Review: Globalization of Addiction by Teodora Groshkova

Bruce Alexander is best known for the 'Park Rat' experiments he conducted in the 1970s, in which drug consumption increased dramatically when laboratory animals were dislocated from their natural group. The present book sets out to draw out the implications of Alexander's research for our understanding of addiction. Generally, the book challenges the construction of addiction as an individual, progressive, relapsing disease caused by drug use that can only be addressed by professional treatment. While this conventional perspective on addiction serves as a useful doctrine in some therapeutic situations, Alexander believes it is too focused on the individual—and is thus failing to cope with the rising flood of mass addiction that is enveloping the modern world.
Extensively researched, drawing on European thinkers from Socrates, Marx and Freud to Erik Erikson and Emile Durkheim, the text impresses with its erudition and ambition. In 15 brilliantly written chapters accompanied with more than 100 end-notes to each chapter—it undertakes a fusion of interdisciplinary views and ideas—to analyse and contextualize a radical reconception of addiction. It is audacious, too, charting the course towards new forms of treatment and global responses to addiction.

Alexander begins his analysis with a focus on the everexpanding meanings of addiction. By contrast with the conventional view, addiction, he argues, does not begin with a single drug, but rather with a whole range of 'overwhelming' and harmful involvements 'with any pursuit whatsoever . . . gambling, love, power-seeking, religious or political zeal, work, dysfunctional relationships' and much more. He goes on to assert that all these addictions, that may otherwise be called 'obsessions' or 'compulsions', can seize every aspect of a person's life: 'conscious, unconscious, intellectual, emotional, behavioural, social and spiritual—just as severe drug and alcohol addiction can.'

Conceptualized in these wider terms, addiction is then mapped in the wider culture. An intriguing historical and cultural journey takes the reader to meet all sorts of Alexander's addicts and hear their stories: St Augustine, confessing his enslavement to sex and love and revealing the 'inner void' that lust and women filled and the 'short-term joy' that they gave; the author of Peter Pan—James Barrie—talking about his 'overwhelming involvement with work' and experience of 'sexual passion' for writing. Jumping across cultures and geographical locations, the read is at times confusing and puzzling. These pictures of extended addictions, however, function all too well to illustrate the enduring anguish of all sorts of human desires, dysfunctional attachments and appetitive behaviours—across civilizations and beyond temporal boundaries. A more important implication of the extended addiction concept is that it clearly points out the total incongruity of the notion of chemical or pharmacological determinism promoted by academic medicine and treatment. It is also an invitation for a serious reconsideration of the popular argument and push for prohibition and criminalization of certain addictions, and not others— however costly and devastating.

In later chapters Alexander's fundamental thesis becomes evident: addiction, he argues, is an individual and social response to 'dislocation'. Dislocation, in this view of addiction, may imply geographical separation, but is certainly not limited to it. Alexander goes on to describe dislocation in social terms, but argues that it has crucial psychological aspects too, including the disconnection of people from their identities, feelings of personal power, overall sense of wellbeing and sense of spirituality. The social circumstances that spread addiction in a conquered tribe or a falling civilization are also built into today's globalizing free-market society. However, an important point for Alexander is that it would be too schematic to blame capitalism itself and he is clear that the fundamental problem of dislocation can equally be generated by any other economic or political system.

For Alexander, if addiction is a desperate attempt to 'get a life' while struggling to experience membership in a socially acceptable community that sustains one's wellbeing and identity, the 'antidote' is the generation of communities of recovery where individuals' psychosocial integration can be restored. This is an inspiring social project—at a global level—to reshape society and empower people to experience a sense of identity, belonging and meaning in everyday life. Equally interesting is what discussion Alexander has postponed—where the limits to the dislocation theory lie and how certain dislocated individuals manage to restore and maintain high self-esteem, new identity and to reconstruct social stability, whereas others lose hope and go on ensnared in dysfunctional life-styles. I might be naive to believe that © 2010 The Author, Addiction © 2010 Society for the Study of Addiction Addiction

books can change the direction of the addiction field; but when the field begins to change, it searches for different books. The Globalisation of Addiction is definitely one such book.

TEODORA GROSHKOVA
National Addiction Centre, Institute of Psychiatry, King's College, London, UK