Mail Call: New Weapons in the War on Drugs

' The Hunt for an Addiction Vaccine ' : Readers urged caution about the new medical treatments for addicts. "After reading about the new drugs we'll be using to deal with drug addictions, I hope readers didn't put down the magazine before reading 'Sadly, There Is No Magic Bullet'," one said. Another wrote, "If we're going to start treating addiction like the disease it is, then insurance companies must cover addiction treatment like other diseases." Others touted traditional therapies. "The medical establishment may regard AA as church-basement quackery," one said, "but AA has brought sobriety to many: it works."

On ' With Friends Like These … ' :"Why did The New York Times endorse John McCain when it was frantically working on a scathing article against him that was published recently?"
Hany Hanna, Sioux Falls, S.D.

The Ongoing War Against Addiction
A simple biochemical view cannot explain why 90 percent of heroin-addicted Vietnam veterans were able to quit once they returned home ("What Addicts Need," March 3), why people with drug addictions often substitute nondrug activities such as compulsively cleaning the house or why a person picks up a drink even after years of abstinence when faced with a serious loss or another reason to feel overwhelmingly helpless. These examples suggest an emotional origin to addiction—a breakthrough concept for addicts once they are introduced to a more substantive way to think about themselves. Addiction is hardly as simple as the biochemical reductionists would have you believe, but neither is it a problem without an essential solution close at hand.
Lance M. Dodes, M.D.
Division on Addictions, Harvard Medical School
Boston, Mass.

Your cover package on addiction is a great contribution. However, it essentially overlooks the importance and value of families in treating such disorders. Addiction develops within a family/social con-text, and most addicted adults are closely tied to their families. But this isn't necessarily just a "genetic problem," since only 14 to 36 percent of children of alcoholics de-velop drinking problems, and the majority of those who do develop addictions do not demonstrate a genetic predisposition. Rather, such problems are often precipitated, and reignited, by (usually unexpected) family deaths or other kinds of losses. The "cause" goes beyond simple biology. In fact, there are at least 65 randomized clinical trials documenting the effectiveness of family or couples therapy for such problems. These studies also show that involving family members can greatly decrease clients' likelihood of prematurely dropping out of treatment. Partly for those reasons, 82 percent of adult alcohol and/or drug-treatment programs, and all the programs the Department of Health and Human Services has deemed "exemplary" for adolescents, provide family/ couples treatments for their clients.
M. Duncan Stanton,Prof. Emeritus
Spalding University
Former White House Consultant
Louisville, Ky.

As a 28-year clean and sober recovering alcoholic, I have seen enough deaths, miserable lives and social costs to applaud all approaches that offer hope. Although Alcoholics Anonymous opened the door to a new life, I am convinced that there are other ways. Like Phoenix House founder Dr. Mitchell Rosenthal in the article "Sadly, There Is No Magic Bullet," I am convinced that there is far more to addictions than the physical aspects. Some unique confluence of elements prevents addicts of all sorts from healthily processing uncomfortable feelings and dealing with them. Failure to find effective ways to do that always seems to cause transfer of addictions and/or other major problems, often with terrible additional consequences. Even with wonderful advances in drug therapy, we need to be very alert to the increased incidence of suicides as medications "take away" unhealthy, but more or less (if temporarily) workable, coping behaviors without adding ways to deal with root emotional dysfunctions. My hope is that researchers will spend as much energy understanding other factors affecting addiction as they do pursuing the pharmacological route.
Frank W.
Sarasota, Fla.

As a six-year recovering alcoholic, I agree that genetics and many other key factors play a part in addiction. I also believe that for many addicts, using "disease" and other such words falls under the mighty and weighty umbrella of "pity city." Believe me, I know. I created my own personal hell but, fortunately for me, I was able to escape and move forward with my life. In the very wise words of my father, "It's all in your head," and for the most part, he is right.
Chris Dorsch
De Pere, Wis.