Dr. Stanton Peele: Outline of the Upcoming Discussion

Posted on May 12, 2015

In preparation for our SMART Recovery special event, Tom Horvath and I have developed the following outline for our webinar on Addiction Treatment in the 21st Century.


The Three “C”s of Addiction Treatment: Change, Choice, Commitment

Tom and I will explore where we have been and, more importantly, the continuing direction of change in the addiction field.  We will try to project the future of addiction treatment. In order to accomplish this, we have come up with three key organizing principles:

Change:  Addiction treatment has changed remarkably during our careers, in some cases, involving our personal efforts. We entered the addiction field at a time when to mention harm reduction or alternatives to the 12 steps was to endanger one’s career, when to label something other than a drug “addictive” was ridiculed, when the idea that illicit drugs might become legal was incomprehensible, and when to suggest that the concept of addiction was itself changeable was met with disbelief.  Obviously, the field has raised all of these shades to peer out at new treatment vistas.  But what listeners should know is that the change rate in the field is accelerating, and what is “true” now is shifting under our feet.

Choice: All of the changes above create choices: to use or not to use, to abstain or to reduce or improve problematic use; to rely on AA or another type of group, to seek some other kind of therapy, or to improve one’s life outside of therapy or a group; to regard one’s problem as a disease or as a life problem or as a simple matter of life adjustment; to regard oneself as an addict or alcoholic or as just a person who has one or more appetites out of balance, perhaps only temporarily.  These choices in how to view addictive problems are open to every human being. As for providers and funders of treatment, they too must recognize the existence of alternatives and to offer these choices, or else allow clients to exercise these choices elsewhere.

Commitment: Choice is the result of people having different experiences, values, and mindsets.  They find that different ways of dealing with life, and life problems, work better or worse for them. Or, people just want to do things their own way — people like to exercise choice.  One result of this preference for choosing is that people do better when they follow a path of their own choosing — they are committed to this path. In this sense, there can never be a “best practices” protocol that lays out every step of the treatment process as, for instance, might be done with an infection, or with diabetes.  Thus the addiction field must recognize the need for people to select and commit to their own (informed) choice, including maintenance, abstinence, improvement.


Dr. Stanton Peele, Creator of the Life Process Addiction Program
hosted by Dr. Tom Horvath, President, SMART Recovery