Power, Powerlessness and Addiction

277 Pages·2013·0.61 MB·English

by  Jim Orford

POWER, POWERLESSNESS
AND ADDICTION
Addictionexercisesenormouspoweroverallthosewhoaretouchedby
it.Thisbookarguesthatpowerandpowerlessnesshavebeenneglected
in addiction studies and that they are a unifying theme that brings
togetherdifferentareasofresearchfromthefield,includingthedis-
empowering nature of addiction; effects on family, community and
theworkplace;epidemiologicalandethnographicwork;studiesofthe
legalandillegalsupply;andtheoriesoftreatmentandchange.Exam-
plesofalcohol,drugandgamblingaddictionareusedtodiscussthe
evidencethataddictionismostdisempoweringwheresocialresources
to resist it are weakest; the ways in which the dominant discourses
aboutaddictivebehaviourencouragetheattributingofresponsibility
for addiction to individuals and divert attention from the powerful
whobenefitfromaddiction;andthewaysinwhichthevoicesofthose
whoseinterestsareleastwellservedbyaddictionaresilenced.
jim orford is Emeritus Professor of Clinical and Community
PsychologyattheUniversityofBirmingham.Jimisalong-standing
researcherandwriterintheaddictionfield.Amongsthisprevious
booksaresuccessfultitlesonaddiction,notablyExcessiveAppetites:A
PsychologicalViewofAddictions(stedition,;ndedition,);
as well as others on community psychology, including Community
Psychology: Challenges, Controversies and Emerging Consensus ().
HeisoneoftheUK’sleadingaddictionresearchersandhasaninterna-
tionalreputation.Inhewasawardedtheprestigiousinternational
E.M. Jellinek Award for his contribution to alcohol and addiction
studies.
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POWER, POWERLESSNESS
AND ADDICTION
JIM ORFORD
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Includesbibliographicalreferencesandindex.
isbn----(hardback)
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IdedicatethisbooktothememoryofProfessorGriffithEdwards,who
diedinSeptember2012asthebookwasjustabouttogointo
production.IwouldhavelikedhimtoreaditandIwould
havebeenanxioustoknowhisopinion.Hewasthesingle
personofgreatestsignificanceinmycareerandwasan
inspirationtomeastosomanyothers.
Hewasagiantintheaddictionfield.
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Contents
Preface pageix
Acknowledgements xv
 Powerfulconnections:threeexamplesofaddiction 
 Howaddictionerodesfreeagency 
 Addictionsubordinatestheinterestsoffamilymembers
andfriends 
 Inequalityinthepowertoresistaddiction 
 Powerandpowerlessnessintheaddictionsupplyindustries 
 Reassertingcontrolandpowerintheprocessofchange
andtreatment 
 Facinguptothepowerofaddictionandthosewhobenefit
fromit 
References 
Index 
vii
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Preface
Thisbookisexploratory.Thereisnosinglebodyofknowledgecorrespond-
ing to power, powerlessness and addiction; I have had to make it up as I
went along. The idea for this book merges two streams of thought which
havedominatedmycareerinpsychology.Oneofthoseisaddictionstudies
wherepowerisscarcelyeverexplicitlyreferredto.Theotheriscommunity
psychology,forwhichpowerandpowerlessnessarecentralconcepts.Writ-
ingthisbookhas,therefore,servedapersonalpurposeinunitingthetwo
halvesofmyprofessionallifewhichmightotherwiseremaindisconnected.
I might go further and argue that in order to explore the relationship
between power and addiction it is necessary to bring together theory and
research arising from different scientific traditions: on the one hand the
biomedical,publichealthandepidemiologicalandontheotherthesocial
sciences. The former have dominated addiction studies while the latter
have played a much lesser role. One feature of my earlier book on addic-
tion, Excessive Appetites (Orford ), which left me dissatisfied was its
emphasis on the individual and its relative lack of attention to the social.
Thepresentbookisapartialattempttoputthatright.
Althoughpowerisrarelymentionedwhenaddictionisdiscussed,ithad
longoccurredtomethatpowerandpowerlessnesswereneverfarbelowthe
surfaceand,onceyouwerelookingforthem,theyoftenappeared.Thevery
concept of dependence, often used as a synonym for addiction, implies a
lossofpower.Indeed,acknowledgingone’spowerlessnessisconsideredby
Alcoholics Anonymous and other -step groups to be a requirement for
recovery.Theexperienceoffamilymembersandotherscloselyaffectedby
otherpeople’saddictions–somethingthatmycolleaguesandIhavemadea
specialstudyof–canwellbethoughtofasanexperienceofpowerlessness.
Once the focus moves beyond the individual and the family to consider
thecomplexnetworkofconnectionsinvolvedinthesupply,legalorillicit,
of substances and activities to which people become addicted, then the
exercise of power and the creation and exploitation of the powerless are
ix
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x Preface
impossible to avoid. All those manifestations of power, overt or hidden,
malignantorbenign,andothers,arediscussedinthechapterswhichfollow.
Indefenceoftheword‘addiction’
Terminology in this field is itself controversial. I use the common term
‘addiction’throughoutthisbookalthoughItrytoavoidasmuchaspossi-
bleusingtermsappliedtoindividualpeople,suchas‘addict’or‘alcoholic’,
labelswhichhavebeenassociatedwithstigmaandwhichcancarrypejora-
tiveconnotations.Ihavealsotriedtoavoidanumberoftermswhichhave
become popular in official circles and which appear to be less pejorative
butwhichinfactservetoreinforcethefocusofresponsibilityforaddiction
ontotheindividualwhoexperiencesitatfirsthand,intheprocessshifting
thefocusofresponsibilityawayfromeveryoneelsewhoisconnectedwith
addictioninsomeway.Theexpressions‘drugmisuse(r)’and‘drugabuse(r)’
aresuchterms.Similarintheirimplicationsarethenow-populartermssuch
as‘sensibledrinking’and‘responsiblegambling’withtheirclearlyimplied
opposites – drinking which is not sensible and irresponsible gambling.
Other terms such as ‘drug dependence’, ‘problem drinking’ or ‘excessive
appetites’, are alternatives, each with their own slightly different take on
the matter. In this book I fall back on the word ‘addiction’ because it is
onethatisbothinwidepublicuseandiscommoncurrencyintheexpert
literatureonthesubjectaswell.Formypurposesitisalsoagoodvehiclefor
introducingthethemeofpowerandpowerlessness,asIhopewillbecome
clear later. ‘Addiction’ does, however, carry a number of dangers. It can
easilybetakentoimplyadefinableillness,distinctivelydifferentfromnor-
malexperience,andmostlikelyexplicableultimatelyintermsofbiological
vulnerability,probablyinvolvingsomegeneticpredispositionandpossibly
brainabnormalities.Inmyviewtheoppositeofallthoseistrue.Addiction
is best thought of as a process; at any one time it is represented in the
populationintermsofacontinuum(severalcontinuainfact),withmany
morepeoplemildlyormoderatelyaddictedthanseverelyso;anditscauses
are legion, probably involving many genes which interact with numerous
environmental factors in complex ways which vary by time and place. I
hopeitwillnotbethoughtthat,byusingtheexpression‘addiction’,Iam
tryingtoover-simplifywhatisinfactaverycomplicatedsubject.
I need also to make a point about the diversity of addiction and to
explain why I have concentrated on three forms of addiction, to alcohol,
drugs and gambling. They constitute, for me, the ‘big three’, with many
features in common. Each involves an activity which is indulged in, or
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