With both my sense of writer's pride and the cover of the James Frey book noticeably gathering dust, I finally pulled A Million Little Pieces from the shelf and mined the source of all these months' worth of angst. I sense not having been alone in my hesitation. I have talked to more than a few people, both in my profession and yours, who had eagerly procured the recovery memoir when the San Francisco Chronicle's prediction that it would become “the final word on the topic” still rang true, only to push it aside in disgust later.
Now that I have actually read the book, I'm not sure which profession I think has been saved more by Frey's public shaming: the writer's or the addiction clinician's. While the book's depiction of addiction's horrors is at times utterly consuming, too much of its description of addiction's treatment comes across as an overacted drama, with unyielding professionals and noncompliant patients failing to hear each other. Accounts of Frey's therapy sessions at Hazelden (never mentioned by name in the book) bring to mind the partisan shout-fests that pass for political discourse in prime time.
Of course, with what we now know of Frey's appetite for puffed-up police encounters, we have to consider the source. But it remains interesting that while Frey took heat for dismissing the benefits of 12-Step treatment, the treatment community generally got a free pass in defending statements from 12-Step program clinicians such as this tidbit on page 291: “Yes, of course there are other ways. Do they work? No, they do not. Why? We don't know why, they just don't.”
In reality, a growing body of actual research points to the need to abandon all forms of orthodoxy. Studies funded by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) increasingly show that for this complex disease of addiction, people recover—and don't—in many ways. Some even recover without treatment, as a formerly unseen majority that never attends a treatment session or an AA meeting starts to come into focus.
Now that we know that Frey's word is
not the last, let's hope the next word acknowledges that a complex illness probably does not lend itself to one-size-fits-all solutions.
Gary A. Enos, Editor
An article on methamphetamine use among gay men, published in the January/February 2006 issue, incorrectly cited a statistic on prevalence of meth use in a population of men who have sex with men (MSM). Six percent of 2,916 MSM in a survey reported recent meth use, and 24% of that meth-using subgroup were from the Pacific region of the United States.