mind and the brain.
The “addiction professionals” use the terms mind and brain interchangeably and without regard for the vast differences between the two entities. They consistently conflate these two human components when describing the brain disease theory, the loss of control theory, and “addiction” in general. By using the terms brain and mind in this careless manner, an assumption is made that a person’s thoughts and their brain tissue are in fact the same thing. Therefore, when a loss of control theorist explains how one’s thoughts can be totally controlled and overtaken by substances no one asks how that is possible since one’s mind is not one’s brain. Without any distinction made between the mind and the brain, the affects of substances on one is the same on the other. In this mixed bag, a physical substance taken into the physical body is able to override the will (the mind) of the person taking the substance. This of course, is simply impossible.
Of course, it goes without saying that substances do have an effect on physical brain tissue because like the substances, the brain too is physical. Therefore substances can affect brain tissue and the functions of that tissue. But, can we say that substances can then in turn literally take over one’s thoughts, drives, needs and desires as NIDA states in the loss of control theory?
First, the brain doesn’t have any capacity to think, feel or choose or cause behavior. The mind does all the thinking, feeling, observing, choosing, and causing. This is a simple, self-evident fact of life. Yet the recovery society seems completely unaware of this truth or simply ignores and sidesteps it. As we stated earlier, the brain is a physical organ. Substances too are physical. Yet, by making the argument that substances overtake a person drives, wants, and even a person’s needs, we have just imbued substances with a soul, mind or spirit of its own! If not, how could they overtake one’s mind? The mystical substance-will is the only answer to this lapse in the theory. Without a will, or a mind of its own, a substance could not possibly overtake the host’s mind.
So, the recovery society, through improper use of terms and concepts, hatched the mythical substance-will. Simply put, by stating that substances (physical-based) can overtake a person’s Triad (mind-based) you must make substances somehow mind-based as well. This theoretical leap is the underpinning of the loss of control mythology. Our society takes this illogical premise and dovetails it into the even more absurd idea that this mythical substance-will then has the power to overtake the mind and will of its host completely. Loss of control theory is at its most absurd when a person chooses to believe that their mind, their choices, their behaviors (as well as the result and consequences of their behaviors) are now possessed by the substance-will. Of course it is not stated in this way. There is a lot of scientific jargon trying to explain away this serious flaw in the theory, but undeniably we are talking about a belief, a religion in powerlessness here. A century or two from now, history will look upon this period in time and see the “addiction” movement and the recovery society’s promotion of it as the religion it was, complete with its own senseless rules, mythology and symbols.
Let’s consider cocaine use in this substance-will possession lens. Since the drug keeps you awake, a single snort of coke would literally lead to never-ending cocaine use, which would lead users into either deep psychosis from lack of sleep, or likely a heart attack and death. Again, this would happen every time you used cocaine, and supposing you’re an “addict” who loses control and turns into a drug-taking zombie, then you’d only ever use cocaine that one time until you died. Or maybe you’d go into psychosis, and by some stroke of luck get arrested and forcibly stopped from using before you’re able to sell all of your possessions and commit countless crimes to continue the eternal uncontrolled use of cocaine triggered by that first dose. And if you in fact were forcibly stopped by being placed in a jail cell would you go mad as your possessed mind endlessly craved the drug? Once released you’d kick the whole thing off again the moment you had the first chance to use. Or maybe the cravings would stop after you were away from the drug long enough, assuming you were jailed long enough. But once you had that next single hit, you would die from overdose or the consequences of your madness.
Simple experience and logic prove such scenarios (and thus the notion of loss of control) as completely unrealistic. Think of it – you’re here now reading this rather than getting high or drunk. At the very least, you probably stopped using last night and went to bed. Or maybe you passed out drunk, but why should that stop an alcoholic zombie? Why didn’t you resume drinking as soon as you awoke? After all, there was still alcohol in your blood stream in the morning – so it should have continued to trigger uncontrolled drinking when you awoke.
Maybe you’re like the countless people we’ve met who “lose control” right up to the point at which they’ve spent their entire paycheck. Why not rob someone to get more drugs? If you’re an out-of-control drug-taking zombie, then that should happen every time you run out of money. Or maybe you are someone who does drink all day and then starts again in the morning. Maybe you do feel like an alcoholic zombie driven by cravings and urges to use beyond your immediate control. We have talked with thousands who make this kind of argument; the argument of powerlessness. Yet, every single person in this particular group stops drinking when it gets painful enough or when another more important priority presents itself and has more meaning to the individual. Some stop for periods of time, sometimes for hours, weeks, months and even years. The point is this; if you are truly an alcoholic zombie, once you started, you can never stop until death. No amount of group therapy, rehabs, 12-step meetings, or 12-step sponsorship could stop your use. Not even for a day at a time. The loss of control theory is a binary idea; either it is, or it isn’t. Reality proves the later.
You see, substance-will possession is akin to substances “making you do things.” This idea is radical and downright insulting to common sense, yet the recovery society and loss of control theorists say it all the time. Loss of control by substances literally means there are 2 opposing wills fighting it out within the mind of the sufferer: a living substance-will and your will battling for supremacy – the substance-will always winning once that “line is crossed” (whatever that means). Looked at in this way, it really becomes evident that a substance being personified into a living enemy bent only on your subservience is not only incredibly inaccurate, but simply put, is fictitious. This entire substance-will concept got its roots started in AA’s book entitled Alcoholics Anonymous, where it states that alcohol (and presumably drugs as well) is “…cunning, baffling, powerful. Without help it is too much for us.” These simple, fictional words were the catalyst that started the avalanche we see today in the recovery society. Prominent scientific journals and institutions became driven to make this statement and many like it in our treatment culture, true.
Maybe you are one of the people that’s gone to the extreme lengths of prostituting yourself for substances, selling all your possessions, committing thefts, etc. Maybe you kept going right up until you got hauled into jail, and then you got pressured into attending one of our retreats or a treatment center the moment you were released. Chances are, you can still look back and see plenty of times when you obviously chose to stop, even after extreme binges, and refrained from using where the costs would’ve been too high. Do you smoke crack right on the street the moment you walk out of a crack house? Do you pull out a needle and start shooting up in front of the police? Do you do these things in front of the family members who have dedicated themselves to stopping you from using and saving your life? We doubt it. Instead, you’re probably very careful to use at times and places and in manners in which you can continue to stonewall those folks about whether or not you possess and have been using substances. You probably engage in an incredible amount of calculated manipulation that takes great care, effort, and obviously control over your actions – rather than using in a truly uncontrolled manner.
Simply put, the substance-will is a boogie man. A figment of the recovery society to explain behavior most moderate or non-users don’t agree with, like heavy and problematic use. The key to understanding addiction mythology is to see if each component of the theory is logically sound and self-evident. In the case of loss of control, there is not a single instance in our 26 years of dealing with the issue of loss of control where it made logical and provable sense. Not once. When looked at logically and in detail, the theory simply falls apart. Humans are built to solve problems, not to be weak mental slaves to a substance that cannot think.
We have just begun to expose the tip of iceberg in regards to the loss of control theory here. If you want to read more about why this theory is fictitious, look for parts 2 and 3 in this article series.
MacAndrew, C. (1969). On the Notion that Certain Persons Who Are Given to Frequent Drunkenness Suffer from a Disease Called Alcoholism. In S. C. Plog & R. B. Edgerton (Eds.), Changing Perspectives In Mental Illness (pp. 483–501). Holt, Reinhart, and Winston Inc.