Less effective and focused on only one problem

This is a throwback post that was originally posted January 14, 2012.

Some friends shared this video about the benefits of exercise:

At about 7:00, he says:

So a German researcher named Rainer Hambrecht looked at this with about 100 cardiac patients He got the group to exercise, and by that I mean 20 minutes a day in an exercise bicycle and once a week a 60 minute aerobics class, and the other half got the high tech stent and just did their normal activity, and after one year 88% of the exercise group were event free, compared to 70% of the people who got a Stent. So both worked, but I find it sort of incredible that the low tech made a bigger difference and you have to remember that the Stent just fixes one part of the heart.

Earlier, he outlined the diverse benefits of physical activity in various populations, including:

  • [in knee arthritis patients, it] reduced rates of pain and disability by 47%
  • reduced progression to dementia and Alzheimer’s by around 50%
  • reduced progression to frank diabetes by 58%
  • 41% reduction on the risk of hip fracture
  • reduced anxiety by 48%
  • 23% lower risk of death
  • number one treatment of fatigue
  • shown again and again to improve qualty of life

This got me thinking about whether recovery rooted in mutual aid groups is to addiction what exercise is to heart disease.

Preventing heart attacks is a very good thing. That stents exist and are readily available is a very good thing. This sounds like a very strange thing to wonder, but would we be better off it cardiac care was a little less medicalized? If there was a little more parity in research and resources invested in helping people be more physically active? I know that there are some efforts in this direction, but is the medical system missing the boat?

In the same way we have interventions (like medications) that can prevent overdose and reduce drug use. But, these offer none of the other benefits. Further, the damage done by addiction is often pretty global—physical, emotional, social, familial, spiritual, occupational, educational, etc. So…an intervention narrowly focused on drug use is, at best, a start on the path to wellness and recovery.

Of course we can’t make cardiac patients exercise and we shouldn’t withhold care to patients who do not exercise or give them second class care. But, maybe, the medical system should be more focused on “recovery” rather than just harm reduction?

The addiction treatment system did a lousy with people who didn’t engage in our version of exercise, we didn’t do a good job supporting it beyond a period of a few weeks or months, we sometimes used some dubious and even harmful methods to get people to do it. (We’re not alone in this. Medical history is full of dubious and harmful methods.) We were also too prescriptive about the particulars of the individual’s exercise plan. But…there’s been a lot of improvement, a lot of success, and it offers global benefits that go well beyond abstinence or reduced drug use. So…why are so many people in a hurry to abandon and dismantle this system?