As I read Doug Thorburn’s book, Drunks, Drugs & Debits, How to Recognize Addicts and Avoid Financial Abuse, I was struck that this book is really about missed opportunities. Those living and working with addiction miss opportunities to help them by enabling their behaviors and misunderstanding what is unfolding in front of them. Media misses the opportunity, particularly in books and movies, to portray the disease as it truly is, more frequently depicting alcoholism and addiction as something else, or ignoring it all together. Politicians bypass the opportunity to formulate approaches influencing drug demand while throwing money at an endless supply, which appears unstoppable, and the dependent ones miss their whole process while assertively supporting the above misrepresentation of their malady. This book’s main focus is intended to address addiction and financial abuse, but it’s a primer of excellent information that any politician, human service worker, or medical provider would do well to read.

Many of the concepts presented in this book are not new and my sense is that seasoned clinicians may find the information repetitive. The author’s intention, however, is to aim at an audience who will no doubt find new insight here. The author is a tax accountant and financial planner, not an addiction counselor. It certainly makes sense that he writes about finances and addiction, although I feel that he may be limiting his readership by creating this niche.

His presentation of these issues also applies to the broad range of those affected by dependency. The author makes frequent chatty references to personal experiences with addicted others, perhaps a few too many, and shares things people have told me about addicts and alcoholics, but his anecdotes present concepts that are very sound, his suggestions are credible, and he has done his homework.

He starts out discussing the concept of “bottoming out,” stating that his book “was expressly written not only to enlighten others how to identify likely addicts, but also to guide in helping the addict [hit bottom] far earlier than he otherwise might.” He argues at great length about the prevalence of dependent people in the readers’ lives and endlessly describes the horrors one may experience if having the misfortune to connect with one. He also takes on treatment failures illustrating what works and what doesn’t. He states that, “many professionals try to treat the symptoms of the disease, emotional problems, family problems, school problems, rather than the disease itself” going on to suggest that “this is like treating an AIDS patient for weight loss.” He takes issue with public policy, and also urges that the word “abuse” be discarded. He believes that “abuse implies voluntary, willful action, yet it is used to describe much of what is actually addiction grounded in one’s biological make-up. Addiction is not voluntary.” Bravo!

Thorburn does an excellent job of presenting clear signs and symptoms in a variety of ways for the non-addict to identify addictions. He cleverly organizes them in diagnostic styles and checklists that may help significant others clarify and identify dependency. One is “The Thorburn Substance Addiction Recognition Indicator.”

The author states, “we may be able to determine an addict’s temperament by observing the survival games they play,” thus providing an opportunity to predict the sorts of crisis and intervention needed for them to hit their bottom. He also feels that it is important to comprehend and predict deeper levels of the addiction process, which in turn will guide the interventionist in their approach toward helping the addict.

He introduces the reader to the “Myers-Briggs Type Indicator” which, via a series of questions, categorizes one’s personality and temperament into types. When further defined these types offer additional insight into both the addicted and those around them and also are seen as helpful in matching temperament to treatment and recovery. He says, “The style used to work the program (such as A.A.) must be consistent with one’s personal values and core needs, which vary with temperament.”

As a financial advisor his strong point in the book is his analysis and suggestions regarding the financial abuse of others by the addict. These are areas that have not generally entered into this discussion, and his presentations of them are valuable.

The most interesting part of this book may be a section that introduces notable addicted people (such as Adolph Hitler) and how he feels their compulsions influenced the course of events in history. He gives wonderful examples about the plots of books and movies and how addiction issues were treated (or not) in them. I suspect the reader will be heading off to the video and bookstore to stock up.

For the uninitiated it’s a valuable reference with useful suggestions and tools that could possibly make a big difference in lives affected by another’s addiction. For the professional it’s a good psychoeducational reference for use by their clients. This book warrants checking out.

Lindsay Freese, MEd, MAC, LADC, is associate professor of Human Service at the New Hampshire Community Technical College in Concord, NH. Over the past 20 years he has worked in private practice and both clinically and administratively in residential programs. He is a past president of the New Hampshire Alcoholism and Drug Abuse Counselor Association.

Review by Craig Whalley

This book is not easily pigeon-holed. It centers on a critique of public policy issues surrounding drug rehabilitation efforts aimed at “street” addicts, who have no resources to apply to private treatment. But the author, Lonny Shavelson, approaches his subject in such an astonishingly fresh, compassionate and insightful manner that he manages to shatter a number of myths about “Recovery” along the way.

Shavelson, a physician and journalist (and neither a “recovery” professional, nor an academic, nor a reformed addict), spent two years following the often-Kafkaesque journeys of five different addicts (heroin-2, meth-1, crack-1, alcohol-1) as they were dealt with by the network of recovery facilities in San Francisco in the late 1990s, when that city initiated an “open door” policy promising the availability of treatment for all who sought it. He found that the chaos of the addicts’ lives was replicated in the chaos of the rehabilitation system.

In many ways, the author shows, the “System” is designed to weed out those who most need its help. Dual diagnosed? Go to the drug rehab centers and be told treatment is not available to those with severe mental disturbance. Rejected but not despairing, go across town to the mental health center and be told, “Sorry, we can’t help you until you stop taking drugs.” Suffer a relapse? Be kicked out of most programs, as though the ability to NOT use drugs is a pre-condition for admittance to a drug rehab program. Homeless? Conclude your rehab by being placed in a cheap hotel room in the same part of town where drugs dominate life.

But there’s another level to this book. Shavelson gives a voice to people rarely heard from: practicing addicts. What we see is, superficially, what we might expect, a group of screwed-up people. But he persists for a deeper look and allows their humanity to not just be visible, but to shine through unforgettably. What he reveals are people who are fighting as hard as they can to survive even while they appear, to non-addicts, to be destroying their lives. The addicts are burdened by the results of their “choices,” but they also suffer daily from the other realities that haunt their lives. First and foremost is childhood abuse and neglect. Add some poverty, some emotional distress, and a limited ability to establish healthy relationships, plus lots of unresolved anger and a lack of resources upon which they can draw. The result is chaotic lives.

The goal of treatment is, or should be, to bring order, calmness and good mental and physical health in place of this chaos. But more often than not, Shavelson shows, all else is forgotten in the quest for “order.” In fact, the addict himself is often lost, as the “System” demands conformity and rigid adherence to rules and procedures designed to serve the needs of the system itself, rather than the needs of the addict. “Hooked” is, among other things, a classic story of the nature of bureaucracy.

In the end, Shavelson contends, the best hope for these hardcore “street” addicts comes from what seems, at first glance, to be the least likely source: the criminal justice system. Drug courts (a recent innovation), he contends, expect addicts to relapse and are prepared to offer the sort of stern-yet-forgiving guidance that is crucial to long-term success. In fact, the twin poles of “stern-but-forgiving,” and “nurturing and understanding,” he seems to say, are the real sources of treatment success.

One thing missing from “Hooked” (thank God!) is any discussion at all of A.A. It’s mentioned in passing, but it’s clear that the author considers it irrelevant to a serious analysis of the issues surrounding addiction.

Craig Whalley owns and operates The Odyssey Bookshop in Port Angeles, Washington. Prior to becoming a bookseller, he was a reporter at a Seattle-area newspaper. He’s been involved with LifeRing Secular Recovery, and the web site www.unhooked.com, since 1999.

Reprinted with permission of author from the web site www.unhooked.com.

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