It is said that addicts and alcoholics literally lose control of their substance use after a single drink or hit of a substance. This is the main feature of the disease model of addiction. But is it true? Do they really become zombies who have no choice but to relentlessly use drugs and alcohol? The recovery culture says it’s true, but scientific research paints a different picture…
Loss of Control in Addiction and Alcoholism
The main feature of addiction is “loss of control.” This is what separates heavy substance users from so-called addicts and alcoholics. Heavy users have control of their substance use, but “addicts and alcoholics” – those with the “disease of addiction” – are those who supposedly do not have control over their substance use. Drinking and drugging happens, without their choice – involuntarily – as a matter of compulsion. As the National Institute on Drug Abuse says, the disease of addiction results in:
compulsive behaviors that override the ability to control impulses despite the consequences (Link)
Get it? Addicts don’t have a choice in what they’re doing, according to the ruling paradigm of addiction as a disease.
The most basic form of the loss-of-control claim says that once an addict / alcoholic uses any amount of a substance, they cannot stop using on their own. Some force must intervene – again, the addiction overrides the individual’s control of their own behavior. Either they drink themselves to unconsciousness; get locked up in jail; or are forced in some other way to stop. In this model, taking a single drink or hit of a substance is like opening a floodgate.
This theory is most famously peddled in 12-step programs, where it is taught that a single use of any substance will quickly progress to uncontrolled usage of your favorite substance (a “relapse”).
Recovered alcoholics in Alcoholics Anonymous speak of “loss of control” to denote that stage in the development of their drinking when the ingestion of one alcoholic drink sets up a chain reaction to that they are unable to adhere to their intention to “have one or two drinks only” but continue to ingest more and more–often with quite some difficulty and disgust–contrary to their volition.
It is also said that accidental exposure to an intoxicant will set off the chain reaction too – for example, eating a dessert that contains alcohol such as tiramisu. Some take this so far as to believing that the usage of a mouthwash, aftershave, or even hand sanitizer (products containing small amounts of alcohol) will trigger a relapse as well. Or that taking a prescribed painkiller after a surgery will do the same. I’m sad to say I’ve heard plenty of people to whom this has happened – they ate a tiramisu and “relapsed.” But the fact is that this experience is the product of a placebo effect rather than a biological weakness.
When people believe that any consumption of an intoxicant will cause a total binge, then that’s what they proceed to do. In a famous randomized controlled trial, those who were taught the loss-of-control / allergy theory of alcoholism experienced binge rates 9 times higher than people who weren’t taught this theory (read about that research at this link). Here’s a quick video of a true believer of this theory taking it to its logical conclusion – she won’t use hand sanitizer for fear that the alcohol it contains will seep into her skin and cause her to “relapse”:
But is there any proof that exposure to drugs and alcohol causes a loss of control chain reaction? Is there any real reason for such paranoia?
As far as I can tell, no proof of this claim has ever been found. Furthermore, the best research ever carried out to test this claim shows the exact opposite to be true. Reliable research going back almost 50 years now shows that addicts and alcoholics are making choices about their substance use at all times.
[I encourage anyone who thinks they have actual evidence/proof of loss of control to enter it in the comments below, but keep in mind that 1) evidence of irrationality is not evidence of loss of control and that 2) brain scans can only be “evidence” of loss of control if they support a sound argument for loss of control. – notice that both of those points are links to articles where I’ve dealt with this sort of “evidence”, and check them out if you plan on submitting evidence below]
Alcohol Priming Dose Experiments
The priming dose experiment is quite simple. Since the theory is that the first drink of alcohol chemically triggers off uncontrollable drinking in an alcoholic, this is directly tested by getting an alcoholic, giving him a drink, and then watching what happens. There’s an important twist though – manipulating whether the “alcoholic” knows that he’s drinking alcohol (or not drinking it). The experiments are done this way in order to sort out whether any supposed zombie-like alcoholic behavior was a product of biology or expectancy.
The experiment has been carried out in many ways. For example, one experiment gathered alcoholics who had previously been begging for alcohol on the streets. They were brought into the hospital for an extended stay to detoxify and be nursed back to health. They were given vitamin drinks each morning and were questioned later about their level of craving. On some days, the researchers put a drinks-worth of hard alcohol into the vitamin drink – disguised in taste and unknown to the alcoholic. The results? They didn’t crave alcohol more on those days when they had been “primed” with a shot in their morning drink than they did on the days when they weren’t slipped alcohol. Nor did they check themselves out of the hospital to get drunk.
Another priming dose experiment invited alcoholics to taste-test a new brand of tonic water. As you can imagine, there was alcohol mixed in to a degree where it would be undetectable, and they were unaware that they were drinking alcohol. They had access to a pitcher of the mixture and were allowed to drink as much as they want. Again, they didn’t proceed to “drink uncontrollably” once they got a drinks-worth of alcohol into their system. And when compared to a group whose tonic was really just tonic (without alcohol) they didn’t drink more. The test subjects who were told that their drink contained alcohol were the only ones who drank more – whether the drink really contained alcohol or not! What this shows is that heavier drinking is not a chemically triggered zombie behavior – in fact it is a simple goal driven behavior. When the test subjects believe that drinking the drink will get them drunk (and when this is a state that they desire), then that’s when they are motivated to do so, and tend to follow through.
In the 1982 book Controlled Drinking by Nick Heather and Ian Robertson, the authors reviewed 9 such experiments that took place as early as 1966 (almost 50 years ago now!) – and the basic finding was the same: an initial dose of alcohol (the “priming dose” i.e. “first drink”) doesn’t result in extreme drinking/craving for alcohol when the alcoholic doesn’t know they’ve had the drink. Thus, we have no reason to believe that this seemingly “uncontrolled” drinking is the result of either some special power of alcohol, or a biological/genetic weakness of the individual. Instead, it is a choice, ruled by cognitive factors like any other choice. As Heather and Robertson noted:
The more important point about these experiments is the implication that drinking behaviour conventionally described as loss of control is mediated by cognitive processes and not by a physico-chemical reaction to ethanol.
Drug Priming Dose Experiments
In the decades since the initial alcohol priming dose studies blew up the “loss of control” notion of alcoholism, similar, but not identical experiments have been done with various drugs. Most notably, neuroscientist Carl Hart PhD of Columbia university has discussed his work in this area in the media recently. His experiments were different, but just as illuminating.
For example, he gathered confirmed “crackheads” as subjects in an experiment where he would give them a dose of crack cocaine (priming dose), and then offer them another hit, or a small amount of money that would go into an account that they could access several weeks later. So for example, he’d present them with the option of another hit of crack, or 12 bucks two weeks from now. He’d vary the prices and the dose sizes, offering as much as $20 as an alternative to another hit of crack, and found that he could find a price at which he could essentially buy some abstinence from so-called crack addicts.
How does this fit with our concept of crack and crack addiction? We’ve been led to believe that a single hit of crack will make you addicted. We’ve been led to believe that once you smoke some crack you can’t stop until you crash and burn. We’ve been taught that in crack addiction, you become a zombie who will lie, cheat, steal, and do anything you have to do to get more crack. We’ve been taught that crack addicts are incapable of choosing a delayed reward, and that all they can do is ceaselessly pursue the quick highs of more crack.
Yet even they have a price. The point is simple. If you can say “It might be a good idea to take 8 bucks in the bank that I can use a few weeks from now rather than to have another hit of crack right now”, well then you are making a choice. You are not out of control. And what we can safely assume is that when crack addicts are behaving as if they are “out of control” they are really just pursuing what they believe to be their best option at that time. They are choosing. They are “in control” of all of it. Crack has no special power, and crack addicts have no special biological or genetic weakness – or mental illness called addiction. What they have, is the perception that heavy crack use is their best option for how to spend their time. That’s not a disease – it’s a cognition – it’s a belief.
Carl Hart PhD had this to say about his 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…
Researcher Nancy K Mello carried out experiments that were similar to Hart’s, but with alcoholics in the 60’s and 70’s. The same finding was present – you could buy sobriety from alcoholics. Furthermore, she set up elaborate systems in with various incentives in which alcoholics would precisely limit their drinking to low limits in order to be rewarded with copious amounts of alcohol on a later date. This is evidence of conscious decision-making on the part of alcoholics – and it explodes the zombie-like notion of “loss of control.” You can find this research discussed in more detail in either Controlled Drinking by Heather and Robertson, or Addiction is A Choice by Jeffrey Schaler.
Are Addicts and Alcoholics Lying?
Not necessarily. There may be times when heavy substance users are fully aware that they can stop whenever they want, but they lie by telling others they can’t control it. However, probably a majority of the time, they are not lying. They are telling us what they really feel. They truly feel as if they can’t stop, and they are conveying this feeling honestly. For them, loss of control is a perfectly real feeling, even if it isn’t a physical reality. But where does that feeling come from? It comes from a mindset – a set of thoughts and beliefs about the perceived value of substances, the perceived value of their other options, and their perceptions of their own abilities. Obviously, the popular notion that there is such a thing as an addict and loss of control over substance use is the biggest contributor to this mindset, and thus to the feeling of powerlessness. This is a more complex topic and will be covered elsewhere on this site. For now, please know that there is no scientifically demonstrable “loss of control” of substance use. What looks like “uncontrolled” substance use is actually purposeful, freely chosen, fully controlled behavior.
Summary
If otherwise “addicted” people don’t behave in an addicted manner when they’ve been give a drug without their knowledge, then we know that the drug itself doesn’t chemically/biologically trigger the “addict” to behave in an addicted manner. Likewise, if you can buy abstinence or moderation from a substance user, it becomes even clearer that they are choosing. The reality is that there is no such thing as loss of control over substance use. This is highly important, because the truth matters, and we must understand the nature of “addiction” if we hope to change it. Trying to regain control that was never lost in the first place is a wild goose chase. It will be far more productive to understand what motivates the heavy substance use in the first place, than to invest in a myth that only serves as a temporarily comforting excuse for behavior that is otherwise ugly.
The information on alcohol priming dose experiments referenced in this article comes from:
Heather, N., & Robertson, I. (1983). Controlled drinking. London; New York: Methuen.
The quote on methamphetamine and crack cocaine priming dose experiments comes from:
i am thrilled to read your article. i worked for an alcoholics counselor for 2 years, which is where i first heard that alcoholism was a disease. i have a younger brother who has been an alcoholic for 20 years and has been thru rehab 4 times. our family has tried every possible way to get him to stop to no avail. i have said for years that his greatest problem is not that he is an alcoholic, but that he is very narcissistic and also suffers from a strong disappointment in not being able to relive his past. he was an outstanding athlete in many sports when he was younger and still thinks of himself as such even though he is 52 years old now and has done nothing with his life. i have always felt that he just wanted to remain in the past and refused to move forward in his life because he thinks he can never top what he achieved when he was young. i will always think that prolonged psychiatric sessions would have done him much more good than the rehab or AA. unfortunately, he is now living on the streets and there is nothing more we can do to help him. it breaks my heart to feel so helpless where he is concerned, but your article does help.
It doesn’t matter what you call him. He is anesthetizing the pain from Johnhis punished ego and dissapointment with alcohol.
It doesn’t matter what you call him. He is anesthetizing the pain from his punished ego and dissapointment with alcohol.
How does someone like you Slate..go about informing the public about the common sense truths of the so called “addiction epedemic” I know you have great similarities with Stanton Peele. sadly I feel that man has burned his bridges to have a any kind of substantial power in the recovery community.. He is brutally honest..doesn’t take BS…so that is what happens to him. The other man with these views Carl Hart…has said a few times that he’s not interested in the recovery process of addicts just the social misconceptions of drugs and alcohol on society in particular urban society…criminalizing drug usesers..the war on drugs..etc
Unfortunatley the 12 step..disease model failure is ingrained in our culture….and it’s advertised as a wonderful program for people who need it….ask most non addicts about AA and they will probably praise it…it’s propaganda..even brainwashing
If somebody goes to a psychologist today with any kind of substance issue….more than 90% of the time no matter how bad your abuse rate is they will tell you that you are powerless and have a lifelong disease then command you to go to a ton of AA meetings for the rest of your life
I would like to know how you can combat the hold these myths and propaganda have on society… you are up against quite an ugly beast
I would like an answer to the above question as well, please. On an activism level, what can we do to combat the powerlessness/disease model that is harmfully being shoved down people’s throats as a valuable solution?
I agree with Mr. Slate on this one. I certainly don’t claim to have all the answers, to be sure. However leading by example might be a start. If you were to, for an example, take the one you were concerned about out to lunch. Remove them from the environment that person is accustomed to and open up the mind to a different experience, a positive change may begin. Men go to prison and harbor a desire to return to the “old neighborhood” and their old habits of use/drinking. After a period of time the mind and brain adjust to incarceration. Upon release the free man commits some crime simply to get back “inside”. Back where he knows what he can expect. A change, a real neural change has occurred. This observation can be used in the reverse. To show someone a new and better experience. These changes take time. But they do indeed work. And once it begins, it typically expands. This is a double edged sword, as in twelve step programs. To mindlessly replace one “addiction” with another can be counterproductive. The individual must see that there is meaning to their life. This means different things to each individual. My long winded point is start with a positive change and move in to more meaningful actions. Sorry if I just wrote a term paper on the meaning of life. But I think the points are valid. And they certainly are not my own ideas. These concepts have been around for centuries. Best of luck.
The only people who have ” real insight ” and a complete understanding of the disorder are recovering alcoholics.
Wow you are a complete idiot, you are trying to make money of people missery. Your “binge test” is the point less the chemical of alcohol is not the problem its the addicts mind set. A normal person can have a drink and stop. It is not that an addict can’t have one drink and stop you moron. It is the fact that it is too much of a risk one is to many a 1000 is not enough. Its actually a game the brain plays you drink one drink with dinner and stop go to bed no problem. Than the next morning you wake up proud of yourself you convince your self you got this. That might happen ten times but one day out of know where you talk your self into a second because you have control. Hell that might work ten more times. But, one day out of know where it will happen you will start to drink until it effects you in some negative wat DUI, fight, overdose, fight with girl friend. Not everyone is a binge addict the fact that you are to stupid to know this information that you think addicts turn into zombies shows you should be arrested for acting like you have an answer. You don’t even understand the problem how can you have a solution. I know you won’t respond because, you know you are full of shit you know that you are scamming people. I hope some one teaches you a lesson you deserve what you get offering people an easy button you piece of shit. Oh and I am not so much in favor of 12 steps either but, at least I know its genetic period. I have my family history back 200 years.
Joe: your rant and name-calling are expected from someone in denial. It is easy to bleed, I understand.
However, genetics have only been implicated to be influential to drink heavily, like a million other factors and influences in a specific persons life. Beautiful sunshine will burn some more easily than others, but that doesn’t mean the fair skinned are diseased. If sunburn felt good, there would be a group called ‘Sunburners Not-so-Anonymous”.
We all make choices with addictive predilection. Some are vices; some virtues. You make your own meaning of your life. If you need to create god in your own image, like a ‘higher power’, to decide what you mean to yourself and others, please do so. Afterwards, you will be free.
Good luck.
I just checked the abstract from the Hodgson 1979 study and it said there was priming effect shown in severe dependence. Please explain?
First I would like to know how many of your “test” subjects were female. I would also like to know how many of your “test” subjects suffered from bipolar, schizophrenia and/or ADHD or other severe mental illness.
Perhaps you do not believe in mental illness either. It is also quite evident from the hundreds of peer reviewed articles that an untreated co occurring disorder is highly prevalent in the severe alcoholics who continually relapse. Your study may have merit with a certain level addict but it is unclear to me how severe your “test” subjects were.
Where did the comment go that l made a couple of hours ago ??
Further to my information re my drinking behaviour.
There are hundreds of thousands of people out there whose drinking behaviour is
identical to what mine was “Choices —— what choices”
Instead of all of the studies and conclusions from them why don’t you round up
some of the thousands out there who drink until they are out of control like l did ????
“Choices ——-what choices”
The priming doses ( one drink say 1 and 1/2 ounces mixed with whatever ) as l have stated previously is insufficient to make a person want more.
To me these tests are flawed from the beginning because of the quantity being used for the tests.
When a person is predisposed genetically ( biological ) and has the disorder of being allergic to the
alcohol ( chemical ) and starts drinking then after perhaps 2 or 3 drinks he will continue until he
can drink no more.
He cannot control the compulsion to keep on drinking ” if a couple of drinks make me feel this
good then more will make me feel even better. ”
Giving him one diluted drink will not start this uncontrolled compulsion.
You are free to believe all that, but it doesn’t change the fact that not one single study has ever been consistent with them. In fact, most are consistent with the opposite of your positions and dogma. AA is emotive, not substantive. “Rigorous” honesty with your feelings is fine, for you. But for a group to believe collectively that ‘some must die so that they can live’ is boarderline sickly pretentious.
No AA group believes that sort of nonsense. If you want to criticize AA, at least have the decency to do some first hand research rather than being a parrot of other’s ignorance. It sounds like something from one of Peele’s uniformed diatribes. You’re not hurting AA. You’re merely making yourself appear foolish.
AA does believe that, and their “members” say it repeatedly. There is no need to get personal. My “research” couldn’t be any more “first-hand”. I have examined the studies and listened to thousands of hours of AA dogma. Have you ever asked AA members their opinions about past and current addiction research and theories? If you want to see ignorance, try that sometime.
If AA stuck with the idea that mutual support can help a person improve their life, that’d be the only ‘miracle’ anyone would need. But, they don’t. Alcohol consumption is romanticized into another dimension and a disease with god being the only way out. It’s like mass-movement mentality with cheap soap-box park theatre where anything goes-as long as it can be folded into some self-perceived ‘deep’ connection to 12 steps, traditions or nebulous spirituality experience. AA is no deeper than the paper the pamphlets are printed on.
You seem to believe I am trying to “hurt” AA, but I assure you that AA does enough to be foolish without my input.
I see that I have made a fundamental error. I really should have known from the timbre and content of this propaganda that there was an imbecile at the root of it all with an agenda that excludes any contrary opinions.
You are a waste of time and energy that is far better spent actually helping other alcoholics and addicts. You and your organization will disappear. It’s not viable and has zero substance. It’s simplistic to the degree of inanity. Any user who could get sober following your “program” has already figured it out on their own.
I’ll check back in a year to see how you’re doing. I’m sure I’ll be amazed❗️🙄
Thanks for the name-calling and personal attacks. That attitude is antagonistic and completely antithetical to the piety of AA, so I must conclude you are not a member. My guess is you are a benefactor of the corrupted “recovery” industry? A “counselor” or addiction “specialist” of some sort? Nevertheless, I don’t promote a “program”, I don’t sponsor a “program”, and I’ve made it clear that I respect others with opinions, but not conclusions based on emotive religious healing and fanciful ideas of spiritual disease.
I believe what objective observation and study shows us about the nonsense in AA, but yet, some find difficult to accept. I also believe AA can be a great program, for some, if left to its sense of purpose -social support. Unfortunately, it does not when it makes claims of miracles, 100% effectiveness and exclusivity.
Good luck. Please think about what you are doing to others having difficulty when you push them as they are vulnerable into further dependence and away from inner strength.
By the way, if you want to watch a “program” disappear, look at AA itself and the rapid growth of “programs” having rational approaches to participant support. AA hasn’t grown with our growth in knowledge and understanding. AA is on a course to sail of the edge of its own flat earth.
It is almost a year and I’m anticipating your continued depravity aimed at those who are critically thoughtful regarding a corrupt “recovery” industrial complex. I will wait. Best wishes for now.
Ouch!
I hate being in more than one mind. At least two of them crossed swords reading this. I cleaned up nearly 14 years ago, without treatment, by going to NA meetings. I know many treatment centres use the 12 step or at least the disease model as a recovery mode. It becomes your language, mindset, social structure, and CAN become another dependency. At times I felt your ‘heresy’ stabbing me, like I was being attacked. At others it felt like walking into a warm bath. The term disease is often loaded, like we associate it with cancer or herpes. For me, a simple hyphen gave me clarity: dis-ease. In my using, any sense of dis-ease I would interrupt with a potion or powder or pill. I have learnt to live with dis-ease, be it depression, anger, or anxiety. There are many routes up the mountain and despite my inherent affiliation to 12 steps, it has resulted in me being open-minded enough to consider that other ways are just as viable. The “success” rate of 12 step recovery reminds me of the figures attributed to chemo/radiation therapy. Both are around 3%, which indicates that we would do well to at least consider other paths, including this.
Thanks for the article and Ted talk: awkward but necessary!
Wow- No one should be saying a thing about addict/alcoholics having a choice and whether it is a compulsion unless they themselves have the “Disease of Addiction.” Then, I’d like to hear what you have to say…..
At its most basic psychological level, addiction is no more a “disease” than is brushing your teeth after every meal. While one is a destructive learned behavior and the other usually healthful, both are compulsive. Both can be unlearned. The same neuro-biological central nervous system pathways and messengers can be found to be active and physically altering when reading an enjoyable book or playing a rewarding melody on a musical instrument as when you get dopamine surges with substance use. The brain itself can hypertrophy in specific areas with chronic, prolonged regular specific mental activity (such as with London cab drivers). Furthermore, there has never been a study supporting genetic inheritance of a “disease” of addiction. While disease theory proponents regularly refer to an identical twin association (in one observational study), the only thing it demonstrates is a possible correlation in the face of completely uncontrolled variables with selection bias. Disease theory advocates may as well place bets for the next superbowl using the presidential election results or get their PhD in numerology.
When people who drink too much get together and help each other in supportive ways to change their learned behaviors, it is a great thing, and it works on that social level. Society would get much farther, much faster with attending to the troubles caused by aberrant behaviors if we spoke rationally about the sociological, emotional, physiological tolerance, and psychological aspects of ‘addiction’ rather than dragging mystical divine revelations, inner monsters, moral failings and despicable profiteering into the mess.
Funny how I tell people my problem is not drugs it is my brain but I truly don’t believe if I choose to have some drinks I will stop. Were talking about choosing vs not being able to choose and part of me believes if im wanting a drink……
Really i want lots not just a test controled one. This is already starting the process to get to the clouded point where I fuck everything up. For personal pleasure I believe an addict who has been burned won’t really have any real use for having a couple then stopping cus let’s face it that buz is just a tease lol. I’ve accidentally drunk whine and no I didn’t go crazy, my state of mind was ohh that’s not the juice I wanted so therefore I didn’t want more. I believe there’s something to this as a thinking problem but knowing how to really change the core reasons I want to use. I havnt been able to do that on my own. I go to 12 steps but I’m feeling it’s even better thinking it’s not a disease just a perspective problem. Depending how you view things from 12 step stuff if u really follow the steps it is a way of changing how you think and view the world. Plus it also builds my social life.
Honestly from a scientific point of view im leaning on it not being a disease however i truly belive i wont be able to use succesfully simply cus using hard is so engraved in me its too dangerous to attempt further experiments in retraining regular intoxication. Note clean 10 years minus 5 separate 1 day relapse. Some were honest experiments to have a pint or 2 some were intented go hard from the get go.
All 5 nights ended up costing over $1000 each with 1 ambulance panick attack and 2 should i call the ambulance before my heart explodes. Before that alcohol and crack everyday for 2 years at the end of my using.
To sum yes I believe it’s not a scientific disease now. However u change ur life perspective to successfully not keep using is ur choice just keep going till you find it.
My first drug was at 12 years old. Meth. Got high (various substances) off and on until 16. After that, until I was about 37-38, in any given year, I got high more days than didn’t. (Again. Anything I could get my hands on). One day, I woke up and said screw this life. I’m 60 now. I have chronic kidney stones. I have a safe with approx. 70-80 narcotic pain relievers in it. I will take them AS PRESCRIBED until pain is gone. 1 to 3 days. I go to the ER for a CAT scan to check stone size. With what I have at home, I refuse pain med scrips. When they say they are going to give me morphine, I say no. I ask for Toredal. 10 to 14 nights a month, I do a couple shots of Vodka. And stop there.
So my question to you victims is, where is my disease?
That is a great question. Some might say it is ‘in your head’, otherwise a psychological disease. Addiction is not physical, it is psychological. Yes, physical withdrawal due to chronic use or activity can be quite apparent when the activity or substance is suddenly stopped, but THAT is not addiction. People get addicted to an experience. As the experience is repeated, we develop learned associations and behaviors. Characteristically, we ONLY call a behavior an ‘addiction’ when the behavior becomes destructive to ones well being.
Let’s remember that scientific inquires don’t really “prove” theories, they either support a theory, or they don’t. No studies support the main tenet of addiction disease theory ie. “The loss of control” with EtOH intake, or the lack of personal volition when certain disincentives or other rewards are with higher priority. AA and 12-steps are a method equivalent to using chewing gum to quit smoking at the social level, but destructive on a personal autonomy level, IMO.
I’m incredibly offended by your comments about the question of addicts having choices ie: being narcissistic hedonists versus addicts as defined by the 12 step programs you speak of so derisively…
Who cares what the studies say? I’m the parent of an addict in recovery. I’m incensed with your criticism of the people who have the disease of addiction. You do a incredibly insensitive disservice to those who are suffering from substance abuse!
I suggest that you shut up and stop attacking the addicts and the 12 step programs, the only way that has consistently proven to be a path to recovery for millions of people.
Bottom line is this: the studies regarding crack and meth are flawed in that no one ever claimed those substances are chemically addictive yet they have destroyed countless lives of users and everyone who loves them. My child was introduced to heroin and became addicted almost immediately. The first time or two were choices but the addiction was not. She overdosed a dozen times and was clinically dead. If not for emergency services, who revived her, she’d be dead. Wtf cares if addiction is “real” in your mind?
When you’ve been in my shoes you can speak to me about addiction. I don’t care if they believe they are addicted or they’re chemically addicted. Bottom line is they travel the same path of lies, stealing and prostitution or whatever to get their next fix.
You’re not providing a service to anyone! No one is helped by this article. You’re HURTING so many with this misleading and slanted article. Disgusting that you were willing to write this crap for the almighty dollar. This is GARBAGE, every single word.
I don’t know if your comment is directed at me, or the article, but regardless, I’m sorry for your troubles in life. Your attitude is clearly hostile toward anyone who disbelieves the scientifically negated, intellectually dishonest and culturally corrupt theory that addiction is a state of disease. You mistake my critical thinking for dispassionate apathy and then you are projecting it as the cause of your son’s life struggles or at least the lack of his progress to improve his life.
You make many accusations of me, my motives and my understanding of the seriousness of human compulsions without knowing anything about me. That is behavior steeped in emotion, not reality as anyone else would have it, except you, as you defend a group with a religious undertaking claiming to cure “100%” of those who “work” it. Did you know that the 12-step cult also says that “relapse” is “a part of getting better”? And, therefore, if someone “relapses”, it’s not that the ‘program’ isn’t working, they’re just on the way to ‘recovery’; provided they ‘keep coming back’ and put a dollar in the basket, of course. Such logic means that the more your son goes back to injecting obliviants, the more progress he’s making. Got it now? A “god of (your son’s) understanding will not keep the needle out of his vein if your son doesn’t believe it. Perhaps if he believed that others believed in him, enough to convince him he ought to believe in himself, he’d get a better start to see his efforts as causing improvements and adding meaning in his life?
Good luck.
Linda,
While I am sympathetic for parents who’ve watched their offspring have substance use problems, I don’t take kindly to your statement that “When you’ve been in my shoes you can speak to me about addiction.” You came to my website and decided to tell me off. I didn’t send you this post, I didn’t email or call you to speak about addiction – you came here. So if you want to insult me and put words/ideas in my mouth, I’m gonna talk back.
I have never said that people with substance use problems are “narcissistic hedonists,” and I certainly did not even come close to suggesting any such thing here – which means you came up with the “narcissistic hedonists” thing on your own. That isn’t the only alternative to suffering from “the disease of addiction” and “loss of control,” but it’s apparently the only alternative in your mind.
“Narcissistic hedonist” has a negative moral connotation that I do not agree with. I go to great lengths in my book to help people with substance use problems to avoid seeing themselves in such a negative moral light. For example, while explaining (in chapter 4 of The Freedom Model for Addictions) the many potential reasons we might develop a strong desire/preference for intoxication, I also show several times why it would be completely natural and even rational to feel so attracted to substance use. I stay away from framing it in moral terms.
Pleasure seeking is th e key feature of “hedonism.” I believe that pleasure is one of many reasons people feel attracted to substance use – but I don’t think it’s the only reason. Nor do I think that wanting pleasure is bad. My co-authors and I put all the potential reasons (including pleasure) under the wider umbrella of “pursuit of happiness” in our approach to substance use problems. Maybe you’ve read where we said that somewhere else and you translated it to “narcissistic hedonism,” but that’s not what we mean by it, and these two terms are definitely not synonymous.
I don’t criticize “people with the disease of addiction” and I don’t know where you got that from. In this article, I have criticized the concept of “loss of control” – not people who themselves have substance use problems. If you read my book, you’d see that when it comes down to it, I criticize the professionals who indoctrinate substance users into believing they literally lose control of their substance use. The concept of “loss of control” is scientifically bankrupt, and really amounts to nothing more than a disinformation campaign to scare (coerce) people into choosing to abstain from substance use. I abhor such manipulation – but not those who’ve been manipulated.
You say that “no one ever claimed” methamphetamine and crack “are chemically addictive.” I don’t know how you think this, since they are regularly called highly addictive in the media. I grew up in the 80’s exposed to countless movies about crack addiction, and the idea that smoking crack just once was enough to become addicted. Even the National Institute on Drug Abuse says that “Methamphetamine is a powerful, highly addictive stimulant that affects the central nervous system.” I don’t agree with the idea of a quality of “addictiveness” inherent in drugs, but that’s beside the point – everyone calls these drugs addictive.
You say “I suggest that you shut up and stop attacking the addicts and the 12 step programs, the only way that has consistently proven to be a path to recovery for millions of people.” In fact, the most travelled path out of a substance use problem is “self-change” – that is, getting no treatment and attending no support group meetings. Most people who get over their substance use problems do so without any help. Here is some data backing up that fact: Over 90% of addicts will recover even though less than 25% will get treatment. Please understand, that by the most conservative estimate there are 23.5 million living americans who have gotten over their substance use problems. AA & NA’s combined US membership stands at about 2 million people. If we generously assume that all of their members have gotten over their substance use problems, this would mean that for every 1 successful 12-Step group member, there are at least 10 more successfully “recovered addicts/alcoholics” who are not in 12 step groups.
You say “Wtf cares if addiction is “real” in your mind?.” But you obviously cared enough to write a tirade against me for expressing my thoughts here. You talk as if I’m denying that people have problems with substance use. I am doing no such thing. Instead, I am discussing the nature of the problem. When I had a severe problem with heroin use for 5 years, I believed this addiction disease garbage I was taught. When I got over my problem, it was in large part due to changing the way I viewed my problem. I stopped seeing myself as diseased, out of control, and in for a lifelong struggle which would require endless “treatment.” I’m gratified to have personally interacted with thousands of people who found the non-disease view of substance use problems to be both more accurate and more helpful than the disease view.
We’ve been sold the idea that the only way to have sympathy for people with substance use problems is to consider them diseased. I disagree with this notion. I have sympathy for people with substance use problems, and yet I do not consider them diseased. I also happen to think the average person is capable of sympathizing for people with all sorts of problems that are not diseases.
Best,
Steven Slate
Actually Linda I have been helped by this site and this article in multiple ways. I shouldn’t have to share my “credentials” of having used addictively, but, I think it is necessary in this case. I used alcohol and opiates addictively and destructively for years. I carry official diagnoses of poly substance dependence (DSM IV) or with the DSM 5 opiate use and alcohol use disorders and I have been in treatment multiple times and failed for many years. I became successful only after changing my perspective of being powerless over drugs and alcohol (ie the normal disease and 12 step model of substance use disorders) and losing control. Once I developed the new perspective of always having a choice over using substances even after I started using, even during destructive use, I became successful. People who use drugs and alcohol destructively always have a choice whether or not to use as to ingest drugs and alcohol people must make a series of conscious choices (buying the drugs and alcohol, getting money, driving to the supply, where and when to use) and must make a series of voluntary muscle movements to ingest the drug. People often conflate the word “choice” with difficulty and it is harder to chose not to use in certain situations (withdrawal, physical cravings) than in other situations, but, that difficulty doesn’t negate the fact that a choice always exists. This is one way this site and article helped me, it gave me knowledge that I had the power and drugs and alcohol were not stronger than I was and I always have the choice and I stopped using destructely and am currently working on a PhD. The article, well the priming studies it referenced, also helped me get the medication I needed to treat severe ADHD. Most doctors are weary about prescribing supposedly addictive substances (like pain meds and psycho stimulants) to people with a history of destructive use because most doctors buy into the idea that any amount of “addictive” drugs will cause the person to lose control. Even though I never used let alone abused stimulants, my doctor would not consider prescribing stimulants because of my history. After a year of debate and my extensive literature review, citing these priming studies and other studies showing that the fear of priming is unfounded, he prescribed long acting Ritalin. I have been on the stimulant for over a year, a supposedly addictive drug has been flooding my brain for over a year and I have not returned to destructive use of alcohol or opiates and I have never abused the stimulant. In fact, I have given him unused stimulants when we changed the dosage. So this site, article, and different perspective empowered me and I took control and changed my life and the priming studies allowed me to get proper treatment even thought that treatment is to use supposedly addictive drugs. I understand your child struggles with destructive use, but, please don’t speak for everyone who has a history or currently uses destructively.