ADDICTIONS PREJUDICIALLY MISPERCEIVED
BY JAMA EDITOR WITH (UN)INTENDED CONSEQUENCES FOR ADDICTS IGNORED
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
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
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
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
"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
- 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