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I need time to order a cake.” — Victorious Proposition 8 lawsuit plaintiff Paul Katami, asked if he will marry his partner now that California’s same-sex marriage ban has been overturned


Myths about the ‘tea party’ T


5 by David Weigel


he grass-roots conservative activists who march under the “Don’t tread on me” Gadsden flag and the “tea party” label have put a new


twist on Gandhi’s maxim: First they were ignored; then they were ridiculed; then they began to fight. They battled health-care reform and then the Republican establishment, which became angry about the less-than-seasoned candidates it was suddenly saddled with. ¶ In short order, a movement that few people took seriously has become the most obsessed-over and overanalyzed political backlash since the 1960s. And as long as both parties are grappling with it and publishers are putting out tea party books every month, it’s worth busting a few myths about the movement.


The tea party isn’t a reaction to President Obama, it’s a reaction to the bank bailouts.


long before Barack Obama took office, and they were organized by supporters of Rep. Ron Paul (R-Tex.) to raise money for his long-shot presidential bid. They received the respectful, hey-look-at-that coverage sometimes given a candidate flipping pancakes at a church social. Some of the people recognized as leaders of the tea party movement, such as FreedomWorks Chairman Dick Armey, have loudly condemned the 2008 financial-sector rescue package. And several members of Congress, such as Sen. Bob Bennett (Utah), have been unable to survive their TARP votes when facing GOP primary voters. Here’s the thing, though: The tea


1


parties were kicked off by CNBC reporter Rick Santelli’s rant about, of all things, Obama’s Homeowner Affordability and Stability Plan, an effort to lessen the damage to people who’d taken out mortgages they couldn’t afford. And it picked up steam when conservative groups fired up activists about energy and health-care legislation —the Obama agenda, not a last-ditch conservative plan to rescue the banking industry. If you think the tea party would have risen up to oppose a Republican president who spent like mad and violated conservative principles, then where was it in the Bush years?


The tea party is racist. 2


It’s a phenomenon that some activists call “nutpicking” — send a cameraman into a protest and


he’ll focus on the craziest sign. Yes, there are racists in the tea party, and they make themselves known. But tea party activists usually root them out. Texas activist Dale Robertson, who held a sign likening taxpayers to a racial epithet at a 2009 rally, was drummed out of that event and pilloried by his peers. Mark Williams, formerly the bomb-throwing spokesman for the Tea Party Express (he once told me he wanted to send the liberal watchdog group Media Matters “a case of champagne” for calling him racist), was booted after penning a parody that had the NAACP pining for slavery. Liberal critics of the tea party argue


that conservative opposition to social spending is often racially motivated. That’s not new, though, and it’s not the basis for the tea party.


Sarah Palin is the leader of the tea party.


3


After she and John McCain lost the 2008 election, and after eight unhappy months back at work


governing Alaska, Sarah Palin took her time to reenter national politics. She spent the last half of 2009 writing Facebook posts that, for all the attention they got, mostly praised the work of people such as Rep. Michele Bachmann (R-Minn.). It wasn’t until this past February, at the National Tea Party Convention in Nashville, that Palin picked up the movement’s banner. Her credentials aren’t ideal: Tea partiers unanimously agree that the TARP was what turned America’s decline into a freefall; as a vice presidential candidate, Palin backed the TARP. But she showed plenty of political savvy and hitched herself to the movement, and reporters, eager to find a party politics angle to the tea party story — and knowing that Palin’s name brings traffic to news Web sites — anointed her. Palin has more devoted fans than any other Republican politician, but according to an April New York


There are some kernels of truth here. The first modern tea party events occurred in December 2007,


Times/CBS News poll, only 40 percent of self-identified tea party activists think she would be an “effective chief executive.” They’d like to be leaderless for now, thank you very much. But the Tea Party Nation, which planned the Nashville event, and the Tea Party Express, which invited the former governor to rallies in Nevada and Massachusetts, knew they could get media to show up if Palin came along, and they won’t forget that lesson.


The tea party hurts the GOP. 4


Sen. Lindsey Graham (R-S.C.) predicted recently that the tea party movement will “die out.”


Rep. Bob Inglis (R-S.C.), who lost his primary race to a tea party-backed candidate, has made the media rounds to accuse the movement and some of its heroes, such as Glenn Beck, of poisoning politics. There is no shortage of Republican grumbling about the primary wins of tea partiers Sharron Angle in Nevada and Rand Paul in Kentucky, two Senate candidates who are being hammered by Democrats for their anti-big-government rhetoric. Democrats are doing their best to make Republicans answer for it when tea party activists pledge to dismantle Social Security or the Environmental Protection Agency. But in every political cycle there are


“bad” candidates who say the wrong things — and with the right electorate, they still win. The tea party movement is giving Republicans a dream of an electorate, one in which surveys find more GOP-inclined voters enthusiastic about casting ballots than voters who lean Democratic. Democrats have done some damage to the tea party brand— its favorability has fallen in polls — but in general, the presence of a new political force that is not called Republican and is not tied to George W. Bush has given the GOP a glorious opportunity to remake its image, at a time when trust in the party is very low. Some liberals deride the tea party as a new bottle for old Republican wine. But rebranding works. (Even Coca-Cola eventually benefited from the publicity of New Coke.)


The tea party will transform American politics.


5


Here, Sen. Graham has history on his side. A popular, and correct, aphorism about grass-roots


movements is that they act like bees — they sting, then die. Third parties fold into major parties, like the 19th century Populists did with the Democrats. The tea party is unlikely to even reach third-party status, because the vast majority of its members — up to 79 percent, in some polls — identify as Republicans and are savvy enough not to take actions that would help Democrats. (Liberals only wish that Ralph Nader thought like this.) The movement’s big innovations, such as fast organizing, are mostly technological, inspired by and improving on Obama’s 2008 campaign. Their demands are really the same ones that conservative Republicans were making after Obama won, and that Rush Limbaugh and most GOP lawmakers were already making, too. So the tea party will succeed, if it


hasn’t already, in making one of America’s political parties more devoted to supply-side, pro-war-on-terror, anti-spending principles. But it is pushing on an open door. david.weigel@slate.com


David Weigel is a Slate political reporter. on washingtonpost.com


David Wiegel will discuss this article Monday at 11 a.m. at


washingtonpost.com/liveonline. JACOB THOMAS 12 steps to nowhere by Bankole A. Johnson L


ast week, Lindsay Lohan left jail and entered a drug and al- cohol rehabilitation facility. If the scene inspired deja vu, it wasn’t just because it was the


fourth time she had headed to rehab in four years. It was because the spectacle of a celebrity entering a drug and alco- hol treatment center, relapsing, then heading to rehab again — and again and again — has become depressingly famil- iar.


For decades, Americans have clung to


a near-religious conviction that rehab — and the 12-step model pioneered by Al- coholics Anonymous that almost all fa- cilities rely upon — offers effective treat- ment for alcoholism and other addic- tions. Here’s the problem: We have little in-


dication that this treatment is effective. When an alcoholic goes to rehab but does not recover, it is he who is said to have failed. But it is rehab that is failing alcoholics. The therapies offered in most U.S. alcohol treatment centers are so divorced from state-of-the-art of medical knowledge that we might dis- miss them as merely quaint — if it we- ren’t for the fact that alcoholism is a deadly and devastating disease. And the way we attempt to treat alco- holism isn’t just ineffective, it’s ruin- ously expensive: Promises Treatment Centers’ Malibu facility, where Lohan reportedly went for her second round of rehab, in 2007, has stunning vistas, gourmet food, poolside lounging and acupuncture. It costs a reported $48,000 a month. Even nonprofit facilities that don’t ca-


ter to Hollywood types are too costly for most people. At the 61-year-old Ha- zelden center in Minnesota, which bills itself as “one of the world’s largest and most respected private not-for-profit al- cohol and drug addiction treatment centers,” a typical 28-day stay costs $26,000. These prices might be justified if these programs worked. But finding out the success rate of a given program is ex- tremely difficult. Controlled studies of specific treatment centers are rare; compounding the problem, many pro- grams simply don’t follow up with for- mer patients. And when they do report a success rate, be it 30 percent or 100, a closer look almost always reveals prob- lems. That 100 percent rate turns out to apply only to those who “successfully completed” the program. Well, no kid- ding. The 30 percent rate applies to pa- tients’ sobriety immediately after treat- ment, not months or years later. It’s understandable, if unfortunate,


that treatment centers that have a fi- nancial stake in recruiting patients might be reluctant to aggressively track


— much less publicize — data on their patients’ success down the road. But the problem is more fundamental than that: There is little compelling evidence that the AA method works, inside or outside a rehab facility. Although AA’s emphasis on anonym-


ity makes it difficult for outside research- ers to determine its success rates, some have tried. What they have found doesn’t inspire much confidence in AA’s ap- proach. A recent review by the Cochrane Library, a health-care research group, of studies on alcohol treatment conducted between 1966 and 2005 states its results plainly: “No experimental studies un- equivocally demonstrated the effective- ness of AA or TSF [12-step facilitation] approaches for reducing alcohol depen- dence or problems.”


AA itself has released success rates at times, but these numbers are based only on voluntary self-reports by alcoholics who maintain their ties to AA — not ex- actly a representative sample. Even taken at face value, the numbers are not impressive. In a 1990 summary of five membership surveys from 1977 through 1989, AA reported that 81 per- cent of alcoholics who began attending meetings stopped within one month. At any one time, only 5 percent of those still attending had been doing so for a year. Many health conditions resolve them- selves through what’s known as sponta- neous remission — that is, they improve on their own. In the case of the common cold, for example, nearly everyone gets over the virus without medical interven- tion. In a 2005 article in the journal Ad- diction, Deborah A. Dawson and her col- leagues calculated a natural recovery rate for alcoholism of 24.4 percent — that is, over the course of a year, 24.4 percent of the alcoholics studied simply wised up, got sick and tired of being sick and tired, and quit. Without treatment and without meetings. When AA’s retention numbers are compared with alcoholism’s rate of spontaneous remission, they look even worse. Many proponents of AA cite Project


MATCH (Matching Alcoholism Treat- ments to Client Heterogeneity), a study completed in 1996 by the National In- stitute on Alcohol Abuse and Alcohol- ism that seemed to find that 12-step treatment works. The study randomly assigned alcoholics to one of three be- haviorally based treatments with marked differences in philosophy and practice: a 12-step therapy based on the principles of Alcoholics Anonymous, cognitive behavioral therapy and moti- vational enhancement therapy. After eight years and $27 million, the study concluded that the techniques were equally effective. More to the point, a 2005 article in the journal BMC Public Health that reanalyzed the data


from Project MATCH reported that al- most all of the effect of treatment was achieved after attending a single ses- sion. In other words, it was the initial decision to try to get better that deter- mined a person’s chances of succeeding; what followed made little difference. Although AA doubtless helps some people, it is not magic. I have seen, in my work with alcoholics, how its philos- ophy can be harmful to patients who chronically relapse: AA holds that, once a person starts to slip, he or she is pow- erless to stop. The stronger an alcohol- ic’s belief in this perspective, the longer and more damaging relapses can be. An evening of drinking turns into a month- long bender.


Equally troubling, AA maintains that when an alcoholic fails, it is his fault, not the program’s. As outlined in the or- ganization’s namesake bible, “Alcohol- ics Anonymous” (also known as “The Big Book”): “Those who do not recover are those who cannot or will not give themselves completely to this simple program, usually men and women who are constitutionally incapable of being honest with themselves. There are such unfortunates . . . they seem to have been born that way.” This message can be devastating. In the end, there is simply no need to remove alcoholics from the support of relatives and friends and shut them away for the customary month in rehab. There is no need for alcoholics to be led to expect a miracle, only to be judged a failure if one does not occur. And there is no need to spend tens of thousands of dollars, again and again and again, on an approach that keeps landing people back where they started.


Alcoholism is an illness. But although those in the rehab business sometimes use that word, the 12-step approach they advocate is weak medicine. When any other illness causes great suffering, our society devotes time and money and effort to studying it and to developing treatments that are empirically found to work.


Alcoholism and drug addiction should be no exception. Recent ad- vances in neuroscience have led to a greater understanding of how alcohol and other drugs affect the brain. They have, in turn, allowed medical research- ers, myself included, to begin to ap- proach alcohol dependence as we would any other disease: by searching for ef- fective medicine.


Bankole A. Johnson is chairman of the department of psychiatry and neurobehavioral sciences at the University of Virginia and has served as a paid consultant to pharmaceutical companies developing medications to treat alcoholism. His book “The Rehab Myth: New Medications That Conquer Alcoholism” will be published in January.


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