Mickey is an old friend and colleague from way back. His 1992 book, The End of Equality, was hugely influential for welfare reform in the Clinton years.
You can listen to the episode right away in the audio player embedded above, or right below it you can click “Listen in podcast app” — which will connect you to the Dishcast feed. To hear three excerpts from my conversation with Mickey — on the history of how neoliberalism gutted the middle class; on whether Joe Biden’s amnesty policy amounts to “open borders”; and our questioning of what Biden actually believes, if anything — head over to our YouTube page.
Mickey in the first ten minutes of the episode touches on a much-forgotten history noted by this reader:
You wrote in your column last week that Johnson was a radically progressive president. Actually, I think that Nixon was more radically progressive. He might have been the most left-wing president of my lifetime since 1953.
Nixon created the EPA and supported environmental legislation. He tried wage and price controls to combat inflation. Nixon’s 1969 Family Assistance Program included a guaranteed income (what we increasingly call UBI), and it passed the House but not the Senate. Nixon and Senator Ted Kennedy were also in negotiations for a federal universal health coverage plan. These negotiations didn’t get too far because of Watergate distractions and other priorities.
Peter Beinart sizes up the LBJ-Biden analogy when it comes to foreign policy.
Looking back to last week’s episode with addiction expert Sally Satel, a reader writes:
Thank you for your incredibly fair treatment of AA, and 12-step programs generally. I’m 21 months sober and active in AA, and honestly my main issue has always been depression (which I largely see as my feelings of hopelessness and meaninglessness in this life). I believe the two are intimately connected for me. And I hear how people speak of the program in popular culture and even people who are in addiction services and they don’t seem to understand it, and I think it serves to actively dissuade people from going, which is a huge disservice to lots of people.
I think you really understand it (have you spent some time in 12-step recovery?), and I just want to say thanks for doing it justice, in my mind. I also really appreciated this conversation with Sally generally, and the nuanced treatment of depression and addiction and how they are really social disorders, with biological and psychological and other bases.
Never done 12-step myself. But I’ve seen its power in others. Another reader dissents a little:
Sally Satel is so close! It’s true that addiction isn’t a disease, it’s a symptom — a symptom of a larger psychological problem, usually trauma of some kind. Something that requires escaping. Dr. Gabor Maté found from working with addicts that every single one of them had some kind of traumatic experience that they seek to escape through chemical means. Check him out:
This next reader recommends Gabor Maté for the Dishcast and offers some excellent observations about the opioid crisis — both from a professional perspective and a personal one:
Fantastic podcast this week with Sally Satel on a topic that interests me greatly (I edited a book about the opioid crisis). You asked some probing questions that the recovery community hasn’t been able to collectively answer: To what degree should we think of addiction as a brain disease, versus something that a person can control? And where should we assign responsibility for the scourge of addiction that is sweeping our country?
Surely, the pharmaceutical companies behave villainously. And as you suggest, there are obvious reasons why addiction epidemics strike hardest where people were already suffering.
But there is another issue that your podcast failed to take up, and I fear it is likewise lost in the broader conversation, at least among certain educated, liberal circles. I cannot believe that what I’m about to say should strike anyone as remotely controversial, but people often don’t like hearing it: People should not fuck around with certain dangerous drugs, such as crack, meth, or heroin. Not ever, and even a little bit, not even if they are “responsible grown-ups.” So, I regard Carl Hart, whom Sally mentioned on your show, as a terribly misguided menace.
(P.S. I feel differently about MDMA and psilocybin, though that muddles my message.)
Studies show that the overwhelming majority of opioid addicts did not, initially, receive narcotics from a careless doctor. They started using opioids recreationally. Furthermore, about 70 percent of opioid addicts started fooling around with other drugs before they got hooked on OxyContin or heroin. When overdose deaths occur, they typically involve combinations of drugs, such as when heroin is laced with fentanyl, or when people mix opioids, cocaine, benzos and booze. That happened about 80,000 times last year.
Obviously, this is not an invitation to shame, marginalize, or humiliate drug abusers. No decent person would do these things. But we should have a greater capacity — a better language — for compassionately encouraging addicts to take more responsibility for their lives. Whenever we say people are “slaves” to their addictions (or compare opioid users to “zombies”), we are using metaphors. Even when a person’s compulsion to use a drug seems irresistible, their free will is never entirely extinguished. Everyone who ingests an addictive recreational drug is making a choice (and usually it’s a bad one).
Toward the end of your podcast, you spoke wonderfully about the virtues and benefits of AA. That organization has yet another salutary quality that I want to mention: It brings people together from all walks of life, working to solve a common problem. We are so unbelievably fractured these days — by race, region, education, class, sexual and gender orientations and (of course) our degraded political situation. But none of those things matter whatsoever in AA. (I mean, I guess they can come up, if a meeting goes off the rails, but they are not ever supposed to.)
I’m certain that some of my old-AA cohorts were rabid, FOX-viewing Trump supporters. But I bet if I asked them for help, in an AA context, they would be there for me, just as I would for them. I cannot think of another institution in American life that fosters these kinds of benevolent interactions with people from opposite ends of the political spectrum.
Shifting gears to mental illness, a reader relays some interesting and tragic history:
Cost was the main reason that the large mental hospitals (“asylums”) were closed in my state. The hospitals overwhelmed state budgets (see Ten Drugs: How Plants, Powders and Pills Have Shaped the History of Medicine by Thomas Hager), but the conditions of the hospitals were embarrassing when shown (see, the documentary Titicut Follies or Geraldo Rivera’s Willowbrook investigation.)
Freeing patients into the community with medications like Thorazine and a promise of support seemed to permit the hospitals to be closed and the patients to enjoy life with fewer restrictions. This was an apparent win-win: state budgets freed from the burden of the mental hospitals and the patients liberated.
The first part worked brilliantly; the second part, less so. Not only did promised outpatient services fail to emerge, the patients stopped their meds. And with good reason: Thorazine has permanent and irreversible physical side effects.
But there was a second reason that my clients (I was a Legal Aid lawyer in Manhattan) stopped taking their meds: they did not think they needed them. And who could blame them? When properly medicated, they were self-aware and rational. And like you and me, they tended to believe that was who they were and would continue to be. As they experienced it, they had overcome their mental issues and had put them behind them. Just as you were eager to get off steroids for your bronchitis, my clients were eager to get off Thorazine.
Insidiously, stopping their meds did not have an immediate effect. This reinforced their belief that they no longer needed them. And when they began to deteriorate, their illness blinded them to it.
All of this also applies to the mentally ill homeless today. I have no idea whether jails are cheaper than mental hospitals, but I assume that they must be since there seems to be no political stirring to revive them. And, of course, it seems inhumane to restrain people who, once medicated, seem fine until they are not.
Another reader has some gut feelings about the spiritual nature of drug addiction:
The most recent podcast episode was great food for thought, as usual. Something was said toward the end about nondenominational churches involved in addiction recovery, and made me think of this:
I grew up Pentecostal Protestant, and I’ve had a lot of experience in Pentecostal churches and communities. Pentecostal worship practices, and group behavior in general, is extremely emotionally and viscerally charged to the point that transcendental experiences can be triggered in people open to these experiences. At some point I noticed that a lot of people who have recovered from a substance addiction were drawn to this tradition of Christianity and tended to be most open to intense mystical experiences, and that in certain cases the pattern of addiction carried over into their spiritual practices and beliefs. But I also know people (family members) whose recovery from drug addiction and life stability was directly assisted by charismatic experiences.
I mention the fact that these groups were Christian simply for context, because I think that this phenomenon probably also applies to other spiritual traditions where ecstatic experiences are a focus.
Lastly, on a very different subject, a reader wants me to go there, again:
Thanks so much for the podcast with Michael Anton a few weeks ago. I appreciated that both of you could keep your cool talking about such heated topics, and I thought you both made many good points about issues I am torn on.
You should talk to Charles Murray at some point about human biodiversity and the plausibility of genetic bases for disparate outcomes in our society between the sexes or among racial groups. His extensively researched, carefully written book on that subject last year, Human Diversity, was intentionally ignored by most mainstream media outlets and commentators, and he has a timely short follow-up book coming out this summer that will address our current derangement over racial issues.
So I think he would be thrilled to talk to you about his recent scholarship. Obviously this subject is incredibly controversial and most people would rather avoid thinking about it entirely, but I think intelligent heterodox adults like your audience should be able to grapple with these issues and their implications for fully understanding the world we live in. I’d understand if you’d rather avoid more notoriety of course. But since you essentially got fired from your last job for refusing to condemn Murray’s work, and you started your own independent outlet to maintain your intellectual freedom, I do think it would be a shame to never touch on those types of taboo ideas in your future work.
That’s a good idea. I read Human Diversity carefully, and found it nuanced as well as fascinating. I didn’t review it because, well, the process of getting that through the woke-checkers at New York Magazine would have destroyed what T-cells I have left. But since the elite media won’t touch these subjects, it seems to me that those of us with independent platforms should bear the burden of pursuing the truth, even through the relentless harassment and obloquy. In all honesty, that’s why I’m a writer. I’m interested in the truth about the world.
