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Diseasing of America: Addiction Treatment Out of Control

Barbara G. Orrok, MD
JAMA. 1990;263(18):2519-2520. doi:10.1001/jama.1990.03440180131048.
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There is no question that "the drug problem" has taken center stage in the American consciousness in recent years. Use of illegal drugs has gone from the questionably halcyon days of counterculture mind expansion to the current situation of mainstream drug use accompanied by the acquired immunodeficiency syndrome, violent crime, and other societal maladies, directly and indirectly touching all Americans. Government policies to combat the manufacture and distribution of drugs are increasingly prominent in domestic and foreign policy, and programs to recognize and treat substance abuse and dependence are being promoted by employers, educators, and even health insurers. Treatment of addiction seems to have become big business. In these times of attempts to cut back health care costs, a treatment modality that is growing is of some interest.

Dr Peele opens his provocative book with some incisive observations and questions. He disagrees with the idea that an addiction is a


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