The Globalization of Addiction. A Study in Poverty of the Spirit


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Alexander, Bruce K. (2008) Oxford: Oxford University Press, 470 pp.The Globalization of Addiction. A Study in Poverty of the Spirit is a thought-provoking, provocative treatise on the nature of the relationship between the individual and society. The author, Bruce Alexander, emphasizes the importance of psychosocial integration, “a profound interdependence between individual and society... [that] reconciles people's vital needs for social belonging with their equally vital needs for individual autonomy and achievement” (p. 5). In contrast to the dominant biopsychosocial model of addiction, he purports that “dislocation”, or the enduring absence of psychosocial integration, is necessary and sufficient for the onset of addiction, contending that the global movement toward unregulated, free-market societies results in the “destruction of psychosocial integration” (p. 61).Alexander criticizes contemporary addiction researchers for focusing primarily on substance-related disorders and instead advocates for a broad definition of addiction: “Overwhelming involvement with any pursuit whatsoever that is harmful to the addicted person or society, or to both” (p. 29), including religious or political zealotry, work, gambling, love, power-seeking, video games, Internet, sports, socializing, and pornography. Unfettered advancement of free-markets and its associated dislocation have produced conditions under which addiction “is spinning out of control in the modern world” (p. 326). “Addiction is neither a disease nor a moral failure, but a narrowly focused lifestyle that functions as a meagre (sic) substitute for people who desperately lack psychosocial integration” (p. 62). Given that Westernized free-market societies reportedly engender addiction, it is not surprising that psychosocial and pharmacologic approaches to addiction treatment are devalued in Alexander's approach and societal interventions are favored. The latter include restructuring the mass media, which is viewed as an unalloyed ally of free-markets; increased regulation of electronic games to enhance psychosocial integration; settling indigenous people's land claims; fostering community art; and “reclaiming Christianity.” According to Alexander, “Ever since the American Christian right discovered that Jesus loves the American way of life and hates communism, its flamboyant and highly publicised (sic) actions have reinforced the impression that Christian faith is linked to free-market zealotry” (p. 382).Any reader who has ever taken a Sociology 101 course will likely recognize that Alexander's critique of free-market economics and its purported impact on human behavior is not new and in some ways can be viewed as an offshoot of Anomie Theory. For Emile Durkheim, industrialized Westernized societies promote disruption of the collective social order resulting in anomie (feelings of alienation associated with absence of clear norms) and in extreme cases suicide. Alexander cites a motley cadre of sociologists, anthropologists, political theorists, theologians, philosophers, economists, and historians, among others, as well as field work conducted in Vancouver, Canada (accounts of community activist work and discussions with heroin addicted individuals) to support his dislocation hypothesis. Although these diverse sources provide fascinating reading (e.g., Alexander explores at length St. Augustine's history of addiction prior to his conversion to Christianity) and, in some cases, poignant testimonials, they fall short of offering empirical support for his theory of dislocation. Instead of providing an overview of relevant literature with clearly delineated methods (e.g., systematic review), his choice of cited studies and reviewed literature, as well as the conclusions he draws, are idiosyncratic and not readily testable.Alexander's appraisal of heroin addiction from the perspective of dislocation theory is perhaps the most provocative, and for this critic, the most worrisome part of the book. He downplays the addictive nature of heroin, lambasts its portrayal in the mass media as a “demon drug,” and suggests that current treatments are largely ineffective.

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