First, there was MAGA. Then MAHA. Should we now be getting ready for MASA? Will our new Health and Human Services Chair, Robert F. Kennedy, Junior, dedicate himself to Making America Sober Again?

It would make sense, right? After all, his own story of addiction and recovery is one of the foundations of his personal brand. And, in his current role, he continues to talk quite a lot about addiction, calling it a national security threat and vowing to spend $4 billion combating it.

But do these facts promise more and better help for people struggling with alcohol use disorders? Let’s look at the evidence.

The first thing to notice is that Kennedy doesn’t seem very concerned about AUDs specifically. When he talks about addiction, his focus is elsewhere: on opioids and on psychiatric medications. Yes, you read that right; he does consider daily use of Prozac to be addiction. Anyway, Kennedy name-checks “alcoholism” now and then, primarily in his own recovery story, but it’s not a major focus of his policy initiatives. Could that be because of the $85,000 that the alcohol industry donated to his short-lived presidential campaign? Perhaps not, as that’s a relatively modest amount for those particular donors. On the other hand, perhaps it is, as the alcohol industry typically donates ZERO dollars to independent presidential candidates, instead favoring guaranteed winners with established power, so even a modest $85K might inspire some gratitude in a guaranteed loser.

But all we can say with certainty is that he doesn’t talk about alcohol much, especially considering that it was his gateway drug.

So what does he say about addiction—or about health generally—that could indicate his administration’s approach to alcohol problems?

First, he thinks that the problem, hence the solution, is largely systemic, and that view I endorse full-throatedly, as any reader of this blog already knows. We’ve created a hyper-individualistic, winner-take-all culture that is profoundly isolating, that breaks down hard-working bodies and anxious minds long before their time. Then, rather than solving these problems or at least mitigating them a bit with decent health care and restorative recreation for all, we offer a drink that kills the pain, a drink we’re well aware creates dependency in vulnerable individuals, yet we shame anyone who develops the dependency, make them wholly responsible for staying sober and blame them if, after seeing hundreds of bottles every day in restaurants, bars, supermarkets, drug stores, gas stations, furniture stores, movie theatres, sports arenas, airports, and the like, they finally reach for one. We shame them for taking the drink that beckons from every corner of their built environment, from the airwaves, and from inside their own skulls, which hold thousands of hours of pro-alcohol propaganda blasted their way since they were young children cracking Daddy up by imitating the “Whassup” Budweiser ad.

And we could do something about that culture to make it less toxic, less prone to produce alcohol dependency in its citizens. There are lots of things, in fact, from laws that prevent the exploitation of large populations to restrictions on the advertising and sale of alcohol. I’ve made a whole bunch of suggestions at the end of this post, if you’re interested.

So, does Kennedy’s belief that addiction is systemic lead him toward any kind of systemic solution?

Well . . . not really. When he speaks systemically about addiction, he tends to issue vague platitudes such as “We need to focus on reestablishing historic ties to the community,” as he does in this recent speech. What does he mean by that? It’s a little hard to tell at first because he explains himself by telling the story of the first AA meeting, an ad hoc conversation between founders Bill Wilson and Dr. Bob, but what he means is that we can prevent—and treat—addiction by giving sufferers opportunities to be of service to their communities. And by banning cell phones in schools and at the dinner table.

In other words, treat addiction by putting phones away and living by the principles of AA. Sorry, folks, nothing new—or systemic—here, though, of course, there are people who can and will get sober this way. But, if Kennedy has any revolutionary impulses, he’s saving them for other issues because, when it comes to addiction, HHS is taking a giant step (or twelve) backwards.

Oh wait, I forgot about the healing farms. These are also a bit of a backward step as they were pioneered in the same decade that saw the founding of AA and are also heavily reliant on AA principles and practices. But they’re forward-looking and systemic in the sense that they attempt to substitute collaborative communities for competitive communities and foreground peer support in a way that, compared to regular rehabs, could turn out to be kind of forward-thinking, ish, depending on how they’re governed and whether they can develop organically. That said, as currently envisioned, they preserve the biggest problem with current addiction treatment, which is AA’s one-size-fits-all mentality in spite of evidence that, while the program works beautifully for some people, it’s ineffective, and even harmful, to others. So it should never be the only game in town—or on a farm.

As for the general idea of long-term care accompanied by vocational training available at residential treatment centers way out in the country, I think that could be quite helpful for some people, as long as it’s somewhat individualized and not mandatory. And free, of course. I have a hard time getting my head around some of the logistics, starting with how the farms would be funded and how they’d find enough qualified staff to treat the large number of trauma survivors that appear in any group of people with addictions, and how they’d cope with addicted people who have young children. But, if Kennedy actually ends up with the $4 billion he claims to have, surely solutions to some of these problems could be tested.

All in all, I’d be interested in seeing a pilot program. I don’t hate the training requirement, and I wouldn’t even mind if there were some kind of required spiritual or philosophical component, as long as its nature weren’t prescribed. And, very importantly, as long as it didn’t serve as a substitute for any necessary health or mental health treatment. But, as soon as I wrote those words, I remembered that Kennedy considers psychiatric medications “addictions,” and I realized that he and I will never see the same thing when we try to imagine what a healing farm could be. For him, I think, sobriety is some kind of purity, a body and mind free of chemicals, whereas, for me, purity is impossible and not worth pursuing anyway, For me, sobriety is the sublime conjunction of impure and pure, torn and mended, broken and whole, and there are as many different paths to it as there are people.