Fergie Chooses her Own Journey

Is addiction a disease or is it a choice? I believe it is a problem of choice, really a disorder of choice or a mis-perceived set of choices. It is widely known that Stacy Ann Furguson, frontwoman for the Black Eyed Peas music group has a history of addiction to methamphetamine. She has said so herself in interviews. She has chosen to stop using the stimulant and has not returned to it for years now.

Can this be true? Can a person who suffered with one of the most addicting substances have not only put it aside but also drink a glass of wine from time to time? Apparently, yes. She would not be the first, nor will she be the last, to have met critera for substance dependence and yet move on from that wretched state to freedom form that drug. In the recovery community she is a unicorn. Here is an excerpt from a recent  Glamour interview of Grammy-winning singer and actor Fergie.

KATIE COURIC: Let me ask more about body image. What would you say to young women who are filled with self-loathing? I read a scary statistic recently that said only 2 percent of women like how they look.

FERGIE: It’s become actually the norm, I feel. And it’s really sad. The thing that I can say is, you’re not alone. [And if] you start making the right choices for yourself, all of a sudden you start feeling better and better. You’d be surprised how addicting high self-esteem is.

KATIE COURIC: You’ve often talked about your recovery from crystal meth addiction. Is staying sober a conscious act for you every single day?

FERGIE: Well, I’m not claiming to be sober. I think that that would be misleading. I drink alcohol. My father has a vineyard, and [the wine is] really delicious, by the way.

KATIE COURIC: Send me a bottle.

FERGIE: I will. Anyway, for most addicts, they would advise never to have any sort of substance. I just have my own journey, and I am very blessed to this day to be alive.

Ask the next ten people you meet in recovery who have stopped using drugs and/or alcohol for a considerable period and they will tell you that cross-addiction is so likely that they dare not touch a drop of alcohol. In the case of Ms. Ferguson, she has found another path. In 1985 the Rand Institute (1) study on alcoholism found up to 18% of people with a prior history of alcoholism reported a return to successful controlled drinking. Pertinent to Ms. Ferguson’s clinical course, being female and employed were positively correlated with drinking alcohol again without problems.

Even the reference text of the Alcoholics Anonymous makes it clear that there are several different categories of alcoholics. They refer to the heavy drinker as a certain variety and even suggest that if you are not sure that you drink alcohol to find out. On page 31 of the “big book” of Alcoholics Anonymous it states:

If anyone who is showing the inability to control his drinking can do the right about-face and drink like a gentleman, our hats are off to him.

The founders of the recovery movement knew that one size does not fit all drinkers. There is a dearth of research on the relationship between methamphetamine use and the return to social drinking. Dr. DuPont and colleagues in Washington D.C. found that heroin addicts usually reported a history of alcohol problems prior to beginning heroin use. They found that their drinking did not worsen when they underwent treatment for their illicit drug use.

What if we get it wrong? Ambrogne (2) and colleagues in 2002 found that when two patient groups were randomized to abstinence or non-abstinence as a goal the non-abstinent group generally switched to the abstinent path. They conclude that people need to collect their own data for their own experience. This is not to suggest that people should switch to alcohol if they have recently quit using drugs, by no means. It does lend support to this idea that Fergie puts forth regarding “her own journey.”

So which it is? Once a person receives the diagnosis of “addict” or “alcoholic” must they remain abstinent for the rest of their lives? The truth is that science cannot answer that question just yet. There are very interesting efforts aimed at neuroimaging and even genetic diagnostics. For now at least, the diagnosis can only be made by the individual with the problem. A room full of specialists cannot convince you not to drink if you believe you can. Similarly, only your behavior in response to alcohol will tell the truth about your ability to be a social-drinker. What do you think?

References:

1) Polich JM, Armor DJ, Braiker HB. The course of alcoholism: four years after treatment. New York: Wiley; 1981.

2) Ambrogne JA. Reduced drinking as a treatment goal: what clinicians need to know. J Subst Abuse Treat 2002;22:45–53.

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Category: Current Events, Drugs, Neuroscience

About the Author: Dr. Jason Giles is certified by the American Board of Addiction Medicine and the American Board of Anesthesiology. He is a physician specializing in the treatment of drug, alcohol, and behavioral addictions. He is the founder of Haywire.


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