Who would choose addiction? No one would. People don’t make bad choices. They always act completely rationally.
If you believe this, then you probably believe the disease theory – which rests on the premise that if a behavior is self-destructive, then it must be involuntary. Gene Heyman astutely identifies this premise in his groundbreaking book Addiction: A Disorder Of Choice
. It’s a point so obvious, that most of us battling the disease theory never even consider it. Nevertheless, it stares us straight in the face at every turn. We say that addiction is a choice, and someone inevitably disagrees and expresses righteous indignation saying “my father’s an alcoholic, it broke up his marriage, he lost his job, and went to jail for a year for drunk driving – why would anyone choose that?”. This is of course emotionally charged, stifles debate, and we usually redirect our argument, without directly questioning the challenger’s premise. Well, inspired by Heyman’s point, I’m here today to challenge the notion that your loved one is infallible. I’m here today to say that your parent, child, sibling, or spouse willingly chose to be a jerk.That’s right, people are capable of making bad decisions, and they do it all the time. People choose to eat foods which will make them fat. They choose to spend time watching tv rather than studying for school. They choose to ignore their “check engine” light until their car breaks down in the middle of nowhere. They choose to worry about their social life more than their career, and end up poor. They choose to….you get the picture (I hope). My point is that there probably aren’t that many people who say “I want to be 50 years old with no savings, and struggle to pay the rent every month” – but when they choose to spend all of their free time on recreational activities, spend their money like there’s no tomorrow, and move from place to place without ever building a reputation and solid network of professional contacts – then by default, they’ve chosen to be penniless at 50. Likewise, I don’t directly choose to be a slob. I choose to eat and leave my dishes in the sink after each meal, to be cleaned at a later time. I choose to avoid the small amount of work now, in favor of other activities, such as watching tv or checking email. But before I know it, I end up with a sink-full of dirty smelly dishes – a slobbish state I have indirectly chosen, but chosen nonetheless.
So, I choose to be a slob. There was a time when I chose to be a substance abuser/addict. What both of these problems have in common is that they’re built upon a series of smaller choices which have the character of being shortsighted. When I leave the dishes in the sink, or the socks all over the floor, I’m not thinking about them accumulating into a mess, I’m not focused on the long-term consequences of my choices – I’m thinking about my enjoyment of the immediate moment. Likewise, I didn’t think “I want to be a miserable drug addict, with no life outside of chasing a high” – but that’s what I became. I got to that point by thinking only of the immediate pleasures of drug use, I avoided focusing on more important things, hell, I avoided even figuring out what could be more important and valuable to me than a high. In that way, I chose to be the miserable, loser, directionless, asshole-y drug addict I eventually became.
Your loved one, the one you think so much of, the one you care so much about – is capable of choosing to be a jerk. It’s not the end of the world, if they try to weigh other options, and get honest about what they’re choosing for themselves, then they can choose to stop being a jerk. But if we make excuses for their behavior, and pretend that they can’t be responsible for the state of their own life, then we aren’t giving them a fair chance at succeeding.
Exercise: Pay attention to yourself and others throughout the next week, notice where people make choices that may be immediately gratifying, but result in later compounded problems. Try to see it in many different settings. Could all of these behaviors be a disease? Do you believe that all irrational/self-destructive behavior is involuntary?
There is nothing more hypocritical than a "former" addict. You have no facts other than your own opinion. In Fact, over time, the brain in a substance abuser changes considerably. Can it be rewired? Maybe so over time, but the facts are that addiction is a disease. The fact that it's caused by people making bad decisions only means that causality. It's still a disease.
Thanks for your input, Anonymous. I assure you I have many facts at my disposal. Here's a fact much like the one you presented: Musicians brains change considerably over time. Also, just listening to music effects many of the same neural pathways effected by drugs/alcohol.
By your logic, being a musician is a disease, and while we're at it, let's call being a music fan a disease too!
I started writing this email after one of your last posts, but forgot to post it. Now, seeing you most recent post, I must chime in. First, you sound like one of those hypocritical left or right wing nuts the way you debate half truths, and vague statements. Seriously, get into fortune telling or psychic readings. I'm waiting for you to say something like, "you will have a major change in your life in the next year." No kidding, we all have major changes in our lives—almost yearly, in fact, the absence of a major change is a major change itself. God I feel like you writing that. Anyway, here is what I started writing last week.
You aren't asking the right questions, rather you are debating a ridiculous notion. OF course, you can be an asshole, or I can, or so and so's dad. That's not the point. The point is, in a sober state of mind, I have a CHOICE to drink or do drugs. They are inanimate objects that can do me no harm. When I take them, I set off a craving that I cannot control as well as a chemical reaction that reinforces the behavior and changes our mind over time. This has happened to me in the happiest moments of my life and the saddest. Your argument is silly—I can't honestly think of anything better than that to describe it. It takes me back to a place where while denouncing treatment, I was in treatment, while claiming over 80% success, I KNOW that the survey methodology was flawed. (I was there when they were fudging results for their so called independent survey.) Did Baron CHOOSE to die? How about Dave? Did he choose to go back out and almost die? And all of the others that have died as a result of misinformation bestowed upon them like some holier than thou crap. Listen, they CHOSE to drink or shoot up or whatever; my contention is once you start, it sets off a chemical response in the brain (which is backed up my science) not circular arguments, and it is VERY difficult to stop without a little support one way or the other.
You like to pick and choose facts, very similar to the place where you got sober. Your thinking is flawed my man, that I can assure you. Having been to a 12 step meeting and having gone through the same program as you have, you do realize that you got sober on a 12 step program right? They shortened it to 6 steps or so, but for all intensive purposes, that's what it is. They just don't call it that. I'm not sure why I care what you think or write, other than the fact, I hate misinformed people and you my friend are one. You have this holier than thou attitude that permeates in upstate New York. I hope you never drink or do drugs again, because if you do; I'd give you less than a 10% chance of survival. In fact, if you are so sure it's a choice, go out and have a shot of booze, or bang some dope…see how you do. I'm sure you will be fine in the end. That end might be a early grave, or back to upstate NY, or it might be you decide to stop; plain and simple. If you are able to, please let me know, I'd love to hear the success story. I wish you a happy, sober life, if that's what you want. When you have some real facts, again, not circular arguments, but rather REAL facts, then and only then do you get a seat at the adult table. Until then please keep it down, the grown ups are trying to work.
Now, here is your required reading.
http://www.nida.nih.gov/scienceofaddiction/brain.html
I’d like to chime in if possible…
I do not believe “Addiction” is a disease, because having a disease is something you cannot “QUIT”.Can you just stop having Cancer or HIV when you feel like it? I think not.
Sure, I believe that it may take a bit of hard work to cure yourself, of Cancer or HIV, but most people are stuck with these diseases until they die.
Now as far as addiction goes, its going to take a lot of work to put down the habit, and re learn a new behavior, but that doesn’t mean your “stuck” with a death sentence, like having a disease.
I used to love my Marijuana, Cocaine, Beer, etc!!! I did it almost day for years upon years..
Until i figured out that it was emotional stress, and boredom that made me think drinking and drugging were such a great idea.
Then I was able to slowly take control of my life again by re learning to be able to manage every day life without the urge to drink or smoke weed every time there was a problem in my life.
After a little practice, i learned to be happy living life without the alcohol and drugs..
Today I am free of addiction, and I live happy just like most people do.
I no longer need to pickup a drink , or snort a line of coke when i wanna have a blast.
Now if I had a “Disease” i would probably be still doing the same thing , or thinking the same way right? I would still have an impulse to snort a line , or run out and get wrecked when i didn’t want to face reality.
But that’s not the case at all, in fact i can’t even picture my self in that scene at all!!
I would much rather live a clean and sober life, knowing that tomorrow is full of life!
I remember going to the 12 step programs at AA, and hearing people whine,and cry about all their problems.
The only solution to everyones problems were to “keep” coming!
Is that it? keep coming????
No other solution to quitting besides to “keep coming”?
I think it made me worse when I went to AA being reminded of all the drinking and drugging all the time in fact , I sorta liked hearing about other peoples issues, because it reminded me that i didn’t have it so bad.
So what the hell? My problems were nothing compared to these people, so I might as well continue to drink and drug so long as it didn’t come to that!
Truth is, AA is nothing but a waste of time, and gas money.
And you can’t just quit a disease when you feel like it, If your body depends on a substance, then you have a “Dependance” issue, but that’s still not a disease..
Cheers
I've researched and written full pieces on the brain disease theory before for other purposes, and I will put something together which is more appropriate for this blog soon – but for now I'll just say that the link you provided, the "required reading", is extremely remedial. It does absolutely NOTHING to prove that addiction is a disease. Nothing. Explaining the chemical process by which a drug gives a user a high is just that -an explanation of how you get high. It doesn't prove that the administration of the drug was compulsive. Nor does showing temporary changes in brain activity prove that substance use is compulsive. It only proves that substances cause temporary changes in brain activity. While some of these changes may last longer there is still no way to connect them to the views you've expressed of compulsive use – except by the subjective accounts of some substance abusers who believe they become powerless upon using a drug.
Furthermore, as I stated above, the fact that learning to play music changes the brain – as do plenty of other activities – calls into question the relevance of these facts you've brought up. Facts are great, I can list plenty of facts, but to reach a true conclusion you have to string those facts together in a logical way. The hole in the brain disease rhetoric is in the missing connection between these facts and the conclusion that substance use is a compulsive behavior.
The burden of proof is on the person claiming something to be true. I have not seen the disease proponents ever prove their theories to be true. I've only seen them provide several circular arguments which they will abandon as soon as you ask the right question – and they'll switch to another argument. I've identified at least 7 fallacious arguments which are commonly used to browbeat a person with a troubled life into believing they are incapable of change- and zero arguments which actually prove their assertions.
I'd also like to say that I'm sorry that we were unable to get through to you at SJRH, whoever you are. I hope you know that I no longer represent them – I left my job there in 2005, and while we have many parallel views, we may not currently agree on everything – but I have deep trust in the staff I know there and highly recommend their program. Nevertheless, when reading this blog please remember that these are Steven Slate's views, not the views of Baldwin Research Institute or the Saint Jude Retreat House.
To make the point of this post more clear – I was saying that while people may not directly say or think "I wanna be a junkie when I grow up!" (like the famous PSA), that they choose this lifestyle indirectly, and thus the consequences, indirectly. They choose it by choosing to indulge in dangerous cheap thrills.
The exact circumstances of Baron's death are murky to me. I don't know if it was ever proven to be an OD or something else. If it was an OD then I would have to say he probably chose that – indirectly of course – nevertheless he was well aware of the risks involved in substance use. Now, just because I see it this way doesn't mean I think Baron was a horrible person. I fondly remember him as a person who helped me, was a great friend, and a true joy to be around. In the end though, it seems that he probably made some bad choices which lead to his death.
As for Dave – I'm sure you can track him down and speak to him yourself to ask about his experiences.
I have visited the link this commenter provided and have provided a detailed analysis available here: http://www.thecleanslate.org/2010/08/critique-of-drugs-brains-and-behavior.html
Another interesting thing about “addiction” is that it’s the only disease that requires the input of Zero medical professionals to diagnose – the accusation is the diagnosis. You hear criminals claiming that their father, or parents or relatives were alcoholics [or addicts] and it’s taken as true, even though the claim is being made by someone who wouldn’t be believed if he testified the sky is blue.
Also frightening is that someone denying the claim is taken as proof of the truth of the claim. The last time American society took denial of the claim as evidence of its truth was in Salem, Mass, when people denied practicing witchcraft.
Steve,
I think you are right on. I have watched people enable people all of my life. There is always an excuse why someone screws up constantly. However, when you chose not to screw up constantly, people think you are “just that way.” No, you CHOSE your way. It’s not to say people can be perfect, it’s to say people are responsible for their own stuff. No way is addiction a disease anymore than doing what is right is accidental.
It says that they chose to be jerks but u don’t understand all my dad wants out of is to work while he sits on his lazy butt and doesn’t get up until he goes to bed. That may just be his personality but he doesn’t give a shit about me and my sister.
I think people don’t always choose emotional pain and lack of sanity – I think circumstances and biology to play a role – but I do think that the only person who can make someone get better is the person himself. So, responsible for getting well – yes – responsible for being unwell in the first place – not so much