The first thing I will say is that I don’t think it matters if addiction is technically a disease or not. As long as it's classified as a disease insurance will pay out for treatment that addicts sorely need. Whether addiction is a disease or not, addicts are not getting the treatment they need which leads me to believe that we are way off on our assumptions about addiction. Here is an excerpt from a New York Times blog by Jane E. Brody  

 "A groundbreaking report published last year by the National Center on Addiction and Substance Abuse at Columbia University concluded that “the vast majority of people in need of addiction treatment do not receive anything that approximates evidence-based care.” The report added, “Only a small fraction of individuals receive interventions or treatment consistent with scientific knowledge about what works.”"   

 https://well.blogs.nytimes.com/2013/02/04/effective-addiction-treatment/

 My opinions on addiction require that I explain what first led me to them. I was listening to Dr. Peter Attia discuss obesity. He was saying that he believed obesity was less of a disease and more of a marker. 

 The following is information from Dr. Peter Attia. His field is human longevity. Here is his Ted talk. 

Here is his interview with Joe Rogan I've also included a seven minute excerpt from that interview below, where Dr. Attia explains his theory better than I ever could. If you don't have time to listen to the entire interview, definitely just listen to the excerpt. 

What I got from this is obesity is basically a marker at which point your risk of suffering negative health conditions increases dramatically. He talks about how overweight people on average don't actually eat that many more calories than people of average weight, but that they simply do everything wrong metabolically. Years of doing everything wrong metabolically (high sugar, eating for 14 hours or more out of the day, not exercising, etc.) has effectively broken their metabolism and created a sub optimal hormone imbalance. Everything that happens after you swallow your food is controlled by your hormones and years of doing everything wrong metabolically has a huge effect on your levels of testosterone, estrogen, insulin, etc. This creates a problem because now when a person swallows food the hormones that dictate how those nutrients like fat, protein, and carbs are partitioned to the body aren't working. Years and years of this only makes the problem worse and worse. The worse the problem the more extreme the measures needed to fix it. This might look like a 10 day fast under medical supervision once every three months, or 500 calories a day for the first two days of each week for six months followed by time restricted eating the other five days of the week for six months. Simply cutting calories may not be sufficient to fix the deep underlying problem. 

 Okay so why did I just spend a whole paragraph on obesity when this is about addiction? Because I think obesity, as described by Dr. Peter Attia, has so many parallels to addiction.  I believe what we call addiction is a marker. Most people who have spent time in a 12 step program, like me, have heard the cucumber/pickle analogy. It says that when a person crosses the line to addiction they can never go back, just like a pickle can never go back to being a cucumber. Every addict understands what this is referring to. It's that line you cross from which there is no going back. I believe this is a flawed assumption and this flawed assumption is the foundation that all attempts to deal with addiction are built on.  

Addiction is so much more than just the inability to stop using drugs. I actually think that the physical/psychological dependence on narcotics is just the spark that sends us down this road of negative feedback loops. Along with drug addiction comes behaviors that rewire our brain. The longer you spend rewiring your brain the more work you have to do to repair it. Now to be fare this isn't anything that flies in the face of what we already believe and I think even the most ardent member of AA would agree with this. My problem is that 12 step groups/rehabs/sober livings focus a lot on changing behaviors but at the same time drill into you that addiction is an incurable disease that you will always have. That if you ever pick up a mood or mind altering drug again you'll be right back where you started. The issue is, of course, that almost no one that is "sober" or "clean" in a 12 step group actually stopped using mood or mind altering drugs. The drugs of choice in the rooms are caffeine and nicotine. On top of that most people are on at least one anti-depressant. So clearly it's not that an addict can't ever use mood or mind altering drugs and be okay, it just depends on the drugs. So then the question becomes "what drugs are acceptable for a person who is clean in 12 step allowed to use?" The answer makes little sense. Basically all drugs that are legal are allowed... except of course for alcohol. Then all drugs that are prescribed are allowed as long as you use them as prescribed... except opiates, barbiturates, and benzos. And all drugs that the U.S. government arbitrarily decided are illegal are off limits. I remember the first time I went out with some NA folks we went to a club and everybody bought a Redline. Redlines are energy drinks. I was so gacked out, it was like speed without the euphoria. I clearly remember thinking at the time "so I can drink these all day and be sober but if I smoke weed I'm dirty?" It makes absolutely zero sense. I promise you your brain has no idea about the legality of the drugs you do.    

 What if we have this all backwards? The focus is primarily on the drugs as the primary problem. What if there is no such thing as the disease of addiction. What if addicts simply have certain personality or genetic factors that simply predisposes them to getting hooked on human manufactured or refined narcotics that they would have never encountered in nature? What if those personality or genetic factors aren't inherently bad but only become bad when you mix them with the narcotics we have manufactured? For instance for over 4,000 year’s coca, Erythroxylon coca, has been used as a medicine and stimulant in what is now Colombia, Peru, and Bolivia. It wasn't until 1860 when Dr. Albert Nieman isolated cocaine that it turnen from basically a cup of coffee into one of the most addictive horrifying drugs the world had ever seen.   

So now I am going to tell you what I think is going on here. I think that addiction, like most things, is far more complex that we would like to believe. I find it interesting that tribes in South America and Africa such as the Bwiti still living pretty much the same lifestyle they have been for hundreds of years, and for whom drugs play a big part of their society, have no word for addiction. Now really think about that for a second. Here are cultures where people do and have been using drugs for a very long time and don't have this disease of addiction. So much so they don't even have a word for it. So what's going on here? In thinking about what the differences are between an African tribe relatively untouched by western society and us has led me to what I think are some pretty profound observations.  

Western society made alcohol its drug of choice: We are currently in an opioid epidemic in the U.S. but if you look at opioid related deaths the number doesn’t hold a candle to alcohol related deaths. The Bwiti view drugs as tools not as a means to get wasted. Because alcohol is the drug of choice in the west this led to looking at sobriety as a virtue. Sobriety being a virtue makes sense if your society’s drug of choice is the most devastating drug in existence. I believe this has informed how we feel about drugs in general. We don’t look at drugs as tools for life but rather as bad things that should be done as little as possible.   
The western diet: Processed foods, a food pyramid that recommends a high carbohydrate diet, and, worst of all, sugar. I am going to devote an entire blog post on this so I'll only say that the effects of refined carbohydrates on the body is very similar to the effects that a lot of recreational drugs have in terms of, among other things, how it effects the reward system in our brain. A high carbohydrate diet is also a high inflammatory diet and all the current science seems to show that inflammation is the root of a lot of evils including depression. The way most of us eat is a massive shift from the nutrient ratios our ancestors evolved to eat and we are only beginning to see just how big of a problem this is. Say nothing about the effect this type of diet has on our gut micro biology and how that effects things like anxiety among other things.   
Alcoholics Anonymous: AA has done so much good for the world. AA and its 12 Step spin offs have helped millions of people worldwide. The problem I think is that it is the driving force behind the "addiction is a disease you will have to deal with for the rest of your life" idea. For myself, the psychological impact of hearing this over and over again was devastating because I took it as an absolute fact. I believed it was based in science and that science was settled. Only recently when I started looking into the actual research did I find that the science is anything but settled. I believe the unintended consequence of AA was sending us down this path of treating addiction with a fundamentally flawed assumption of it being an incurable disease and we have been building upon that fundamentally flawed assumption ever since.  
Sleep: We have figured out how to create light in the absence of the sun, the moon, or light from a fire. Artificial light has been one of the amazing gifts modern society has given to the world but with that comes consequences. The exposure to light, especially at the blue end of the spectrum has a huge effect on sleep quality and poor sleep quality is linked to a whole host of negative effects. Here is a link to an amazing interview with Shawn Stevenson where he talks about his own incredible journey. His story is not about drug addiction but is about thinking outside the box to solve a problem.

5. A sedentary lifestyle: I will be doing a whole blog on exercise and its profound impact on the addicts mind. A sedentary lifestyle is nonexistent in tribal cultures that have been using drugs forever but have no addicts. Simply put everything they have to do to survive requires much more physical activity than what we have to do to survive. Here is a link to Dr. Rhonda Patrick's interview on the Joe Rogan experience where about 28 minutes in she talks about exercise and the effect on our opioid receptors in the brain. 

I believe there is a lot more going than what I just mentioned above. The lowest hanging fruit, I believe, is nutrition. My own personal journey led me down a path where I first cut out all refined sugar/carbs and eventually cut all carbohydrate consumption to less than 5% of my total calories. When I did that I was truly in awe of the results. I went through this period of feeling like utter crap, some people refer to this as the keto flu. Well it didn’t feel like the flu to me. What it felt like was drug withdrawal. A lot of people in my life are a little taken back at what they perceive as very extreme dietary and lifestyle changes but I'll tell you that just removing sugar from my life created just as profound a change as removing heroin. Extreme changes were what was needed. The longer you dig yourself into a hole the more you will have to do to climb back out. In order to rewire my brain to what it was before addiction required hyper focus on nutrition, exercise, sleep, and many other things that I will cover in future blogs but it absolutely worked. And this brings me back to my original point. 

I am going to reword Dr. Peter Attia’s Ted Talk. 

What if we are wrong about addiction? 

What if addiction is a symptom of a much deeper problem? 

What if addiction is a coping mechanism for the much deeper problem of modernity that I outlined above? 

What if drugs are not the problem?    

There are many examples today, in the Aboriginal populations for instance, about the devastation that is brought when a western diet is introduced. They start suffering from all these diseases that were nonexistent before. Why would we assume that addiction is different? 

What if there it is not that a certain subset of the population are born addicts?  

What if the modern world creates a perfect storm of conditions that when mixed with drugs humans would have never been exposed to in the natural world turns into what we call addiction? 

What if there are certain personality and genetic factors that aren't inherently bad but become bad when they are mixed in with the negative effects of things like a high sugar diet, a sedentary life style, poor sleep due to artificial light, etc.    

What if we could identify these personality and genetic factors as well as the environmental and psychological factors that come with the modern world that cause addiction and treat the cause instead of addiction itself?            

What I believe is that this problem is worse than ever. With the opioid epidemic there should be a sense of urgency to solve this problem because I think clearly the conventional wisdom on how to deal with addiction at the very least deserves a reexamination. My goal here is not to shit on 12 step or any other methodology. My goal is to start a discussion. I think that the more ways to treat addiction the better. I believe that what works for one person may not necessarily work for another and we need more than one way to treat addiction. I believe that the AA party line, which says that addiction is an incurable disease that can only hope to be arrested but never cured is fundamentally flawed and that the whole way to treat addiction has been built on that fundamentally flawed assumption and that is the reason why only 5% of people who go into a 12 step program will stay clean/sober for two years or more.  

So I asked myself the two questions Tim Ferriss suggests in his book "The 4 Hour Work Week" when you come across a problem you can't solve.  

What would this look like if it were simple?

What is addiction at its most basic form? I thought if I could answer that I could formulate a plan to combat it. Addiction as I see it is being locked into repeating patterns of extreme highs and extreme lows. Up and down, up and down, day after day, multiple times a day, and for an extended period of time. When most people find themselves in a daily drug habit they get locked into this repeating cycle of withdrawal, which I describe as a feeling so shitty it is almost impossible to reproduce this type of desperation and emptiness outside of drug withdrawal. And when you finally get more of whatever your poison is you get shot like a rocket from the worst you could possibly feel to the best you could possibly feel in seconds. Over and over. Day after day. So if you were to track how good you feel everyday while hooked on drugs you would see a clear pattern of massive highs followed by unbearable lows followed again my massive highs. People seem to have and absolute need for patterns and routines. Patterns and routines can either be a person's greatest super power or a person's kryptonite. Positive patters create self-reinforcing positive feedback loops and conversely destructive patters lead to self-reinforcing negative feedback loops. So if we look at addiction this way then a plan to treat it (after removing the drugs of course) must be centered around removing this pattern of highs and lows as much as possible and move towards a more even steady state that has an upward arch. This is why I think cutting out refined carbs and especially refined sugar is the lowest hanging fruit. Something that seems to be far more popular with sober/clean addicts are the 24 ounce energy drinks like ROCKSTAR. Think about what happens when a person drinks one of those multiple times a day. It's an assault of way more caffeine than a person should have in one sitting and way more sugar than a person should have in a month. What is the result? A massive kick from the caffeine and simultaneous massive kick from the sugar leading to an insulin spike. The leads to a high followed by a crash. While not as extreme as crack, it still follows the same pattern we experience when we are in our addiction. Everything that I do in my life to make sure addiction never touches me again has to do with creating an even state that is trending in a positive direction. Nutrition, meditation, sleep quality, exercise, drugs etc. 

` 2. What if I did the opposite?  

I applied this to my problem of 12step never working for me.  What if I took all the assumptions made in 12 step and did the reverse? What if I said the answer is absolutely control? Power.  Power that I create for myself, not that a supernatural being gives me. What if I threw the abstinence only attitude out the window? Because after all, I wasn't abstinent. I was consuming caffeine, smoking cigarettes, and taking antidepressants. What if I threw all my assumptions about drugs out the window and made a conscious effort to look at drugs as tools and then decide which of those tools would help be achieve this even state with an upward arch that I was looking for? 

The answers to these two questions, along with reading the 80/20 principle completely changed my life. I identified the 20% of inputs (people/places/things/activities) that were responsible for 80% of the positive results in my life and did more of that. I identified the 20% of inputs that were responsible for 80% of the negativity and chaos in my life and was absolutely ruthless in mitigating or completely removing those inputs from my life. I realized that I had dug myself into a very deep whole and used a line from AA "half measures availed us nothing". I decided to turn that obsessive nature in myself from a negative attribute into a positive attribute and became obsessed with self-experimentation. All my self-experimentation has one goal. Creating an even state of being that trends towards the positive. Rewiring my brain. And it absolutely worked.                                                               