There’s an odd little bit of logic or assumption that comes up when discussing addiction that I need to discuss. Those who favor the disease model of addiction, or any model of addiction that includes an inability to choose differently, tend to assume that those who don’t quit can’t quit.
I, however, see addiction as freely chosen substance use, and so just as people choose to use, they can choose not to. To understand the significance of this, let’s look at something most people would agree is a free choice – divorce. In states where anyone is free to choose to initiate and receive a divorce, there are still, one can assume, people that stay in loveless, bitter, miserable marriages. If we generated statistics on this, and found that say, 10% of people in miserable marriages do not ever divorce, we would never explain that data by saying that these people “can’t divorce.” We would never suggest that they literally lack the ability to fill out a form requesting a divorce (or whatever the procedure involves). Instead, we would recognize that this 10% simply must not see good enough reason to divorce, and therefore also see good enough reason to continue the marriage. That is, we’d understand that this 10% is choosing to stay married for whatever reasons, though we may not understand or agree with their personal reasons for doing so. We wouldn’t cite the statistics as proof that 10% of people can’t divorce.
Yet somehow, when statistics show that 10% of people never cease the heavy substance use patterns classified as addiction, we cite this statistic as proof that they “can’t” quit. Why should this be interpreted as proof that they lack ability to change their situation? As in divorce, the fact that some people don’t do something isn’t necessarily proof that they “can’t” do it.
This reasoning is the product of the view that addiction is an entity unto itself that people are battling in some way. Under this premise, addiction is an opponent, thing, or force of some kind that exerts power against the “addict,” causing them to use substances. From this view, the addict needs some kind of special strength or ability to “overcome addiction.”
This view makes quitting an addiction like losing a game against an opponent. So it’s like a game of chess, where you’re outmatched, and can’t come up with better moves and strategy than your opponent. Or a game of tennis, in which you’re physically unable to run fast enough to return your opponent’s powerful serves. Or it’s like some other kind of tough task against the forces of nature, say, putting out a raging fire, or putting enough sandbags out to protect your property from quickly approaching floodwaters. In these situations, you may try with all your might, yet your abilities/strengths may not be objectively good enough to achieve the goal.
So with addicts, we say that they can’t “resist the overpowering cravings” as if a “craving” is an entity which the “addict” is in competition with – something they go up against, and either have the strength to conquer or not. They can’t “resist peer pressure” as if their peers send some kind of forceful magic rays at them which must be resisted. They need to avoid triggers, which are often completely inanimate lifeless objects, that exert a force that causes people to use substances. In this situation, the “addict” becomes akin to a refugee in some war-torn land trying to navigate a treacherous minefield, and if they take one wrong step, say, past a bar where they used to drink, there’ll be an explosion of substance use. Some rehabs have actually told heroin “addicts” not to eat with spoons, because due to their use in preparing heroin for injection, spoons have become powerful triggers that will essentially, force them to want and to use heroin.
Often, the opponent isn’t so clearly defined as in the examples above, and so we just hear that the addict simply “can’t beat their addiction.” But it’s right there – the “addict”, the person, is portrayed as being in competition with an amorphous thing called an “addiction”, which may be too strong an opponent for them.
Under the view that there is an entity called addiction, whether they “can or can’t” beat it becomes the issue. Assuming they “can’t”, treatment, support, and safe environments to compensate for the inability are needed. But under the view that the “addict” is choosing their substance use, ability to beat the opponent of addiction, that is, whether they “can or can’t” isn’t an issue whatsoever. The issue under a choice view is whether they “will or won’t” choose differently. In this case, treatment, support, and safe environments are fully irrelevant. The elements that lead to different choices are what need to be considered.
The elements that lead to different choices are different:
Since choices always involve picking from two or more options, then the mental products mentioned above need to be applied to two or more options. For example, the substance user who is upset by their habitual choices to use substances and is considering a change, will have to see if they can come up with some new thoughts about not only substance use, but also new thoughts about going without substance use, or less substance use. What do they believe are the benefits of heavy substance use, and what do they believe are the benefits of moderation or abstinence? If these thoughts weigh out to create a continued desire for heavy substance, then only NEW thoughts on the benefits of the various options will point them toward a new desire and decision regarding substance use. Thinking the same things will beget the same desires and choices. New information can aid in thinking new things.
So the choice view has nothing to do with strength or ability. Strength isn’t an issue at all, and the ability is there. It’s a question of whether the ability will be used. Will they think differently, weigh things out differently, and make a new choice, or not. It’s a matter of “will they or won’t they” – not a matter of “can they or can’t they.”