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The Globalization of Addiction Rating: 8 on a scale of 10 Review This is an important book and should probably be read by all people trying to keep up with what is happening in the world. This book is an important polemic for our current time. This is a marvelous work, it takes us to a new place, on the edge of something important for the world. In 1986, I attended the Hazelden alcohol treatment center in Minnesota for a clinician training course. It was a tremendous educational event during the early days of my career. We rode the van in from the Minneapolis airport with our group of clinician trainees and about four quite drunk clients coming into the treatment program. Our training at Hazelden had already begun. It would be difficult for me to express how valuable this experience at Hazelden was for me as a clinicain. I having nothing but praise for the program, staff and clients I met there. One of the fascinating pieces of information they informed us about was how there were actually a few cultures in the world that had a "healthy" relationship with regard to their societal use of alcohol. This was fascinating to me. I was at that time an officer in the US Public Health Service working on a quite remote Native American reservation. I was seeing first hand on a daily basis the "ravages" of alcohol on a population of people. They told us the Armenian people had a healthy relationship to alcohol. They could use alcohol for purposes of increasing trust and relationship without using it to reach drunkenness. In short, alcohol was used in a way that enhanced their relationships and trust. I had never heard of such a thing, and I was skeptical about this, but it was good to hear that it was possible to use alcohol in a responsible fashion. I have since left the world of the "reservation", but our situation in "mainstream" culture is only a little better than reservation life. Alcoholism and the destructive qualities of alcohol and drugs are common in all realms of American culture. Addiction seems to be our way of existing. It is abundantly clear that we are addicted to far more than just alcohol and drugs. We all seem to have various addictions. I will confess one little one of my own that I have overcome. Many years back in the early 1990's I obtained a copy of a game called Tetris for my first desktop computer. It was a terribly fun game to play. It was not long before I found myself sneaking off from my family at any moment I could, to go upstairs and get some Tetris time. Over the course of about 6-8 weeks I began seriously accelerating the time I spent playing Tetris. Soon, I was actually trying to avoid my family in order to go play my game. My wife began catching me sneaking off to the computer. Eventually, she confronted me regarding my problem. I could feel the urge to play overcome me. When she pointed out my obvious problem I knew I had to go "cold turkey". I quit Tetris and returned to family life, but I have never forgotten how insidious it was for me. At this point in history we are all familiar with various people who have had such issues. Dr. Alexander's book takes us into this discussion with gusto. Western culture has become amazingly advanced, yet something seems amiss in our very nature. We seem to move deeper and deeper into multiple avenues of addiction. He begins by defining four types of addiction. These are helpful and relatively easy to remember. Addiction1 he describes as the classic alcoholic who has become overwhelmed and transformed by alcohol to the point of "enslavement" to it. Addiction2 refers to essentially any use of alcohol or addictive substances. Addiction3 refers to addiction to things beyond alcohol and drugs. Addiction4 refers to positive addictions, yes, sometimes you can be addicted to something in a way that is helpful, examples might be things like being addicted to "bible reading" for example. He has three big principles. First, psychosocial integration is an essential part of human well-being and the absence of it is very painful. In short, we all need a culture to exist and thrive in, a place where people know who we are, we have a history together, we are valued and important and appreciated/loved, we feel and are included in this culture in an ongoing fashion. Second, he believes the globalization of free market society/economy produces a general breakdown of psychosocial integration causing what he terms dislocation. Dislocation is a painful experience, causing people to look for something to relieve the pain. Addiction turns out to be the something to relieve the pain, which is the third principle, people use addiction to adapt to chronic dislocation. He believes psychosocial integration involves four important things: compassionate agape love, shared beliefs, differential social roles, and economic interdependence. In the beginning of the book he expresses his lack of belief in any particular faith based system of religion, i.e. he seems to be an atheist. However, he admits that in the course of his study he has come to recognize the tremendous importance of the values inherent in a Christian based faith system with regard to addiction. Our issue seems to be one of how do we love each other? To my way of thinking this book is a screaming manifesto asking us to look at how we love and care for one another, how we create and maintain culture, how we involve other people of all sorts. It challenges us in much deeper ways though. He asks us to look more at our economics, how economics isolates and fractures our culture and what we will do about this. It is not easy. I see many people in my medical practice and often many of them just need to be reconnected with a loving, caring, life enhancing community/culture. But, alas, culture is vanishing in my experience. We are increasingly being overwhelmed by the slavery of the economy. I make this statement knowing that it would take pages and pages to explain what I mean, so let me tell one story. I grew up in the Willamette Valley. I am from a family that hunted for pheasants every year I can remember growing up. It is one of my greatest sadness's in life that the ability to hunt pheasants is more or less gone. Why, what changed in our fair land? First, the fence rows were all removed to make more room for crops to grow more intensively. Then the land was treated like a brood mare. The land needed to produce more. A piece of land now will sometimes produce at least two crops in a season. No longer can you find a fallow field with vegetation and cover left to sit for the winter. It is all plowed under in about 24 hours after the crop is taken off and within a few days it will have been fertilized, prepped and planted with a new crop. The land has become a production line and we all march to the beat of that line. Pheasants are not part of the production line. Fence rows are not part of the production line. Bird cover is not part of the production line. Animal habitat is not part of the production line. And I, we, are the poorer for it. Of course the farmer is doing better, well the corporations who direct how and what the farmer will plant are doing better while farmers take the risk. I would trade a goodly number of years of my life to have back the culture of hunting in my family that has been lost to serve the needs of the agricultural production line. I do like the fences being gone, but was that worth the trade-off? I could do more for culture and another human being during a good day hunting than about anything else I can think of. Some will think I am nuts. Others know exactly what I am talking about. A fellow stopped by my place the other day to ask who a piece of land with a corn crop on it. He had visions of hunting there this fall. I hope he is successful, but I rather suspect the production line will win out and his hoped for hunting field will be reduced to a planted field getting ready for next year. Recently, our medical community where I work lost a good physician. He decided to move back to Nebraska. Now there are many reasons to pull up stakes and move but his were the best. He opting to return home to be near family. He wanted to have his kids grow up able to do things like hunt pheasants with him. He wanted to be able to go to a baseball game and enjoy himself with his sons. It is time we choose more for high quality culture and less for economic efficiency. I understood exactly why he moved. All opinions are those of Curtis Climer, MD Copyright 2011
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