An important statement of the problem and consequences of adopting an overly-medicalized view of addiction. In part, it says:

“Convincing us that addiction is inevitable and inescapable—in the face of ubiquitous evidence that it is culturally and cognitively inculcated and very escapable—is a self-fulfilling prophecy. (Unlike addiction, people don’t generally escape diseases like cancer through developing an overriding purpose.)

“In the 1970s, ‘80s and ‘90s, psychologists like Alan Marlatt, Nick Heather and Stephen Rollnick, Jim Orford, and William Miller conducted experiments and treatment assessments demonstrating that individual and cultural beliefs were critical to treatment outcomes such as controlled drinking versus abstinence and relapse.

“But these results have gone by the wayside in the hypermedicalized 21st century. NIDA’s partial admissions are too little, too late. The agency’s fundamental direction is not changing, any more than the consequent self-defeating addiction beliefs of most Americans.”

With regards to MAT specifically:

“MAT, dispensed as an option for people seeking to navigate drug use in rational ways, can be valuable. But dispensing it as the only viable option for people proposed to be struggling with a disease from which they cannot ever truly escape—certainly not through developing their own skills and resources—is dangerously counterproductive.”