Addiction counseling in the modern era has been practiced as an essentially clinical activity, but this has not always been the case. There have been key points in the history of addiction treatment when the functions of community organization and social activism competed with, or complemented, this clinical orientation. The first section of this paper draws on nine episodes in this history to explore the relationship between addiction recovery and the addict’s identification with, and participation in, a community of recovering addicts. The second section utilizes the work of John McKnight to explore how professionalized and institutionalized services can inadvertently undermine the development and vitality of indigenous community support systems. The third section outlines a series of recommendations that would shift the focus of addiction recovery from something that happens exclusively in the context of professionally-directed treatment to a process that unfolds within the larger community. It is argued that the professionalization (medicalization and psychologization) of addiction treatment needs to be balanced by a re-emphasis on recovery as a connection with indigenous resources and relationships beyond the self. The paper closes with a discussion of the potential pitfalls of this shift in focus from clinical technique to community resource mobilization.

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A Lost Vision: Addiction Counseling as Community Organization

The Tunnel Back: Synanon.

Using the literature as a data source, this paper attempts to: a. examine the wide range of etiological and treatment alternatives with a primary focus on heroin addiction; b. briefly examine the concordance between the etiological and treatment modalities and various conceptualizations and explanatory models of substance use/abuse and social problems; c. outline an examination of both treatment modalities and theoretical approaches to substance use/abuse and their relationship to the question of political-economic influences and gatekeeping factors; d. through critical evaluation of the preceeding issues, suggest what the important areas of concern could or should be in the near future. This work is able to only briefly discuss the very complex issues enumerated above; the findings and recommendations attempt to provide systematic research alternatives.

Substance Use/Abuse Conceptualization, Etiology and Treatment

(1974). Cultural Therapy - A New Conception of Treatment. Journal of Psychedelic Drugs: Vol. 6, No. 2, pp. 173-177.

Wilson Van Dusen

Papers

Cultural Therapy - A New Conception of Treatment