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TL;DR Book Report – The Addiction Solution by Lloyd Sederer, MD

lloyd-sederer: the addiction solution book cover

The Addiction solution covers a wide range of addictions, how our society tries to deal with drug dependence, and what would ideally be done to recover the people lost (and prevent further generations from becoming lost) in repetitive destructive behaviors.

Take particular note of my phrasing: ‘recover the people’: in this book, Sederer brings up a very apt quote which drove me to phrase it that way:

The good physician treats the disease; the great physician treats the patient who has the disease. -Sir William Osler

As doctor Sederer brings up on numerous occasions (pages 14-16, 40-42, 48-49), many of the highest contributing factors to becoming an addict come from outside a person’s personal control. Be it with Adverse Childhood Experiences (as in the case the author brought up of Billie Holiday) or a genetic disposition, or even just being born in the wrong neighborhood.

Looking into the main risk factors which are brought up (page 61), Sederer makes me reflect on the attitudes to these risk factors which I have seen across socio-economically different neighborhoods.

A quick breakdown of the risk factors that the good doctor compiled here from his case study (page 61) are:

  • Early Aggressive Behavior
  • Lack of Parental Supervision
  • Substance Abuse
  • Drug Availability
  • Poverty

The important thing to distinguish about these risk factors to addiction are that they happen in very different scopes. For example, availability of drugs is hardly ever measurable on the personal level, more so the community. The book goes on to match these risk factors with their scope, or as the author calls it, ‘Domain’.

This table can be found on (Page 61)

Risk Factors Domain Protective Factors
Early Aggresive
Behavior
Individual Impulse Control
Lack of Parental
Supervision
Family Parental Monitoring
Substance Abuse Peer Academic Competence
Drug Availability School Antidrug Use Policies
Poverty Community Strong Neighborhood
Attachment

I think the good doctor is very hip in his attitudes towards people with addiction problems, but the ‘Protective Factors’ section of the above table really shows the thought patterns that many previous generations seem to be stuck in. I think we’ve very reliably seen that programs like D.A.R.E. do not work, and that top down (parent/teacher => student) ‘policies’ don’t work.

Additionally, the people afflicted by these problems are the ones who need to be empowered to fix these problems, and so using terms outside of their vernacular is like creating a guide of how to fix European made cars but only using imperial (US) measurements. In his defense, Lloyd rips into many of the same problems that I have, with the overly simplified table above.

The good doctor, Llyoyd Sederer, MD, philanthropist, Author, then brings up that any of these individual factors are not bound to create addicts in a population, not even availability of the drug (page 74)! I’m instantly reminded of a vice documentary I saw on youtube. For the duration of the season where poppies are ripe to extract opiates for no monetary cost, the junkies of Prague go on holiday. With such easy access to this substitute for heroin, the external problems associated with heroin addiction all but disappear. Since then, I have also heard of a huge effort across Northern Europe to offer free & safe injection sites. Norway in particular has seen huge improvements.

Sederer brings in plenty of zinger quotes, but I think this one is the best (Page 86):

Doctors are men who prescribe medicines of which they know little about, to cure diseases of which they know less, in human beings of whom they know nothing. -Voltaire

The process from which a mentally sick person arrives at a treatment is lengthy, complicated, and traverses many areas where context could break a possible treatment. It makes me think this must necessarily be a personal journey, which begins with a very broad literacy with the concepts which inform the researchers to come to the conclusions that they do, and travels through the recovery journey as both the patient and provider.

As somebody who has put a bit more time than average into learning about the scientific process (and more specifically, psychological research into implicit behaviors), I felt a bit groggy going through Sederer’s lengthy introduction to the subject, but I recognize the value of over compensating for peoples lack of knowledge in a particular subject before trying to share/teach that subject. The other side of that, of course, is that you could jump into The Addiction Solution with no previous knowledge and remain engaged the whole way through.

The book does get into a few of the neurological effects which the main addictive substances incite, as well as how pharmaceudical treatments act on the brain to combat this (Page 90). This is pretty much what I picked the book up for, but I won’t go too far into it. I think it has been thoroughly (and in more concise terms) covered.

If you get this book, and are interested in how to help loved ones/community, you should definitely check out Sederer’s Priciples of Good Addiction Treatments (Page 93). He goes over integrating many complimentary angles to integrate when confronting addiction. He goes on to discuss CBT (Cognitive Behavioral Therapy), which has been seen to have very positive results in patients.

Additionally some alternative treatments are brought up, like Psychedelic Agents of Recovery (Page 135). Although there hasn’t been much legal leeway to experiment with mind altering substances (Like LSD and Psilocybin ), it has long been known by aboriginal cultures that their local/naturally growing psychedelics are to be revered, respected, treated as medicine for the mind. Please ring me if the powers that be ever catch up, but I won’t hold me breath.

Lloyd concludes by proposing a vision for where we can realistically take our solutions/minds and a place we would ideally reach, together. Have you read the book? What are your thoughts on how to deal with addiction issues in your communities, and across the dividing lines between us as humans?