Pubdate: Tue, 13 Mar 2001
Source: New York Times (NY)
Copyright: 2001 The New York Times Company
Contact:  229 West 43rd Street, New York, NY 10036
Fax: (212) 556-3622
Author: Alex Wodak
Note: Dr. Alex Wodak is a hospital director of alcohol and drug services.


To the Editor:

The report on Dr. Sally Satel suggests that if she draws so much criticism 
for her views on drug addiction, she must be saying something important. 
Would that it were so ("A Critic Takes on Psychiatric Dogma, Loudly").

Dr. Satel argues that addiction is an entirely voluntary behavior while 
Washington prefers the fiction that addiction is just a brain disease. 
These polar extremes are both overly simplistic.

People taking mood-altering drugs for the first time do so voluntarily. But 
control is progressively lost as addiction gradually takes over.

Dr. Satel's perspectives are inappropriate for an advanced country like the 
United States. Worldwide, addiction is now accepted increasingly as a 
chronic, complex condition, which unpredictably often improves and 
sometimes relapses. Much has been learned about reducing the harm drugs 
cause to individuals, their families and their communities.

The United States should pay more attention to its many outstanding 
clinicians and researchers working within a public health and evidence 
based framework.

Dr. Alex Wodak, Sydney, Australia 
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