Do drug addicts really lose control of their drug use?
Many drug users certainly feel as if they have no control of their drug use. Many drug users (especially heroin and other opiate users; meth or methamphetamine users; other speed or stimulant users; and crack users) appear as if they can’t control their drug use. However, there is still no scientific proof that they actually cannot control their substance use, and that they are not choosing to take each successive hit of their chosen drug.
One of the core claims of the disease model of addiction is that “addicts” will literally lose control of their substance use upon taking a single dose of their drug of choice. In other words, the first drink or hit is equivalent to knocking down a set of dominos – once the first domino goes down, the rest are guaranteed to follow. It’s said that they lose control and that a chain reaction happens without their consent.
Do drug addicts really lose control of their drug use? No, they do not. In fact, the available scientific research shows the exact opposite. It shows people choosing the behaviors they think will be most satisfying, given their perceived feasible options. For one example of the evidence, listen to the words of Dr Carl Hart PhD, describing some of what he learned in approximately 15 years of research as a neuroscientist at Columbia University:
The more I studied actual drug use in people, the more I became convinced that it was a behavior that was amenable to change like any other…
In one study, we gave methamphetamine addicts a choice between taking a big hit of methamphetamine (50 mg.) or five dollars in cash. They took the drug on about half of the opportunities. But when we increased the amount of money to twenty dollars, they almost never chose the drug. We had gotten similar results with crack cocaine addicts in an earlier study. This told me that the addictive potential of methamphetamine or crack was not what had been previously claimed; their addictiveness wasn’t extraordinary. Our results also demonstrated that addicts can and do make rational decisions…
The bottom line is, that if supposed “addicts” can forego the opportunity to get high when they perceive a more attractive opportunity – then this means that they are choosing – that they are in control – that they are doing what they currently believe is their best feasible option for a positive return (i.e., happiness, pleasure, satisfaction, or whatever you wanna call it).
Dr Hart’s work on drug addiction is extremely similar to a series of experiments done with alcohol in the 60’s and 70’s (these are known as priming dose experiments, because they measure people’s behavior after an initial dose of an intoxicating substance). Some of those studies, such as the work of Nancy K Mello, showed that alcoholics could be paid to refuse the opportunity to drink even while already under the influence, just as Hart’s work showed with crack and meth users. In some other priming dose experiments, hardened alcoholics were given alcohol without their knowledge – and yet they did not proceed to “lose control” and seek out alcohol or report heavy irresistible craving. It’s unlikely that the exact experiments with drugs (slipping someone crack or heroin without their knowledge) will be done today. However, the principle demonstrated in those experiments should also hold true for other intoxicants such as heroin, cocaine, meth, etc. For more information on the experimental scientific evidence pertaining to alcohol and loss of control, see this article: Do Alcoholics Lose Control? The Results of Priming Dose Experiments Say NO.
More data will be added to this page over time as I get the chance to add it, but for now, I wanted to have something up that addresses this basic question. If anyone thinks they have data that proves “loss of control” I encourage them to provide links to it in the comments section. Be forewarned, the fact that the sight of a drug paraphernalia correlates with certain brain activity is not proof of loss of control. If you’re going to present such data, please include a logical argument that demonstrates how control is lost or substance use is “caused” by such brain activity.