Last week I received an e-mail from The Journal of the American Medical Association (JAMA) informing me they were considering publishing a letter to the editor I had submitted. They asked me to call if I had questions, so I did. I spoke to an assistant editor about some of my concerns which were redirected to an editor, Dr. Richard Glass, who was busy but would return my call.

When he called me back, I began to express my concerns with two of their published articles¹, one by Alan Leshner, 10/99, and one funded by his department at the NIDA, 11/00 on smoking causing agoraphobia. I have discussed both of these articles on this web site in other articles so I won't repeat the discussions.

I expressed my opinion to this editor that both articles were invalid scientifically, should never have been published and in that they were published, they would lead to (un)intended negative consequences for addicts, a major concern of mine. He asked me to hold on while he got copies of the articles. When he returned he asked me for my specific complaints about the articles.

I began with Leshner's article about the science based treatment of addictions in office medical practice. First, I noted Leshner wasn't a physician, just a psychologist, so how could he teach physicians about treatment of addictions, and secondly, his paradigm of drug addictions was wrong, so his treatment recommendations were consequently wrong and misleading as well? Glass wasn't bothered by this and casually asked, "Which part of his paradigm was wrong?"

I said, "The very first sentence of his paradigm, 'the first use of the drug is voluntary,' is wrong and unproven by any science, yet is the key to his whole incorrect paradigm and all mistakes and faulty conclusions and recommendations that follow from it. Where was your peer review? And, how did they allow that unproven remark to pass their scrutiny?"

He replied, "Really? But I agree with it. We keep the peer review secret by the way."

I was taken aback by that remark, but realized it was true and that he believed that as an editor for a medical science journal, his personal beliefs and those of his peer reviewers were seen as tantamount to proven science and that my queries about this review process was seen as disrespectful and discourteous.

So, I asked him again, "How has that stipulation, that the first use of the drug is voluntary, been proven scientifically? What difference does it make if you agree with it? Your agreeing with it doesn't make it correct or proven. What if it is wrong? Couldn't that possibly lead to doctors treating addicts and public policies about addicts and addictions to be wrong and hurtful?"

He replied, "How could it be otherwise? How could it be involuntary?"

I said, "You didn't answer my question."

Whereupon he replied, "No, because it's not wrong." Of course, he still didn't tell me where and how it was proven right.

We then got into a conversation about other human behaviors where volition is questionable even when it may only seem to be volitional (misperceived as volitional) such as homosexuality, heterosexuality, various eating behaviors, normal and distorted, and even something as simple as breathing. "Aren't there gradations of volition among these behaviors from total volition to total nonvolition depending on various factors from environmental stimuli to availability to neurobiology and unconscious biological forces?" "No," he replied, "not at all. They're all volitional."

"You can't conceive of any behaviors in these groups of behaviors that could possibly be involuntary, caused by unconscious and uncontrollable neurobiological forces?" I queried. "How about a eunuch's lack of sexuality? Is that voluntary, a choice? Isn't it possible that in some people, people with particular in-born neurobiology that inexorably leads to genetic addiction to drugs, the first use of the drug is involuntary? How is it possible for addictions to be so highly genetic and voluntary at the same time? Isn't it possible for some underlying neurobiology to be as powerful a motivator as that of the eunuchs in determining behavior? And besides, if his complete hypothesis, the Hijacked Brain Hypothesis, is correct, as you say, why doesn't everyone who uses addictive drugs get addicted. And, how does this hypothesis explain the behavioral addictions where there is no drug ingested to hijack someone's brain as a cause of the addiction?"

At that point, and without answering, he got short with me and said he had another phone call waiting and that he had to go. When I asked him to call me back to continue the conversation, he said, "I don't think that would be productive," and hung up abruptly.

The point here isn't whether or not this editor believes something, but when publishing it in his journal he sees to it that it is peer reviewed objectively and when questionable remarks are made in an article, the article isn't published under the trusted approval of his journal's reputation. His job, obligation, and responsibility is to ensure the integrity of this process because the readers don't all have the expertise and skills necessary to differentiate truth from lies, valid from invalid.

One of the reasons the field of addictionology is such a mess is that instead of science and the scientific method being the criteria for publication of articles, it is rather the personal biases of the editors and their opinions of where these articles originate that are used to make these decisions. Dr. Glass believes he understands addictions and makes his publication decisions based on this belief rather than the validity of the articles. I can't think of another area of real medicine, discounting most of psychiatry from this categorization, where bias and personal opinion has overruled scientific validity the decision-making on journal publications than in addictionology. Thus, addictionology is a disgrace and a sham that needs to be publicly exposed so the public can know it has been intentionally and prejudicially scammed and to ensure valid addictionology science in the future and reevaluate past invalid addictionology as a much needed corrective measure. If and when this happens will determine when we arrive at a valid paradigm on addictions that can begin to help the victims of the disease rather than the treaters and the controllers of these victims.

1. Science-Based Views of Drug Addiction and Its Treatment. Alan I. Leshner; JAMA; Vol. 282 No. 14, October 13, 1999, and, Association Between Cigarette Smoking and Anxiety Disorders During Adolescence and Early Adulthood. Jeffrey G. Johnson; Patricia Cohen; Daniel S. Pine; Donald F. Klein; Stephanie Kasen; Judith S. Brook; JAMA. 2000;284:2348-2351