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A Doctor Confronts His Addiction
by Peter Grinspoon
Hachette Audio, 2016
Review by Christian Perring
Jul 19th 2016 (Volume 20, Issue 29)

Peter Grinspooon recounts the story of his prosecution for misusing his doctor privileges to get himself drugs, and his road to both recovery and gaining back his license to practice medicine. He sets out the details of his past, his deteriorating marriage, and his relationship with his young children. It's a complex story because there are many different elements. His father was a famous psychiatrist who advocated for the use of marijuana as a form of pain control, and his parents led a somewhat bohemian life, often smoking pot at home with friends. Grinspoon had three brothers, one a twin. His elder brother had cancer and died with Peter was 7 years old. All through the book, Grinspoon tells the story of his childhood and some experiences he had as an adult, from his college days to his time working for Greenpeace and then medical school and his early practice. He looks at his history of drug use since he was 12 and his growing dependence on it. He grew up in a culturally Jewish house and was an atheist, and this posed a problem for him in the many twelve step treatments he was compelled to participate in.  The medical authorities came down on him hard and then even harder when he relapsed in his drug use. But their reaction was mild in comparison with that of his wife, who does not come out well in his depiction. "H" is perpetually angry with him and punishes him for his addiction and relapses. While she had a job, it paid nothing like as much as his medical job, and focused on superficial signs of wealth, constantly shopping. Even though they had enough savings to get through the years during which Grinspoon's medical license was suspended, because he had worked so much previously, she constantly threatened him with divorce, and not surprisingly, their marriage didn't survive. But even though this was a terrible blow and also difficult for his children, Grinspoon eventually goes on to recover and flourish, speaking for doctors who have had addiction issues.

Much of Grinspoon's reservations about twelve step plans are familiar: an over-reliance on catch-phrases and religious ideas that have no medical backing. More informative is Grinspoon's experience of how the medical profession's attitude towards addiction. He points out that doctors have a very high recovery rate from addiction, at around 80 or 90%, and attributes this mainly to their ability to pay for the best treatment options and their very strong motivation to be able return to their professional life and regain their incomes. He argues that paradoxically, the medical profession takes a punitive approach rather than treating addiction as an illness.  He also says that doctors who have broken the rules are put in a difficult position: the more they confess, the more trouble they are in, but if they withhold any information and get found out, the results are even worse. The decisions of governing bodies are unpredictable and often arbitrary. Yet doctors still do better than most other populations, and that suggests that there could be great improvements in addiction treatment for everyone. So Grinspoon has an interesting perspective that goes beyond the usual addiction memoir of growing dependence in a cycle of emotional problems, strained and broken family relationships, and a haphazard journey leading eventually to recovery.

While Grinspoon confesses a lot of his problems and failings, he also has a good deal of ego and indignation about the failings of others. He is a liberal who has been involved in many protests in the past.  The book is initially off-putting but it is worth sticking with the story, even if that means skipping forward to the more interesting parts. The unabridged audiobook is performed by Kiff VandenHeuvel and whose performance is a little heavy handed, but is lively and consistent in his tone.

 

© 2016 Christian Perring

 

Christian Perring lives in New York. He likes hiking.


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