Category Archive 'Addiction'

26 Jan 2017

The Myth of Addiction

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Image of addiction from anti-marijuana propaganda film “Reefer Madness” (1939).

Peter Hitchens has published, in First Things, an excellent essay attacking the notion of addiction, the preternatural ability of certain morally disreputable substances to offer temptations so powerful as to overwhelm completely the free will of any normal human being. The late Thomas Szasz was attacking the same generally accepted delusion decades ago.

The chief difficulty with the word “addiction” is the idea that it describes a power greater than the will. If it exists in the way we use it and in the way our legal and medical systems assume it exists, then free will has been abolished. I know there are people who think and argue this is so. But this is not one of those things that can be demonstrated by falsifiable experiment. In the end, the idea that humans do not really have free will is a contentious opinion, not an objective fact.

So to use the word “addiction” is to embrace one side in one of those ancient unresolved debates that cannot be settled this side of the grave. To decline to use it, by contrast, is to accept that all kinds of influences, inheritances, and misfortunes may well operate on us, and propel us towards mistaken, foolish, wrong, and dangerous actions or habits. It is to leave open the question whether we can resist these forces. I am convinced that declining the word “addiction” is both the only honest thing to do, and the only kind and wise thing to do, when we are faced with fellow creatures struggling with harmful habits and desires. It is all very well to relieve someone of the responsibility for such actions, by telling him his body is to blame. But what is that solace worth if he takes it as permission to carry on as before? Once or twice I have managed to explain to a few of my critics that this is what I am saying. But generally they are too furious, or astonished by my sheer nerve, to listen.

So let us approach it another way. The English language belongs to no state or government. It is not ruled by academies or even defined by dictionaries, however good. It operates on a sort of linguistic version of common law, by usage and precedent. And the expression “addiction” is very widely and variously used. There are people who claim, seriously, to be “addicted” to sex or to gambling.

It is now impolite to refer to habitual drunkards. They are “alcoholics,” supposedly suffering from a complaint that is not their fault. The curious variable ambiguity of Alcoholics Anonymous on this point has added to the confusion. AA, to begin with, asked its adherents to admit they had no control over themselves, as a preliminary to giving that power to God. Somehow I suspect that God plays less of a part in modern AA doctrine, but the idea of powerlessness remains. Members of the organization quietly moved from calling alcoholism an “illness” or a “malady” to describing it as a “disease,” round about the time that the medical profession began to do the same thing.

We are ceaselessly told that cigarettes are “addictive.” Most powerfully, most of us believe that the abusers of the illegal drug heroin are “addicted” to it. Once again, the public, the government, and the legal and medical systems are more or less ordered to believe that users of these things are involuntary sufferers. A British celebrity and alleged comedian, Russell Brand, wrote recently, “The mentality and behaviour of drug addicts and alcoholics is wholly irrational until you understand that they are completely powerless [my emphasis] over their addiction and, unless they have structured help, they have no hope.”

Brand is a former heroin abuser who has by now rather famously given up the drug. But how can that be, if what he says about addiction is true? The phrase “wholly irrational” simply cannot withstand the facts of Brand’s own life. It will have to be replaced by something much less emphatic—let us say, “partly irrational.” The same thing happens to the phrase “completely powerless.” Neither the adverb nor the adjective can survive. Nor can the word “addiction” itself, which is visibly evaporating. We have to say “they struggle over their compulsion.”

Or you might turn to this definition of addiction from the American Society of Addiction Medicine:

    Addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social and spiritual manifestations. This is reflected in an individual pathologically pursuing reward and/or relief by substance use and other behaviors.

This definition prompted one writer at Alternet, an influential pro-addiction website, to say:

    If you think addiction is all about booze, drugs, sex, gambling, food and other irresistible vices, think again. And if you believe that a person has a choice whether or not to indulge in an addictive behavior, get over it. . . . Fundamental impairment in the experience of pleasure literally compels the addict to chase the chemical highs produced by substances like drugs and alcohol and obsessive behaviors like sex, food and gambling.

In other words, conscious choice plays little or no role in the actual state of addiction; as a result, a person cannot choose not to be addicted. The most an addict can do is choose not to use the substance or engage in the behavior that reinforces the entire self-destructive reward-circuitry loop. So even if the supposed “addict” ceases (as many do) to be “addicted” in practice to the addictive substance or activity, he remains “addicted” in some spiritual, subjective way, which cannot actually be seen in his behavior.

The defender of the concept of “addiction,” confronted with evidence that many “addicts” cease to be “addicted,” will say that of course he didn’t mean to suggest the phenomenon was wholly irresistible and could not be mastered by will. Oh no, he will say, reasonable people quite understand that it is not like that at all. In any normal argument, this would be the end of the matter. Anyone who confesses to using a word in one sense when it suits him, and in a wholly contradictory sense when it also suits him, has expelled himself from the company of all reasonable people and admitted that he respects neither truth nor logic.

A must-read.

In reality, everything pleasurable is “addictive” in the sense that one naturally desires to repeat the experience. The notion that certain unholy pleasures are so powerful that they must inevitably come to dominate those foolish enough to dare to encounter them is really just an imaginatively compelling literary narrative that has been widely accepted as factual.

13 Feb 2010

Crazy Spending

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Interviewing Robert Duvall about his new film “Crazy Heart” (2009), co-starring Jeff Bridges, in which a broke-down alcoholic country singer is salvaged by the love of a good woman, got Hugh Hewitt reflecting on addiction in a different context.

Thus I was thinking about addicts and their troubles when yesterday’s story about a new “jobs bill” hit the news. Senators Baucus and Grassley had appeared to announce a new era of bipartisanship and an $85 billion dollar spending bill to help create jobs.

The United States doesn’t have $85 billion. It would simply be added to the deficit, the enormous, gigantic and growing deficit.

The “deal” had collapsed by the end of the day as Republicans shuddered and Harry Reid beat a retreat, but the message to the country was clear: The Congress still doesn’t get it. It is still addicted to spending money it doesn’t have in pursuit of a political redemption they cannot earn after TARP and the stimulus that wasn’t, after the takeover of GM and the still underway attempt to takeover all of banking and of course the undead Obamacare monster.

Congress is still hitting the bottle, hard. Even though it is going to kill many of its members politically. Most of the Republicans are in recovery, but as Senator Grassley proved yesterday, each one of them is one shiny press availability away from falling back into the depths of the governing style that proved their undoing in 2006 and 2008.

I doubt we can find anything like the required number of good women needed to redeem all the incorrigibles making up the majority of the current Congress. We’ll have to settled for a major intervention come November.

25 May 2006

The Myth of Addiction

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In the waning decades of the 19th century, Western societies experienced a wave of panic over the idea that various intoxicating substances offered pleasures so exquisite and seductive as to overcome the will and corrupt and enslave their users. One intoxicant after another became the target for prohibition efforts by ameliorist do-gooders.

All forms of prohibition make whatever is banned more desirable, and result in black markets. Black markets provide an opportunity for large profits by criminals, and typically lead to violence as rival gangsters fight over territories. The association of large profits with victimless forms of crime commonly results in the corruption of law enforcement.

Theodore Dalrymple draws on his medical experience as usual, in today’s Wall Street Journal, to debunk opiate addiction.

In 1822, Thomas De Quincey published a short book, “The Confessions of an English Opium Eater.” The nature of addiction to opiates has been misunderstood ever since.

De Quincey took opiates in the form of laudanum, which was tincture of opium in alcohol. He claimed that special philosophical insights and emotional states were available to opium-eaters, as they were then called, that were not available to abstainers; but he also claimed that the effort to stop taking opium involved a titanic struggle of almost superhuman misery. Thus, those who wanted to know the heights had also to plumb the depths.

This romantic nonsense has been accepted wholesale by doctors and litterateurs for nearly two centuries. It has given rise to an orthodoxy about opiate addiction, including heroin addiction, that the general public likewise takes for granted: To wit, a person takes a little of a drug, and is hooked; the drug renders him incapable of work, but since withdrawal from the drug is such a terrible experience, and since the drug is expensive, the addict is virtually forced into criminal activity to fund his habit. He cannot abandon the habit except under medical supervision, often by means of a substitute drug.

In each and every particular, this picture is not only mistaken, but obviously mistaken. It actually takes some considerable effort to addict oneself to opiates: The average heroin addict has been taking it for a year before he develops an addiction. Like many people who are able to take opiates intermittently, De Quincey took opium every week for several years before becoming habituated to it. William Burroughs, who lied about many things, admitted truthfully that you may take heroin many times, and for quite a long period, before becoming addicted…

Why has the orthodox view swept all before it? First, the literary tradition sustains it: Works that deal with the subject continue to disregard pharmacological reality, from De Quincey and Coleridge through Baudelaire, Aleister Crowley, Bulgakov, Cocteau, Nelson Algren, Burroughs and others. Second, addicts and therapists have a vested interest in the orthodox view. Addicts want to place the responsibility for their plight elsewhere, and the orthodox view is the very raison d’être of the therapists. Finally, as a society, we are always on the lookout for a category of victims upon whom to expend our virtuous, which is to say conspicuous, compassion.

The myth of addiction has a powerful appeal to the human imagination, and is enormously useful in exculpating personal misbehavior. But a society which holds more than a million people in prison for victimless crimes is paying a terrible price in order to cling to its illusions.


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