In this article, review of the latest scientific discoveries reveals the latest information on the role of particular genes that influence addiction to alcohol and drugs. Neuropsychology, as well, ties addiction to the limbic portion of the brain, to the aptly named “reward center”. As we explore the latest in scientific discovery, however, it is also revelatory to reflect on knowledge acquired through many years of experience with the addict and addiction. In this historical study, we shall retrogress to the late 1930’s. This period in our nation’s history was a “high stress era” following World War I, the roaring twenties, and The Great Depression. Looming on the horizon was World War II. It was an era of tremendous social and cultural change and anxiety, and a period where many succumbed to the bottle, the pill, the powder, and the needle.
It was a period when communications and transportation accelerated rapidly, and the media and the press and the screen stepped forward with social commentary and up to the minute news reports. Earnest Hemingway, F. Scott Fitzgerald, Sigmund Freud, and Albert Einstein were hallmarks of an epoch that featured wealth and lost wealth, war and peace, scientific advances and brutal war, excess and moderation. In my own family, those with too much money and too little sense were termed the “idle rich”; they stamped our family history with tales of their demise. In the midst of the roaring twenties, the first true addiction treatment systems arose, fueled by the wealth created in that decade and fueled by the decadence that followed in its path. With the popular media shaping public opinion, families embraced institutional treatment to face the tragedies that came to individuals. In this burgeoning democratic society, it was no longer fashionable to overlook or to ignore the addicted. Secrets of the family were gradually exposed to the public, and the afflicted treated as having an illness rather than simply an embarrassment.
The private sanitoriums of the 1800’s became nationally prominent hospitals specializing in alcoholism and drug addiction. They were extolled for their fearless desire to improve society. And yet, these medical authorities encountered frustration in their pursuit of the “cure” for the addicted. Time and again, the medical world faced frustration and regret, and individuals failed to embrace a medical cure for addictive behavior. Fortunately, in 1934 a physician with two decades of experience in the medical treatment of these disorders stepped forward to announce what he considered to be the first real breakthrough and success in working with addicted patients. The first light of hope appeared in 1934 when Dr. William D. Silkworth wrote of strong results with “… certain ideas concerning a possible means of recovery”.
Dr. Silkworth did not create this new program through medical discovery, but he was closely in touch with the recovery community and was amazed by the progress made by a certain group of individuals joined in fellowship. This group, of course, came to be known by the name Alcoholics Anonymous. From 1934 to 1955, it grew from one hundred members to 1,600 groups and a reputed 160,000 recovered alcoholics. The growth of this organization has been exponential since and the community of groups continues to bloom and prosper today. In future articles, we will look at this group more closely. However, for this review let us focus on the comments of Dr. Silkworth in 1934. He was a wise man who had a profound and lasting influence on the future of treatment and recovery community, with insights expressed in cogent terms beyond simple scientific methodology.
It was the doctor’s belief that an addict has both mental and physical abnormalities. It was his presumption that alcoholism was essentially an allergy to alcohol that resulted in addiction. Dr. Silkworth stated hospitalization was normally required to treat the physical abnormalities resultant from addiction. As he stated, an alcoholic “ought to be freed from his physical craving for liquor”, which must occur under supervision in a clinical medical setting. Once the physical addiction is addressed, then a psychological and spiritual transition must occur. He emphasized the need for essential psychic change, and regretted that medical science simply did not have the means to achieve this end.
Dr. Silkworth observed that addicts were characterized by restless, irritable and discontent behavior. He noted a state of agitation in his patients that could only be soothed by the intake of alcohol or drugs. Thus, only through the ingestion of intoxicants could an addict achieve the feeling of normalcy they so desired. He emphasized that the addict could not overcome the need of addiction with will power alone. He stated that all alcoholics have one common symptom: “they cannot start drinking without developing the phenomena of craving.” This craving was the allergy peculiar to the addict and, he believed, this craving could not be eradicated by medical or psychological treatment. Most importantly, Dr. Silkworth stated that the only solution for addiction was complete and absolute abstinence.
In reflecting on the observations and beliefs of Dr. Silkworth, there are similarities with the scientific discoveries of the twenty first century. The concept of an allergy of addiction of his era has today become scientifically defined as genetic influences discovered in mice and, now, in human studies. These genes produce predictable addictive behaviors in those with the genotype; the same occurred in the mindset of the thirties and was called an allergy. In both instances, the peculiar condition of the addictive personality, be it an allergy or a gene, is thought to be permanent, and a fixed and immutable element of the individual. And, as in the 1930’s with Dr. Silkworth, researchers today have no final medical solution to the issues of addiction. Genes cannot be surgically removed, nor can they be medicated.
It still lies outside the strict bounds of the scientific and medical community to find realistic treatments for addiction. Chemicals and psychotherapy alone will not solve the issue of addiction. As Dr. Silkworth stated in the thirties, it is also recognized today that medicine must first address the anatomical/physiological dependencies faced in addiction, and then there must be the spiritual and psychological aspect of life for the individual that must be addressed through meaningful and profound activities that create the sense of community and support necessary for the addict to succeed.
Hanley Center is a well-known care provider offering a range of treatment programs targeting the recovery from substance use, mental health issues, and beyond. Our primary mission is to provide a clear path to a life of healing and restoration. We offer renowned clinical care for mental illnesses and have the compassion and professional expertise to guide you toward lasting wellness. For information on our programs, call us today: 561-841-1033.