In a podcast interview with Tom Horvath, Ph.D., the president of SMART Recovery, recovery maverick Dr. Stanton Peele, peered into the future of addiction treatment in the 21st century. The conversation focused on three primary themes: Commitment, Choice and Change. Dr. Peele noted that the 21st century, particularly the last three to five years, has seen a substantial increase in recognition of the multiple pathways to recovery, including harm reduction models and moderate-drinking outcomes that go against the grain of the disease model of alcoholism and addiction.

Dr. Peele believes the changes now taking place will continue to accelerate as time passes. In a review of the podcast, Dr. Horvath described how much he agrees with Dr. Peele’s rejection of the one-size-fits-all approach of the 12 steps and the disease model of addiction. SMART Recovery has been a proponent of personal choice in recovery throughout its 20-year history. Against the labeling of an individual or others as "addict" or "alcoholic," Dr. Peele believes one of the most powerful forces for change lies in cultivating mindful awareness through cognitive behavioral therapies.

“To question the efficacy of AA and offer non-abstinence-based solutions in the last century was really to risk your career," he said in expressing his frustration with that approach. "There used to be nothing beyond AA, so SMART Recovery was such a milestone ... The SMART Recovery keynotes of choice and self-empowerment are exactly where addiction treatment is heading in the 21st century."

Dr. Peele emphasized a personal commitment to the concept of personal self-determination. Treatment providers and support groups in the future need to adopt a focus on broad measures of success rather than only on perfect abstinence. The goal should not be abstinence no matter what, but rather living a life that is both rewarding and positive.

The framework offered by Dr. Peele encourages people to look at addiction in the context of their lives, rather than limiting themselves to any single label. He wants a person experiencing an addictive episode to believe that:

“People are able to evolve out of addiction. It’s not a fundamental part of their make-up. Identifying as an addict is going to soon be out-of-date and the label will no longer be used like we no longer use the word retard," Dr. Peele said. "Only an individual can decide for themselves how harmful a substance is to them and how much they want to change their relationship to that substance."

"Going forward in the 21st century, harm reduction and moderate drinking outcomes are going to become the norm,” he said.