The New Nature of Facebook

Comprehensive Assessment Project: Addiction is a Disease Community Facebook Page
Robert Shane Haas Page 1
The New Nature of Facebook:
An Inappropriate Platform for Serious Issues
Robert Shane Haas
Comprehensive Assessment Project
Brent Henze, Ph.D., Donna Kain, Ph.D., & Matthew Cox, Ph.D.
11 December 2014

Part I: Background and Platform
Background
An individual very close to me is a recovering addict with a little over 12 years clean from all
mind or mood-altering drugs (her name is not provided for reasons of anonymity). In an
exceptionally candid conversation with her, she told me when active addiction took hold and
became progressively worse, she began to think she was defective in some way, either morally,
spiritually, emotionally, physically, or all of the above. She thought she was weak-willed, a bad
person, a coward and a hopeless failure. Why can’t I stop? she asked herself repeatedly. She said
she tried everything: psychiatry, medicine, yoga, “white-knuckling,” the “geographical cure,”
dating “good guys,” just drinking and no “hard” drugs …the list could go on. “Once,” she said, “I
even stopped by a roadside tent revival meeting on the way home from work when I was about
19. I walked right down the aisle and told the preacher that I couldn’t stop using drugs. He put his
hand on my head and shouted all kind of prayers into the microphone, and the congregation put
their hands on me as I walked back out of the tent. I went right home and got drunk as a dog.”
However,when she finally arrived in drug treatment in 2002, the people there told her that what
she has is a disease, not a moral dilemma. They also said this disease could be arrested and she
could live a happy and healthy life if she so choose. But although the medical director of the
facility, an addictionologist, thoroughly explained the disease model of addiction to her via
population histories, charts, graphs, statistics, etc., she wasn’t completely sold; she still thought of
herself as a moral failure. There were a number of factors that contributed to this belief, such as
low self-esteem,shame, remorse,demoralization, and degradation; however, most (if not all) of
those feelings stemmed from the social stigmas and misconceptions associated with drug use and
the diseases concept of addiction.
Because of these misconceptions, the disease model of addiction is highly controversial. There
are many who claim that addiction is a choice, although there is an overwhelming amount of
scientific data that proves the contrary, some of which I have listed in my annotated reference list.
Additionally, there is very little scientific data that supports the “choice” model. Indeed, I
couldn’t find one scholarly journal article that supported this view, other than a few short
opinion-based pieces. That being said, there are a numerous books and newspaper articles that do
support this view, a few of which I have also included.
Why Facebook?
I chose Facebook as the medium for this project for a number of reasons: 1) there seemed to be an
absence of information on Facebook, by far the most popular social media site in the world; 2) the
multimodality aspect of Facebook, or the ability to use numerous forms of communication and
accommodation beyond the written word; 3) to function as a public sphere, which offers
interaction and public deliberation; and 4) to reach as many addicts, family members of addicts,
and the general public as possible through promotion and distribution. Yet the overarching,
fundamental purpose was to bring help, hope, and information to those who need it.
The individual’s background information in the previous section sufficiently explains my motives
for addressing and hopefully clearing up some of the misconceptions surrounding the disease
model of addiction: chiefly, my close relationship with her has given me intimate knowledge of
this disease and its effects; and moreover, I have witnessed her being misdiagnosed and
misunderstood due to these skewed misconceptions, and repeatedly branded with the negative
stereotypes associated with it for her entire adolescent and adult life.
Thus the primary purpose of my Facebook page, “Addiction is a Disease,” was/is to clear up as
many of these misconceptions as I can, utilizing all of the resources available to me. And given
the criticality of this disease, when I began this project in the fall semester of 2013, I felt the best

accommodation mode or platform for this purpose would be Facebook, the reasons for which I
explain in more detail below. I felt that for my target audience, which is addicts and families of
addicts, and for the general public or laity, translating, communicating, and/or accommodating
some of the scientific data about the disease required something easier to grasp; I thought that
using the Facebook platform could provide visual, audio and interactive qualities that an article or
pamphlet couldn’t provide, given the confines of the written word. In short, my theory was that
limiting my communication mode would limit my audience. And for the most part, my Facebook
page still has a much greater propensity for reaching my target audience than any single article,
essay,or pamphlet ever could. However,it did not “take off” as I thought it would. More will be
discussed on that subject later.
Some of the main theories I used for justifying the social media platform were from an article by
Jeanne Fahnestock (1998), entitled “Accommodating Science: The Rhetorical Life of Scientific
Facts.” The first is stasis theory,what Fahnestock calls “a neglected component of rhetorical
invention,” allegedly developed by second century B.C. rhetorician Hermagoras of Temnos, and
later explicated by Cicero in his De Inventione and De Oratore. “Concerned primarily with legal
argument,” she goes on, “stasis theory defines and orders the kinds of questions that can be at
issue in a criminal case” (p. 344). However,I found it to be an extremely good fit with my subject
matter and target audience. Basically stasis theory is defined as follows:
It is a practical system of ordered questions … accounting for the ways issues naturally
develop in public forums. People inevitably have to be convinced that a situation exists
before they ask what caused it or move to decisions about whether the situation is good or
bad and what should be done about it and by whom. (p. 345)
First stasis: Does a thing exist? Did an event or effect really occur?
Second stasis: What is its nature or definition?
Third stasis: What value should be placed on it?
Fourth stasis: What action is called for, and by whom?
Using the first stasis, one of the first posts on the Facebook page (November 27, 2013) was a link
to an article entitled “Is addiction truly a disease?” On the same day, I immediately followed that
article with a post listing two definitions of the disease of addiction from experts in the field of
addictionology. One could say this was my “evidence and definitions of key terms” from my
sources (p. 345), or natural movement to the second stasis. Then, over the rest of the month of
December 2013, I posted various articles and links that address why is this disease concept
valuable—the third stasis. These types of articles examined the consequences involved when
stereotypes and stigmas are attached to certain people and circumstances, including deaths and
overdoses, when the disease model would have provided a way out and possibly saved lives.
According to Fahnestock, for the fourth stasis my target audience would then move the
information back into higher stases,such as “Why is this happening?” and “Is this good news or
bad news?” before arriving back at the final stasis, or “what should be done about it.” In this vein,
I have recently posted a link that takes users to a “treatment center locator” that will help them
find available help in their area quickly and easily.
At the very least, I thought these types of questions would be a good segue into offering some
strong solutions or at least having a bit of healthy debate with my audience. The problem, as I
have alluded to, was that not many people were actually seeing the posts on their newsfeed,and
even less people commented on any of them. For example, the first post on the page, ironically,
was a video of an interview with Robin Williams talking about addiction. Although “52 people
[were] reached,” no one liked or commented on it. The same thing happened for the second post.
I then paid for the third post to be “boosted,” which reached 699 people, yet I only received four
likes and no comments. Explanations of this and more will follow.

Another reason I chose Facebook stems from a chapter I read in a dissertation by Dr. Caroline
Dadas (2011). In this chapter Dadas examines two YouTube channels as well as two Facebook
pages, all dealing with marriage equality. However,what is relevant here are the rhetorical
qualities that Dadas points out in her research:“Today’s communication increasingly turns to
visual literacies as a primary way of making meaning” (p. 2), she states; and also that although “it
is tempting to view multimodality merely as a fun alternative to composing with alphabetic text. .
. . I see multimodality serving an important function: offering citizens a broader range of options
for engaging in a public” (p. 34). I can post images, links to websites, YouTube or other videos,
podcasts, online newspaper articles, in addition to scholarly journal articles. Besides, in
accommodating science for the laity, scholarly journals may be too complex for my readers to
grasp. Further, my target audience is addicts and families of addicts, and most of these individuals
are in dire circumstances. They will be looking for a quick solution out of the extreme pain that
they’re in, and will quickly tire of reading journal articles, if they read them at all. There aren’t
any quick fixes to addiction, of course; yet individuals in the throes of active addiction are
looking for relief and they want it yesterday. Thus my Facebook page will provide quick and easy
navigation to multiple avenues where these individuals can at least begin to find solutions, which
subsequently provides hope—a very important factor to someone who has been hopeless for
years,decades,or a lifetime.
The interactive quality is another reason in choosing a Facebook page. As I’ve said, the audience
for this project isn’t solely for addicts and their families; it is also the public in generalor the
laity. Thus I would like my page to not only to serve a purpose but to function as a public sphere
as well. “One concept endemic to public spheres is debate,” states Dadas (p. 8), and goes on to
discuss the importance of deliberative democracy:
Public deliberation leads to better and more just political decisions only if there is equal
access on the part of people with genuinely different points of view, the opportunity to
make arguments … the time for exploration of different options, and a cultural milieu
that values listening. (p. 10)
This means inviting healthy debate on the disease concept instead of excluding those who don’t
happen to agree with me. If I don’t invite discourse with those who disagree, then I’m essentially
no better than those who zealously claim that addiction is a choice. Instead, I need to back up my
arguments with reliable sources and do my best to listen to their side, which will require
compassion, patience, and empathy. However,I must also attempt to persuade through
information and education, which will require utilizing the eight values of ethical conduct:
balance, judgment, attention to standpoint, fairness, thoroughness, criticality, intellectual
generosity, openness.
I believe this deliberative democracy aligns with Fahnestock’s deliberative genre:what she states
as “the reason for reporting” something and “the point of making” my observations and “its place
in an ongoing debate” (p. 333). The reason for reporting that addiction is a disease is simple:
suffering addicts (and their families) need help, and as long as they believe that it’s a moral
deficiency or weakness,the ends are always the same—jails, institutions, or death. And its place
in the ongoing debate is its tremendous criticality to those affected by the disease.
Dadas also points out the significance of distribution and circulation:
Distribution refers to the initial decision about how you package a message in order to
send it to its intended audience; circulation refers to the potential for that message to have
a document life of its own and be redistributed without your direct intervention. (p. 22)
These two elements are very important to my project, and recalls Fahnestock’s epideictic genre:
“[adjusting] new information to an audience’s already held values and assumptions” (p. 334), or
how I “package the message” to my intended audience. Successful adaptation or accommodating
the information I have found in my sources (primary, secondary, SMEs, artifacts, examples) is

part of why I chose a Facebook page to begin with; employing multiple forms of communication
from these sources (links, videos, podcasts, images, etc.) creates greater potential for reaching a
wider audience and for visitors’/readers’ comprehension.
Distribution in this communication mode can be accomplished in a couple of ways. The first way
was to pick a title with appropriate keywords that would show up in the Facebook search bar. My
title, “Addiction is a Disease,” pops up first when users type in the terms addiction or disease,
I’m guessing because my page has by far the most number of “likes.” Currently there are two
other community pages with the exact same name as mine, and one closed group with the same
name. However,the highest number of “likes” for these is 34 and the lowest 14. Two other
groups have “Addiction is a Disease” in their titles; one is a public page called “Addiction and
Alcoholism is a Disease,” a page with Christian overtones and 101 “likes,” the second is
“Addiction is A Disease That We Can Overcome Together 2.0,” a closed group with 75 members.
Finally is “The Disease Model of Addiction.” Forty-eight people liked this page, and the text and
information on it is copied and pasted straight from Wikipedia. Additionally, it wasn’t created by
an individual. The following sentence is on the page: “This page is automatically generated based
on what Facebook users are interested in, and not affiliated with or endorsed by anyone
associated with the topic.”
I was a bit astonished that I didn’t find any more about the disease of addiction than I did on
Facebook, which is by far the most popular social media site on the planet. As of 2012, there
were over one billion Facebook users, which is roughly one-sixth of the world’s population. Thus
I thought that massive number of users, coupled with the exceptionally poor showing of related
pages, would make it a perfect platform for the type of rhetorical argument that I wanted to make
and the issues I wanted to address: I initially thought my page had the potential to reach hundreds
of thousands of suffering addicts and their families, if not millions. Yet again, I wasn’t aware of
the algorithm changes implemented a month before my page launch. And to be fair, Facebook
didn’t advertise these changes nor did they inform their stakeholders. I will explore these matters
further later.
The second method of distribution I conducted was inviting my Facebook friends and/or those I
deemed subject matter experts (SME) to “like” the page and get involved. But that meant more
than just sending out a mass “please like my page” bulletin on Facebook. It also meant having
face-to-face interactions with SMEs that I know in the field: addictionologists, psychologists,
counselors, and physicians, as well as friends of mine who are addicts, which I did. Most if not all
of these people have liked the page, and a few have continued to like or comment on certain posts
here or there,but once more, I don’t think they have seen most of the posts in their newsfeed due
to the new algorithms Facebook has implemented regarding organic reach.
Also, in the interest of initiating healthy debate, I also invited those who perhaps know very little
about the disease in addition to those in the addiction field. This was the non-addicted, the
uninformed, or the laity—the portion of my audience that was more likely to have
misconceptions or stigmas and needed persuasive information and education. This is precisely
where the wonder and application appeals Fahnestock mentions (p. 333) served best: the
“wonders” aren’t just startling facts related to the disease,such as mortality rates and the cunning,
baffling and powerful attributes that come with it; it is also the overwhelming amount of evidence
that proves addiction is a disease. This informational “wow”-type appeal served as a stimulus for
this portion of my audience to recommend the page to others, which they did. As for the
application appeal, if any visitors to the page happen to find help or are persuaded to see
addiction as a disease, there are many practical benefits, such as arresting the disease and finding
recovery, which subsequently improves the addict’s physical, emotional, spiritual, and mental
health, and also increases their employability and overall ability to be a responsible member of
society, which not only affects addicts and their families, but society at large and humankind.

Hopefully, though, all of my intended audience—addicts, family members, SMEs, friends,
friends of friends, and the uninformed—will continue to recommend the page, giving it what
Dadas calls the “life of its own” and redistribution that will multiply exponentially without my
direct intervention.
My research also makes a deontological argument,which Fahnestock defines as “attempts to
praise or excoriate something by attaching it to a category that has a recognized value for an
audience” (p. 334). Most of my sources praise the disease concept and denounce the choice/moral
deficiency view by attaching addiction to other similar brain disorder diseases. As for the
teleological argument,or “[claiming] that something has value because it leads to further
benefits,” my data show that the disease model for addiction is exceptionally valuable; the
benefits of this concept are literally the difference between life and death.
Fahnestock also borrows from a taxonomy of statement types suggested by sociologists Bruno
Latour and Stephen Woolgar in their discussion of scientific discourse. According to Latour and
Woolgar, there are five types of statements that are ranked according to the degree of certainty
they convey:
Type 5: the most certain; asserts the sort of knowledge that seems self-evident to insiders,
knowledge that only surfaces when an outsider’s questions force the exposure of
presupposed information.
Type 4: consists of uncontroversial information that is nevertheless made explicit; expressed
certainties.
Type 3: usually has a citation of a numbered reference or source following an assertion, which
slightly weakens the certainty of a claim because it suggests the need for backing.
Type 2: the need for qualifications is stronger; these statements include words such as “may,”
“seems,” “suggests,” and “appears to be,” which convey the tentative status of the claim.
Type 1: openly frank and speculative, admitting the insufficiency of evidence and the very
tenuous nature of a claim. (as cited in Fahnestock, p. 342)
The above explanations of these statement types correlate nicely with my annotated references,
which I have listed under two very simple headings: “Authors That Support the Disease Model of
Addiction,” and “Authors that Do Not Support the Disease Model of Addiction.” As the reader
will see, there is a great deal of data that support the disease model, the majority of which is
presented in type five or type four statements; they are self-evident to insiders (and some
outsiders) and uncontroversial certainties.
People affected by this disease can display all sorts of symptoms of other diseases while in the
throes of active addiction, such as schizophrenia, clinical depression, chronic anxiety, obsessive-
compulsive disorder (OCD),attention deficit disorder (ADD),post-traumatic stress disorder
(PTSD),dementia, and even Tourette’s Syndrome and Alzheimer’s Disease. To complicate
matters, oftentimes these other serious disorders can also be present in those suffering from the
disease of addiction, which some call being “dual-diagnosed.” Further, sometimes these other
disorders are a direct result of many years of active addiction, especially depression, anxiety, and
PTSD. Other times these disorders are present before the individual contracts the disease of
addiction, which can cause the person to “self-medicate” mind or mood-altering substances until
the disease of addiction “hijacks” their brain; it’s the old “chicken-before-the-egg” argument.
Therefore given these countless complexities and misdiagnoses of the disease of addiction, the
annotated reference section also includes plenty of type three or two statements; there are of
course numerous citations in these articles and many instances where the author must use terms
such as “appears to be” or others listed in the definition above.
What’s interesting about the sources that do not support the disease model is that most all of them
present their information as uncontroversial certainties—type five or type four statements—in

that they seem very sure of their “cure,” theory, or opinion. However,many of the scientists,
physicians, and other SMEs in my research utterly refute their claims, declaring them “openly and
frankly speculative” and loaded with “insufficiency of evidence,” which Fahnestock would
classify as type one (p. 344).
Further, in a debate with someone about the disease model, in the interest of persuasion and
saving lives,I need to present the disease of addiction concept as uncontroversial information as
well (type five and type four statements). And when speaking about the choice model, cures, or
any stigmas, I should use types three through one, using words like “may,” “suggest,” “appears to
be,” etc.,or point out as many instances as I can where the information is openly speculative or
an insufficient amount of evidence. This isn’t to dishonestly trump my cause or shut theirs down
unfairly, either; it is simply using persuasive rhetoric in the interest of helping someone as a
means to an end.
Finally, the Facebook page employs five strategies of adaptation: narrative, example, comparison,
analysis, and genus-differentia definition. The narratives on the page not only include my own
personal story with addiction, located in the “About” section, but other recovering addicts’ stories
as well; for example, Aerosmith’s Steven Tyler tells part of his story in the link I recently posted.
There are also multiple examples of the disease in my sources and posts, such as the articles
addressing the Pat Kennedy car crash or the death of Amy Winehouse. Many also employ the
analysis strategy; they list and give examples of the progressive stages of the disease. There are
also ample comparisons to help my audience understand the disease better, such as Robin
Williams’s humorous description of a blackout: “It’s more like sleepwalking with activities, or
your conscience going into witness protection.” Lastly, many of the authors use the definition
strategy, by placing addiction in with other brain disorders such as Alzheimer’s, Tourette’s,and
schizophrenia (genus),then delineating it by listing addiction’s specific signs and symptoms
(differentia).
Part II: Boosting, Navigation, & Appearance
The meat of this project, of course, is the actual Facebook page itself. Thus far this accompanying
essay has provided some personal background information and more than sufficient justification
for using the social media platform. Part II provides useful and practical information concerning
the actualsite, and some generalinstructions regarding navigation around the page, as well as
showing how certain processes work,such as paying Facebook to promote the page or “boost” a
certain post. And I thought the best way to show this would be via screenshots,which will
expedite the process and show how these various pages appear on PCs,laptops, and phones.
Although this section is mostly comprised of screenshots and material from the fall semester of
2013, immediately after I started the page, some updated supplementary notes to the captions
have been added.
To find the Facebook page, please log in to Facebook and type in “Addiction is a Disease” into
the search bar; it should be the first one in the drop-down menu. The profile picture is a silhouette
of a human head showing “gears” and “wheels.” If for some reason that doesn’t work, the URL
is: https://www.facebook.com/Addictionisadisease/timeline. Please click on “About” for a more
detailed description of the page, as well as my personal background. Posts on the page are pretty
self-explanatory.
I launched the page on Facebook on Thursday, November 21, 2013, at around 3 p.m., by inviting
most of the people on my personal Facebook “Friends list” to “like” the page. In the first three
hours, I had received 46 likes. By the end of that first day, the page had 63 likes. After that the
rate was slower; in one week the page had a total of 75 likes, all but one of which was from my
personal invitations.

So on Friday, November 29, 2013, I elected to promote my page by paying Facebook $10.00 a
day for a week. When I clicked on “Promote Page,” the following series of screenshots (Figures
1-5) reflects the options Facebook offered and the process it took to begin a paid ad:
Figure 1
Figure 1 shows “What kind of results do you want for your ads?” The question was somewhat
useless, however, because there weren’t any other options to choose from other than “Page
Likes.” Next is the “Select Images” option, in which I chose which images I would like to use for
the ads that will appear on the right-hand side of the screen in the public’s newsfeed.

Figure 2
Figure 2 shows the options for editing the text that will appear in the ad. The original descriptor
for the page stated,“The purpose of this page is to dispel misconceptions associated with the
disease of addiction, and to offer help and hope to addicts and their families.” However,the
number of characters for the ad is much less than that, so I chose to shorten it to “Dispelling
misconceptions associated with the disease of addiction.” I figured that a suffering addict or
family member of and addict seeking help or information would probably be attracted to this
sentence,so the second part of the page’s purpose is still fulfilled somewhat.

Figure 3
Figure 3 displays the options for payment. One can either “run my campaign continuously
starting today,” or set a start and end date, which is what I chose. I will not be charged until the
end date (I checked my bank account and there haven’t been any charges).

Figure 4
Figure 4 shows Editing and Pricing, which at first concerned me when I read “You will be
charged every time someone sees your ad or sponsored story (CPM).” As for “CPM,” I found the
following:
CPM stands for cost per 1,000 impressions. This means you’ll pay when people see your
ad. When you set up your ad, your impressions will be optimized so your ad shows to
people who are most likely to help you reach your goal. For example, if your goal is to
get more people to like your Page,your ad will be shown to people in your target
audience who are most likely to also like your Page.
However,after more investigation I read that I will never be charged more than my specified
daily amount ($10.00).
*Note: The above statement from Facebook is somewhat ambiguous and deceptive. It leads the
user to believe that Facebook will specifically target individuals “who are most likely to also like
[my] page,” which simply hasn’t borne out to be true. A large number of the individuals whom
have “liked” my page aren’t actual people, judging from their profiles (more on this later).
Perhaps I should have clicked on the links in the small print, such as the “Facebook Statement of
Rights and Responsibilities.” However, I doubt it would have explained the complex algorithms
or process that controls the number of “likes.” Facebook isn’t under any obligation to do so.

Figure 5
Figure 5 shows options for reaching my intended audience. I could choose just the United States
only, which had a possible 118 million people, or expand that number by promoting the page in
other countries, which I did: now my possible audience is 292 million.
*Note: Again, I was naively under the impression that my page would be promoted fairly and
equally to all of these countries, specifically targeting individuals within those countries that
matched some of the key words I used, such as “addiction,” “Alcoholics Anonymous,”
“codependency,” and so on. As I show in the next two screenshots,this isn’t what happened.
Facebook only seemed to target certain countries, or in the following example, one country: Italy.
I’m still not 100 percent sure exactly how this works, but I have an idea; more will be explained
on this phenomena in the Part III.

Figure 6
Figure 7
Interestingly, from November 29 to December 1,I have had copious amounts of “likes” from
Italians; Figures 6-7 show a sampling of these people. No one from any of the other countries I
included in my intended audience has “liked” the page as of yet.
*Note: This “clustering” of likes in certain countries has happened each time I have boosted the
page or any particular post. I will present a screenshot of these countries in Part III.

Figure 8
Figure 8 displays the options associated with “boosting” a certain post: dollar amount, estimated
reach,audience, duration, and payment.
*Note: The “estimated reach” is deceptive. What they’re not telling the buyer is that the majority
of likes one receives either will not be actual people, will never engage with the page, or both.
Figure 9
Figure 9 shows the post of the photo album, “Authors who claim to have the cure.” As the reader
can see,609 people saw the post, yet the tab on the right states that it was “not boosted.”

Figure 10
Figure 10 displays the email Facebook sent me regarding why they couldn’t boost my post. The
reason, they said, is the following:
Your ad wasn't approved because it uses too much text in its image, which violates
Facebook's ad guidelines. Ads that show in the Feed are not allowed to include more than
20% text. You'll still be charged for any impressions or clicks your ad received before it
was disapproved.
Figure 11
Along with another explanation of why my post couldn’t be boosted, Figure 11 shows how many
engaged and liked the post, and the dollar amount spent before the ad was disapproved.

Figure 12
Figure 12 is the Ads Manager page, which for the average user,isn’t very helpful. I could not
figure out what all of the figures represent,and there aren’t any satisfactory explanations, even if
one hovers the cursor over the question mark icons. For example, at the top, the “campaign
reach” is allegedly 4195. At the time of this screenshot (December 1,2013), I had a little over
100 page likes. Currently (November 2014) there are 1583 likes, nowhere near 4195.

iPhone 5 Screenshots
Figure 13 Figure 14
Figures 13 & 14 offer views of how Addiction is a Disease appears on an iPhone, which is
cleaner looking, thanks to the lack of negative white space that the PC or laptop view offers.
Overall it is simply less “busy” and cluttered. Yet the most salient advantages over the PC are 1)
the mobility of the smart phone, and 2) the ability to scroll with one hand (or finger) to find or
click on posts.
Figure 15
Figure 15 shows Facebook Pages Manager,an app Facebook offers for free. However,although
it’s free and recently updated for the iPhone 6, due to the poor reviews I chose not to use it. I
honestly couldn’t see many advantages that the regular administrator page didn’t offer.

Part III: Algorithms and Click Farms
I started the Addiction is a Disease community Facebook page in the fall semester of 2013 as the
final project for my Writing Public Science course. I had high hopes for the page’s purpose,
which was to help addicts and their families find help and hope. And as previously mentioned,
one of the salient reasons I chose Facebook as my platform was basically because it has so many
users: at the end of 2013 there were roughly one billion Facebook users,or one sixth of the
world’s population. I had also read a number of articles and one dissertation (Dadas) in particular
that promoted the social media platform as the best method to reach a target audience; all of
which was true at their times of publication, and for that matter, still rang true when I began this
project at the start of the fall 2013 semester.
However,as I have insinuated, recent internal algorithm changes regarding Facebook Newsfeed
have significantly altered the “organic reach” of all pages on the site. (“Organic reach” refers to
how many people you can reach for free on Facebook by posting to your page.) In the last year,
while my page’s “likes” have slowly grown (currently 1582, from 144 in the first week after
launch), it’s not anywhere near as many as I had hoped for when I initially conceived the page.
In the final thoughts section of the December 2013 essay I wrote for this project, I noticed I wrote
that the page didn’t “take off” as I thought it would, and that I was “a bit perplexed” as to why
only certain countries or clusters of people seemed to be “liking” the page. In the end I assigned
most of this to people being busy with Thanksgiving, end of semester busyness,and the
Christmas holidays coming up. Now, thanks initially to my friends and the subsequent research,I
know better.
Essentially what these new algorithms do is decide what’s most relevant to each individual user’s
Newsfeed:“By looking at thousands of factors relative to each person,” the algorithms “rank each
possible story from more to less important” (Boland, para. 6). One of the reasons for these
changes, according to Brian Boland, leader of the Ads Product Marketing team at Facebook, is
There is now more content being made than there is time to absorb it. On average,there
are 1,500 stories that could appear in a person’s News Feed each time they log onto
Facebook. For people with lots of friends and Page likes, as many as 15,000 potential
stories could appear any time they log on. (para. 3)
This makes sense. For example, I have 620 friends on my personal page. If I were to get every
post from every one of my friends in real time, most likely I wouldn’t see the posts that are more
important to me. For instance, let’s say my dad posted that he was at the ER having chest pains.
Then, immediately after that,a distant acquaintance of mine, say some junior high school
Facebook friend or other, posted 29 “Grumpy Cat” memes. If I’m receiving all posts in real time,
then my dad’s ER post would be 30 posts down the scroll on my Newsfeed,and I’ll probably not
get that far. “People only have so much time to consume stories, and people often miss content
that isn’t toward the top when they log on,” asserts Boland (para. 9). So the algorithms definitely
have a relevant function.
However,these algorithm changes,or “story bumping,” as insiders call it, weren’t widely
advertised by Facebook, although Boland writes that “Facebook has always valued clear,
detailed, actionable reports” (para. 13). My significant other, Sheri Fording, is a senior account
executive at Sales Factory Woodbine (SFW), a powerful marketing firm here in Greensboro. At a
SFW function last summer, I mentioned my page’s poor engagement issues to her and a couple of
her coworkers. As it turns out, they had already been researching this stuff for months, and they
were all over it. They said they’d had the same experiences with their clients’ Facebook pages,
and supplied me with some possible solutions and a few of the articles I use in this essay.
Furthermore, they informed me that Facebook began to implement these changes in October
2013—one month before I launched the Addiction is a Disease page.

So what do these changes mean for people like me, who have little to no knowledge about
marketing, algorithms, or organic reach? What does it mean for my small community page? The
first article I read was from Tara Urso (2014), a social media content strategist at insight180
branding and design. “Whether you’re a huge brand with millions of likes, a community
organization page or a non-profit, this dip in organic reach will affect you,” (para. 4), she states,
and “Facebook’s organic reach could be zero very shortly” (para. 13). This was alarming, to say
the least. So my page isn’t going to reach anyone in the near future unless I start regularly paying
for advertising? It’s no small wonder Facebook didn’t advertise this.
According to the SFW personnel, the real “whistleblowers” on these changes came from an
organization called Ignite Social Media (ISM), one of North America’s first social media
agencies. The three articles from their site were not only insightful, but very timely and
appropriate to my page and the time of its launch. For example, just one week after my page
launch, between December 1 and 10, 2013, ISM reported that
[After] analysts reviewed 689 posts across 21 brand pages (all of significant size, across a
variety of industries) [they] found organic reach and organic reach percentage [had] each
declined by 44% on average,with some pages seeing declines as high as 88%. Only one
page in the analysis had improved reach,which came in at 5.6%. (Tobin, 2013, para. 1)
So what has been the response? Earlier this year,a survey conducted by ISM found “43.2% of
users found the content in their News Feed less relevant than they did six months ago, while only
12.0% found the content more relevant” (Andrews,2014, para. 2). This is disappointing news to
me because what that translates as,essentially, is that the content I have been posting on the
Addiction is a Disease page,according to the “thousands of factors relative to each person,” has
been deemed less relevant or less important to my “fans” (those who liked the page). It simply
doesn’t appear in their Newsfeed. My friend Becki told me this morning that although she liked
the page last year, she hasn’t seen anything from it for a long time.
However,I knew that I had been posting stimulating and relevant content, so what was the
problem? Why was only a sampling of my 1500-plus fans seeing my posts? A quick look at my
insights page tells me exactly how many people my posts have reached:
Figure 16

As the reader can see in Figure 16,just as Facebook predicted, the posts with the highest number
of engagement received the highest reach. The post from November 7, for example, reached
almost my entire fan base,and I’m guessing the 100 post clicks contributed to that. I don’t know
why this post received the attention it did; perhaps because it centers on white upper-class heroin
addicts in Charlotte. But it’s really a “chicken-and-egg” problem: which came first, the post’s
engagement or the likes? The YouTube post featuring Ozzy Osbourne only reached a measly 48
people, although it’s a video (which supposedly catches more people’s attention) and features a
celebrity. I couldn’t make sense of it.
Kevan Lee (2014) had some exceptional insight in this regard, however; his article provides
insights and tips, as well as a Facebook-algorithm “do’s and don’ts” checklist to help novice users
(like me) navigate these new changes. But that still didn’t answer all of my questions. Why is it
that most of my fans are from developing countries? And why have none of them—not one
ever—liked, commented, or shared on any of my posts? Figure 17 shows my “fan” base:
Figure 17
So supposedly my largest fan base is in Egypt (647), Iraq (476), and India (141), with the U.S.
being a close fourth (137); and more of them speak Arabic (833) than English (467). Yet no one
from any of the top three countries has engaged with one of my posts, ever. So what gives?
As it turns out, the source of the trouble are called a “click farms:” businesses “that pay
employees to click on website elements to artificially boost the status of a client's website or a
product … [and] are usually based in developing countries. Workers typically make a dollar or
two per thousand clicks, perhaps as little as $120 a year” (Wigmore, 2014, para. 1-2). Another
term for this behavior is “click fraud,” which is simply what the employees do at click farms.
Veritasium (2014), a science video blog on YouTube, released a video called “Facebook Fraud,”
which is where I first heard of click farms. The narrator describes how the exact same thing
occurred with his two Facebook pages (and others), and goes through a step-by-step process of
how and why having thousands of fans doesn’t equal engagement. Figures 18-20 below
condense and accelerate his explanation:

Figure 18
According to the narrator, the countries with the largest numbers of these click farms are in two
out of three of my top three fan base (Veritasium, 2014).
Figure 19
In Figure 19,the spheres represent western countries that have liked the narrator’s page; the
larger the number of likes per country, the larger the sphere. The largest sphere,for example, is
the U.S. … that smaller sphere hovering over 60%, is Austria, which for some reason has a lot of
fans engaging with his page. The horizontal axis ranks what percentage these countries engaged
with his page in a one month period. For instance, 30% of his U.S. fan base engaged, while
almost 60% of his Austrian fan base engaged with his page that month (Veritasium, 2014).

Figure 20
Figure 20 was the realeye-opener. Those large spheres represent countries such as Egypt, India,
Pakistan, the Philippines, Indonesia, Bangladesh, Sri Lanka, and Nepal. This large number of
supposed followers equal 80K page likes, which is over 75% of his fan base,yet altogether they
only made up 1% of engagement.
The reason for this is partly the aforementioned algorithm:
When you make a post, Facebook distributes it to a small fraction of people who like
your page, to gauge their reaction; if they engage with the post (by liking, commenting,
or sharing) Facebook then distributes the post to more of your likes, and even their
friends. [But] if you somehow accumulate fake likes, then Facebook’s initial distribution
goes out to fewer realfans, and therefore receives less engagement, and so consequently
you reach a smaller number of people. (Veritasium, 2014)
He goes on to say that this is also making Facebook twice the money: “once to help you acquire
new fans, and then again when you try to reach them.” This is exactly what has happened to me,
and I’m glad someone finally figured it out. There would have been no way for me to know this.
And it seems as if this is happening all the way at the highest levels. The U.S. Department of
State, for example, spent $630,000 to acquire 2 million page likes and then realized only 2% were
engaged. Now they spend just $2500.00 a month (Hicks, para. 8). But that still doesn’t
appropriately address the problem, although it’s a great start; the fact is, neither I, the narrator of
the video, or the State Department bought fake likes from click farms. We all did it the legitimate
way by paying Facebook for advertising. Yet the results are still as if we paid the click farms.
Now what?
One might think that the way to avoid this is to not target countries where these click farms are
most prevalent. But the Veritasium guy actually did that, too; he started an incorrigible page
called “Virtual Cat,” and only targeted cat lovers in the U.S., Canada,Australia, and the U.K. But
the same thing happened, even though all of his likes came from the countries he targeted.
The narrator researched some of these fake fans’ profiles, and they have next to no information
about themselves. Additionally, most of them have liked hundreds and even thousands of other

pages, and there’s no rhyme or reason to them. They like everything.One account liked T-
Mobile, Verizon, and Sprint, as well as Jeep, Lexus, Volkswagen, and Chevy. They even like
kitchen scrubbers and mouthwash. “Who reports that on their Facebook page?” he said.
So I checked out some of my fans profile pages,and picked this Egyptian one at random:
Figure 21
This profile is totally counterfeit. For starters,the name Mohamed Gawdat is just a couple letters
off from Mohammad Gawdat, Vice President of Google. Secondly, when I clicked on any of his
“about” information, I got a “Sorry, something went wrong when loading this section. Please try
again later.” Lastly, and most damning, he has literally hundreds of liked pages,most of which I
can’t read, but some of the ones I can were vitamin supplements, shoes, Queen Elsa (from
Frozen),a page simply called “Feelings,” and strangely a page entitled “Just Teenage Things.”
So how am I getting these fake click farmers when I paid for them legitimately via the proper
channels? The answer is that the click farmers,in order to go undetected by the Facebook spam
radar,are using Facebook’s new “Page Suggestion” feature to click on pages for which they
haven’t been paid to target (Schneider, 2014, para. 22). In other words, if a thousand likes for one
particular page came from one specific overseas location in a short period of time, it would look
suspicious. However, if these likes are “buried in a torrent of other likes, they would be
impossible to track. They will literally click on anything” (Veritasium, 2014).
What does Facebook say about click fraud? See Figure 22 below:

Figure 22
One click farm site I found is called “Click Monkeys,” and here is what they say about the
“legality” of their service:
Would we be offering this service over the Internet if it weren’t legal? Hell no! Click
Monkeys!! is a Ukrainian company and the giant tanker ship click farm we have stationed
just outside U.S. waters off the coast of San Francisco is registered at a Ukrainian berth
so we’re not subject to any U.S. laws! You’re not breaking any laws because you’re just
contracting us to deliver unique visitors, page views and click through, the same as you
would be doing by paying Google or Bing for impressions! (Click Monkeys!!, n.d.)
Click fraud is illegal. In 2005, Yahoo settled a class-action lawsuit against it by plaintiffs alleging
it did not do enough to prevent click fraud. Yahoo paid $4.5 million in legal bills for the plaintiffs
and agreed to settle advertiser claims dating back to 2004. In July 2006, Google settled a similar
suit for $90 million (Sullivan, 2006; Ryan, 2006). However,detecting click fraud is very difficult,
simply because the behavior of the fakers is exactly the same as that of a legitimate visitor.
Part IV: Final Thoughts and Future Directions
One viewpoint we discussed at length in my Writing Public Science course in the fall of 2013
involved the following sentence: “A scientific statement is valuable if it is _________.”
The overarching “scientific statement” for the Addiction is a Disease Facebook page would
essentially be the following: “Addiction is a chronic brain disease that is progressive, incurable,
and fatal; however, it can be arrested and recovery is then possible.” After reviewing my answers
from the original project, I still think they hold up well. Consider the following sentences:
“A scientific statement is valuable if the data are convincing.” My data on the page are
convincing enough to persuade my intended audience into believing that addiction is a disease. I
had just hoped for more traffic and interaction.
“A scientific statement is valuable if the source is trustworthy.” My sources are absolutely
reliable, and the design of the page is the right mix of inviting and professional. I didn’t want it to
look too casual, or it would lose credibility; yet I didn’t want it to be overly professional or
clinical looking, because that could work in the same way. I felt that for my target audience,
which is addicts and families of addicts, and for the general public or laity, accommodating some
of the scientific data about the disease required something easier to grasp; overloading the page
with scientific data isn’t the answer.
“A scientific statement is valuable if one is desperate.” My target audience is addicts and families
of addicts, and most of these individuals are in dire circumstances. There aren’t any quick fixes to
addiction, of course; yet individuals in the throes of active addiction are looking for relief and
they want it now. My page provides quick and easy navigation to multiple avenues where these
individuals can at least begin to find solutions, which subsequently provides hope—a very
important factor to someone who has been hopeless for years,decades,or a lifetime.
“A scientific statement is valuable if it is timely.” In rhetoric, kairos not only refers to the
timeliness of a message,but of its appropriateness as well. I don’t think my topic could be more
timely or appropriate. Hundreds, if not thousands, are dying every day from this disease.
A scientific statement is valuable if it can be applied.” This is the application appeal I mentioned
in Part I. There are many practical benefits: once one embraces the disease concept, action can be
taken to find the solution.
Despite these elements, however, the Addiction is a Disease page just hasn’t performed as well as
I thought it would. My initial goal—to dispel some of the misconceptions associated with the
disease and to offer help and hope to addicts and their families—may have been somewhat
achieved, but just on a considerably smaller scale. I had hoped for much better engagement, and

was looking forward to some heated discussions and debates. The bottom line is that I can
provide all of the convincing data and reliable sources I can find, yet they cannot be applied and
accomplish nothing if no one sees them.
As for the desperation factor,as I suggested above, I just don’t think Facebook is the appropriate
platform for initiating public discourse on a subject as serious as the disease of addiction. Let’s
face it; if I have reached the desperation phase (or “rock bottom”) in active addiction, then I’m
probably not going to be cruising Facebook. I probably won’t even have a computer or access to
one: there aren’t many laptops in crack houses, unless you count the stack of stolen ones in the
closet. Further, if I have a family member in the same desperate phase (jail, overdoses, etc.) then
Facebook probably isn’t where I’m going to look for answers. I’m going to be Googling drug
treatment centers in my area,detoxes, and other mental health facilities.
Facebook isn’t a go-to for serious issues. It has become more of a default mechanism of sorts for
its users; it’s simply something we do to pass short amounts of time. We don’t go there to find
factual information, solve serious problems, or seek help for grave illnesses. The best description
I’ve heard of what Facebook has become was coined on Twitter by Nick Bilton, columnist and
reporter for The New York Times:
Figure 23
The other issues that make Facebook an inappropriate platform, obviously, are what I discussed at
length in Part III. The bottom line is the new algorithms + click farms/fake fans = poor
engagement on my page. And paying Facebook to promote my page or boost certain posts is a
waste of time and money. As I’ve said, when I launched this page it was with high hopes that I
could offer some real answers and help to addicts and their families. Simply stated,Facebook
isn’t helping me reach that goal.
Thus the Addiction is a Disease page,I think, best serves individuals who are beginning to see a
problem or problems, or have begun getting some real consequences from their addiction, such as
DUIs,drug charges,dropping grades, marital problems, financial issues, and so on. Individuals
that are having these sorts of preliminary problems would most likely still have some of the
trappings of their life—employment, family, house, car,decent grades, a laptop, a Facebook
account—and may very well be on the cusp of the downward spiral of active addiction, but aren’t
in the hopeless last stages described above. So perhaps one could say that for individuals in these
earlier stages of active addiction, the aforementioned kairos could still apply, just not in the same
way, exactly.
Thus if I desire some level of success at this level, there are some practical solutions. In addition
to Lee’s “algorithm do’s and don’ts” list, Sheri put me in contact with a woman named Renee
Robinson, who happens to have a Master’s in Social Media from Elon University. She gave me
the following five tips, most of which I have already instigated:
 Try posting just once daily. If you do more than that on Facebook, sometimes people get
annoyed (but if you have a bunch of really good quality content on one particular day,
don’t feelyou can’t post more than once, it’s just a general rule . If you start posting

more regularly (like once daily), you might see engagement go up because it will start
popping up in people’s Newsfeed more and if they interact with it, people connected to
them will see as well.
 Try experimenting with the timing of your posts. You may find your particular audience
is more active at certain times of the day than at others and therefore more likely to see
your content. If you go to “Insights" and then “posts,” you’ll see that your particular
audience right now is generally most active between 11am and 4pm, with 4pm being the
height of activity (Monday is your slowest day).
 Your community is almost 50/50 male: female ratio with a slight skew towards male
(54%), with the bulk being 18-24 year olds—just something to keep in mind as you share
things.
 Be sure to really think about targeting it to as specific an audience as possible each time,
the more narrow you go, the more likely you will gain people who are definitely
interested in your topic. You can narrow down not only by location, age,gender,
interests, etc. but by behavioral tendencies, as well.
 As far as recommending what other platforms to use,I’m not sure what would be good
for this particular community. As frustrating as Facebook is with its organic reach
decline, it’s still a great way to reach a large amount of people and I’m not sure I see any
other platforms being more engaging for this page’s purpose (not Twitter, LinkedIn,
Pinterest, Instagram, etc.). If you have enough you want to say and/or stories you want to
share - you may want to consider starting a blog, if you haven’t already. Your blog would
become your main community and you could use Facebook to support it/amplify the
reach of its content/encourage more debate, etc. (R. Robinson, personal communication,
October 28, 2014)
In Renee’s last bullet point she mentions starting a blog, which may be the best possible way to
reach my initial target audience (addicts and families of addicts in need of answers,help, and
hope). Before beginning this project in 2013, I had actually considered starting a blog, but when I
researched blogs that were related to my topic, Googling phrases such as “Addiction is a Disease
blogs,” there were hundreds. I remember skipping over to the ninth or tenth page and there were
still numerous blogs addressing whether or not addiction is a disease or a choice.
However,there are some blog sites I found that are similar to my purpose, and they’re not at all
what I was thinking a blog page would be—endless dialogs and arguments from armchair
addictionologists and psychiatrists, and no solutions. These sites are extremely professional, with
inviting interfaces and engaging posts and articles. Moreover, they cater to specific demographics
of addicts, not just addicts in general. Shatterproof,for example, is dedicated to helping children:
“Shatterproof is a bold, new national organization committed to protecting our children from
addiction to alcohol or other drugs and ending the stigma and suffering of those affected by this
disease” (“Shatterproof,” 2014). Stop Medicine Abuse exclusively focuses on teens and
Dextromethorphan (DXM): “a safe & effective ingredient found in many over-the-counter cough
medicines, but approximately one in 25 teens report abusing excessive amounts of DXM to get
high” (“Stop Medicine Abuse,” 2014). The point is these are the kinds of sites desperate addicts
and family members need for quick answers. The mission statement for Addictionblog.org,for
instance, is very similar to my own: “Our mission is to connect families and individuals
struggling with addiction to necessary and appropriate treatment options” (“Addictionblog.org,”
2014).
Therefore,I will keep Addiction is a Disease up and running, and continue to follow the advice
from Renee,the SFW team,and the articles I mentioned, in hopes of reaching addicts in the
initial stages of addiction. However,if I want to reach those for whom I started this project, I will
need to explore utilizing a platform better suited to these serious issues.

References
Addictionblog.com (2014). Retrieved from http://addictionblog.org/
Andrews,J. (2014, February 6). 43.2% of Facebook Users Find the News Feed Less Relevant.
Ignite Social Media.Retrieved from http://www.ignitesocialmedia.com/facebook-
marketing/users-find-facebook-less-interesting-less-used/
Boland, B. (2014, June 5). Organic Reach on Facebook: Your Questions Answered. Facebook for
Business. Retrieved from https://www.facebook.com/business/news/Organic-Reach-on-
Facebook
Click Monkeys!!. (n.d.). ClickMonkeys!! Retrieved from http://clickmonkeys.com/
Dadas,C. (2011). Chapter 5: “We Can Show Our Lives asThey Are”: Surfacing the
Complexities of Marriage Equality through YouTube Videos and Facebook Pages
(Doctoral dissertation). Retrieved from https://blackboard.ecu.edu/
Fahnestock, J. 1998). Accommodating Science: The Rhetorical Life of Scientific Facts. Written
Communication,15 (3), 330-350. Retrieved from wcx.sagepub.com
Hicks, J. (2013, July 3). IG report: State Department spent $630,000 to increase Facebook ‘likes.’
The Washington Post. Retrieved from http://www.washingtonpost.com/blogs/federal-
eye/wp/2013/07/03/ig-report-state-department-spent-630000-to-increase-facebook-likes/
Lee,K. (2014, November 4). Decoding the Facebook Newsfeed:An Up-to-Date List of the
Algorithm Factors and Changes. Buffer. Retrieved from
https://blog.bufferapp.com/facebook-news-feed-
algorithm?utm_source=feedly&utm_reader=feedly&utm_medium=rss&utm_campaign=f
acebook-news-feed-algorithm
Ryan, K. (2006, July 5). The Big Yahoo! Click Fraud Settlement. iMedia Connection. Retrieved
from http://www.imediaconnection.com/content/10294.asp
Schneider, J. (2014, January 23). Likes or lies? How perfectly honest businesses can be overrun
by Facebook spammers. The Next Web, Inc. Retrieved from
http://thenextweb.com/facebook/2014/01/23/likes-lies-perfectly-honest-businesses-can-
overrun-facebook-spammers/
Shatterproof (2014). Retrieved from http://www.shatterproof.org/
Stop Medicine Abuse (2014). Retrieved from http://stopmedicineabuse.org/
Sullivan, D. (2006, March 8). Google Agrees To $90 Million Settlement In Class Action Lawsuit
Over Click Fraud. Search Engine Watch. Retrieved from
http://searchenginewatch.com/article/2059444/Google-Agrees-To-90-Million-Settlement-
In-Class-Action-Lawsuit-Over-Click-Fraud
Tobin, J. (2013, December 10). Facebook Brand Pages Suffer 44% Decline in Reach Since
December 1. Ignite Social Media. Retrieved from
http://www.ignitesocialmedia.com/facebook-marketing/facebook-brand-pages-suffer-44-
decline-reach-since-december-1/
Urso, T. (2014, March 24). Your Facebook Page's Organic Reach Is About to Plummet. Social
Media Today. Retrieved from http://www.socialmediatoday.com/content/your-facebook-
pages-organic-reach-about-plummet
Veritasium. (2014, February 10). Facebook Fraud [Video file]. Retrieved from
https://www.youtube.com/watch?v=oVfHeWTKjag
Wigmore, I. (2014, February 1). Click Farm definition. WhatIs.com. Retrieved from
http://whatis.techtarget.com/definition/click-farm

Authors That Support the Disease Model of Addiction
Angres, D. H.,& Bettinardi–Angres, K. (2008). The disease of addiction: Origins, treatment,and
recovery. Disease-a-Month,54(10), 696-721.
doi:http://dx.doi.org.jproxy.lib.ecu.edu/10.1016/j.disamonth.2008.07.002
Angres and Angres’s article is a good overview and discussion of the disease model of
addiction and various treatment plans for recovery. The authors begin by examining the
neurobiology of the disease, including genetics, reward,learning and memory,
motivation, and decision making. Next is a discussion of Addictive Interactive Disorder
(AID),which describes how the disease manifests itself in other areas of an addict’s life
apart from drugs, “such as gambling, food, sex, work, certain financial behaviors, and
even religiosity” (AID section, para. 1). The last third of the article is dedicated to
numerous treatment strategies that include AA (or other 12-step programs), various levels
of care,meditation, and harm avoidance, for example, and specialized treatment for
professionals.
The authors’ research is pertinent for my project because it provides detailed scientific
evidence of the disease of addiction, most specifically the biological and neurological
aspects of it. Data such as this was essential to me in my early recovery; hearing that it
was a brain disease that could be treated similar to other neurobiological diseases made
the difference in my believing and accepting the disease concept, which allowed me to
seek recovery. Type five and four statements from articles such as this one will be used in
response to the first stage of my stasis theory as evidence that disease actually exists, and
can answer other questions as my target audience moves through the other stases as well,
including the value of the disease concept and what should be done about it. Daniel H.
Angres is an MD, and Kathy Bettinardi–Angres is an APRN,CADC.
Cooper, A.,Foreman, T., Gupta, G., Hill, E., Kaye,R., Quijano, E., & Todd, B. (2006, May 5).
Questions remain unanswered about Kennedy crash. Anderson Cooper 360 Degrees
[Television series]. Atlanta, GA: CNN Interview. Retrieved from
http://infoweb.newsbank.com
This entry is a transcript from the live broadcast of Anderson Cooper’s 360 Degrees,and
covers the allegations made against Congressman Patrick Kennedy regarding his 2006
car crash,and includes an examination of the statement Kennedy made to the press
following the incident and overall history of Kennedy’s past substance abuse problems
that have plagued him all of his life. The show also interviews addictionologist Dr. Drew
Pinsky about this incident and other addiction-related problems with Congressman
Kennedy.
This transcript is useful for my research and Facebook page for a number of reasons.
First, because it presents a real-world example of addiction and its consequences,one that
is (or was) fairly well known and recognizable. Second, the portion of the show with Dr.
Pinsky is a revealing and rational discussion that goes beyond Kennedy’s car crash and
drug problems, and extends into a conversation about the disease of addiction in general:
“Addiction is a disorder of the reward system of the brain, a part called the medial
forebrain bundle,” he states at one point, and further down, “Addict is addict is addict. It
doesn’t matter what your drug of choice is.” He goes on to talk about addiction being a
family disease, and the diagnosis and prognosis of being dual diagnosed (e.g. addiction
and depression). Finally, the fact that Pat Kennedy is the son of well-known Senator Ted
Kennedy, who has had his own addiction battles, underscores the hereditary and family
aspect of this disease; it also points out that it doesn’t matter how much money one has
and that the disease of addiction doesn’t discriminate.

Crowe,R. (2006, August 5). Some skeptical of new anti-drug campaign message - ads equating
addiction with a disease provoke strong response. Houston Chronicle. Retrieved from
Crowe’s article is mainly about the reaction to Houston’s Partnership for a Drug-Free
America’s campaign to overcome the stigmas that are associated with the disease of
addiction. For example, Psychiatrist Stanton Peele “worries that the disease definition
will have negative, long-term effects,” and said, “[the disease concept] will condemn
them to having to act that way for the rest of their lives because disease is a lifetime
malady. You also might find people are not held responsible for their actions” (para. 8).
My Facebook page needs articles such as this one to show what sort of thinking is out
there, or what we who believe in the disease concept are up against. It shows that this
antiquated view of chemical dependency is still rampant amongst professionals in the
field. It should also be noted that this quote is from a psychiatrist; a lot of times
psychiatrists will be against the disease model because they are under the impression that
12-step fellowships infringe on their profession and revenue, which isn’t true.
Dadas,C. (2011). Chapter 5: “We Can Show Our Lives as They Are”:Surfacing the
Complexities of Marriage Equality through YouTube Videos and Facebook Pages
(Doctoral Dissertation). Retrieved from ECU Blackboard.
The chapter from Dr. Caroline Dadas’s dissertation is an interesting study of how the
controversial issue of marriage equality is presented and perceived through four examples
of two types of social media: Facebook pages and YouTube pages/videos. The two
Facebook examples she uses represent polar opposites in the debate. One page is cleverly
titled “Marriage is So Gay,” with the other more straightforwardly titled “Defending
Traditional Marriage.” Dadas discusses the effectiveness and ineffectiveness of the visual
and interactive qualities of Facebook for this public discussion regarding marriage
equality. For example, the “Marriage is So Gay” page has tee-shirts for sale, and takes
advantage of “one of the affordances of Facebook—the ability to easily post images—to
compile a bodily representation of marriage equality supporters” (p. 4). She then
describes how these images of one’s body also represent one’s identity; the gender, race,
ethnicity, sexual preference,and age are all represented in just one image.
The YouTube pages are both for marriage equality, one is titled “Engagement ring for
marriage equality,” which is a simple amateur video, and “Depfox,” which is more of a
website than a page, having many videos of a gay couple named Bryan and Jay and their
two children. Once again, Dadas compares the two pages, giving examples of why one
works better than the other, or has more views. One reason that Depfox has more views,
she states,is because of their “rhetorically savvy move” in the juxtaposition of scenes of
“normativity and queerness,” such as one scene portraying them as a “normal” family and
then another showing the emotional impact of the Prop 8 passing. Dadas states that these
types of contrasts help to dismantle gay stereotypes regarding family and children.
Detar,D. T. (2011). Substance Abuse in Office-Based Practice:Understanding the Disease of
Addiction. Primary Care: Clinics in Office Practice, 38(1), 1-7.
doi:10.1016/j.pop.2010.11.001
Detar’s short but comprehensive article describes addiction as a brain disease,and
delineates drug addiction from drug dependency, which he states is because “dependency
may not manifest as an addictive behavior. This problem is fundamental to understanding
the disease of addiction” (para. 2). Detar then goes into the neurobiological aspect of the
disease, presenting two images that compare the brain’s pathways and neurochemistry in
rewarding adaptive behaviors, one showing dopamine and serotonin pathways and the
next depicting how those areas in the brain are affected by certain drugs and how. Detar

then examines genetics and addiction: “Between 40% and 60% of the vulnerability to
addiction is attributed to genetic factors,” he asserts (para.11) . He ends the article with a
short discourse on abstinence-based remission, which he states is the “most stable,”
backing up his statements with data from the American Society of Addiction Medicine.
Detar ‘s article is included here in part because of the two brain images, which I plan on
posting on my Facebook page, but also because it is yet another article describing the
neurobiological aspects of the disease in some detail. Additionally, his detailed
paragraphs on the genetic aspect of the disease could be used to back up my claims that
addicts are born with this disease: “Several key chromosomal regions in humans have
been identified and linked to substance abuse. . . . Polymorphisms in receptor genes
mediating drug effects are associated with higher risk of addiction,” he posits at one
point. Dr. Detar works at the Department of Family Medicine, Medical University of
South Carolina.
Galanter, M. (2007). Spirituality and recovery in 12-step programs: An empirical model. Journal
of Substance Abuse Treatment, 33(3), 265-272.
doi:http://dx.doi.org.jproxy.lib.ecu.edu/10.1016/j.jsat.2007.04.016
Galanter examines the role of spirituality—what he describes as the third perspective that
frames how we conceptualize recovery,along with psychopathology and behavioral
psychology (Introduction section, para. 2). He posits that although spirituality is “more
difficult to subject to measurement …instruments are being developed that can be applied
for its study” and that “this approach is inherent in the spiritually oriented psychology of
Carl Jung” (Introduction section, para. 3). His article examines spirituality in a clinical
way, exploring scientific aspects of how it works for the addict and why, including its
relationship to Alcoholics Anonymous, recovery, positive psychology, social networks,
and so on. He ends the article with a section called “Defining recovery based on
spirituality,” which has a list of spiritually grounded criteria that is actually measurable.
Galanter’s approach is exactly what I need for my research,in that it examines the
spiritual aspect of recovery from this disease in scientific terms, or an empirical model.
This sort of data will be extremely useful on my Facebook page regarding the powerful
attribute of spirituality, something I always knew was an essential part of my recovery,
but have never been really able to articulate it in such a way that actually describes how it
works. Marc Galanter, M.D.,works in the Department of Psychiatry at the NYU School
of Medicine.
Groubert, M. (2008, June 25). Addiction: Buying the Cure at Passages Malibu. LA Weekly.
Retrieved from http://www.laweekly.com/2008-06-26/news/buying-the-cure/
Groubert personally interviews Chris Prentiss,author of The Alcoholismand Addiction
Cure and owner of the Passages Treatment facility in Malibu. Prentiss reveals some of
his history with addiction, why he started Passages,and how his cure works: “Our fully
customized treatment program first discovers and then heals the underlying causes of a
person’s addiction using one-on-one therapy.” In a phone interview, Groubert asked Dr.
Drew Pinsky about this statement, and Pinsky emphatically stated,“There’s no evidence
that aggressive therapeutic intervention early in the course of addiction does anything but
make addicts want to get loaded more” (p. 3). In the interview, Prentiss mentions his
“cure rate” (84.4%), which he claims is based on “the latest survey involving 700 of his
graduates” (p. 4). Prentiss also discusses certain ideologies and treatment strategies he
uses, such as the I Ching.
Groubert also interviews Dr. Hamlin Emory, former medical director at Passages (2001-
2003), who states that Prentiss is “the consummate Ringling Brothers and Barnum &
Bailey circus-barker showman” (p. 4), and that he resigned because Prentiss was

interfering with his work. When Groubert asked Prentiss about this he said he fired him
because he was over-medicating people. In response to that, Emory said, “I find it
fascinating to be debating a person who has no education and just a real estate license”
(p. 8). Dr. Jason Giles, the medical director who succeeded Emory, stated the “cure rate”
“[does] not come anywhere near what he is quoting ,” and that Prentiss is a “charlatan”
(p. 7). Giles also states that he has intimate knowledge of how Passages is ran, and that’s
why Prentiss is trying to destroy his reputation (p.8). Groubert also interviews multiple
former patients, one of which claims she is now “normal,” yet when Groubert asks her
why then can’t she drink or use drugs like normal people, she says that “because then I
won’t want to stop.” Groubert stated that she was “befuddled” when he pointed out that
that wasn’t normal (p. 8).
This article is included here in an attempt to repudiate and expose Chris Prentiss, his
claims, and Passages Treatment facility. Groubert initially seems somewhat biased in his
approach, but as I read on it became apparent that he is just practicing good journalism,
and his observations are spot on. Additionally, the article is extensive enough to cover a
lot of significant information about Prentiss, and reveals much about his character and
ethics. I will post it on my Facebook page in an attempt to save addicts lives, and
hopefully save them (or their family) $67K a month to boot.
Harris, T., Gupta, S., & Feig, C. (2005, March 5). Interview of Dr. Drew Pinsky. House Call with
Dr. Sanjay Gupta [Television series]. Atlanta, GA: CNN News. Retrieved from
This is a transcript of Sarah Gupta’s House Call TV series,in which she conducts an in-
depth interview with Dr. Drew Pinsky, discussing numerous topics related to the disease
of addiction at length. Gupta asks Pinsky her own sets of questions/arguments, as well as
taking questions from viewers. Some of the issues addressed are the following: clear,
medical definitions and explanations of the disease,which includes addressing the
addiction is a moral weakness/choice view; the new alcoholism drug Campral, which
allegedly “attacks the biological mechanisms of the disease itself” (Dr. Pinsky, para. 20);
delineating dependency from addiction; detox as a beginning for treatment; the family
aspect of the disease, and/or genetics; anxiety and depression and the risk factors of
addiction; the addictive qualities of marijuana; and how the disease goes beyond
chemical addiction—to food addiction or gambling or whatever.
The interview with Pinsky is a sort of “catch-all” regarding this disease. There isn’t much
he doesn’t cover in this transcript. And his approach and explanations are very rational
and clear, without much room for controversy. For example, he had the following to say
about addiction and will power (or choice):
Addiction clearly is a biological process. . . . It’s a failure of volition, but it’s an
overwhelming drive that absolutely crushes volition. And so, volition can no longer be
functional, no longer works in the defense of these powerful drives that take over.
Literally addiction is a hijacking of the survival drive mechanisms of the brain. That’s
fundamentally what it is. (para. 36)
“Dr. Drew,” as he’s more famously known, is no quack or TV celebrity. He really knows
his stuff. I’ve heard that from numerous other addictionologists and SMEs in the field.
On this show, he answers every question that is asked of him in a calm, direct manner, no
matter how irrational or seemingly rudimentary the question happened to be. It’s a great
source to draw from for my Facebook page, especially in regards to responding to
questions from visitors. I personally only have my experience with the disease; thus I
need professional such as Pinsky to back up my claims and answers.

Hendricks, L. (2012, November 5). Alcoholism: Is it a disease, or bad choices? Arizona Daily
Sun. Retrieved from http://infoweb.newsbank.com
Hendricks’s article directly addresses the “disease versus choice” argument, using
quotations from Dr. Jason Powers,a board certified addictionologist and family physician
that supports the disease model, and Gene Heyman, a psychologist who teaches at
Harvard and Boston College, who discusses his latest book, Addiction: A Disorderof
Choice. Hendricks clearly supports the disease model, as the last third of the article
discusses the symptoms, causes,and recovery strategies related to disease.
As with most opponents of the disease model, Heyman doesn’t have much to support his
opinion, other than ambiguous statistics and theories. And additionally, he has a new
book to sell, so any press is good press,I suppose. Powers,on the other hand, states that
after the drugs stop working, “the self-aware frontallobe of a person, the place where a
person can make a choice,is overridden by the much older and very primitive part of the
brain’s limbic system” (emphasis added) (para. 18). He explains it in very rational terms;
in one is told they will win a large sum of money if they hold their breath for six minutes,
“The frontal lobe makes the choice to do so, but the limbic system, in charge of survival,
makes a person breathe well before six minutes are up, no matter how much the frontal
lobe wants the money” (para. 20). He goes on to say that once this happens, it’s like
trying to turn a pickle back into a cucumber. This is yet another article (and doctor) that
supports my claims that addiction is disease, and can be cited or used on my Facebook
page for skeptical using addicts or family members.
Hunsicker, R-J. (2007). Symbolizing the disease of addiction. Behavioral Healthcare, 27(7), 48.
Retrieved from http://www.behavioral.net/article/symbolizing-disease-addiction
Hunsicker makes a case for creating a symbol for the disease of addiction, the same as
red ribbons symbolize AIDS, or the 16 different wristbands that signify a specific type of
cancer. His argument for creating a symbol is that it could raise awareness and funds for
ongoing research into the disease of addiction (para. 1).
I have included this short article because Hunsicker also points out four reasons why
those with this disease don’t have a symbol (at the time of publication, that is; although I
don’t know of one today, either), and I think these reasons are significant:
We don’t have an umbrella federation or society to pull together such an activity;
We do not have a lot of history of allowing one part of the field to initiate leadership on
behalf of all;
We tend to be idealists (e.g., spending too much time looking for the perfect symbol
instead of deciding on one and moving forward); and
We have so many individual organizational priorities that it becomes difficult to allocate
resources to a national effort such as this.
The fact that “we” don’t have a symbol is beside the point. These four reasons point to
larger issues regarding this disease. It is a complex disease with many facets,strands,and
symptoms, which not only makes it difficult to diagnose, but that means that many
organizations are and must be involved that all relate in one way or another with it. Thus
there is no “one” federation or society, part of the field, or person that overrides another,
which delineates “us” from most other diseases and produces a convoluted number of
opinions, remedies, cures,treatment strategies,etc. Basically, I have included this article
here to argue for pronouncing addiction as a disease once and for all, by all parties
involved, so that we may have more unity as a community and more federalfunding.
Ronald J. Hunsicker is President and CEO of the National Association of Addiction
Treatment Providers and also a member of Behavioral Healthcare’s Editorial Board.

Hyman, S. E. (2005). Addiction: A disease of learning and memory. The American Journal of
Psychiatry,162(8), 1414-1422. doi:10.1176/appi.ajp.162.8.1414
Hyman presents a comprehensive study of the neurobiological aspect of the disease of
addiction, specifically focusing on the “molecular, cellular, systems, behavioral, and
computational levels of analysis … [which] suggests that addiction represents a
pathological usurpation of the neural mechanisms of learning and memory” (emphasis
added) (abstract,para. 1). Hyman’s hypothesis is that addictive drugs have a “competitive
advantage over most natural stimuli,” which essentially hijacks the using addict’s
thinking and subsequently his or her behavior, and that what we know to date about
addiction is best captured by this view (Dopamine Action, para. 1). He also concedes that
there are still large pieces of the puzzle that are missing; however, “basic and clinical
neuroscience have produced a far more accurate and robust picture of addiction than we
had a few short years ago” (conclusion, para. 1).
This article will be useful to my Facebook page in that it offers scientific and technical
agreement with what Powers and Pinsky both state regarding the neurobiology of the
disease. In other words, if and when I do quote Powers or Pinsky from the above
articles/transcripts, I can back them up with specific scientific data from Hyman’s article.
Scientific evidence and explanations made the difference for me in early recovery; I
didn’t believe the disease concept until it was explained using scientific information such
as the data in this article. My hope is to help using addicts who visit the page in the same
manner that initially helped me eleven years ago.
Steven E. Hyman, M.D., teaches at the Department of Neurobiology at Harvard Medical
School in Boston.
Leshner, A. I. (1997). Addiction is a brain disease, and it matters. Science,278(5335), 45-47.
doi:10.1126/science.278.5335.45
Leshner discusses the fact that addiction is a brain disease, but the focus of his article
deals more with the public and social aspects,such as the delay of transferring scientific
knowledge into practice or policy, the gap between scientific fact and public perception,
and/or the many stigmas attached to addicts. Another barrier, he states,is that people who
work in the field hold “ingrained ideologies” and “zealously defend a single approach”
(para. 4). Leshner also points out certain public health problems that are linked to
addiction, such as serious infectious diseases (AIDS,hepatitis, and tuberculosis) and
violence (Drug Abuse and Addiction as Public Health Problems, para. 1).
In addition, Leshner addresses public misconceptions of withdrawal symptoms, such as
thinking that because a particular drug has worse withdrawal symptoms than others, then
that drug must be worse than other drugs that are actually just as dangerous.
Methamphetamine, for example, is highly addicting but has few physical withdrawal
symptoms. He also points out the importance of the social contexts regarding this disease,
and cites the example of returning Vietnam veterans who were addicted to heroin yet
relatively easy to treat,because their drug use started in Vietnam, and their new
environment here at home lacked those same environmental cues (But Not Just a Brain
Disease,para. 1). In his conclusion, Leshner addresses criminal justice strategies, positing
that simply incarcerating addicts isn’t enough, and that if these individuals are left
untreated, their chances to return to crime and drug use is very high. Thus Leshner
recommends treating addicted criminals in prison to reduce these rates (para. 2).
This article is included here because of its different take on the disease of addiction.
While Leshner does agree that it’s a disease,he leaves the technical data for other articles
and focuses on the social and public concerns related to the illness, which are just as
serious and important to my research. This type of information will be helpful to family

members as well as addicts that visit my page, which could also be considered the lay
public. Having type-five and type-four information regarding these broader aspects of the
illness in response to their questions will help bridge the gap between facts and public
perception, which is precisely what Leshner prescribes. Alan I. Leshner is in affiliation
with the National Institute on Drug Abuse and National Institutes of Health.
Leyton, M. (2013). Are addictions diseases or choices? Journal of Psychiatry & Neuroscience :
JPN, 38(4), 219-221. doi:10.1503/jpn.130097
Leyton answers his title question through a series of rational questions and explanations,
in a sort of elimination process leaves one conclusion: addiction should be considered a
disease. Leyton starts with definitions of “disease” from the Oxford English Dictionary
and Stedman’s Medical Dictionary, which require certain traits, such as “pervasive
medical, emotional, personal and professional problems” (para. 2), and follows with
evidence of pre-existing vulnerability traits.
Leyton submits that in addicts, chances of acquiring the disease are 50% genetic and 50%
environmental (para. 3). He compares addiction with Tourette’s syndrome, in that both
patients have compulsive behaviors that are difficult to manage. Addiction requires
external triggers (e.g. exposure to a drug), the same as other neuropsychiatric disorders
such as phobias, which require specific stimuli. He concludes with recommending certain
changes in research strategies that can give scientists a better understanding of the basic
neuroscience associated with addiction.
I think Leyton’s practical approach will be particularly useful to the laity. Starting with
the definitions of disease and how addiction fits the criteria, and using comparison to
other well-known diseases,makes some of the more complicated distinctions of addiction
understandable in a way that other more-complex articles in my research do not. Addicts
and their families could read and comprehend this article in its entirety, whether they
have education or exposure to the science of addiction or not. It is an article that could be
used as a starting point for someone unschooled in these topics, in other words.
O’Brien, K. (2010, November 3). Robin Williams on addiction and comedy.NewsOnABC.
Retrieved October 22, 2013, from http://www.youtube.com/watch?v=DyctIk4YwZk
O’Brien interviews actor and comedian Robin Williams about his then-new standup
routine, which included his experiences with and the consequences of addiction.
Williams discusses certain warning signs, such as “DUIs in a cul-de-sac” (3:30); relapse
after 20 years “dry” (3:55); blackouts, which he describes as “sleepwalking with
activities, or your conscience going into witness protection” (4:20); and rehab (6:00).
From about 6:33 until the end, O’Brien and Williams discuss acting and being a
comedian.
This video is included here because of the humor, of course,which was and is an
essential part of my recovery; I have found that laughing and finding the funny side of
this illness has healing qualities. Moreover, Williams’s self-deprecating humor teaches us
that it’s okay to laugh at ourselves, even at the most severe consequences of our
addiction.
Another reason for the video, similar to the CNN piece about Pat Kennedy,is to show
that this disease doesn’t discriminate; it affects the wealthy and poor alike, and it doesn’t
matter how much one has going for oneself or how many accomplishments one may
have. Although Williams is funny, he does speak seriously about his addiction as well; he
has good experience, strength, and hope for the suffering addict. I will perhaps reserve
uploading this video onto the Facebook page when I feel some levity is required, such as
after a particularly intense discussion or question and answer session, or if I feel as if the
page needs to lighten up in general.

Pinsky, Drew. M.D. (2011, July 25). Dr. Drew Talks about Amy Winehouse Death . Dr. Drew.
Retrieved October 25, 2013, from http://www.youtube.com/watch?v=pY9gnsWRZ2g
Pinsky discusses the death of Amy Winehouse, on the actual day she died (July 25,
2011). He begins by addressing Winehouse’s parents directly, stating to them among
other things that “it’s a fatal condition; it is not your fault” (:55). Pinsky also interviews a
number of guests, including Estelle, singer and close friend of Winehouse, actor Tom
Sizemore, a recovering addict who has battled addiction all of his life, and Shelly
Sprague, addiction counselor and recovering addict. Additionally, Pinsky answers a
number of callers’ questions from 12:15 until the end of the video, in which he addresses
the stigmas associated with addiction, and offers help/answers to addicts and families
when dealing with those who are skeptical of the disease concept.
I included this video as an example of what happens with untreated addiction, and
because it is loaded with information. Originally, this entry referenced the transcript of
this show, which can be located under the heading Amy Winehouse Dead at 27,at
http://infoweb.newsbank.com. However,I felt that the visual quality of the YouTube
video communicated the conviction of the various speakers’ information more clearly;
the transcript is the exact wording from the show, it repeatedly includes phrases such as
“you know” or excludes certain breaks in sentences,which can be confusing and the
conviction/message is lost. In addition, the video has video clips of Winehouse and
certain press releases of her parents that couldn’t be properly conveyed in the transcript.
Including videos is better rhetorically suited for a Facebook page and my target audience.
Shriver, M. (2007, March 23). The nightmare of addiction. Larry King Live [Television series].
Atlanta, GA: CNN News. Retrieved from http://infoweb.newsbank.com
Transcript of Maria Shriver hosting Larry King Live in place of King, who was off that
night. A YouTube search for this interview yielded no results. Shriver begins with an
interview with actress Jamie Lee Curtis, a recovering addict and board member of the
Center for Addiction and Substance Abuse at Columbia University, and also defense
attorney Robert Shapiro, whose son, Brent, died of a drug and alcohol overdose in 2005.
Curtis tells a bit of her personal experience with the disease: experiences during active
addiction, hitting bottom, recovery in a 12-step program, and hope. Shapiro discusses
how he dealt with his son’s addiction, and how the Brent Shapiro Foundation is raising
awareness about addiction and its misconceptions: “This is not unlike any other disease,
and people view it as shameful,” he said (para. 35).
In the second half of the transcript Shriver interviews Susan Ford Bales, daughter of
former first Lady Betty Ford, and delves into a deep discussion with Bales about the
family aspect of the disease: about her mother’s illness, intervention, eventual recovery,
and creation of the Betty Ford clinic; the genetics involved that affect the entire family
and Bales’ children; and the vital spiritual element in finding recovery, or “healing the
soul” (para. 87), which aligns with what Galanter describes as the third element essential
to recovery in his above article.
I included this article mainly for the portion with Susan Ford Bales. Her discussion on the
family aspect of the disease will be a useful article to post or reference on my Facebook
page for affected and uniformed family members. However,the portion with Curtis and
Shapiro are also very informative and shed light once again that anyone can have this
disease regardless of age, race,creed,or financial or celebrity status. Curtis’s interview is
especially effective—although she’s talented, wealthy, and famous, her story, her feelings
are exactly the same as mine were at the end, and many other addicts. The identification
and credibility she provides is significant; she’s experienced the same levels of shame,
degradation, and demoralization that unite us as addicts, no matter our social status.

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