Bad Advice Hangover

In a program remarkable for the number of myths and misconceptions about addiction it managed to include in a single broadcast, CNN's medical correspondent Sanjay Gupta interviewed Drew Pinsky, M.D. for the March 5 edition of his House Call show.

Dr. Sanjay Gupta asked Pinsky whether addicts could recover without help from 12-step programs. Pinsky, author of the book, Crack, responded, "I've not seen it. There are certainly behavioral programs, cognitive – something called cognitive behavioral interventions that have been shown to be quite effective. But by far, the most effective is the 12-step program."

In fact, 12-step programs like Alcoholics Anonymous have not been proven superior to cognitive-behavioral treatments: Both methods were statistically equal in the largest study ever done on alcoholism treatment and cognitive-behavioral treatments have been shown to be superior in some other studies.

As the National Institute on Alcohol Abuse and Alcoholism puts it on their web site, "Although AA is generally recognized as an effective mutual help program for recovering alcoholics, not everyone responds to AA's style or message, and other recovery approaches are available. Even people who are helped by AA usually find that AA works best in combination with other forms of treatment, including counseling and medical care."

In a taped segment which, like most of the other recent coverage on this topic, promoted potentially dangerous rapid detox programs without noting their serious risks, Gupta himself then managed to misstate the facts on addiction to painkillers. His voiceover proclaimed, "A federal study shows that 1.5 million of the 30 million patients who use prescription pain relievers in 2002 became dependent."

But the study shows nothing of the kind: it looked at people who abuse painkillers, not pain patients. The vast majority of these abusers either bought the drugs on the street, obtained them from friends or family who were legitimate patients or otherwise illegally acquired them. The statistic offers no information on what percent of legitimate pain patients become hooked on their medications.

Pinsky went on to make other equally unsupportable and unchallenged claims, saying of marijuana, "The fact it is addictive [sic]. And it seems to be an opioid mechanism, very much like heroin." In reality, marijuana affects the brain's cannabinoid receptors, not the opioid receptors. While the drug can lead to addiction in some cases, the percent of marijuana users who become addicts is far smaller than that for heroin users.

There are so many other misstatements, myths and outright errors in the rest of the piece that it's not worth listing them. The bottom line: Pinsky is clearly not an expert on addiction and CNN did its viewers a great disservice by presenting him as one.