They’re screaming it from the rooftops: “addiction is a disease, and you can’t stop it without medical treatment”! But why are they screaming it so loud, why are they browbeating us about it, why is it always mentioned with a qualifier? You don’t hear people constantly referring to cancer as “the disease of cancer” – it’s just “cancer”, because it’s obvious that cancer is a disease, it’s been conclusively proven that the symptoms of cancer can’t be directly stopped with mere choices – therefore no qualifier is needed. On the other hand, addiction to drugs and alcohol is not obviously a disease, and to call it such we must either overlook the major gaps in the disease argument, or we must completely redefine the term “disease.” Here we will analyze a few key points and show that what we call addiction doesn’t pass muster as a real disease.
Real Diseases versus The Disease Concept or Theory of Drug Addiction
In a true disease, some part of the body is in a state of abnormal physiological functioning, and this causes the undesirable symptoms. In the case of cancer, it would be mutated cells which we point to as evidence of a physiological abnormality, in diabetes we can point to low insulin production or cells which fail to use insulin properly as the physiological abnormality which create the harmful symptoms. If a person has either of these diseases, they cannot directly choose to stop their symptoms or directly choose to stop the abnormal physiological functioning which creates the symptoms. They can only choose to stop the physiological abnormality indirectly, by the application of medical treatment, and in the case of diabetes, dietetic measures may also indirectly halt the symptoms as well (but such measures are not a cure so much as a lifestyle adjustment necessitated by permanent physiological malfunction).
In addiction, there is no such physiological malfunction. The best physical evidence put forward by the disease proponents falls totally flat on the measure of representing a physiological malfunction. This evidence is the much touted brain scan[1]. The organization responsible for putting forth these brain scans, the National Institute on Drug Abuse and Addiction (NIDA), defines addiction in this way:
Addiction is defined as a chronic relapsing brain disease that is characterized by compulsive drug seeking and use, despite harmful consequences. It is considered a brain disease because drugs change the brain – they change it’s structure and how it works. These brain changes can be long lasting, and can lead to the harmful behaviors seen in people who abuse drugs.
The NIDA is stating outright that the reason addiction is considered a disease is because of the brain changes evidenced by the brain scans they show us, and that these changes cause the behavior known as addiction, which they characterize as “compulsive drug seeking and use”. There are three major ways in which this case for the disease model falls apart:
- the changes in the brain which they show us are not abnormal at all
- people change their behavior IN SPITE OF the fact that their brain has changed in response to repeated substance use jump to section
- there is no evidence that the behavior of addicts is compulsive (compulsive meaning involuntary) (point two addresses this, as well as some other research that will be presented) jump to section
This all applies equally to “alcoholism” as well. If you’re looking for information on alcoholism, the same theories and logic discussed here are applicable; wherever you see the term addiction used on this site, it includes alcoholism.
Brain Changes In Addicts Are Not Abnormal, and Do Not Prove The Brain Disease Theory
On the first count – the changes in the brain evidenced by brain scans of heavy substance users (“addicts”) do not represent a malfunctioning brain. They are quite normal, as research into neuroplasticity has shown us. Whenever we practice doing or thinking anything enough, the brain changes – different regions and neuronal pathways are grown or strengthened, and new connections are made; various areas of the brain become more or less active depending upon how much you use them, and this becomes the norm in your brain – but it changes again as you adjust how much you use those brain regions depending on what you choose to think and do. This is a process which continues throughout life, there is nothing abnormal about it. Here, Sharon Begley describes neuroplasticity: [2]
The term refers to the brain’s recently discovered ability to change its structure and function, in particular by expanding or strengthening circuits that are used and by shrinking or weakening those that are rarely engaged. In its short history, the science of neuroplasticity has mostly documented brain changes that reflect physical experience and input from the outside world.
So, when the NIDA’s Nora Volkow and others show us changes in the brain of a substance user as compared to a non-substance user, this difference is not as novel as they make it out to be. They are showing us routine neuroplastic changes which every healthily functioning person’s brain goes through naturally. The phenomenon of brain changes isn’t isolated to “addicts” or anyone else with a so-called brain disease – non-addicted and non-depressed and non-[insert brain disease of the week here] people experience neural adaptations too. One poignant example was found in the brains of London taxi drivers, as Begley and Jeffrey Schwartz pointed out in The Mind and The Brain. [4]
Is Being A Good Taxi Driver A Disease?
A specific area of the brain’s hippocampus is associated with creating directional memories and a mental map of the environment. A team of researchers scanned the brains of London taxi drivers and compared their brains to non-taxi drivers. There was a very noticeable difference, not only between the drivers and non-drivers, but also between the more experienced and less experienced drivers:
There it was: the more years a man had been a taxi driver, the smaller the front of his hippocampus and the larger the posterior. “Length of time spent as a taxi driver correlated positively with volume in…the right posterior hippocampus,” found the scientists. Acquiring navigational skills causes a “redistribution of gray matter in the hippocampus” as a driver’s mental map of London grows larger and more detailed with experience. [4]
So, the longer you drive a cab in London (that is, the longer you exert the mental and physical effort to quickly find your way around one of the world’s toughest to navigate cities), the more your brain physically changes. And the longer you use drugs, the more your brain changes. And indeed, the longer and more intensely you apply yourself to any skill, thought, or activity – the more it will change your brain, and the more visible will be the differences between your brain and that of someone who hasn’t been focused on that particular skill. So, if we follow the logic of the NIDA, then London’s taxi drivers have a disease, which we’ll call taxi-ism, that forces them to drive taxis. But the new diseases wouldn’t stop there.
Learning to play the piano well will change your brain – and if you were to compare brain scans of a piano player to a non-piano player, you would find significant differences. Does this mean that piano playing is a disease called Pianoism? Learning a new language changes your brain, are bilingual people diseased? Athletes’ brains will change as a result of intensive practice – is playing tennis a disease? Are soccer players unable to walk into a sporting goods store without kicking every ball in sight? We could go on and on with examples, but the point is this – when you practice something, you get better at doing it, because your brain changes physiologically – and this is a normal process. If someone dedicated a large portion of their life to seeking and using drugs, and their brain didn’t change – then that would be a true abnormality. Something would be seriously wrong with their brain.
Its not just physical activity that changes our brains, thoughts alone can have a huge effect. What’s more, whether the brain changes or not, there is much research which shows that the brain is slave to the mind. As Begley points out elsewhere, thoughts alone can create the same brain activity that would come about by doing things[2]:
Using the brain scan called functional magnetic resonance imaging, the scientists pinpointed regions that were active during compassion meditation. In almost every case, the enhanced activity was greater in the monks’ brains than the novices’. Activity in the left prefrontal cortex (the seat of positive emotions such as happiness) swamped activity in the right prefrontal (site of negative emotions and anxiety), something never before seen from purely mental activity. A sprawling circuit that switches on at the sight of suffering also showed greater activity in the monks. So did regions responsible for planned movement, as if the monks’ brains were itching to go to the aid of those in distress.
So by simply practicing thinking about compassion, these monks made lasting changes in their brain activity. Purely mental activity can change the brain in physiologically significant ways. And to back up this fact we look again to the work of Dr Jeffrey Schwartz[3], who has taught OCD patients techniques to think their way out of obsessive thoughts. After exercising these thought practices, research showed that the brains of OCD patients looked no different than the brains of those who’d never had OCD. If you change your thoughts, you change your brain physically – and this is voluntary. This is outside the realm of disease, this shows a brain which changes as a matter of normality, and can change again, depending on what we practice choosing to think. There is nothing abnormal about a changing brain, and the type of changes we’re discussing aren’t necessarily permanent, as they are characterized to be in the brain disease model of addiction.
These brain change don’t need to be brought on by exposure to chemicals. Thoughts alone, are enough to rewire the very circuits of the human brain responsible for reward and other positive emotions that substance use and other supposedly “addictive” behaviors (“process addictions” such as sex, gambling, and shopping, etc.) are connected with.
The Stolen Concept of Neuroplasticity in the Brain Disease Model of Addiction
Those who claim that addiction is a brain disease readily admit that the brain changes in evidence are arrived at through repeated choices to use substances and focus on using substances. In this way, they are saying the disease is a product of routine neuroplastic processes. Then they go on to claim that such brain changes either can’t be remedied, or can only be remedied by outside means (medical treatment). When we break this down and look at it step by step, we see that the brain disease model rests on an argument similar to the “stolen concept”. A stolen concept argument is one in which the argument denies a fact on which it simultaneously rests. For example, the philosophical assertion that “reality is unknowable” rests on, or presumes that the speaker could know a fact of reality, it presumes that one could know that reality is unknowable – which of course one couldn’t, if reality truly was unknowable – so the statement “reality is unknowable” invalidates itself. Likewise, the brain disease proponents are essentially saying “neuroplastic processes create a state called addiction which cannot be changed by thoughts and choices” – this however is to some degree self-invalidating, because it depends on neuroplasticity while seeking to invalidate it. If neuroplasticity is involved, and is a valid explanation for how to become addicted, then we can’t act is if the same process doesn’t exist when it’s time to focus on getting un-addicted. That is, if the brain can be changed into the addicted state by thoughts and choices, then it can be further changed or changed back by thoughts and choices. Conditions which can be remedied by freely chosen thoughts and behaviors, don’t fit into the general understanding of disease. Ultimately, if addiction is a disease, then it’s a disease so fundamentally different than any other that it should probably have a completely different name that doesn’t imply all the things contained in the term “disease” – such as the idea that the “will” of the afflicted is irrelevant to whether the condition continues.
People change their addictive behavior in spite of the fact that their brain is changed – and they do so without medication or surgery (added 4/18/14)
In the discussion above, we looked at some analogous cases of brain changes to see just how routine and normal (i.e. not a physiological malfunction) such changes are. Now we’re going to look directly at the most popular neuroscientific research which purports to prove that these brain changes actually cause “uncontrolled” substance use (“addiction”).
The most popular research is Nora Volkow’s brain scans of “meth addicts” presented by the NIDA. The logic is simple. We’re presented with the brain scan of a meth addict alongside the brain scan of a non-user, and we’re told that the decreased activity in the brain of the meth user (the lack of red in the “Drug Abuser” brain scan presented) is the cause of their “compulsive” methamphetamine use. Here’s how the National Institute on Drug Abuse (NIDA) explains the significance of these images in their booklet – Drugs, Brains, and Behavior: The Science of Addiction :
Just as we turn down the volume on a radio that is too loud, the brain adjusts to the overwhelming surges in dopamine (and other neurotransmitters) by producing less dopamine or by reducing the number of receptors that can receive signals. As a result, dopamine’s impact on the reward circuit of a drug abuser’s brain can become abnormally low, and the ability to experience any pleasure is reduced. This is why the abuser eventually feels flat, lifeless, and depressed, and is unable to enjoy things that previously brought them pleasure. Now, they need to take drugs just to try and bring their dopamine function back up to normal.
[emphasis added]
They go on that these same sorts of brain changes:
..may also lead to addiction, which can drive an abuser to seek out and take drugs compulsively. Drug addiction erodes a person’s self-control and ability to make sound decisions, while sending intense impulses to take drugs.
[emphasis added]
That image is shown when NIDA is vaguely explaining how brain changes are responsible for “addiction.” But later on, when they try to make a case for treating addiction as a brain disease, they show the following image, which tells a far different story if you understand more of the context than they choose to mention:
Again, this graphic is used to support the idea that we should treat addiction as a brain disease. However, the authors mistakenly let a big cat out of the bag with this one – because the brain wasn’t treated at all. Notice how the third image shows a brain in which the red level of activity has returned almost to normal after 14 months of abstinence. That’s wonderful – but it also means that the NIDA’s assertions that “Addiction means being unable to quit, even in the face of negative consequences”(LINK) and “It is considered a brain disease because drugs change the brain… These brain changes… can lead to the harmful behaviors seen in people who abuse drugs” are dead wrong.
When these studies were done, nobody was directly treating the brain of methamphetamine addicts. They were not giving them medication for it (there is no equivalent of methadone for speed users), and they weren’t sticking scalpels into the brains of these meth addicts, nor were they giving them shock treatment. So what did they do?
These methamphetamine addicts were court ordered into a treatment program (whose methodology wasn’t disclosed in the research) which likely consisted of a general mixture of group and individual counseling with 12-step meeting attendance. I can’t stress the significance of this enough: their brains were not medically treated. They talked to counselors. They faced a choice between jail and abstinence. They CHOSE abstinence (for at least 14 months!) – even while their brains had been changed in a way that we’re told robs them of the ability to choose to quit “even in the face of negative consequences.” [5]
Even with changed brains, people are capable of choosing to change their substance use habits. They choose to stop using drugs, and as the brain scans above demonstrate – their brain activity follows this choice. If the brain changes caused the substance using behavior, i.e. if it was the other way around, then a true medical intervention should have been needed – the brain would’ve needed to have changed first via external force (medicine or surgery) before abstinence was initiated. They literally wouldn’t have been able to stop for 14 months without a real physical/biological medical intervention. But they did…
Substance Use Is Not Compulsive, It Is A Choice
In his classic book Addiction & Opiates, Alfred R Lindesmith PhD explained the requirements of reliable scientific theories explaining the causes of things such as heroin addiction:
…a genuine theory that proposes to explain a given phenomenon by relating it to another phenomenon must, in the first place, have clear empirical implications which, if not fulfilled, negate the theory.
If the theory is that neural adaptations alone cause uncontrolled behavior, then this proposition can easily be shown to be false. I demonstrated above that in the midst of having fully “changed” or “addicted” brains, people do indeed stop using substances, so essentially, it is case closed. But the depths to which the brain disease theory of addiction can be negated go even further, because the basic theory of addiction as representing uncontrolled substance use has never been explained. Explanation of the mechanism by which substance use happens without the individual’s consent is conspicuously missing – yet such explanation is a necessary part of such a theory, as Lindesmith writes (again in Addiction & Opiates):
…besides identifying the two types of phenomenon that are allegedly interrelated, there must be a description of the processes or events that link them. In other words, besides affirming that something causes something else, it is necessary to indicate how the cause operates to produce the alleged effect.
“Here Comes the Bogey-Man” by Goya, circa 1799
There doesn’t seem to be any explanation or evidence that substance use is involuntary. In fact, the evidence, such as that presented above, shows the opposite. Nevertheless, when the case for the disease is presented, the idea that drug use is involuntary is taken for granted as true. No evidence is ever actually presented to support this premise, so there isn’t much to be knocked down here, except to make the point I made above – is a piano player fundamentally incapable of resisting playing the piano? They may love to play the piano, and want to do it often, they may even be obsessive about it, but it would be hard to say that at the sight of a piano they are involuntarily driven by their brain to push aside whatever else they need to do in order to play that piano.
There is another approach to the second claim though. We can look at the people who have subjectively claimed that their substance use is involuntary, and see if the offer of incentives results in changed behavior. Gene Heyman covered this in his landmark book, Addiction: A Disorder of Choice[3]. He recounts studies in which cocaine abusers were given traditional addiction counseling, and also offered vouchers which they could trade in for modest rewards such as movie tickets or sports equipment – if they proved through urine tests that they were abstaining from drug use. In the early stages of the study, 70% of those in the voucher program remained abstinent, while only 20% stayed abstinent in the control group which didn’t receive the incentive of the vouchers. This demonstrates that substance use is not in fact compulsive or involuntary, but that it is a matter of choice, because these “addicts” when presented with a clear and immediately rewarding alternative to substance use and incentive not to use, chose it. Furthermore, follow up studies showed that this led to long term changes. A full year after the program, the voucher group had double the success rate of those who received only counseling (80% to 40%, respectively). This ties back in to our first point that what you practice, you become good at. The cocaine abusers in the voucher group practiced replacing substance use with other activities, such as using the sports equipment or movie passes they gained as a direct consequence of abstaining from drug use – thus they made it a habit to find other ways of amusing themselves, this probably led to brain changes, and the new habits became the norm.
Long story short, there is no evidence presented to prove that substance use is compulsive. The only thing ever offered is subjective reports from drug users themselves that they “can’t stop”, and proclamations from treatment professionals that the behavior is compulsive due to brain changes. But if the promise of a ticket to the movies is enough to double the success rate of conventional addiction counseling, then it’s hard to say that substance users can’t control themselves. The reality is that they can control themselves, but they just happen to see substance use as the best option for happiness available to them at the times when they’re abusing substances. When they can see other options for happiness as more attractive (i.e. as promising a greater reward than substance use), attainable to them, and as taking an amount of effort they’re willing to expend – then they will absolutely choose those options instead of substance use, and will not struggle to “stay sober”, prevent relapse, practice self-control or self-regulation, or any other colloquialism for making a different choice. They will simply choose differently.
But wait… there’s more! (Added 4/21/14) Contrary to the claims that alcoholics and drug addicts literally lose control of their substance use, a great number of experiments have found that they are really in full control of themselves. Priming dose experiments have found that alcoholics are not triggered into uncontrollable craving after taking a drink. Here’s a link to the evidence and a deeper discussion of these findings: Do Addicts and Alcoholics Lose Control? Priming dose experiments of cocaine, crack, and methamphetamine users found that after being given a hit of their drug of choice (primed with a dose) they are capable of choosing a delayed reward rather than another hit of the drug.
Three Most Relevant Reasons Addiction Is Not A Disease
So to sum up, there are at least two significant reasons why the current brain disease theory of addiction is false.
- A disease involves physiological malfunction, the “proof” of brain changes shows no malfunction of the brain. These changes are indeed a normal part of how the brain works – not only in substance use, but in anything that we practice doing or thinking intensively. Brain changes occur as a matter of everyday life; the brain can be changed by the choice to think or behave differently; and the type of changes we’re talking about are not permanent.
- The very evidence used to demonstrate that addicts’ behavior is caused by brain changes also demonstrates that they change their behavior while their brain is changed, without a real medical intervention such as medication targeting the brain or surgical intervention in the brain – and that their brain changes back to normal AFTER they VOLITIONALLY change their behavior for a prolonged period of time
- Drug use in “addicts” is not compulsive. If it was truly compulsive, then offering a drug user tickets to the movies would not make a difference in whether they use or not – because this is an offer of a choice. Research shows that the offer of this choice leads to cessation of substance abuse. Furthermore, to clarify the point, if you offered a cancer patient movie tickets as a reward for ceasing to have a tumor – it would make no difference, it would not change his probability of recovery.
Addiction is NOT a disease, and it matters. This has huge implications for anyone struggling with a substance use habit.
References:
- 1) NIDA, Drugs Brains and Behavior: The Science of Addiction, sciofaddiction.pdf
- 2) Sharon Begley, Scans of Monks’ Brains Show Meditation Alters Structure, Functioning, Wall Street Journal, November 5, 2004; Page B1, http://psyphz.psych.wisc.edu/web/News/Meditation_Alters_Brain_WSJ_11-04.htm
- 3) Gene Heyman, Addiction: A Disorder of Choice, Harvard University Press, 2009
- 4) Sharon Begley and Jeffrey Schwartz, The Mind And The Brain, Harper Collins, 2002
- 5) Links to the 2 methamphetamine abuser studies by Nora Volkow:
http://www.jneurosci.org/cgi/content/full/21/23/9414
http://ajp.psychiatryonline.org/cgi/reprint/158/3/377
Important Notes from the author to readers and especially commenters:
On “badness” or immorality:
Please do not attribute to me the idea that heavy substance users must be “bad” or “immoral” if they are in fact in control of and choosing their behavior. I do not think this. I think that at the time they’re using, it is what they prefer, given what life options they believe are available to them – and I don’t think it’s my job to decide what other people should prefer for themselves, and then declare them bad if they don’t live up to my vision of a “good” life. That’s what the disease recovery culture does, de facto, when they present the false dichotomy of ‘diseased or bad’. To say that addiction is chosen behavior is simply to make a statement about whether the behavior is within the control of the individual – it is not a judgment of the morality of the behavior or the individual choosing it.
On willpower:
Please do not attribute to me the suggestion to “use willpower.” I have not said that people should use willpower, nor do I think it’s a coherent or relevant concept in any way, nor do I think “addicts lack willpower” or that those who recover have more willpower, nor, and this is important, do I believe that a choice model of addiction necessarily implies willpower as the solution.
“Addicts” do not need extra willpower, strength, or support, to change their heavy substance use habits if that is what they want to do. They need to change their preference for heavy substance use, rather than trying to fight that preference with supposed “willpower.”
On compassion:
Please don’t accuse me of not having compassion for people who have substance use problems. You do not know that, and if you attack my motives in this way it just shows your own intellectual impotence and sleaze. I have a great deal of compassion for people with these problems – I was once one such person. I am trying to get at the truth of the nature of addiction, so that the most people can be helped in the most effective way possible. I don’t doubt the compassion of those who believe addiction is a disease, and I hope you’ll give me the same benefit of the doubt. I assure you I care and want the best for people – and I don’t need to see them as diseased to do so. When you see someone who’s gotten themselves into a mess, don’t you want to help, even if it’s of their own making? Why should we need to believe they have a disease to help them if the mess is substance use related? I don’t get that requirement.
Some Agreement I’ve Found From Addiction Researchers (added 6/10/14)
I began working out my understanding of the brain disease model back in 2005 as I started working on a book about addiction; published this article in 2010; and was happy to find in 2011 when I went back to work with Baldwin Research that they had arrived at a similar conclusion. The way they stated it amounted to “either everything is addiction, or nothing is” – referring to the fact that the brain changes presented as proof of addiction being a brain disease are so routine as to indicate that all behavior must be classified as addiction if we follow the logic.
I was also gratified to have found a neuroscientist who arrived at the same conclusions. I think Marc Lewis PhD and I may disagree on a few things, but it seems we may see eye to eye on the logic I presented above about such brain changes being routine, and thus not indicative of disease. Check what he wrote in 2012 for the PLOS Blog, Mind The Brain:
every experience that has potent emotional content changes the NAC and its uptake of dopamine. Yet we wouldn’t want to call the excitement you get from the love of your life, or your fifth visit to Paris, a disease. The NAC is highly plastic. It has to be, so that we can pursue different rewards as we develop, right through childhood to the rest of the lifespan. In fact, each highly rewarding experience builds its own network of synapses in and around the NAC, and that network sends a signal to the midbrain: I’m anticipating x, so send up some dopamine, right now! That’s the case with romantic love, Paris, and heroin. During and after each of these experiences, that network of synapses gets strengthened: so the “specialization” of dopamine uptake is further increased. London just doesn’t do it for you anymore. It’s got to be Paris. Pot, wine, music…they don’t turn your crank so much; but cocaine sure does. Physical changes in the brain are its only way to learn, to remember, and to develop. But we wouldn’t want to call learning a disease.
….
In my view, addiction (whether to drugs, food, gambling, or whatever) doesn’t fit a specific physiological category. Rather, I see addiction as an extreme form of normality, if one can say such a thing. Perhaps more precisely: an extreme form of learning. No doubt addiction is a frightening, often horrible, state to endure, whether in oneself or in one’s loved ones. But that doesn’t make it a disease.
I think that quote is very important, because it highlights neuronal changes that occur in the same region implicated in addiction (whereas the examples I presented earlier in the article represented some other regions).
In a brilliant paper titled “The naked empress: Modern neuro science and the concept of addiction”, Peter Cohen of The Centre for Drug Research at University of Amsterdam, states that:
The notions of addiction transformed into the language of neurology as performed by authors like Volkov, Berridge, Gessa or De Vries are completely tautological.
He essentially argues that Volkow et al take for granted that heavy drug and alcohol use is uncontrolled, identify neural correlates, and present them as evidence of uncontrollability. Yet they don’t do so with other behaviors, and he provides plenty of examples. He notes that they start with assumptions that certain patterns of behavior (e.g. heavy drug use) are uncontrolled, and others are controlled – based purely on cultural prejudices. He accurately identifies addiction as a learned behavior, or as routine bonding to a thing, and then expresses something very close to my thesis presented above (that all learned/intensely repeated behaviors result in “brain changes”).
The problem of course is that probably all learning produces temporary or lasting ‘change in neural systems’. Also, continuation of learned behavior may be functional in the eyes and experience of the person but less so in the eyes of the outsider. Who is right? We know of people remaining married in spite of-in the eyes of a beholder- a very bad marriage. Who speaks of lasting ‘neural change’ as the basis of the continued marriage? But, even when a person herself sees some behavior as counter functional, it is not necessarily seen as addiction. It may be seen as impotence, ingrained habit or unhappy adaptation. It all depends on which behavior we discuss, not on the brain.
The great points contained in this article would be done an injustice if I tried to sum them up here, so check it out for yourself at The Center for Drug Research University of Amsterdam. As with Marc Lewis, I suspect that Peter Cohen and I might have some substantial disagreements about the full nature of addiction and human behavior in general, but I think we at least agree that the changes in the brain of an “addict” do not necessarily represent disease, and more likely represent a routine process.
Writing in 2013 for the journal Frontiers In Psychiatry, esteemed behavioral and addiction researcher Gene Heyman pointed out something so painfully obvious that we don’t even take notice – no causal link has ever been found between the neural adaptations caused by excessive substance use and continued heavy use. That is, correlation is not causation:
With the exception of alcohol, addictive drugs produce their biological and psychological changes by binding to specific receptor sites throughout the body. As self-administered drug doses greatly exceed the circulating levels of their natural analogs, persistent heavy drug use leads to structural and functional changes in the nervous system. It is widely – if not universally – assumed that these neural adaptations play a causal role in addiction. In support of this interpretation brain imaging studies often reveal differences between the brains of addicts and comparison groups (e.g., Volkow et al., 1997; Martin-Soelch et al., 2001) However, these studies are cross-sectional and the results are correlations. There are no published studies that establish a causal link between drug-induced neural adaptations and compulsive drug use or even a correlation between drug-induced neural changes and an increase in preference for an addictive drug.
Did you get that? Let me repeat the words of this experienced researcher, PhD, and lecturer/professor from Boston College and Harvard who, in addition to publishing scores of papers in peer reviewed medical journals has also had an entire book debunking the disease model of addiction by Harvard University press (I say all of this about his credentials so that I can hopefully STOP getting commenters who say “but you’re not a doctor, and what are your credentials wah, wah, wah,……” here’s a “credentialed” expert who essentially agrees with most of what I’ve written in this article – so please, for the love of god, save your fallacious ad hominems and appeals to authority for another day!)- he (Gene Heyman PhD) said this, as of 2013:
There are no published studies that establish a causal link between drug-induced neural adaptations and compulsive drug use or even a correlation between drug-induced neural changes and an increase in preference for an addictive drug.
And this was in a recently published paper in a section headed “But Drugs Change the Brain”, in which he continued to debunk the “brain changes cause addiction” argument by saying:
There are no published studies that establish a causal link between drug-induced neural adaptations and compulsive drug use or even a correlation between drug-induced neural changes and an increase in preference for an addictive drug. For example, in a frequently referred to animal study, Robinson et al. (2001) found dendritic changes in the striatum and the prefrontal cortex of rats who had self-administered cocaine. They concluded that this was a “recipe for addiction.” However, they did not evaluate whether their findings with rodents applied to humans, nor did they even test if the dendritic modifications had anything to do with changes in preference for cocaine in their rats. In principle then it is possible that the drug-induced neural changes play little or no role in the persistence of drug use. This is a testable hypothesis.
First, most addicts quit. Thus, drug-induced neural plasticity does not prevent quitting. Second, in follow-up studies, which tested Robinson et al.’s claims, there were no increases in preference for cocaine. For instance in a preference test that provided both cocaine and saccharin, rats preferred saccharin (Lenoir et al., 2007) even after they had consumed about three to four times more cocaine than the rats in the Robinson et al study, and even though the cocaine had induced motoric changes which have been interpreted as signs of the neural underpinnings of addiction (e.g., Robinson and Berridge, 2003). Third [an analysis of epidemiological studies] shows that the likelihood of remission was constant over time since the onset of dependence. Although this is a surprising result, it is not without precedent. In a longitudinal study of heroin addicts, Vaillant (1973) reports that the likelihood of going off drugs neither increased nor decreased over time (1973), and in a study with rats, Serge Ahmed and his colleagues (Cantin et al., 2010) report that the probability of switching from cocaine to saccharin (which was about 0.85) was independent of past cocaine consumption. Since drugs change the brain, these results suggest that the changes do not prevent quitting, and the slope of [an analysis of epidemiological studies] implies that drug-induced neural changes do not even decrease the likelihood of quitting drugs once dependence is in place.
Read the full paper here – it’s an amazingly concise summary of the truths about addiction that contradict many of the accepted opinions pushed by the recovery culture – Heyman, G. M. (2013). Addiction and Choice: Theory and New Data. Frontiers in Psychiatry, 4. doi:10.3389/fpsyt.2013.00031
Why Does It Matter Whether or Not Addiction Is A Brain Disease?
When we accept the unproven view that addiction and alcoholism are brain diseases, then it will lead us down a long, painful, costly, and pointless road of cycling in and out of ineffective treatment programs and 12 step meetings. You will waste a lot of time without finding a permanent solution. When we examine the evidence, throw out the false disease concepts, and think rationally about the problem we can see that addiction is really just a matter of choice. Knowing this, we can bypass the rehabs, and find the true solution within ourselves. You can choose to end your addiction. You can choose to improv your life. You can choose to stop the endless cycle of “recovery” and start living. You don’t need to be a victim of the self-fulfilling prophecy that is the brain disease model of addiction. There are alternative views and methods of change which I hope you’ll take the time to learn about on The Clean Slate Addiction Site.
There are many different ways to argue against the brain disease model of addiction. I have only presented 3 basic arguments here. But beyond just addiction, many modern claims of “brain disease” are fatally flawed, in that they are founded on the logically impossible philosophical stance of psychological determinism. From this standpoint, any evidence of any brain activity is immediately interpreted as a “cause” of a particular mind state or behavior – with no regard for free will/the ability to choose one’s thoughts and thus behaviors. If you understand the impossibility of psychological determinism (or “epiphenomenalism”) then you’ll take all such claims with a grain of salt. For a detailed examination of this issue, see the following article: The Philosophical Problem with the Brain Disease Model of Addiction: Epiphenomenalism
How To End Addiction, Substance Dependence, Substance Abuse, Alcoholism, and General Drug and Alcohol Problems (updated 11/4/2015)
Due to the fact that most conventional rehab and addiction treatment programs follow the false belief that addiction is a disease, they are generally not effective at dealing with these problems – so I really can’t ethically recommend any “treatment” programs other than a run of the mill detoxification procedure if you feel you may be experiencing physical withdrawal symptoms – you can find that through your local hospital or emergency room; by asking your primary care doctor; or by calling 911 if you feel your life is in danger due to withdrawal (beware that withdrawal from alcohol and some prescription drugs such as the class known as benzodiazepines can lead to fatal seizures). But what comes after detoxification is simply personal choices, and treatment programs actually discourage productive personal choices by attempting to control people and feeding them nonsense such as the disease theory and idea of powerlessness.
If you want to end or alter your own substance use habits you need to make the choice to do so. Many readers will object to this answer as flippant, cruel, out of touch, et cetera. I realize this, but I chose to change, and in reality everyone who moves beyond problematic substance use chooses to change as well.
There is too much to unpack within what people believe is contained in the statement “choose to change.” I have tried to address some of that here in the past, but I realize this article is not the place to do that. This article’s scope needs to remain limited to the question of whether or not addiction is a disease.
My conclusion is that addiction is freely chosen behavior, and that the person who continues heavy substance use despite mounting costs still sees heavy substance use as their best viable option at the time they’re doing it – even though they recognize many costs and downsides. Choosing to change then, really means that they rethink whether heavy substance use is their best viable option. The only way I know to come to new conclusions is to re-examine the issues methodically, and this may often mean gathering new information and perspectives. Thus, the help that can be given to troubled heavy substance users is information. Helpers can provide accurate information that troubled people can use to change their perspective and come to believe they have better viable options than continued heavy problematic substance use.
I endeavor to give accurate information here that will help people to understand that change is possible, and that they are not doomed to a lifetime of addiction. Hopefully, this helps them on their way to believing in better viable options.
About this article:
I originally published this article on September 25, 2010. I have since added some significant supporting work I was able to find over the years, and those additions are noted. Some other minor edits from the original article are not noted.
Author
Hi, I’m, Steven Slate, the author of this post and of all content on this website. Yes, I was what you would call an “addict.” If you want to know more about me, go to the About page. If you want quotes from PhDs and such (as if I haven’t given enough here already) go to my Quotes From Experts About Addiction page. Please be civil in your comments, and many of your angry comments may already be answered on my FAQs page, so maybe check that out before you scream at me.
Just to contribute to these arguments in the comment section…I have been shooting heroin and using other opiates for years. I only recently got clean. When I first was told addiction was a disease I thought it was an absurd idea. But after looking at myself and others drug use…I’ve concluded that yes…claiming that addiction is a disease is completely asinine and probably dishonest. Every addict I’ve heard claim they have this disease that they cannot do anything about is either misinformed or uses the word disease as an excuse for their behavior. It’s a choice. You can choose to use drugs or you can choose to not use drugs. You can also choose to stop using drugs after using drugs and changing your brain with those drugs. We’re humans. We’re self aware. I was aware that my brain had changed after shooting dope 4 times a day every day. I was aware that those changes would cause me to have urges to continue using heroin. I was aware that when I stopped using dope I would be sick, BUT my brain would eventually change again and I wouldn’t be sick. And now I’m sober and have the choice to use drugs or not use drugs. I choose not to use drugs. End of story, no disease. Just Charlie sheen that shit. Just don’t get hiv. Thanks for reading my rant about why addiction is not a god damn disease. All you addicts out there…man up and quit if you wanna quit. Go through the pain and get a hobby. You know you can you just have to suck it up and do it.
Alexander, I’m happy to see there IS someone, besides me, who acknowledges we have CHOICE in all we do and say!! Thank you
Man… The non-alcoholic will truly never understand, will they?…
Alexander and the others who don’t believe alcoholism is a disease — It’s great to hear from you that you consider alcoholism not a disease. I believe my uncle is a sterling example of someone was not “diseased,” and recognized it as behavior on his part. In his 70s, he’d been drinking every night. He was a physicist, and loved short wave radio broadcasts, since he was a kid. He would listen from about 2:00 a.m. till later in the morning sometime, every night, and drink while he was listening. For decades he did this. Then one day he started babbling words that made absolutely no sense! He was alarmed — he thought he was having, or going to have, a stroke. (Too much alcohol consumption can be instrumental in having strokes.) So Uncle went immediately to his doctor. He doctor asked how much alcohol he was having, and then told my uncle, “If you don’t stop drinking, you will die.” So my uncle immediately quit alcohol, continued his late night radio habit and drank ginger ale. He lived till he was somewhere in his 80s.
You are exactly correct you use because you want to not because you have no choice I shot and smoked an Oz of coke a day sometimes more for more than 3 years I went to lock up got out did the same thing just kept repeating the cycle of madness until one day I had enough I looked inside of me told myself your done with this shot and walked away no rehab no doctor no other drugs just my choice it was a battle I won’t lie but it was my choice I was the user I was because I chose to be liked it loved the rush then one day I had enough the idea that one drug for another to help you kick and get clean is absurd it’s Ludacris. You are just swapping of e crutch for another. It is your own self and only you that can take Away that choice and give you another and only you will know when it’s time just my thoughts
Perhaps regarding it as disease is the best way for some to deal, and to overcome it. It’s different for everyone. I too am an addict, currently using methadone to maintain. I couldn’t not manage on my own, I couldn’t ‘man up and just quit’. If it were just ‘will power’ I would have willed myself to stop a long, long, time ago.
Totally agree 100%i am not an addict never have been; family members have been .I try to understand why they tink its a disease am i misding something? No its a choice its yours. I posted your article on my facebook!
It is a free choice in their own minds addicts say they can’t help themselves or control it this is one lyrics true because it the addiction part becomes easier to live with socially doesn’t make it any more right than anything else but it still remains an easy way for society to label and except the user in their midst. We label because it makes it easier to handle in all ways drug use is a choice of any human that has the sense to utilize their free will it is a choice between doing it or not it’s not technical to make it so pharmaceutical companies make billions rehabs stay funded doctors have more patients
I just have to reinforce your comment by saying, “I also agree”. And while people could split hairs on Addiction being a Disease, I wonder what category it could possibly fall into? Is it an acute or chronic disease? What about the saying “Once an Addict, Always an Addict”? I don’t plan on spending the rest of my life letting my drug use DEFINE who i am. If that’s the case, why even stop? Ya feel me? I, like you, KNEW drugs would change how I “felt”. I never thought past that; as in, changes in brain function, the risk to my organs or anything else. I just wanted to get “high”. My drug of choice was also Heroin, and I did feel like it was a disease… to a degree. I chose to “feed the disease” and hated myself because I didn’t see any way out.. I was “terminal” so to speak. But there was one HUGE difference between my selfish, self-proclaimed “disease” and those with unwarranted, unwanted “terminal illness”. I had a simple cure, JUST STOP POISONING MYSELF. My drug use isn’t a disease that’s gone into remission… it’s a CHOICE, just like you and the author said. I also do not believe “relapse” is part of “recovery”. And I agree more than ever with the author as far as calling substance abuse a disease because we DO recover. I don’t consider recovery a life long process either. Although, similar to an injury, once healed, there are days you will feel it. It doesn’t mean your still recovering tho. I also don’t understand how someone abstinent would continually identify themselves as “an addict”. (Ex: “hi, im John Doe, and I’m an addict. Been clean 13 years”) addictions don’t allow us to go long without satiating the need. But CHOICES will.
I’m clean 11 months and 3 days today. And if “addiction” (merriam-webster definition) WAS my disease, then I want to know how I PERSONALLY CHOSE not to use on the days the urges come. And we all have heard “nobody says they wanna be an addict when they grow up”. But the very definition (all dictionaries/encyclopedias) plainly insinuates “addiction” is congenital. There would be some manifestation in babies then too.. It’s gonna come down to a persons choice with any intoxicating substance… To include sex, gambling, whatever. Of course there’s days I’ve felt like I’ll just die if I can’t scratch that itch. Guess what? The itch subsides and im still alive. Ha!! But I know now the brain is a complex machine. And the neurotransmitters for opiates take a long time to recalibrate. Knowledge has been the biggest part of my treatment. That and refusing to “ween” my body off dope by way of pharmacology. My choice to be done meant going cold- turkey. I felt like the agony during withdrawal probably paled in comparison to the pain and suffering I brought to others when I was afflicted. Thanks for letting me vent. 😉
Here’s the problem, using drugs is a byproduct of addiction. There are so many other behaviors involved in addiction. Addiction does not always mean drug use. Do you bite your nails all the time, drink caffeine or eat the same exact candy, smoke or chew tobacco, hoard or over eat?
I am an addict and currently prescribed suboxone and I agree 100%that Addiction is NOT a disease. I also agree that drug use is a choice but when it comes to addiction I have to disagree 100%that it is a choice! It’s a Side effect of drug abuse that comes with severe withdrawal symptoms that if not properly managed can lead to death. I believe strongly that over time you can ween yourself off of the drug but you have to go through some sort of counseling and effort to do so. It’s not something that can be done over night out of choice! Now I haven’t gotten over that last hump and I no longer take opiates but I take suboxone which technically is one. But I know with all my heart that I can stop sometime soon and once I do I have to Choose to never take another pain killer or do heroin or any of it’s derivatives. Over time I will no longer be addicted and will consider myself an Ex-Addict because in my opinion you Are Not an Addict for life. An addict is someone who’s currently using and is still addicted to drugs!
You still aren’t off drugs. Suboxone is still a drug and the side affects from getting of it are sometimes worse than heroine itself. The urges and insanity of addiction will hit you then. I don’t believe addiction is truly a disease either, but make that decision for yourself once you are actually sober.
You’re right!!! I’m with you on your “addict” statement. Why would we want to shackle ourselves to something that no longer defines us? And idk how long you’ve been on suboxone… but please TALK to your provider when you’re ready to come off it too. That and methadone have been around since like 1914. (It blocks your opiate receptors & hinders your brains ability to self heal) just my opinion, but something to think about; i think the “war on drugs” is a battle of whether our dollars go to the government or to the cartel. The dope man dont get your money anymore, but big pharmacy does instead. I’m proud you stopped dope, I’m 11 months 3 days clean today myself. I emphasize CLEAN bcuz I still feel like I’m “sobering” up lol. Stay strong!
I’ve been looking for such a summary as posted above (along with the other ideas presented on this site) for a bit now. I’ve been in AA for four years. While discussing a recent bout of depression with my sponsor, she claimed that God, not me, had pulled me out of the state. What happened was one day I got up even though I didn’t feel like it, and went through the day like normal, even though it was hard, and continued to build back up from there. I had been a zombie for weeks, and without outside help, realized I needed to do something different, so I took action. My sponsor told me I was experiencing “grace”, leaving out my ability to make healthy choices. I disagreed pointedly with her, and days later was feeling like “The Program” was overreaching its grasp. This experience turned me to the bigger picture of AA and its codes of what you are taught to believe about yourself. The idea presented above is correct, I did drink because it was my best option for feeling ok in the life I was in, but I’ve moved on from that life. I lately have been feeling like AA, as a society, depends on and promotes the weaknesses of its members. The saddest part for me has been, that by teaching me I am different, and that I need to surround myself with other alcoholics, I’ve let myself be practically estranged from prior friends and family. I never gave them a chance to be there for me, because from the beginning I was taught that they wouldn’t understand. AA will tell you that your friends and family can’t understand, and that is why you need the fellowship. I’m taking baby steps right now, getting back in regular contact with people I was distant from. I will be moving back to my home state, as well. I’ve told my recovery community that it is for financial reasons, but the truth is I want to physically get away from them, because I do feel like AA as a is a cult.
I think you need a new sponor. There are gifts that come to you and gifts you earn. Nothing changes if nothing changes, and you have decided to change. Go to meetings aftetr you move and wear a different pair of glasses.
I whole heartedly agree with you about your experience in AA . I was self medicating myself with prescription pills and alcohol back in 2003 when my marriage ended after 20 years. I reached a bottom, had a desire to stop drinking so I started going to meetings. After attending meetings for a week I declared out loud ” I am an Alcoholic” got a sponsor and started doing the 12 step work. It was suggested to surround myself with the people in the rooms and to call 3 Alcoholics a day because I had a disease only other alcoholics could understand. I pulled myself away from my family and friends because I was told that they did not understand my disease. After 7 years I realized the only thing I really had in common with most of my new AA friends was a desire to stop drinking. I realized that I missed my old friends and my family members who I distanced myself from.
I made a decision to integrate these friends and family members back into my life.
I made a choice to stop going to meetings and live my life sober one day at a time. It now has been two years and I can honestly say that I am the happiest I have ever been. I have my family and friends back in my life and I choose not to drink or drug. Meetings are not for everyone.
This is a great articulation of the oppressive dynamics of AA. The myths of helplessness and of the necessity of divine intervention are profoundly dangerous and dehumanizing. Make no mistake about it: these two facets are the modus operandi of a cult.
I can’t stand the twelve step program. The whole idea of needing a ‘higher power’ to overcome really irked me. I am an atheist and told them that I didn’t have a ‘higher power’ so they recommended that I view the universe itself as my higher power and that it would help me overcome. What a crock! I think the only true help is information, awareness, and knowledge. I do, however, believe it is a disease. And if some people get by believing it so then that’s ok. I respect if others’ don’t see it the same way but I will say it again, if it was sheer WILL POWER that would have brought about the cessation of this problem, I would have been rid of it long ago.
Cheers,
debi
Hello,
I thoroughly enjoyed your article, but respectfully do not agree several points you make.
1. You say changes in brain behavior are not abnormal, in the sense they are too be expected from drug use. Furthermore, upon abstinence from drug use brain behavior reverts. Because of these facts, and your statement that brain changes do not affect behavior addiction is not a disease.
But the fact that brain changes are expected as a result of drug use does not mean their changes are not a disease. For example, smoking cigarettes is known to cause lung cancer. It is a normal and expected result of the drug use. So does that mean lung cancer from drug use is not a disease? No, of course not.
Does that mean other physiological issues that are caused by environmental sources which resolve after removing the environmental source are not diseases? No.
A disease is something that causes abnormal physiological functions or structure. The fact that the body’s response to the disease pathology is to be expected is not relevant.
2. You say that people change their behavior in spite of brain changes from drug use. But you provide no reasoning to support this.
3. You say addiction is a choice because addiction by definition is a compulsive use of the drug. Compulsive meaning involuntary. Since most addicts quit, it is voluntary and therefor not compulsive.
Well frankly that’s silly. You always have a choice, but the thing that is of interest is people making choices that are irrational and cause significant negative consequences to themselves and others. That is compulsive behavior.
You cite sources that mention a non-zero percent of addicts never give up their addiction. So you can’t use this as a reason to disprove the idea that addiction is a disease. Not all addicts give up their addiction, and it is impossible to know if they are simply choosing to continue to use or are unable to stop.
4. You say that brain changes are not abnormal (in the sense they are to be expected), and therefor there is no physiological malfunction in addicts that is required to meet the definition of a disease.
People choosing to continue to use drugs because of withdrawal, severe cravings, compulsive use, even in light of severe personal consequences IS ITSELF a physiological malfunction.
5. Because addicts can choose to stop, they do not have a disease. Well if cancer patients can choose to get treatment which cures their disease, does that mean they had no disease to begin with? The fact people can make choices in the outcome and result of their disease is not relevant.
Furthermore, stopping your abuse of one substance does not cure your addiction. You are an addict for life. Because you can choose to avoid substances which you are pre-disposed to have a high risk for abuse does not change the fact of that pre-disposition.
To put it simply, most people can choose to use a drug or not. But you cannot choose if you are an addict or not. If you know you are an addict, you can make educated decisions about risks and make choices that limit the negative consequences of being an addict.
I am an addict. The choice to stop using was mine. But the decision making changes that occur in my brain as a result of my use are not a choice, and they are not typical of other people who used the same drug.
Hi Dave – here are my responses point by point:
1. The neural adaptations in addiction are directly analogous to those that occur with the creation of routine habits and skills. If you’re prepared to call toothbrushing, piano playing, driving a car, etc “diseases”, then maybe you’re right. But I think disease loses all significant meaning at that point.
Our brains adapt to make us more efficient at the behaviors we repeat most often, including substance use. But these changes don’t compel us to repeat any of these behaviors, nor do they represent disease, injury, or illness.
2. Yes, I did offer reasoning AND evidence for this point, it was an entire section of the article titled: People change their addictive behavior in spite of the fact that their brain is changed – and they do so without medication or surgery
3. You have some tiny point here: nobody can ever prove a broad negative claim. That’s logic 101. So at some time in the future we may find some evidence that substance use is compulsive in those categorized as addicts.
But here’s another rule of basic logic: the burden of proof is on those who make a positive claim. The pro-disease crowd repeatedly insist that addiction is compulsive. Over 40 years of research has turned up no proof. When I argue that addiction is not a disease, I can point out that lack of proof. It is on those who make the positive claim to provide the proof. I linked within that section to another article on my site with citations to a large body of research demonstrating that the behavior of “addicts” shows all the hallmarks of voluntary behavior when carefully tested.
As of now, there is no proof that addiction is compulsive, and there really isn’t anything that even credibly implies some future discovery of proof. If you have it, I implore you to provide it. The currently available evidence demonstrates voluntary choice.
4. This point is like a repetition of previous ones, and just asserts that a physiological malfunction is to blame. I think you also assume that “cravings” are especially physiological, when in fact craving is an active process of ideating about the benefits of a thing. Craving will have neural correlates–as does literally every thought or action performed by a human being does–but that doesn’t mean it isn’t chosen. If the mere fact that it has neural correlates meant that it was unchosen, then literally all human behavior would be unchosen, and then all human behavior would be compulsive, and then it would all basically fit the same idea of the disease model of addiction, and then addiction would have no significance whatsoever as a concept if it described all behavior.
Yes, you can strap someone into an FMRI machine and show what happens in their brain when they “crave.” But showing the mechanism behind it doesn’t demonstrate compulsion or disease any more than showing the operations of a stomach digesting food would demonstrate eating and digestion to be diseases. Addiction theorists try to have their cake and eat it too by claiming addiction to be a loss of free will by simply showing neural correlates while ignoring the fact that all behavior has neural correlates. They never define what freely willed behaviors look like in the brain, yet they insist that “addictive” behavior is not free with no comparison. It’s nonsense.
5. This point is silly. Substance use is an active choice. Thinking about substance use is an active choice. It takes continuous choice and action to maintain these behaviors. Cancer takes on a life of it’s own, even if you make the choices that result in acquiring it. You can directly choose to use or not use; to believe that further drug use is your best choice or not–but you can’t directly choose to shrink or grow your tumor. YOu can only hopefully shrink it indirectly with medical treatment.
so you don’t just make a choice that indirectly affects some far away outcome of a disease with addiction as you do in cancer. In addiction, you directly choose to change your thoughts and behaviors, directly changing things in the here and now.
And as far as involuntary things go, you can be locked up in jail and have no further substance use, but if the same were done to someone with cancer, the tumor would remain.
So alcohol affects/ damages every organ of the body, heart, liver. kidneys, etc, but does no damage to the organ of the brain? That seems highly unlikely.
If I claimed ANYWHERE that alcohol can’t damage the brain, please show that to me. Alcohol certainly can damage the brain. However, my point in this article is that the neural adaptations often mentioned are of the sort that are neuroplastic changes that happen even with habits that don’t include ingesting chemicals, rather than damage from toxicity.
Let’s consider some info like this, from a Scientific American Addiction Gambling Brain Drugs article on gambling and the brain:
Even more compelling, neuroscientists have learned that drugs and gambling alter many of the same brain circuits in similar ways….
…Whereas experts used to think of addiction as dependency on a chemical, they now define it as repeatedly pursuing a rewarding experience despite serious repercussions. That experience could be the high of cocaine or heroin or the thrill of doubling one’s money at the casino. “The past idea was that you need to ingest a drug that changes neurochemistry in the brain to get addicted, but we now know that just about anything we do alters the brain,” says Timothy Fong, a psychiatrist and addiction expert at the University of California, Los Angeles. “It makes sense that some highly rewarding behaviors, like gambling, can cause dramatic [physical] changes, too.”
I don’t agree with everything in that article for sure, but it highlights my point: there are many neural adaptations seen in addiction that have nothing to do with the toxic effects of a drug. They have to do with repetition of a behavior perceived as rewarding. So, again, please understand that this post is not a denial of any toxic effects of drugs and alcohol, it is referencing a different type of change to the brain.
Steven,
Thanks for your considered reply and for your web site.
I think the point everyone can agree on is that activities such as gambling and drug use cause adaptations and brain changes focused possibly in the reward systems of the brain. To define these as “normal” misses the point. Normal adaptations aren’t always positive or neutral. they can be “normal” and negative based on results produced.
These brain adaptations are in addition to any toxic effects of substances might have on the organ of the brain.
The question for me is do these changes diminish the capacity to choose. It sure seems that they do just based on experiences of addicts. Diminished capacity of course is not the same as compulsion, or complete loss of control which I believe the evidence doesn’t support as people do make life changes despite negative adaptations. But an organ functioning at diminished capacity that affects decision making could be considered “diseased” and I think this is the questions science and medicine must answer. The fact that we are able to overcome with struggle bad adaptations doesn’t mean they don’t occur.
“The question for me is do these changes diminish the capacity to choose.”
Agreed. That’s a big question, and if it could be definitively answered it would be significant.
I don’t think it has been answered at this point, and I think that the sort of points I’ve offered here, and that Gene Heyman put forward in that paper I linked suggest that these changes don’t compromise the ability to choose. Who knows, maybe that will change.
Thanks for arguing in good faith – that’s a treat I rarely get around here 🙂
-Steven
Disease, Merriam Webster Dictionary:
“an illness that affects a person, animal, or plant : a condition that prevents the body or mind from working normally”
It is my belief that science and medicine will prove that the brain of an addicted person is not “work normally” and by normally I mean optimally, especially in those areas that are responsible for decision making. Diminished capacity not rising to the level of compulsion can still be considered disease if the brain is not “working normally”
Chuck C –
I think the Steven’s (wonderful, kick-ass) article addresses this point. While it’s possible that you may be right, and that someday evidence will be discovered (science rarely “proves” things – everything is a hypothesis with more or less evidence for or against; proof is for mathematics) that supports your position that neural changes brought about by drug use diminish one’s ability to choose to stop using drugs, Steven provides evidence against this hypothesis. I’m speaking specifically of the rat experiments, where it was demonstrated that:
1) Cocaine-using rats preferred artificial sugar to coke, no matter how long they’d been on the drug
2) Rats preferred artificial sugar to coke independent (key word there) of past cocaine use.
So at this point, as a critical thinker – which you obviously are – you should would weigh the available evidence as follows:
1) The hypothesis that drug use reduces ability to choose to stop using (while certainly possible and which may match subjective observation) currently has no actual objective evidence (at least not that I’m aware of – if you can site research for it, please do).
2) The null hypotesis (i.e. that drug use does not affect ability to chose to stop) does have evidence, as shown in the rat study above.
From this evaluation, then, one should conclude that it is more likely that null hypothesis is true, and that drug use does NOT diminish the ability to choose to stop using.
Jeff,
1. Brain scans show definitively that the brains of substance users are clearly different from those without substance problems. The brain systems adapt to drug use in a way we don’t understand completely. Steven makes the argument that driving a cab also causes brain changes so it doesn’t matter that drugs also cause adaptations. I’d argue that while brain adaptations are “normal” that doesn’t mean that all brain adaptations could be judged to be positive.
2. People that have damage to certain parts of their brain are known to have problems making good decisions. So brain damage leads to diminished capacity to choose well . This has been scientifically confirmed.
3. As you point out, addicts behavior seems to indicate that something in their decision making process has gone wrong. I don’t think it’s wise to ignore the experience of drug users when trying to decide if there is a problem beyond choice.
4 . I am not arguing that users are “powerless” or compelled (have zero control over their decisions and actions). I am hypothesizing that based on brain scans that show adaptations, and addict behavior, that something in their brains is detrimental to their ability to make good choices. It is even possible that their brain systems are damaged prior to using, by say childhood trauma, and that drugs simply feel like they fix an already existing problem.
5. If you think of addiction as the brain making dysfunctional value decisions, then sitting down with an addict and exploring the value they give to substances might allow them to change the “equation” in their brain that calculates the value risk/reward of substance abuse and resetting the equation allows them to change their behavior.
6. We will hopefully know a lot more over the next 10 or 20 years and I’m completely open to changing my view. My hypothesis is constantly changing the more information I get and isn’t set in stone at all.
To points 1&2: “There are no published studies that establish a causal link between drug-induced neural adaptations and compulsive drug use or even a correlation between drug-induced neural changes and an increase in preference for an addictive drug.”
To point 3: “Although the brain disease model of addiction is perceived by many as received knowledge it is not supported by research or logic. In contrast, well established, quantitative choice principles predict both the possibility and the details of addiction.”
Both quotes from: Heyman, G. M. (2013). Addiction and choice: theory and new data. Frontiers in Psychiatry, 4, 31.
Steven,
Not convinced by Heymann. He seems to suggest that because people are able to quit there is no disease.
The fact that most people quit by 30 might have something to do with the development of the prefrontal cortex which is said to still be developing into the late 20’s and which is said to have an executive control function on decisions. Maybe it’s not a coincidence that addiction starts in younger years and ends when a part of the brain responsible for controlling risky decisions is fully developed.
The lack of published studies thing is incorrect. There are plenty of studies that show damage to specific parts of the brain directly results in decision making dysfunction, i e that people can’t make good choices. There is also plenty of research that shows brains systems are changed by substances. Put 1 and 1 together.
You would have to make the argument that changes to the brain due to substance abuse are not harmful/damaging in order to believe that they don’t affect choice and decision making the way say a lesion on that part of the brain is proven to affect decision making/choice.
Dave and Steven, I really enjoyed your exchange. Dave brought up some good points, and Steven had some good responses. I think you both scored a couple points.
The elephant in the room here is the pendulum that is always swinging in big issues like these. At one time, too much focus was put on addiction being a moral failing. As AA became more popular and had more visible successes, the public’s and therefore the medical establishment’s allowance for intrinsic factors for addiction began to increase, because they knew their addict family members were not moral failures, yet they kept on hurting them. Empathy raised and people were looking for reasons their fathers and daughters and friends were risking so much for such a painful behavior. It defied rationality, so it must be something people have no control over, it was thought. Most addicts were happy to jump on board this train of thought, because it allowed them to justify to others and explain to themselves why indeed were they causing so much pain to their relationships. Treatment centers were happy to have a new rationale to explain to addicts and families why it is so hard to change addictive behavior. Medical establishment was happy to go along with it, too, because it allowed a very convenient thing to occur: ability to send to specialists. Who wants to try to treat people who are acting irrationally? But now it has swung too far toward the disease model because it’s become party line, not due to evidence. Because we can show that the brain reacts to things does not have anything to do with diseases or not.
So the pendulum swings back and forth between free will and compulsion. There are other pendula swinging, too, like whether addiction requires a spiritual awakening or psychological retraining.
We need to stop these pendula, collect the facts, and re-evaluate without presuppositions. The disease concept is out until it can be proven. We will allow in pre-disposition to addiction in only the vaguest sense… some people more than others tend to find a coping behavior that seems to really stick.
In treatment in this future Descartes world of doubting everything until investigated, we will take as much time as we need to ask each person about why they keep repeating their behaviors. For those who have clear explanations, we will ask them if they want help changing. If not, we stop trying. For those who seem lost as to why they are behaving the way they are, we perform motivational interviewing if they’d like it. We will see what was attractive at first and what continued to motivate them.
Some people will say they always felt lost, like their lives had no direction or purpose. These people might be happy to pursue a life where spiritual action and ideal plays a large part. Or they might want to explore whether we make our own meaning by choosing things we value and accomplishing those things. Or they might be happier becoming nihilists. It’s each person’s choice.
For other people, they will sense that they had like 75% of their behavior to their liking but they had been modeled badly as children, so they had chosen to (for example) lie to get ahead or reject asking for help from others or thinking they had to perform perfectly. Their acceptance of lying to get ahead or their perfectionism might have allowed the idea of boosting their performance with drugs or behaviors that they kept secret. But these people, upon looking at their life, decide they want to change some of these poor coping strategies when they also stop using their chemical of choice. They might feel spiritually fine but see the counter productive assumptions they made as unskillful. These people might ask for professional or peer group help keeping honest or dealing with perfectionism.
Other people might have some other mental illnesses that cloud issues of clear thinking or inexplicable anxiety, and, like anyone with such issues, might have gotten caught up in drugs as an aide to those issues. Mental health specialization might be called for here.
Some people grew up feeling they had to cheat and break the law to get ahead. Along that kind of path, they crossed the paths of others like them, some of whom had used drugs. They became enamored of the lifestyle. They might keep that lifestyle going to the bitter end. Who knows what might help them? Maybe spirituality, maybe 3 years of therapy on loving yourself and trusting that most people can get by in society without breaking the law and enjoy it. Maybe a death sentence.
My point here is that we need a CLEAN SLATE like this one. We need to drop the assumptions and listen to one another. Addicts can be sure they aren’t choosing, but they are possibly wrong. Others can be sure that it’s completely voluntary, no questions asked, yet possibly wrong. The large area between these two, though, must be given much acceptance until proven otherwise: until shown to be false, we have to assume that these behaviors are like any others…. some easy, some difficult to visualize changing. By our saying you can change, addicts should rejoice not feel defensive. We’re not saying you weren’t better than average candidates for becoming addicted… we’re just saying you can change.
If we assume the brain adapts in some way to heavy substance abuse or addictive behavior, it’s not a giant leap of faith to say that based on the observations of addict behavior, the “normal” brain adaptation to abuse could be judged to be a negative based only on the observation that the results produced tend to be negative.
If one of the functions of the brain is to make decisions, and through adaptation that process is diminished in some way (the reward feedback loop gets out of whack), does that “negative” adaptation rise to the level of “disease?” Can we say the normal functioning of the brain is “damaged” but not destroyed? Making it simply more difficult to make “normal” good decisions but certainly not impossible?
Very interesting article. Let’s say someone is sober for a number of years and their brain is restored to normal. One day they choose to have a drink out with friends. One drink isn’t enough so they order another and then another. If the brain is back to a healthy state why can’t he or she stop at one drink? Isn’t the brain permanently changed so the choice to have just one drink is almost impossible?
I think the answer is that science hasn’t answered those questions yet as we are still studying the brain and understanding exactly how it works.
Is the brain restored to normal after years of sobriety? If neural pathways are created by drinking, do they disappear once you stop drinking? I don’t think we know yet.
Why do you assume that they “can’t stop” at one drink?
I think this is one of the most frustrating parts of discussing this behavior. It’s simply assumed that if someone drank more than they originally intended – (i.e. changed their mind) – that they were not in control of themselves. On what grounds do we make that assumption?
Well i am a recovering addict and i can tell u that the obssession that comes with addiction is what drives addicts to keep using! Because there is something in our lives that we dont want to feel or deal with so we turned to numbing the pain and alcohol n drugs do that for a short period of time, then you come down from the euphoric high and now on top of feeling the pain that you chose to numb now u are faced with guilt because you know ur not supposed to get high n its a vicious circle that keeps going around n around n it gets so bad our lives become unmanagable, its the obssession with the feeling you get from getting high and once you feed that obssession the compulsive trait starts to kick in and thats all you can think of ….. Its a very difficult disease and for somebody who has never personally lived it you will NEVER EVER understand what its like being addicted !!! So you can read all your books n blogs ect. But none of that will ever give you true insight to an addicts mind!!!!!! Once we hit bottom n have had enough n just cant do it anymore n realize we need help and most important we finally realize that im worth it, you can finally step fwd to do things in your life including medication that assist in addiction by stopping the cravings so you can focus on fixing whatever it was in the first place that hurt u so bad you decided to numb it. Its a process n ppl dont become addicted overnight and surely wont be all better overnight either!!!! If you keep an open mind n try to see things from somebody else point of view you may just realize that no body has all the answers and addiction is so complex ……
I hope that you, and all suffering people, will come to realize that drugs and alcohol do not really numb emotional pain. They only provide a distraction, and not even a reliable one at that. People often focus their mind on emotionally painful topics and ideas while drunk and high.
It doesn’t numb emotional pain.
It doesn’t numb emotional pain.
It doesn’t numb emotional pain.
It doesn’t numb emotional pain.
It doesn’t numb emotional pain.
It doesn’t numb emotional pain.
It doesn’t numb emotional pain.
It doesn’t numb emotional pain.
It doesn’t numb emotional pain.
It doesn’t numb emotional pain.
Realize this, and you won’t feel the need to use it to numb emotional pain any more than you would want to get waterboarded to numb emotional pain.
-Steven
I went online to educate myself on addiction and like you, at first, thought there was no way drug addiction is a disease. However, I’ve now changed my thinking process. After stumbling on your ‘very long’ article that seems to reiterate over and over again, your reasonings why I should adapt to your side of the brain thinking…..I went searching elsewhere. My biggest argument would be Narcan. The very existence of Narcan, and how it works at a cellular level, should be enough to show you that drugs effects the brain much more than a brain scan could ever reveal. What I do believe, is addiction in the early stages is a choice. Progression into addiction….not so much. If certain drugs program your brain to not have receptors functioning the way they should, then how can it be expected the addict to make a logical choice?
Just out of curiosity, if someone gets lung cancer and smoked for years…..Is that considered having a disease or was it a choice to get sick? It’s the chicken or the egg dilemma. I think the disease is the consequence of the choice. Same with drug addicts .
Hi Renee,
To answer your last question – the smoking itself was a choice, the cancer was likely an unwanted consequence of that choice. However, smoking remains smoking (a behavior chosen because of the perceived benefits of relaxation, improved concentration, energy, etc), and cancer remains cancer (a condition of mutating cells that can be quite deadly, and can’t be directly stopped by choice). They are two different things. Regardless of how you acquire the disease of cancer, it is not directly under your volitional control. It is a disease no matter whether you made the choices that led to acquiring it or not.
Regarding your comments about Narcan – I’m very curious to know more about what you think the significance of Narcan is to this topic.
-Steven
If a person has taken opioids and is then given Narcan (naloxone), the opioids will be knocked out of the opiate receptors in the brain.
A quote taken from: http://thebrain.mcgill.ca/flash/i/i_03/i_03_m/i_03_m_par/i_03_m_par_heroine.html#drogues
Explains the opiate receptors effected from certain drug use.
“The reason that opiates such as heroin and morphine affect us so powerfully is that these exogenous substances bind to the same receptors as our endogenous opioids. There are three kinds of receptors widely distributed throughout the brain: mu, delta, and kappa receptors. ”
Now, I have not throughly researched what each receptor does within the brain but I’m willing to bet, one of them, effects some sort of decision making process.
I think a better example is early stages of diabetes. This disease can be brought on by poor eating habits and weight gain can get to the stage where the body does not do an adequate job of allocating insulin. However for some people, this disease, which everyone acknowledges is real and caused by poor choices, can be reversed by significant weight loss and better eating habits, to the point where medication/insulin need is reduced or in some cases eliminated. Isn’t substance abuse similar, that it causes a real disease affecting the brain and decision making that can be reversed with better choices?
Chuck C
“This disease, which everyone acknowledges is real and caused by poor choices, can be reversed by significant weight loss and better eating habits” is an uneducated statement. My son was diagnosed at 3 years of age with type 1 diabetes. It was NOT due to his weight or unhealthy eating habits. He was a healthy, active toddler who became sick out of the blue. He did not choose this nor did we put our son in a position to develope it by giving him unhealthy food. If that were the case then my other 3 kids would have also developed diabetes. They, 14 years later, do not have it and are all healthy. What choice does a 3 year old have in the matter? He has a true disease and can’t get rid of it no matter how much he (or anyone else who loves him) chooses to get rid of it. I understand that there are people out there who, by their poor choices, “can” develope diabetes but the point needs to be stressed that diabetes is not a disease that is brought on by neglecting ones self in most cases. Here we are again touching on the “choice” and “disease” topic. My son did not choose diabetes. Addiction is caused by those who choose to use a substance repeatedly, over and over again. No one forced the addict to use the drug, or alcohol, that they abused. It was a choice to pick it up (over and over) and it is a choice to put it down. It may not be an easy choice to put it down and they obviously really like feeling the “high” gave them, but it IS a choice to stop and they CAN choose to stop. Regardless of how much they damaged their brain by choosing to use their chemical of choice. There is a payoff for what someone chooses to do, good or bad. Otherwise they wouldn’t do what they do. Some people no doubt need support to make better choices and there is no blame in that. However, it is still a choice they have to make to quit and get support. Diabetes is not something you can quit no matter how much support you choose to get. That is a true disease. The medical world assigns “addiction” as a “disease” so it can slap a billing code on it and collect money from insurance companies, sucking funds from true diseases like cancer, diabetes, heart disease and other real issues that people have no choice or say over. My husband is a severe alcoholic and I watched him every day to choose his addiction over family at a seriously high cost to all of us emotionally and financially. He was drinking a case (24 pack) of beer a day. He got in to trouble at work and almost lost his job over it. He now chooses to remain sober in order to keep his job. He needed no medical intervention. He simply was confronted with a price that we too high for his liking. So he stopped. Does he have other issues that he needs to deal with???? For sure and without question!! But the drinking was a choice he made to stop because he values his job. He became an alcoholic because he liked the “high” he got from it. So he repeatedly drank over and over to have that feeling. In turn he became addicted to the alcohol. But he made the choice to drink it over and over which led to his becoming addicted. However, no matter how much damage was done (without having any brain scans to confirm) over the 15 years of heavy drinking, he made the choice to stop drinking in order to keep his job. Which is evidence that supports this article. The article talks about addiction being a disease (needing medical intervention) vs. a choice. Everyone has a price and a limit that they are willing to pay. It just depends on how much that price is. Some people choose to pay with their life. Others find that price too high and quit before they die. For some people it’s their freedom, others is the loss of a marriage mate or other relationships. My husbands was his job. The point is, people will only do something as long as it has some kind of pay off for them. When the price becomes too high to pay, they stop the behavior. In conclusion, addiction is a choice. Diabetes is a disease.
I applaud you with a standing ovation!!! I am also a recovering opiate addict , i am lost for words lol you made the point and knocked this uneducated, ignorant blog that is nothing but an opinion and a crappy one at that!!! I suppose there are always gonna be ppl like this and its sad! I will pray for them all!! But way to go on telling it like it is!!!!!
Wow, awesome articles. I have been addicted to oxycodone since 1982 when I spent three months in a hospital with my leg in traction from a motorcycle accident. In the last year I have gotten to the point where I was taking 700 milligrams of oxycodone a day. After nearly a quarter of a million dollars worth of Street purchases, I’m nearly broke. I’m just realizing I may actually have a choice to live my day differently and I like it. Thank you all and may God bless you!
I found your article interesting and would like to see your own research into this subject particularly with treatment and relapse rates. I am also curious about your years of experience actually working with this population not just critiquing studies and concepts of others.
Thanks
Woah, hey I had to stop reading early. There is a physiological marker for the disease of addiction – over expression of the gene delta-fosB . Butthole. This isn’t even including the physical pain of withdrawal. When you stop using your only in remission, like herpres perse. Not that it is an excuse to steal money, of course! But addicts are sick, some innocently, like productive citizens turned drug dealer, this and that fact it is progressive when untreated for SOME needs to be recognized.
Wow. That sounds very sciencey, Anus.
Look at the definition for disease. It falls under it perfectly. Addiction stems a genetic disorder. Some people think there’s nothing they can do about their genes but behavioral genes are expressed by our actions and we have control over them. Absteince from drugs and sex will cause a down regulation of delta-fosB, the addiction or pleasure seeking gene. I think this is why most people fix themselves only for sexy times with a significant other lol, sex will definitely fill the void.
Disease- a disordered or incorrectly functioning organ, part, structure, or system of the body resulting from the effect of genetic or developmental errors, infection, poisons, nutritional deficiency or imbalance, toxicity, or unfavorable environmental factors; illness; sickness; ailment.
Look in the mirror, Steven. There’s an anus. Child.
The disease theory of addiction is nonsense and dangerous. I never knew anyone who had committed suicde. Then after spending a year in AA I had known 14.
Luckily I left before I “relapsed”. Am much happier now not having to listen to nonsensical shares about higher powers or defects of character.
No longer, publicly declaring I’m an alcoholic upwards of four times a week means I rarely even think about drinking. I put the time spent not going to meetings to exercising. I now have a six pack and have stopped smoking.
Oh yeah!!!!!
I have been an addictions’ counselor for 17 years. I must admit that your article has some sense it it. Yes, a person does have a choice to use and a choice not to. But the person who decides to use is using because they know what the alcohol or drug will do. Giving out small rewards for continued abstinence may work for a time, but ultimately the person will return to using if he or she does not uncover the reason why they do use. People have consequences if they continue to use and theirc coping skills becaome poorer the more they continue. As I proceed a counselor I am realizing that drug dependence is a mental illness created to avoid deeper, unresolved issues. As these issues continue to be unresolved, drug dependency becomes a mental illness. In that respect I believe that addiction, if untreated, will lead to physical health issues. So there is choice but the mental illness can’t be resolved until use is stopped. Similar to diabetes, use requires a better diet to recover from addiction. Thank you.
Have you read Jack Trimpey’s book called Rational Recovery? I think it would be of much interest to you.
Free will is an illusion. Moralizing with a poor understanding of analytic philosophy leads to pointless suffering, at best.
https://www.youtube.com/watch?v=pCofmZlC72g
Since it’s a complex topic, watch this clarifying video.
I haven’t watched the video yet, but I see that it’s Sam Harris, so here’s my quick reply. I’ve read his book on free will, and it seems that he hangs his entire case on Libet’s experiments regarding the readiness potential, which are not the smoking gun many would have you believe they are. Here’s an interesting paper from 2012 taking another angle on the meaning of the readiness potential: http://www.pnas.org/content/early/2012/08/03/1210467109
I should also say that if free will is an illusion, then the disease model of addiction is still a complete and total sham. It claims there is both free behavior and un-free addicted behavior. It claims that “drugs hijack the brain and rob the addict of free will.” It rests entirely on the idea that behavior is normally freely willed, but not in the case of addiction. Then, it problematically goes on to explain addiction in terms of the same mechanistic elements that could be found for every other behavior. It’s really quite silly.
I am a believer in free will, and I doubt you could confidently call me wrong. Since your theory would say that we are both compelled to believe what we believe, neither of us could claim our belief is more reliable than the other’s.
Steven I’m sorry but you come off as sounding silly. In our debate about what happens during a blackout and how do we know we can make a choice, your argument was how do we know we can’t, which I replied how do we know we can? Sam Harris explains it so clearly…. If you’re a serial killer you compelled to do kill, your set off by your genes, your history, past behaviors, and whether you had a bad day. If your obsessive-complusive you repeat behaviors that might cause anguish if you don’t. If your schizophrenic you have hallucinations… you can’t just choose not to have them… In “A Beautiful Mind” Russel Crowe’s character was able to understand he was having hallucinations but he couldn’t stop them. So if you’re not a serial killer, obsessive-complusive or schizophrenic you don’t have to deal with those things. So if you’re an addict or alcoholic you are compelled to use, be it a genetic component (which has been proven), learned behaviors, history of what you’ve done in the past or if you had a shitty day. You can’t control it… You can learn new behaviors, it can be treated, but it’s not just a “simple choice”. If you’re don’t have the disease of addiction, you don’t have to deal with that compulsion for cocaine or alcohol…. but if you have the disease of addiction its not just a ” simple choice”.
Please stop using “simple choice” in quotes like that to argue against a strawman here. See this article I wrote from 2014: Choices Come In All Shapes and Sizes, or this other article I wrote in 2011: Choice and Will Power and you’ll see pretty clearly that I am NOT making the argument you’re arguing against. I’m pretty sure I responded to you on this before though, so I doubt this will make much difference.
And if all behavior is compelled then it MAKES NO SENSE TO SINGLE OUT HEAVY SUBSTANCE USE AS AN ESPECIALLY COMPELLED BEHAVIOR. So if your stance is that all behavior is fully determined and we have no control over ourselves, then go out there in the world and convince everyone of that, but for godssake please leave me the hell alone. After all, I can’t help myself. I’m compelled to write all of this.
Who says all behavior is compelling? All behavior is neither compelling or willful. Being compelled to use drugs and going to the movies are both behaviors, and our reward system acts completely different in both cases. Who died and made you god anyway? You act as if your articles and conjecture, whether it be by opinion or something you researched or read, is complete and utter truth, and the final answer. You proclaim your righteousness and superiority from a place of privilege and a complete lack of any resemblance of real world experience. Shut up and get rid of your extremely over-inflated ego.
Hi Clay,
If you scroll back through the comments, you’ll see that the first one in this thread says:
“Free will is an illusion. Moralizing with a poor understanding of analytic philosophy leads to pointless suffering, at best.”
and then links to a video by Sam Harris, in which he states that free will is an illusion. I responded to that. Then another commenter responded to my comment, again referring to Sam Harris, and therefore again claiming that our behavior is not free.
Those who say that free will is an illusion are also necessarily saying that all human behavior is determined. Another way of saying that is that it’s compelled – ie caused by forces outside of the individual’s power to choose. In determinism, there is no choosing, so everything is compelled.
So in answer to the question “Who says all behavior is compelled?”*: Sam Harris, and at least the two people who commented here to whom I am replying (other than you).
-Steven
*although you wrote “compelling” I assume you meant “compelled”, since the former didn’t make sense.
Well, it is indeed bullshit to call one case clinical and one case “non-clinical.” It’s all problematic. It’s such a stupid, arbitrary cutoff. I know exactly what you’re talking about there and that does get me irritated.
As for free will, it’s logically impossible unless you redefine it in compatibilist terms (which, to me makes less sense than using spherical coordinates to describe the structure of some material with a rectangular molecular geometry – possible, but pointless, horribly inelegant needlessly difficult).
Basically, you’re made up of stuff – invoke the supernatural if you want to even – I’ll even give you that (not that I believe in it). So, you’re made up of this stuff, perhaps it’s magical soul stuff. But, you run into a problem when trying to define free will.
Since you’re made up of stuff, that stuff has to produce physical results somehow. It’s going to do that with deterministic processes – unless those processes literally don’t make sense. If a process makes sense, it is by definition deterministic. If it doesn’t make sense, it is either chaotic or truly random. So, if something is deterministic, it is by definition, nonrandom. If it is nonrandom, it is deterministic. You can get some combination of these, but you can still break them down into their deterministic or random components. And, neither one of those is capable of producing free will.
So, no, we’re all equally not responsible. But, we’re intelligent and the fact that I care about society functioning well causes me to automatically feel a drive towards actually taking actions that benefit society.
You can still use free will as an approximate model – sort of like the Bohr model of the hydrogen atom is a usable model – except that it doesn’t reflect reality, basically at all.
A disease isn’t always a random occurrence though, and it can be brought on by environmental factors. i.e. exercise, diet, habits, etc. Soooo diabetes, not a disease, you chose to have a shit diet. Cancer, we are now understanding that many cancers are caused by environmental or dietary factors. SO is it not a disease? Addiction, isn’t drug use. But drug use, can lead to addiction. Addiction is the product of your environment and the choices you make, just like any disease. If you choose to go to the beach every day, and get skin cancer from being in the sun all the time, are you gonna try and argue that its not a disease, because you made the choice to absorb all the suns radiation? like yes many addicts made bad decisions leading up to them being diagnosed, but same can be said about people who suffer from heart disease as a bi-product of their alcohol abuse. The disease accompanied by bad lifestyle choices, is still a disease. whether they are brought on by poor life choices or not, its not the point. the point is recognizing the problem in the individual and treating it. The brain does change in addicts like you said, their seek and reward systems are altered, and they seek out those chemicals that make them feel that way. the treatment for addiction may not be drugs or any traditional medical treatment, but it is treatable, and it is a disease. not every ‘disease’ is a physical one, some diseases I believe, personally, are spiritual illnesses and can be cured with compassion, and hopefulness for the future. Treating addicts with medication, may never cure them. but maybe helping them stay away from these mind altering chemicals while the body heals itself, is the way we treat them. Like cancer, if we stop feeding the cancerous cells and try to only nourish the healthy ones, maybe thats how we cure it, like in addiction, stop the bad habits encourage the good, idk. just my take on it. I don’t have a medical background or anything, just life experience. so disregard my words if you believe them to be rubbish, but their is some truth in what I say based on my own personal experience with addiction. I have a disease, and I am treating it. The first step is getting help. take it from their, its a step by step, day by day fight against our own minds.
Is addiction a disease? Hell, I don’t know. I’m not a doctor, and I don’t play one on TV. But I am an addict-alcoholic, now five years c & s, with another 12 years of on-and-off addictive behavior prior to that. And I think I’ve picked up a thing or two both from my own experience and observation, and from listening to various rehab counselors, a few of whom (tho not all) seemed to actually know what they were talking about.
I have always questioned the ‘disease’ on a certain level. I’m not sure what a ‘disease’ actually is, and I’m sure we could easily find a couple of experts, each with equally impressive sets of credentials next to their names, to provide different answers as to what the ‘real’ definition is. What I do know is that ‘true’ addiction is a physiological condition of some sort; it is much more than a matter of “choice.’ I think it’s important to note that the behavior itself (i.e. drinking or using) is not the condition; it’s merely the byproduct. The condition is the set of chemical processes that push us toward this particular compulsion.
Part of the problem is this: We just don’t know that much about addiction, on a number of levels. And it’s certainly true that many people in the rehab/recovery and 12-step communities make a lot of strident pronouncements, some of which aren’t always true for all people, and some of which may just be utter bull@#$. Like most things, you have to take the good with the bad. And there is a lot of good in the 12-step community, if you approach it with the right mindset. I know, because AA has been a key component in my own sobriety. More on the other component in a moment.
You’ve cited research claiming that addiction is not a compulsion, but I would take all of it with more than just a big fat grain of salt. That whole thing about successfully encouraging addicts with movie tickets — Really??? As a real addict, I cannot think of enough ways to tell you how ridiculous that sounds. I mean, maybe this happened. But not with any of the addicts I know.
The way addiction was explained to me — (and this was during my recovery, not before; I want to make that clear because some people seem to think the evil recovery community has somehow brainwashed everyone into thinking they’re powerless, even though millions of undiagnosed addicts who’ve never heard the 12-step rhetoric behave in predictably ‘powerless’ ways every day) — is it is essentially a function of the so-called animal brain, the fight or flight center taking over and asserting itself where the rational brian would ordinarily hold sway. This made a lot of sense when I finally heard it, why I couldn’t ‘think’ my way out of cravings, even after I reached a point where I wanted to quit using. (And btw, the whole notion that the craving itself is a choice??… no. just, no.)
Again, I think part of the problem is that we understand relatively little about addictive processes. For instance, who really qualifies as an addict? Why do some people seemingly exhibit behavior that seems ‘addictive,’ and then suddenly quit, because they got married or found jesus or whatever? We don’t know. I think this is something that people inside the 12-step community and outside of it, as well, need to recognize: There are lots of things that don’t seem to fit the ‘model,’ or don’t seem to hold true at times. That doesn’t mean there’s not something going on here called ‘addiction,’ a compulsive physiological and psychological condition that seems to afflict some people and that is not addressable by means of ordinary, rational ‘choice.’
And by the way, from what I understand, the images you have of brain scans returning to normal is perfectly in keeping with what addiction specialists know about the condition — yeah, sure, brains get better. And cravings tend to lessen over time. I’ve heard a good deal of discussion about the six, 12, and 18 months windows, and how each of those tends to coincide with a return to ‘normal’ brain function, and a corresponding decrease in the craving function. There’s also plenty of evidence — I don’t know what the brain scans in these cases look like, but most of us in recovery have seen it happen oh, so many times — that people who return to using even after some time often do so with a vengeance. It doesn’t take much to go from zero to ‘no control’ again.
It’s worth noting in passing, too, that my own recovery was also enabled by my psychiatrist, who would take serious issue with many of the things you’ve put forward here. He’s the best in my town in what he does, and he’s on the forefront of addiction science. He prescribed me a simple medication — i think its standard use is for blood pressure, or something, no side effects — that very recent research has found to be useful in cutting down on cocaine cravings. That pretty quickly enabled me to enter the five-year period of sobriety I am currently enjoying, after years of absolutely soul-crushing cravings that constantly knocked me off the wagon. A matter of choice? I don’t think so.
Wow! Finally someone with real-world experience AND intelligence. Steven cites a lot of scientific quotes and references statistics, charts and scans, but has absolutely NO real world experience and sits way up high somewhere proclaiming (from the rooftops) that his word is final. It doesn’t matter if I don’t subscribe to the disease theory in its entirety. It’s the know-it-all attitude and an over abundance of condescending tone that is hard to digest. All this “knowledge” and then he calls someone an anus. I think Steven’s head has been up his (anus).
Hi Clay,
Perhaps you missed that I was responding to someone who said this to me:
Woah, hey I had to stop reading early. There is a physiological marker for the disease of addiction – over expression of the gene delta-fosB . Butthole.
But go ahead, keep lecturing ME on tone. I face constant daily abuse here, and respond with real answers trying to really explain my points. Yet if I respond in kind once in a while, or use some sarcasm, I’m a moral criminal. And YOU have the damn nerve to call ME self righteous? You know where you can go with that.
-Steven
Ok, all of you, enough! Bottom line is that addictions are complicated and treatment doesn’t adhere to any one particular school of thought because we’re HUMAN! Research provides empirical data but there is also the “personal, HUMAN experience that provides a whole different perspective. What is most important is that whatever it takes, it’s about healing from addictions, no matter what that may be. Whether you’re presenting your argument from a researcher’s or a personal perspective, taking things personally or becoming defensive is an emotional deterrent from what we are all trying to accomplish…Presenting views from a dogmatic, evangelistic perspective is closed verses just the sharing of knowledge and experiences gained so we can all learn from each other…keep the personalizations and defenses out of the equation. That is your “your”stuff. This is not about arguing our case but trying to remain open to all perspectives so that we can learn from each other. It’s ok to disagree and to present evidence based arguments without slamming each other…opposite of emotional intelligence! Each perspective all have merit!
I am a psychotherapist who have helped people for nearly over forty years dealing with addictions. I am nationally known for my work and a scholar in my field yet came across my challenged after winning a large jackpot while going through multiple loss in my life. I am now wroth a book titled: Living with a Loving Heart…lesson learn on suffering and pain (from a professional and personal experience). To me, the two can’t be separated…because we aren’t just intellectual beings, we are HUMAN beings!
Deborah Greenslit, LMHC/RN
The disease concept is A concept, although it is usually presented as THE ONLY concept. It is by medical doctors, for medical doctors, only! I could “diagnose” myself with hypertension if I did research and felt it was appropriate, but I COULD NOT prescribe myself any type of medication because I am not a medical doctor. The disease concept is how doctors are trained to assess any condition. A doctor’s interventions include medications any surgery.
So, is addiction a disease? Yes, to a doctor. To anyone else, no. I am a licensed counselor, but I cannot use the disease concept to treat anything, including addiction.
I did not learn one thing from you Steve other than assumtions and arrogance. I cannot immagine your ego. Really you suck at compassion. And where was your knowledge of this subject revealed? From the used toilet paper roll. I was challenged by your skeptisism that addiction cannot be a desease and was very grateful Dave responded by stating what I and millions who see the long term effects addiction has on ourselves, loved one, community as a whole and for that matter all time lifecycle. I do not claimed to be textbook education on this subject but someone I respect shared this suggestion with me recently.
“You can say what ever you want to me and i will listen but you and i might not agree unless we have walked in each others shoes.”
My thoughts;
I do not have gangreen just because i’ve itched a scratch, but that doesn’t mean gangreen does not exist.
I’m relieved to see that others reject the recent position of the drug culture that drug addiction is a disease. I think it’s an unfortunate choice and find the contention of some that it’s a disease a way to legitimize drug use. In other words ‘it’s okay, it’s a disease and you can’t help it’. ‘It’s not a disgusting waste of a life at the expense of others that ultimately support you whether the person you steal from, mom and dad, other druggues that buy what you are supplying. You are a scourge of society that contributes nothing to your fellow man.
“I’m relieved to see that others reject the recent position of the drug culture that drug addiction is a disease. ”
It’s not a position of “drug culture”, it’s a position of modern science and medicine. Drug addiction is considered a chronic brain disease because it meets the criteria to be considered one, no different from any other disease.
” You are a scourge of society that contributes nothing to your fellow man.”
A bit of rational thought here would lead you to the conclusion that you can’t determine what someone is capable of contributing based purely on the presence of one negative condition, even one that does harm. Plenty of doctors, teachers, counsellers, bankers, mechanics, and just about every other way you could classify a person, have dealt with addictions. How exactly have you determined the sum of their contributions to society based on this factor alone? There is no single variable that will tell you the net sum of someone’s contributions to society. This comment is just ignorance.
Other than our internal life support organs that automatically perform their functions, we have to think about everything we do and say even if it’s only for a nano-second.
Our outer body and thoughts do NOT act until we make the conscious choice to do so…this includes all decisions we make including whether or not to injest alcohol or drugs.
IF our Mother is NOT an addict during her pregnancy with us, we are NOT born with an addiction. Addiction is the result of a bad habit that we, ourselves, create thus we have the power to change it, also.
Addictions are NOT normal – They are the result of using your own free will to choose to abuse the use of a substance. Doing so will cause the body to become dependent on that substance in order for it to feel normal again thus the mind-frame of “I have to have more”. Substance use / abuse IS an individual choice. We have the choice whether or not to risk becoming an addict.
Diseases ARE normal – We do not have any choice as to whether or not we contract a disease.
There are parts of the brain that act automatically, without the need for choice.
There are many “diseases” that have choice components, heart disease, diabetes, lung cancer to name just a couple. You certainly can make choices that cause a real disease.
Some people use drugs in order to “feel normal” due to emotional pain, physical pain, or mental illness.
Yes there is a choice component to addiction. But what if, and science and medicine are exploring this now, those choices lead to changes in the brain that diminish our capacity to make good choices? I’m not saying we lose complete control. I’m saying changes occur that simply reduce the brains decision making capacity or create ‘cravings” for substances due to alterations in the reward circuitry?
Wouldn’t it be good to know this if true so we can better deal with addiction? Many in AA and rehabs tell people that there brains are not functioning optimally after substance abuse. AA calls in “stinkin thinkin” My experience with addicts is that they make incredibly poor decisions despite negative consequences that lead me to suspect that something has gone wrong in the brain that can’t be explained by simply making fully rational bad choices. Their decision making functions seem to be dysfunctional.
Thanks for your reply.
I’m not one to debate topics with scientific facts or any type of studies. Instead, I try my best to use a tool that, seemingly, is steadily becoming extinct. That tool is called “Common Sense”. No, I’m NOT implying you lack this tool…just merely stating that many people do lack it.
When it comes to doing something that most likely will endanger our bodies, common sense (if heeded) will always tell us NOT to do it. It’s a very simple choice…yes, I want to take the chance of hurting my body -OR- no, I will NOT let it happen because I want to live a natural life!!!!
Young people experiment. With drugs. With alcohol. With smoking. With sex. With doing relatively stupid and/or dangerous things. Texting while driving. Driving too fast. Risky behavior. Etc. Unless you think common sense is going to eliminate those choices I think we’re stuck dealing with the consequences of those choices although I certainly support educating people about the risks. I’d say the number of young people that never drink, drug or smoke is relatively low.
Of course trying a drug or even normal use of drugs doesn’t make you an addict. Maybe you should research the risk factors for addiction. many of them deal with emotional pain or physical pain. Gabor Mate, a doctor who worked with heroin addicts in Canada, said in 18 years of working with heroin injectors he never met a woman that had not been sexually abused as a child. Never. So addiction is simply more complicated than just say no.
We humans are tempted with decisions of right and wrong every day. We enjoy “pushing the envelope” sometimes which may result in an injury (mental and/or physical) and even death. I am not talking about accidental injury or death. The use of common sense can and does save many people from injury or death resulting from poor choices.
People have every day problems and some people share the same problem(s) but not all people decide to solve their problems with another problem (alcohol / drugs). Instead, they may try to talk to someone they trust and / or, if need be, Clergy, psychologist, psychiatrist or someone who can help them with their particular problem but NOT a bartender or drug pusher.
Getting drunk or high has only hidden, NEVER solved, any problem for anybody!! Using alcohol and / or drugs is like a band-aid, deodorant or cologne …it covers up the problem for a short time but when it wears off, the problem is still there.
You wrote, “…the risk factors for addiction. many of them deal with emotional pain or physical pain.” Of all the addicts, how many of them became addicted because THEY decided to SELF-medicate THEMSELVES instead of seeking help from a licensed Doctor?? (I know, there are people under a licensed Doctor’s care who are LEGAL addicts, also.) No matter what the excuse, we all have the ability and power to say no to anything, including alcohol and drugs.
You are partially correct about addiction…it is complicated. To become addicted to anything harmful you must first ingest the substance enough whereas the body relies on it…whether born to an addicted mother (HER choice) or ingesting it yourself (YOUR choice).
It’s very irritating when people with addictions don’t own their personal role of becoming an addict by abusing the substance. Instead there is so much “pity me”, “I couldn’t help it”, “I had no other choice”…the excuses are endless!!
No matter what we choose to do or say (good or bad), there are consequences (good or bad). The real question is, “Are we ready to make the correct choices?” If not, it’s usually best to postpone that choice until better qualified to choose wisely.
Not sure if you have any experience with addicts but much of what you assume is very different from what I’ve experienced. I actually have never met an addict that says “I didn’t have a choice” although I have met some that feel that they lose control if they use and can’t predict the outcome of using so they feel abstinence is the only sane choice. I also know many that try to quit, end up relapsing, and are confused as to why it happened and feel shame and guilt about the relapse.
I completely agree with you that alcohol and drugs are only a short term solution and in reality, not a solution at all. I call substance abuse a “problem disguised as a solution” because really using substances only makes things worse not better although the user at some level believes the substances are helpful.
That said, I don’t know what it’s like to have that hole of being sexually or physically abused as a child, being unable to deal emotionally with that trauma as a child, and growing up with feelings that are difficult to process or the feeling there is something very wrong with you simply because you were abused. Or having a mental illness like anxiety or depression that you feel will be ‘fixed” by some drug or alcohol.
Recognize that most people that experiment with drugs, of any kind, don’t become addicts. 80-90% of people who use drugs are not addicted. And as Steven shows on the site, many do grow out of it or become abstinent. My personal feeling is it’s not the drug itself that is addictive, it’s an attempt to use the substance to find relief from an emotional or physical pain. Not 100% of addicts but a large subset have this common experience of childhood trauma.
And personally I believe if you abuse substances in enough volume for enough time, whatever the reason, your brain adapts to that onslaught by making changes that make it more difficult to quit going forward and more difficult to make rational decisions about substance use. Not impossible as people quit all the time. Just more difficult. I believe the brain adapts and since one of the functions of the brain is to make decisions regarding pleasure/reward, the brain is damaged and decision making becomes dysfunctional. I think it’s important for addicts to know this that there thinking might not be 100% until they have been abstinent for some time.
First off GARY, unless you’ve truly been addicted to crystal meth, I suggest you keep your mouth shut. It’s presumptuous and ignorant bordering on stupidity that you claim to know what goes on in the mind of a person on crystal meth. You are utterly clueless, because if you were addicted to meth you would know that Katie’s experiences are typical of meth abuse. You claim to know that EACH and EVERY time a meth addict uses the drug that they have a choice. I can say that when I first picked up meth, I chose to. Hell, I even chose to for the next three, four, five……times, but at some point, the choice is clear, and that is to use more. 12 Step programs have a term called “obsession of the mind”. And if you think the mind and the brain are the same thing, think again. Dr. William Salt’s definition of the mind is this: “Brain and mind are not the same. Your brain is the tangible, visible world of your body. Your mind is the invisible, transcendent world of thought, feeling, attitude, belief and imagination. The brain is the physical organ most associated with the mind and your consciousness, but the mind is not confined to the brain. The intelligence (or in your case, the lack of it) of your mind permeates every cell of your body, not just brain cells”.
There is a lot of great information here, but one thing I have been opposed to is not the information itself, rather the presentation of it. I’ve read quite a few really profound, informative and intelligent comments here on both side of the aisle. The one thing I believe this presentation lacks is a “personal” component. By that I mean all the information presented here is the result of countless hours of research, studies and reports or citations of renowned scientists, doctors and the like. The element that is missing here, and blatantly discredited, is the personal experience of the individual. All the scientific evidence in the world cannot take into account the experience of one person, one individual. Now some scientific evidence is impossible to debunk, such as carbon emissions being one cause of global warming. Other scientific evidence demonstrates that when persons A and B take the same drug, that the effects can be dissimilar. So, not only is science not exact, it’s fallible.
Authors of comments here have suggested that when an organ, such as the brain is impaired and exposed to chemicals not natural to the body over extended periods of time, that it becomes diseased. It may not have an actual disease, but it is not functioning properly. Repetitive exposure over a long period of time not only inhibits normal function while on the drug, its ability to recover during non-use for short periods of time become severely impaired. I used meth for over 10 years, and with the exception of maybe the first month or so, was compelled to seek out and use, every day. If you think a meth addict has the “common sense” to think that if they use, they could die, or that they might get arrested, or lose loved ones or friends, or the roof over their head, they wouldn’t? Think again. They might “think” it, but because the drug is so powerful and hijacks the mind, which is part of the brain, into thinking everything will be alright as long as I get high. At some point, the brain ceases to function normally, and the mind acts accordingly, and in most cases, overpowers function of the brain because what an addict believes, thinks or perceives, has nothing to do with the brain. The definition of the mind includes the word “transcendent”. That is key because it means “beyond the normal human experience”. So you have a brain that is not functioning properly, a mind, of which is inside and outside and affected by the brain, in a body that is dysfunctional, ask yourself this: Why would any rational thinking ever happen? What is crucial to understand about meth is that is unlike any other drug out there. I have witnessed both myself and others doing things and going places that at one time would have never happened. I drank alcohol for quite a while, and I could put it down. I snorted a shitload of coke, and put that down. I’ve done acid, PCP, crack, exstacy, GHB, pot, hash, black beauties….the list is as long as my arm……I put all the shit down. As soon as I tried meth, nothing else mattered. I mean nothing. Compulsion is real. Knowing better but doing it anyway is real. Being aware of the possible consequences and not caring is real.
So GARY, you have absolutely NO right to claim you know if someone has a choice or not. You have NO right to presume you know what’s going on the mind of someone else. And you have NO right to comment on what you might do if it were you. That’s the point, you don’t know shit. I’ve been sober for a while now, and usually I let crap go over my head. I even try to empathize with people and try and understand where they are coming from. But in your case, you’re not deserving of my empathy. Live life as a meth addict for ten years, then open your mouth.
Hi “Ray”,
You talk so much about who has the right to do what. One question – who gave you the right to decide other people’s rights?
😉
For the record, I take BIG issue with what Gary said. Nobody becomes “addicted”, so you don’t choose to get addicted – you choose to think and behave in the manner commonly referred to as addicted, but you are choosing it the whole time, and you can choose differently at any given time.
There is no blame to go around for becoming addicted because no one is addicted (addicted meaning being compelled to use substances).
-Steven
As we have discussed, there is a difference between compulsion or total lack of control, and the possibility that due to substance abuse the brain doesn’t function in an optimal way and becomes dysfunctional and some would say “diseased”
Steve, I know you know who “Ray” is, believe it or not it’s my middle name (Clayton Ray). I’m not hear to debate the disease issue. I get emails when new comments are posted, I read them. Sometimes I chime in, sometimes I don’t. I don’t intend to play God and determine who has what rights, actually people can say whatever they want. But when by exceeding their rights, they claim to know exactly what a person feels, thinks and behaves, like he has intimate knowledge, that is at least unjust. I don’t decide anyone’s rights, and just like he claims to know things about another is his right to declare, it is my right to say he has no right to say it. Would it be righteous for me to say you have this website because it stokes your ego? I have no idea if it does or not, I can say it, but it doesn’t make it right. Look, this site incites a lot of conversation, some a bit off topic and some of it is highly emotionally charged. I don’t claim to know all the answers, but I do admit I feel very strongly about my personal experiences and interpretation of them. I’m passionate about expressing my ideas, and often times it comes across as appearing self-righteous and arrogant. So no hard feelings.
So, the reason I used my middle name is because I tried to comment last night, but every time I hit submit, it kept going back to the original page without my comments posting. From here on out, I’ll be civil and not completely dismiss the content you present here. What I won’t do is stand by and allow anyone to discredit or judge anyone persons personal experience as it relates to their recovery. I know and understand that not everyone thinks alike, and they may disagree with how another person feels or felt in their addiction, but when they assume with such voracious claims of personal knowledge, that is not righteous. That is just plain wrong.
Hello Ray, hopefully your ranting and raving has made you feel better…didn’t affect me at all.
Who decides (chooses) to take the substance of his/her choice for the very first time and then multiple times until the body NEEDS (is addicted to) it?? For whatever excuse he/she had…the user chose to use!! I’m sure nobody WANTS to become addicted but that’s the real chance they take when they use. You DO have the choice whether or not to use every hit/drink up until your body NEEDS the substance.
Our thoughts do impact our behaviors and our behaviors impact our lives.
Correct me if I’m wrong but you sound like someone who made the choice never to try a drug or alcohol due to what you perceive as the dangers of addiction. Is that correct?
Further, the physical addiction you refer to is only a part of the addiction. You can go to a detox center and with some medication, be free of the physical addiction in a relatively short period of time, as little as a few days. But overcoming the physical need for the drug is just the start of the process of getting and staying clean for most addicts. Fixing the mental process is much harder than getting over the physical need for drugs.
Hello Chuck C., You are correct, I did choose not to use drugs of any kind (other than only those I take for epilepsy). As for alcohol, I have been drunk once on beer and rarely drink alcohol. I have never been afraid of addiction…haven’t allowed myself to enter that situation. However, I have been to counseling sessions about how our thoughts influence our lives.
As for the rest of your reply, I don’t know first hand but I am able to understand and agree with what you wrote. It sounds as though we agree that before one can be helped, he/she must want to be helped.
Gary,
Yes, just by your statements it was obvious you have little to no understanding or experience of addiction.
It’s ok and I applaud your decision to be substance free. But you shouldn’t come on a site like this and pretend you have “the answer” You almost come off as “I didn’t use drugs so I made a good a choice and you people who tried drugs made a bad choice” so the answer to addiction is “just say no.” Just say no unfortunately doesn’t work for most young people, either with substances or sex.
Please be aware that 80-90% of people that use alcohol or drugs don’t develop a problem so more the vast majority of people who make the choice you didn’t, to use drugs, don’t develop addictive behaviors. And most people who try drugs or alcohol assume they will be one of the 80-90% to enjoy them and never develop a problem.
I appreciate that through counseling you have discovered that we have choices and those impact our lives. That is true. But people do make bad choices, people do engage in risky behaviors even though they know better, and the solution once someone has made a mistake and developed a problem isn’t to go back and say “you made a bad choice and you should have chosen better’ Once the wrong choice is made, and a problem develops, then what?
Gary, I didn’t expect my “rants and raves” to affect you. And as I expected, you still don’t have a clue. You can spew crap all you like about what you “think” people act, feel and behave. I’ll say this one more time, until you’ve walked in the shoes of a truly addicted meth addict, I suggest you stop making blanket statements that are personally based and have absolutely no depth or relevance to someone other than yourself. It’s ok to be ignorant, but it’s not ok to pretend to know how someone else reacts, thinks or behaves. I suggest you do a little research on meth, that’s how I found this site. Make sure you remain objective, hard to do for some when they already have a preconceived idea. You’ll see that it’s a lot more complicated than a matter of simple choice, and if you don’t, then either you don’t want to see it, or you’re not capable, which would mean you’re close minded. Ah well, it’s not my place to change people, but as long as people like you exist I feel it’s my duty to attempt to enlighten them.
By the way, I’ve disagreed with Steven many times, sometimes not in a very diplomatic way. All the information here is, for the most part, accurate. I just wish a sense of “personal experience” would be introduced so that a blanket statement doesn’t apply to everyone. And you’re right, our thoughts impact our behavior, and behavior impacts our lives. Thoughts cannot be considered as part of the brain’s process, because as I stated before, the mind and brain are not one in the same. In the case of meth addicts, based on MY personal experience think one thing, and the logical part of our brain is disconnected because the pleasure center of the brain takes over. But as I said, you have no personal experience. Thus, you just don’t know. Period. End of story.
Ray, I’ve been trying to help. The only “blanket statement” I have been trying to get people to understand is – Other than our automatic organ functions, we do not / cannot do, or say, ANYTHING without first thinking about it and choosing whether or not to proceed. Whether it’s for a fraction of a second, seconds, minutes, hours, days, weeks, months, years or decades we do nothing until we think about it, first!! This includes the first time we do something through the last time we do it. We’re not machines, we have the capacity to think and make decisions (choices) for ourselves.
I have been through counseling and therapy…it took me some time to grasp but when I did it made so much sense and helps me to this day!!
Gary, I probably should apologize for my strong words and connotations. I completely understand what you’re saying, but I think we have a disconnect here. So yes, we all have thoughts before we take action, speak or any other form of behavior. As I said, I chose to use meth the first few times I did it, at the suggestion of another person. Where I think the disconnect is that at some point, after the brain has over-released all kinds of natural chemicals as a result of the drug, the logical part of the brain disconnects from the pleasure center and that’s when erratic thoughts, delusions and an express absence of cognitive behavior and logic disappear. It doesn’t take long, and in my case, I soon found myself compelled to use over and over again. The brain is saying one thing, the mind another, and an “obsession” of the mind prevails over every attempt at the brain trying to get it’s message through. Because meth causes severe psychosis, or voices in our heads, any thought of possible consequences are quickly rationalized, irrationally. All that matters at that point is getting high, and all stops are pulled and the game is on!
I’m no scientist, I’m just a recovering meth addict trying to make sense of stuff. I’ve been sober for quite a while, and I don’t particularly subscribe to the disease model, in the literal meaning of disease. I do believe that addicts and alcoholics have some sort of predisposition that sets us apart from the person who tries it, puts it down, and never touches it again. I am not that kind of person, when I start, I cannot stop. It’s not because I don’t have the will to stop, it’s more of not knowing I have the will to stop. For me, it came to a point where I was lying on my living room floor, no furniture in my house, in a fetal position begging to die. I did make a choice to seek help, and I fought it tooth and nail. But I saw other people getting and staying sober, and when I stopped blaming others for making me act in a destructive manner, recognized my flaws and saw that my using was directly related to wanting and needing to escape. I was never addicted to any other substance other than meth, so my behavior is not indicative of that of alcoholics and other addicts, but that does not mean they don’t experience delusional thoughts and behavior.
I can only speak for myself, a recovering meth addict, and this is how I see things about behavior, having a choice, but not knowing I do. The brain and mind are not one in the same, however, they are described as being part of one another. Drugs are introduced, the first few times the brain releases so much “good feeling chemicals” to such an extent, that the feeling is like no other ever experienced. The brain doesn’t quite recover from overdosing chemicals, but the mind remembers that feeling, and so I do it again. More natural chemicals are released, then a severe crash occurs. At this point, the only thing I can do that will make me feel good again is to use meth. Now I know I shouldn’t, but I can’t deal with my depression, caused by the over-stimulated pleasure center in my brain. I repeat this a few times, and in the back of my head, or my mind, I should stop this. That’s my logic speaking, but my mind says otherwise. For me, at this time, I was compelled to keep using. It soon goes from wanting to escape things that I’m uncomfortable facing or accepting, to a need to keep feeling better, or forgetting, over and over. The brain is in a constant state of over-stimulation, senses overloaded, logic disconnected from anything rational, and often times, reality.
So with the brain being physical, rendered dysfunctional by repeated exposure to stimulation, has no real connection with my mind. Psychosis, voices in my head, hallucinations, a sense of paranoia so real and intense that any rational idea or attempt at conscious awareness does not exist. Brain=physical, mind=mental…..two different things that are supposed to work in unison, but cannot because one is dysfunctional, and the mind, which is associated with the brain, can’t produce rational or cognitive thoughts, which can be expressed in behavior and words. A brain needs to be uninhibited by any means to allow the mind to form “normal” behavior. I wish I could express just how much compulsion plays an important role in a meth addict using over and over. Chemistry plays a role in this, however that chemistry is only as good as the mind that reacts as a result of the brain functioning properly. This can only really be completely understood by another meth addict. Any idea or notion that we use over and over is a result of ignoring the warning signs out of spite is just wrong. I’ve said enough. And again, I apologize for being so aggressive.
Thanks for your post.
I’m not sure that what you think of as mind and brain being different is accurate but it may be a good way to think about the fact that different areas of the brain perform different functions. I would need more information.
What I do know is that the brain is segmented, different parts of the brain perform different functions. They know this by studying people with lesions or damage to specific parts of the brain and seeing where the damage specifically occurs and then how that damage affects functioning. Decision making is controlled by two different areas in the prefontal cortex, one which evaluates risk/reward and the other makes kind of executive control decisions based on that analysis. They normally work cooperatively together. But if either of these networks is damaged, then decision making becomes compromised. What you think of as mind and brain might merely be these separate sections of the brain failing to cooperate in decision making as you would hope/expect.
Here is an article that explains these sections and how they work in regards to decision making.
http://healthland.time.com/2012/09/04/making-choices-how-your-brain-decides/
It’s my opinion that one or both of these networks is “damaged” by heavy substance abuse, or other as yet undiscovered brain areas. Or it is possible that some people are predisposed or have damage in these regions as a result of prior experiences, especially when they are children that get worse with substances. I don’t know. Chicken or egg. . In any case addiction I believe addiction is a brain disease and science will one day back up what we know from observing addict behavior, it’s related to damage to some decision making section of the brain. Again, this doesn’t mean people can’t stop and don’t stop. It just means the brain is not giving you good information while you are using and in a sense, you can’t trust your own “mind” when it comes to drugs/alcohol or DOC.
Chuck, I think a lot more research needs to be done on this topic. It’s a grey area, and while it seems fantasy like or ridiculous, I think there is some validity to what I’ve stated. It’s so grey that I’m not even sure if I’ve expressed what I’m thinking and/or trying to say. I like Dr. William Salt’s definition of the mind, two words in particular, invisible and transcendent, which speak of the seperateness of the mind and brain, but at the same time, integrated. How I think of it is this: our brain activity, which is variable can be viewed in images and scans. I believe the brain has to be functioning normally in order to form thought in the mind. Thoughts of excitement, fear, anxiety and so on can stimulate, or change brain activity. So this poses a question: does thought preface brain activity or the other way around? Has anyone ever recorded thoughts? It’s an intriguing idea, one I need to research a bit. Thanks for your input.
Chuck,
I just found this website and I do not know if you tried to answer this question before, but why do you care so much about this? If you are not an addict why are you fighting so hard to deny what other addicts are telling you is the truth? I have read most of the comments and website, although I admit, not all of them. I just do not understand why you are fighting so hard to prove these people who have literally been through and are struggling to fight addiction. I am not trying to be malicious or mean, I am simply wondering why you spend your time arguing with addicts about drugs and the effects they have on different people. I am a young 24 year old male and I am currently struggling with cocaine and heroin addiction and I do not agree with anything this site says about addiction not being a disease and I do agree with most of what the other addicts in the comment section are commenting. Maybe I am just trying to make myself feel better about being an addict or something, I do not know. All I do know is that the people who help me and are helping me deal with this horrible horrible thing say it is a disease and it helps me deal with my own addiction and depression that goes along with it. Please tell me why you are fighting so hard to prove these people who have been beaten up and on the brink of death wrong.
Maybe you are confusing “outrageous appetite for” with it “being a compulsion”. Maybe all the disease people here are.
There is a huge appetite for the drug at some point after starting using, for some people. This hunger drowns out lesser hungers, like the ones for social acceptability or familial bonds.
Maybe part of the choice process is how much hunger for the drug develops. It seems like not a choice but a compulsion.
Nah, I’m not confusing anything. Once again, you’re feelings are yours, and mine are mine. Neither one of us is wrong. But both of us are different.
#personalcomponent
There is a specific part of our brain in the prefrontal cortex that allocates value to a decision, that weighs the risk/reward of a choice.
What you describe as having a large appetite for a drug may simply be that specific part of the brain allocating extreme value to getting the drug, and minimizing risk/negative consequences of getting the drug. In a sense that part of the brain becomes dysfunctional, as it no longer does it’s job properly and overvalues the drug use and undervalues the risk/consequences.
I believe that substance abuse damages the functioning of this part of the brain, and/or other parts of the brain, resulting in a dysfunction of choice. That dysfunciton may not rise to the level of compulsion or complete loss of control, but nevertheless it is operating in a dysfunctional manner which leads to drug seeking behavior despite the risk and reality of negative consequences.
Thanks for the positive input Chuck. I have another theory of how we develop our substance use appetites. Here’s an excerpt from a post I wrote about moderation:
Steve. Thanks for your input. Your site is incredible and I value the work you do with people struggling.
What you call appetite for drugs, I call making a decision that uses a value calculation regarding a drug or alcohol. If the perceived value of using is high, then the risk/consequences might be ignored and you will have frequent and heavy use, what you call a large appetite.
My theory is that heavy drug or alcohol users place a very high value on drinking or drugs, but I believe that in the future we will discover that the parts of the brain that make these value equations are not operating optimally in a person we would call addicted. We already know from science that people who have damage to specific parts of the brain struggle to make good decision choices.
If you think of the brain as a very complex computer, substance abuse produces a “programming error” in the brain that overvalues substances and ignores consequences. The risk reward equation becomes heaving weighted toward the reward. “The computer gets a virus” and doesn’t make decisions properly. Not that it can’t, it just has a harder time doing so because the weighting of risk/reward gets out of whack. If you think of decisions as scale weighing reward on one side and risk on the other, it’s as if a heavy object has been placed on the reward side regarding substances (or whatever the addiction) and the decision making scale is out of balance.
My experience with addicts is that the decision making process is abnormal and dysfunctional. They just don’t “think right” about value and consequences. Is this just a person that continues to make bad or uninformed choices (my feeling is people don’t make bad choices just ones in which they are uninformed about what is best) with a normal brain system, or has something gone wrong in the brain systems responsible for good decision making?
The work that you do if I understand St. Jude is basically “reprogramming the computer” to take a different look at the perceived value of substance and to become consciously aware that the brain program making decisions has become dysfunctional and is assigning too high a value to drinking or substances. And possibly that other activities might provide greater value. Or possibly that the negative consequences far outweigh the real value. Or all of the above. In the scale example, to take some weight off the value side of substance use by pointing out for example that substances don’t really solve problems, that they are really a problem in and of themselves disguised as a solution. Or to put more value in alternative use of time or on the other side of the scale negative consequences/risks.
BTW, This reprogramming of the value equation is relevant whether it’s a simple choice or a dysfunctional choice, a choice or a disease, because the objective is to return the thinking pattern regarding substances to normal. To “fix the error in the program” responsible for making choices so the person can make better choices.
Sean, didn’t you know that they’re screaming it from the rooftops for all the world to hear? There is one valid point that Steven makes, which has absolutely nothing to with addiction being a disease or not (scientifically speaking). And that is since it’s classified as a disease, insurance companies pay out large amounts of money for what Steven and others like him claim is not a disease. Call it what you want, disease, disorder, malfunction….it’s still a problem for many and despite what this article claims, not everybody can make a clear choice and stop on a dime. All the research and scientific evidence in the world cannot cover all bases, all (not excluding a single) persons and all situations. Each one is unique, although symptoms and behavior may be similar. Why anyone takes so much interest in trying to prove something false is beyond me, especially when it doesn’t affect them personally. Then, I could ask myself why I care about what Steven and commentators say. The answer to that question is because everything Steven and his article claims can be found to be faulty, same thing goes the other way around. The thing that gets me is that Steven asserts his claims as being final and without doubt, positive truth. This topic specifically is debatable, and until a ruling authority says one way or another, it’s ALL pure speculation. Nothing more. Nothing less.
Ray,
I find it interesting that you said… “There is a lot of great information here, but one thing I have been opposed to is not the information itself, rather the presentation of it.” Yet your presentation is very lacking.
I was addicted to meth and I can say compulsion feels compelled, but it’s also a weighing out of priorities. If you see no REASON to pass up using, it ends up feeling compelled and you’re very willing to say you were compelled because, at this point, who needs more guilt (while using). But when you come out of the cloud, you can see it was choice.
Tony, thanks for your comment. It proves my point, your experience is yours and yours only. Mine belongs to me. I would be out of bounds to say your experience is not true or invalid, because it’s yours. We had different “personal” experiences, each valid and true. There is no question of wrong or right, just a question of what it means to us as individuals.
As to your comment that my “presentation” is lacking, what I wrote wasn’t a presentation, it was a statement made based on personal experience. It is not intended to be right or true and correct, but more of a plausible explanation of a perplexing concept. Thanks!
Gary, addictions are not bad habits. The are compulsions that cannot be controlled. There is science that explains the difference between normal drinkers and alcoholics digestive processes. Explaining the cravings produced. I did not form a habit. And did not ask for my liver or brain to crave alcohol. And I did not have a choice in the matter
Steve, I must disagree. You are still in denial.
You DID have a choice whether or not to drink…unless you were physically forced to drink by another person and I’m assuming that was not the case. Your habit was drinking excessively. Your increase in drinking was your choice. It was your choice not to significantly reduce/stop drinking when you should/could have.
Of course you did NOT want to injure your liver or brain but your drinking injured them non-the-less because of the choices you made.
Our thoughts influence our actions and our actions influence our lives.
I had been in denial about my drinking. But now can fully admit that I am an alcoholic. Or maybe alcoholic is not a term in your dictionary. I mean if it is just a bad choice why have a word like alcoholic. Is the meaning of that word one who makes bad choices. It is not. Alcoholics have a un-normal reaction to alcohol when they drink (allergy which i mentioned above in the digestive track which is scientifically proven.) There is a compulsion to take that first drink, even knowing all the bad that can and probably will happen (insanity). Look at it this way. If your allergic to peanuts and you break out and your airway swells shut, an easy choice to make is not to eat peanuts. That is not the case with the alcoholic. An alcoholic lacks the power to turn away a drink, even through in other areas of life they have the power to be disciplined about things. You should also look at the history of our country. Since it’s beginning there have been temperance societies, dry towns, and religion to deal with the problem of alcoholism (remember not a real word). We even have a period of 12 years in the 20s and early 30s when our country banned (made illegal) with and amendment to the constitution (not just a law) in order to deal with this matter. That sure is a lot of bad choices by a lot of people. Other than that I have spoken to many non alcoholics about their drinking. They do not have, cannot feel, or even describe the compulsions I have when I drink. There are differences between me and a non alcoholic. The difference is not our choices.
Admitting you have a problem is the first important step. Now you can do something about it. Reach out for help. And keep hope. There are millions of people, hundreds I’ve met personally, that felt the same way you do about your drinking. And they all were able with effort and support to put the bottle down and live a good and happy life without it. Good luck to you.
Steve (and others who misinterpret my comments), I have never claimed/speculated that any addiction (dependence of a substance), of any kind, is a choice but it is a choice whether or not to worry/care about the consequences of any choice. Who would actually want to become dependent on anything, especially a substance?? A person can not become dependent on any substance until that person abuses his/her body with abnormal and prolonged use of the substance.
I do claim a choice has to be made before we do/say anything therefore the choice was made to use the substance each and every time it was used. At first, the choice was fairly easy, then the choice became even easier (the user is liking the effects). Even when the user (more accurately, the user’s body) reaches the point of “needing” the substance (now the user is dependent on the substance), he/she (as each time, previous) makes the choice whether or not to obtain it, chooses how to obtain it, chooses where to ingest it and then makes another choice to actually ingest it. These choices may take as little as a fraction of a second to make but, nonetheless, they are made each time.
The concept is the same as talking, moving your legs, moving your arms, using your hands, making decisions, moving your head, blowing your nose, moving your eyeballs, eating, holding Mother Nature back until you reach a bathroom, holding your breath, etc. You have to think about what you’re going to do or say and when you’re going to do it or say it. Once again, it may take as little as a fraction of a second but a decision is always made first.
Gary,
I want you to know that I am an alcoholic so what I say can only pertain to my knowledge of my own alcoholism. I do not think that drug dependence is the same thing. A addict shoots up to relieve their obsession and then they are good for six hours or whatever time until they need another fix. An alcoholic cannot stop the drinking or predict when they will stop each occurance. I am addicted to nicotine (chew) so I have an idea what that drug dependence looks like, but really my comments are just about alcoholism.
We do not choose to worry or obsess, love or hate or anything else that makes up our being. With all the knowledge of our problems drinking causes, we take that first drink anyway, psychologically we think it will be different this time. Our thinking is actually insane. It is not choice driven. And yes, you can be an alcoholic without ever having taken a drink. Believe it or not, it is true.
As for the concept portion of you last comment. Having said that moving your legs, arms, eyes ect is a choice, I can only say, Have you ever made the choice to hold back a sneeze? Further, on the mind side of things, Have you ever driven down the road and suddenly found yourself 10 miles further down and not remembering the previous 10 miles? If you have ever done that, had you missed your exit? Was it by chance that your mind was preoccupied with thought or some other phenomena and you actually did not choose to miss your exit? Have you ever purchased an item, knowing that that the money was not there, that you do not need the item, and you should not get it. But you convince yourself to buy it anyway? This is where the alcoholic losses their choice. It is an impulse an obsession of the mind. And as the case with drinking, an illness. Not a choice.
Steve, I’m replying to your May 15, 2016 response to me. Tour statements are in quotation marks.
“A addict shoots up to relieve their obsession and then they are good for six hours or whatever time until they need another fix.” If this is true, then is it not also true alcoholics drink to relieve their obsession? What I believe is both alcoholics and drug addicts continue using their substance of choice because they have abused their bodies for so long that their bodies depend on the substance they use…the person in question is faced with withdrawals or feeding the body what it is demanding caused by long-term choices to abuse the substance.
“…we take that first drink anyway, psychologically we think it will be different this time. Our thinking is actually insane. It is not choice driven.” Sir, you chose to take that first drink many, many years ago…back when, at first, drinking was not a problem. But it became a problem after choosing to constantly abuse alcohol and now it is a constant problem when you choose to take that first drink. Your thoughts about drinking may be different than a non-alcoholic but you are not insane…if having different thought than someone else meant being insane, we’d ALL be insane. Everything we do is thought and choice driven.
“As for the concept portion of you last comment. Having said that moving your legs, arms, eyes ect is a choice, I can only say, Have you ever made the choice to hold back a sneeze?” Yes, many times although rarely successful, haven’t you? The sneeze itself is an automatic bodily function but we all have to choose to try holding it back.
“Further, on the mind side of things, Have you ever driven down the road and suddenly found yourself 10 miles further down and not remembering the previous 10 miles?” Yes, as a matter of fact, I have (and completely sober) but in my case it was closer to 50 miles of two-lane highways including two 90 degree turns onto the correct highways I needed.
“If you have ever done that, had you missed your exit?” Yes, I have. I don’t remember driving approximately 5 miles on the Interstate thus missing my exit.
“Was it by chance that your mind was preoccupied with thought or some other phenomena and you actually did not choose to miss your exit?” You are right, both times my mind was preoccupied…with sleep. I knew I was very tired but chose to drive to my destination, anyway…a very stupid choice on my part as somebody could have been hurt or killed.
“Have you ever purchased an item, knowing that that the money was not there, that you do not need the item, and you should not get it. But you convince yourself to buy it anyway?” Of course, there’s very few, if any, people who haven’t (drunk or sober).
So you see, the experiences you listed are not unique to alcoholics. They can and are be unique to anybody.
“This is where the alcoholic losses their choice. It is an impulse an obsession of the mind. And as the case with drinking, an illness. Not a choice.” An alcoholic still has the same choices as before becoming an alcoholic…drink or don’t drink. Isn’t the real reason an alcoholic chooses to continue drinking because of the not-so-pleasurable side effects of stopping for too long? Your body became dependent on alcohol because you chose to consistently drink too much, too many times, for too long. Alcoholism is a side-effect of your excessive drinking…calling it by any other name does not change that. Drinking alcohol was and is YOUR choice I do not believe any alcoholic set out from their very first drink with the thought of, “I want (choose) to become an alcoholic.”
Good luck and I hope you’ll give more, deep thought about how we must think about everything we do or say. When my counselors were teaching it, it took me quite some time to absorb it, too, but it does make perfect sense.
Sorry, your counselors are wrong. The vast majority of our thoughts and actions are not conscious and we don’t consciously make any real decision about most of them. Many of our thoughts and actions are subconscious and repetitive.
Do you control very thought that comes into your head? Or do they just pop up? Are you making a choice about which thoughts come into your head at every moment? I’ve read we have as many as 70,000 thoughts per day. How many of those did you choose to have? And if you don’t choose your thoughts, about 70k of them every day , then really how can you say we choose all our thoughts and actions? Reality is we do most things on autopilot and there are only a relatively small number of conscious decisions we make each day. How about your dreams? do you choose them or do they just happen? How many choices are you consciously making while sleeping?
Gary,
The counselors you learned this from have a premise that is completely wrong. (at least about alcoholism). That is why your conclusions are not accurate.
You first have to understand what alcoholism is. You say my body some how became dependent on it after making the choice to drink it the first time. Some people are addicted to alcohol (as I am told) I am not. These people take little drinks throughout the day, maybe carrying a flask with them. If they stop for a length of time, there bodies may react with seizures from the withdrawal. But this is not alcoholism. Although some people may have an addiction and be alcoholics (that would really suck) Alcoholism is three fold. An obsession of the mind (needing that first drink), A physical allergy (once starting I cannot stop), and a spiritual malady (what helps us stop for good). My body did not crave alcohol until I took a drink. But my mind was obsessed with it. So I could go days without drinking, without much problem because I was focused on other things, like work. But once that focus was gone, my mind was obsessed with having the feeling that comes from alcohol. So my body was not dependent my mind was obsessed. When I took that first drink, I could not stop. I am unable to drink with the impunity like normal people. That is alcoholism. That is different from other abused substances. I am not sure on this but I assume most people who do meth, if not all become addicted. Not all people who drink become alcoholics, not even close.
The insanity part of it, Is that although I know drinking most certainly will be harmful to me if I drink it, I do it anyway. Think of a cutter. Do you think they choose to cut themselves. It is insane. It may not fit your straight jacket vision of insanity but that is why some refer to it as such. We all may very well have some insane thoughts. Like, I hope my neighbor with the barking dog gets run over by a bus. Or maybe I’ll just shoot my neighbor and his dog. Our minds become obsessed with some of these thoughts (insanity). We can’t control them and our actions become uncontrollable. Would that person that killed his neighbor not be sick. Or maybe you would say he just made a bad choice.
In conclusion you simply don’t have the definition of alcoholism right. Your counselors redefined it so that they can make a argument that drinking is a choice. (but even then it is convoluted).
Maybe they should run for political office.
Regards.
Gary,
I think you’re going to far in your “everything is a choice” theory. We make tens of thousands of choices each daily and many of them don’t rise to the level of a conscious decision. Thankfully or we would become incapacitated. To think that there is a conscious deliberate decision process to every and all actions is not accurate.
Understand also that many decisions involve some type of risk/reward calculation and the outcome of a decision isn’t completely known. For example everyone who drives a car knows there is at least some chance they could be involved in an accident that might result in injury or death. Every time they drive. For many choices we are making a probability equation of reward and risk. So do I drive today? Mostly I don’t think a lot about it. In my mind I’ve previously decided the reward is greater than the risk and the decision no longer rises to the level of a conscious decision each time I choose to drive. Drug users make these calculations of reward and risk also.
The problem you have is you think all choices are conscious and well thought out. They are not. And you seem also to be under the impression that consequences of a choice are clearly known when in reality there are only a calculation of expected risks and rewards but those don’t always turn out how we expected. Decision making and drug use is simply more complicated than making a simple conscious choice. Finally, if the part of brain responsible for making choices/decisions regarding the risk/reward becomes damaged and dsysfunctional to the point where it doesn’t make optimal choices, then its also not a simple rational decision any longer.
Chuck C. – “Gary, I think you’re going to far in your “everything is a choice” theory. We make tens of thousands of choices each daily and many of them don’t rise to the level of a conscious decision. Thankfully or we would become incapacitated. To think that there is a conscious deliberate decision process to every and all actions is not accurate.”
Are you absolutely sure? You just admitted that you know we make many choices every day. As for many of them not rising to the level of a conscious decision, that’s not true because we make choices (many of them so fast that we BELIEVE we didn’t think about it but we did) in one of two ways…yes or no. A good example is walking…our legs don’t make the decision to move, we have to decide when to move them, in what direction and how fast and stop them…every time! We have to exercise the same control over the rest of our body otherwise we wouldn’t be able to move unassisted.
“…So do I drive today? Mostly I don’t think a lot about it.” Mostly? I submit that every time you choose to go somewhere, you do think about and choose your mode of transportation.
“In my mind I’ve previously decided the reward is greater than the risk and the decision no longer rises to the level of a conscious decision each time I choose to drive.” Good, you previously chose the reward of driving; although the decision whether to drive or not still remains for each occurrence; you understand you choose to drive.
“The problem you have is you think all choices are conscious and well thought out. They are not.” Yes, all choices are conscious and thought out (not always well thought out, though). Our thoughts about anything may happen so fast we don’t even realize it or they may be thought of for years and anywhere in between but we do have to think before we can do.
“And you seem also to be under the impression that consequences of a choice are clearly known when in reality there are only a calculation of expected risks and rewards but those don’t always turn out how we expected.” My impression of consequences are correct…there are variable consequences for everything we do and say.
“Decision making and drug use is simply more complicated than making a simple conscious choice.” I agree that making a good decision after becoming a drug abuser becomes harder to do because the body is becoming dependent on the drug so instead of going through the withdrawals, it’s simpler and the rewards come quicker by choosing another hit which of course can lead to full dependency. But no matter what, the choice to use, or not, is always there.
“Finally, if the part of brain responsible for making choices/decisions regarding the risk/reward becomes damaged and dysfunctional to the point where it doesn’t make optimal choices, then its also not a simple rational decision any longer.” If this is true, then it is all the more reason NOT to ever take drugs. Also, it may not be a simple, rational decision any longer but you still have the ability to make a decision.
What I have learned about having to think before we can do, I learned from two physiologists and then a third psychologist confirmed their teachings. My life has changed greatly, positively since I came to understand the thought process of everything we do. I truly hope others will benefit, also.
Since you have no real experience with alcohol or drugs (you were drunk once) you keep making some errors in your understanding of substance disorders. You for example keep saying the body craves the drug. That is true as the abuse progresses, but people can have serious consequences without getting to the point where they are physically dependent. Ask any addict and they will tell you he mental aspect is by far the more relevant and difficult part of substance disorder.
The physical withdrawal is easier to overcome, just a few days. Some addicts have gone through the withdrawal successfully, where their body no longer needs the drug, dozens of times. But their problem doesn’t end just because the body no longer goes into withdrawal.
Modern science refers to addiction as a “chronic brain disease” Just by observing addict behavior has led me to believe there is something wrong with the decision making systems in their brains.
Since you believe that everything is 100% about choice, then you too should stop referring to substance problems as a body problem related to withdrawal (that is a part but an easier part to fix) and start referring to it as a mental/brain/mind problem
The first time it may be a choice, like it was for me at 14. For sometime, it was fun (maybe till 35), however I always wanted more and wanted it more often. Somewhere along the way I lost the choice and had to drink and use for survival, despite knowledge of the consequences. I also have a large family tree full of addiction (most did not make it).
I believe that those early years of using damaged the pre-frontal cortex where the ability to understand consequences resides, and combined with a genetic propensity, hindered my ability to make a reasonable choice despite understanding the harm I was doing.
Somewhere along the way I decided I did not want to die. I entrusted my care to others as my brain now had an inability to make a proper decision about drinking and drugging. The care I received and willingness to change allowed me to heal my brain to a state where I am now able to make the decision. This did not come without some failure along the way. I am now able to chose NOT to use, so perhaps we are all correct to some extent.
Peace
I do believe substance abuse over long periods of time damage the brains capacity to make good choices. And knowing this is important to someone trying to get clean/sober, i.e. my brain might not give me good information where alcohol/drugs are concerned. I can’t completely trust my own though processes. I actually think realizing this hurdle makes it easier not harder to get clean. This is not an excuse for relapse or continuing to use. It’s understanding the reality that your own brain might not be functioning properly especially where alcohol/drugs are concerned and your reward system may have been compromised although not completely hijacked. . . Stinkin thinkin as they call it in AA.
In the next 10-15 years I expect science will give us a better idea of how drugs affect the brain and I do expect science to confirm what addicts already realize from experience, that something is not quite right with my own thinking while I am using, and even for months after I quit.
Chuck C. – In reply to your May 13, 2016 reply to me, you stated, 1) “…you shouldn’t come on a site like this and pretend you have “the answer” 2) You almost come off as “I didn’t use drugs so I made a good a choice and you people who tried drugs made a bad choice” so the answer to addiction is “just say no.” 3) Just say no unfortunately doesn’t work for most young people, either with substances or sex.” First of all, most people here are talking about now…after the fact they have abused a substance for too long thus making their body dependent upon that substance (it’s being called addiction). Try thinking about what led up to the point of abusing a substance and becoming dependent upon it…what was your role in the problem?
1) Each and every person has “the answer” to substance abuse and/or dependence…if a person feels he/she must use, don’t abuse. Substance abuse is just stepping through the door to hell…being dependent on it. Obviously, not ever using at all is the best answer to staying out of substance hell.
2) You, yourself, have applauded me for choosing to be substance free (“I applaud your decision to be substance free.”) and therefore not having to experience the hell of being dependent on a substance and yes, the people who choose to use a substance do make the wrong choice. If they had not used at all, ever, there would be no consequences from it. No, the answer to substance dependency is not “just say no.” I have never said that. However, I have said “just say no” to a substance before ever using it for the first time. Getting away from being dependent takes a lot of work and determination including saying no and admitting you have a problem.
3) We all have a choice in everything we do for ourselves…the only question is, will we make the correct choice?
You also stated, “Please be aware that 80-90% of people that use alcohol or drugs don’t develop a problem so more the vast majority of people who make the choice you didn’t, to use drugs, don’t develop addictive behaviors.” I can’t/won’t dispute your percentages however, 100%of the people who are in possession of/use illegal drugs, even once, do have a different problem…a problem with the law!
You also stated, “And most people who try drugs or alcohol assume they will be one of the 80-90% to enjoy them and never develop a problem.” Ah, yes. The key word…assume. That word paves the road to places you do not expect to go. Common sense will tell you that too many of those who assume, too much, get into trouble.
You also stated, “…that we have choices and those impact our lives. That is true. But people do make bad choices, people do engage in risky behaviors even though they know better, and 1) the solution once someone has made a mistake and developed a problem isn’t to go back and say “you made a bad choice and you should have chosen better’ 2) Once the wrong choice is made, and a problem develops, then what?
1) What’s wrong with saying, “you made a bad choice and you should have chosen better’ especially if that person doesn’t figure it out for themselves? If we want to (our choice), we learn from our mistakes if we can figure/find out what it was and why it was the wrong decision.
2) Make the correct decision to go to someone who knows what to do to help you!!
Gary,
With all due respect the only thing you have to offer is “Just say no. I did” with the unspoken “I’m smarter than you because I made a choice not to use and you didn’t and now you have a problem and I don’t. You people just needed to be smarter like me and make better choices”
I’m going to hit more raw nerves with this post but sometimes that’s what it takes for some people to “see the light”. Most everyone here admits to be or has been either an “addict or an “alcoholic”. That’s one step towards a possible recovery. However, the consensus is that most do not, or won’t let themselves, take responsibility for their own choices and actions (these are the people I’m addressing this time) that led to their problem. Instead your problems belong to something/someone else!
Think back to the very FIRST time you ingested (used) the substance of choice. Do you remember? Were you forced, by anyone, to ingest? If you were not forced, do you know who made the final choice to ingest? YOU did!. Same questions and statement for the 2nd, 3rd, 4th, 5th, 6th, etc. I believe this is referred to as “social” or “experimental” use.
“Alcoholics”, think back to the very FIRST time you got drunk and “Addicts”, think back to the very FIRST time you got high. Do you remember? Were you forced, by anyone, to get drunk/high? If you were not forced, do you know who made the final choice to get drunk/high? YOU did! Same questions and statement for the 2nd, 3rd, 4th, 5th, 6th, etc. I believe this is commonly referred to as “social” or “experimental” use.
Do you remember the first time you tried to skip a day without using your substance but “couldn’t”…you just “HAD” to have it? Were you forced, by anyone, to get more? If you were not forced, do you know who made the final choice to get more and use it? YOU did! Same questions and statement for the 2nd, 3rd, 4th, 5th, 6th, etc. I believe this is referred to as “substance abuse”.
Prolonged substance abuse leads to your body’s total dependency on your substance of choice. Your choices in the beginning and along the way led you to where you did not want to go. You will always be where you are now (using excuses for why you used too much) unless you take full responsibility for your choices and actions and work from there.
I know, I know…I haven’t been an alcoholic or an addict so I don’t know what I’m talking about. Right? I have never claimed to know what it’s like. I’m not trying to tell you how to cope with the problem you have. I’m trying to help you understand HOW you became dependent on your substance.
Most people would agree that choices are made to begin to use alcohol or drugs. I really don’t know anyone who would dispute that.
But unfortunately you are completely missing the more important points of the discussion. Which is at some point do those future choices become compelled (you’re ability to choose is completely compromised) or as I believe diminished – changes to the brain/body corrupt the decision making systems of the brain to the point where making the right/smart choice is more difficult but not impossible.
Brain studies show that if specific parts of the brain are injured, say through the growth of lessions or trauma, then the ability to make what we consider optimal choices normal to that part of the brain are compromised. They give patients tests and those with damage to the brain system do not perform as well when making choices related to that part of the brain. They are still making choices, but their ability to choose well (to get what testers consider the right answer) is limited by the damage and they make less good choices than someone without damage to that part of the brain.
So the big question you are completely missing in all your posts is do people with a substance disorder lose their ability at some point to make correct choices, either completely or partially. Are their choices either compelled (they don’t feel they have any choice) or diminished (they make more bad choices due to damage to systems in the brain). Unless you are dealing with those issues you are completely missing the point of this web site and the discussions that follow. Just pointing out choices are made is not educational.
Hi Gary et all,
I wanted to address how I, not anyone else, found myself being addicted to chemical substances. I am sure however, that my experience is similar to many other addicts. You’re right, and I have even admitted it, nobody forced me to use the first time, not the second, third, fourth and every subsequent time I used. I had other issues, perhaps I was angry at my parents, school, boss….whoever, and I walked around with a chip on my shoulder. So I decide to use or drink. What I soon found out is that using and/or drinking washed away or deadened all the crap in my head. I have heard alcoholics and drug addicts say that they used or drank in spite of someone. My experience has shown me that the escape that drugs or alcohol provide is a dream come true. Soon the mind/brain finds solace in this escape, and before I knew it, I was using every single day. I know for alcohol, the process of becoming addicted is completely different than meth. I spoke of a difference between the mind and brain, and I admit, this is a grey area. However, I believe the separation, if you will, is important in trying to understand the mind of a meth addict. This drug is so powerful, it hijacks the logic part of the brain into thinking bad behavior is acceptable, that morals and ethics once held precious no longer matter. Meth amplifies the senses to a level no other drug can do. People feel invincible, powerful, and in more cases than not, any sense of knowing better is tossed aside. Personally, I felt compelled to use over and over again, not giving a shit about anything except the next high. Seeking the drug is part of the addiction, in my opinion, and that search will go on and on until it has been obtained. Then more madness ensues. This is a drug that despite our brain knowing the consequences of using, the mind (or emotion if you like) completely overrides any logical thought process. I can’t say what it’s like for other meth addicts, but I have been working with them for over 6 years. They all come from different places, backgrounds and class, but they all have one thing in common: an inability to stop once they start. For some, like myself, it’s a non-stop party for days on end. This is an issue of mind over matter with a twist, in that the mind cannot head to logic the brain attempts to throw in.
I do need to correct you on one statement you made, and that is “prolonged substance abuse leads to your body’s total dependence on your drug of choice”. Meth and alcohol have different “dependence” measurements. While alcohol can have both a physical and mental dependence component, it can cause severe physical withdraw symptoms and depression. Meth on the other hand has very little to no physical dependence, with the exception that it can be characterized by “doing everything possible to experience that first rush when first using crystal meth” (dependency.net). I can attest to this feeling, for over 10 years I chased that feeling, never finding it, but never giving up. The dependence is overwhelmingly mental/emotional. This is where I find some degree of fault with some of the information presented on this site. Addiction, and all the wild speculation that people can quit whenever they want to is just not relevant to meth, and it’s probably that way for addicts addicted to other substances and even some alcoholics.
Contrary to popular belief as is suggested here by some, the 12 Step Programs are not designed, in theory or practice, to make people feel better because they have a disease. While that is part of the program, I do not particularly subscribe to this theory. Although, a dysfunctional brain and/or mind borders on an illness, or even disease. Addicts and alcoholics in 12 Step Programs, at least the ones I know, don’t go around blaming others for their addiction and all the shit that comes with it. Instead, it’s more focused on why we reacted the way we did to what to most people is normal behavior of other people. Sure, there is a root cause, some resentment, anger or fear that drove us to use or drink, but at least for me and many others I know, we ALL take responsibility for our actions. It’s our perception of the world and it’s inhabitants that’s screwed up. I am now speaking for myself and countless others, we do at one point in our recovery, take responsibility for our actions, it’s paramount in maintaining sobriety. I may at one point had blamed other people, but again, I and probably all my friends no longer live on the premise that “it’s their fault”. Doesn’t work that way my friend.
I think it’s very kind of you to offer your take on the subject of addiction. However, and I say this respectfully, whatever you have to say is irrelevant due to the fact you have never had a substance abuse problem. You do make many valid points, but when it comes to why and how people become addicted, this area is completely out of your league.
Addictive behavior is clearly more a mental / emotional disorder than a physical dependence imo. Physical dependence can play a part in decisions to continue using, but imo it’s not the primary reason people develop addictive behavior disorders. And of course just detoxing doesn’t solve the problem for most people. The mental/emotional issues still have to be resolved.
In fact, people have addictive behavior disorders where no drugs are involved such as disorders related to shopping, eating, hoarding, sex, porn, cutting, gambling etc. None of these have substances involved but they all can follow patterns of addictive behavior similar to substance problems which proves that addiction is more mental/emotional than primarily a physical dependence.
Hello,
I am a college student who came across this article in my research. I must say, despite that it took absolutely ages to read through this article and its comments, I must say I am enlightened. This article is the only one I have managed to find that truly has people on each side of this argument bringing up good points and refuting them. I mean no offense, Mr. Slate, but the comments after this article were probably more effective than the article itself! I am doing a paper on this very topic: “Is addiction a disease?” I must ask a favor of all you wonderful people, as you all, in my view, have an equal right to share – addicts, reporters, observers, counsellors – all of these people I will listen to. Will you do the honor of each of you giving me your best argument for whichever side you believe in; just do not let it evolve into another massive battle of wits-I get enough of that at college! Thank you!
| Ryan~
Ryan, Let me give you my answer.
Steven makes an excellent point on his site that alcohol and drug users never lose complete control over their ability to choose. In AA this might be interpreted as “being powerless” over your addiction. I have always been confused by the contradiction of telling an addict they are powerless and then helping them to stop using. If you’re powerless how can you stop? If they succeed, then obviously they are not powerless but powerful. My best guess is that they try to distinguish between the feeling of powerlessness addicts experience while using but retain the ability to be powerful if abstinent. Or another interpretation is that they have a religious/spiritual solution, as in we humans are powerless to stop using but if we pray to God /higher power he/she can do for us what we can’t do for yourselves. I think that might work if you are a person of faith but otherwise I don’t get it really.
So number one Steven asserts that there is no absolute loss of control or compulsion that obliterates the ability to choose. I agree with this as many millions of people with severe problems give up their addictive behavior and get on with their lives, without the help of medicine, surgery etc. If you completely lost control you could never stop and experience tells us that is not true as most do stop or moderate.
Where I may or may not depart from Steven is his claim that because we don’t lose complete control over our decision making abilities, there is no brain disease. My hypothesis is that our brains are damaged by substance abuse. This damage is both a normal adaptation to substances but also could be considered negative. Normal and negative. And while the damage to brain systems doesn’t completely cripple them, it does diminish their capacity to make what we would consider good choices. In the same way persistent substance abuse damages the heart and liver, which up to a point continue to function well enough but just not optimally.
As we understand the brain and how it functions, and how it makes decisions, I believe that we will eventually understand that the brain systems are damaged by substance abuse. And since part of the function of the brain is decision making, a damaged brain will have difficulty performing it’s function of making decisions. Just like a damaged heart will have diminished capacity to pump blood, a damaged brain will have diminished capacity to make decisions. And any organ functioning with diminished capacity due to damage could be said by definition to be “diseased”
I think the exciting thing in recognizes that there is damage to the brain’s decision making system is that science and medicine can then start looking to understand how and where this happens, and develop ways in addition to counseling (medicine, surgery etc) to help. And further it my hope that as a society we will start treating all addictive behaviors as health issues, and not moral failings or criminal behavior.
Chuck C,
Thank you very much. Your argument has been of great help to me, as I most definitely see how addiction can be a choice. My original opinion was that it was a disease, but my mind is changing. Thank you; and thank you, Steven Slate, for taking the time and effort to make this article, and to taking a couple of hits for allowing this to be an open discussion. I also very much admire the website; I am a technology major, after all! Chuck, I must say your comment was very helpful. I also noticed that you went on a slight tangent, but it was important all the same. However, I do require support for the other side of the argument as well, and while I still have to decide where I stand, it does not vary the fact that I must have arguments from both sides. If it is possible, may anyone else also be willing to contribute? I am also open to more arguments as well in Chuck’s and Steven’s favor. Thank you very much.
(P.S: Once again, this is a very nice website, Steven! I do understand you made the content, but may I inquire as to whether you made the actual site? If so, which html version did you use? And what code did you use to divide the comment section into multiple pages? I could never get that one, and my classmates are all laughing at me.)
|Ryan~
Ryan,
Just to be clear, my best guess (and that’s all any of us can do at this point until we get more science) is that substance abuse is likely a brain disease. This is clearly different from Steven’s opinion. I believe that systems of the brain become dysfunctional due to substance abuse. I don’t think the dysfunction rises to the level of compulsion or complete loss of control, but that the ability to make good decisions becomes compromised. It’s kind of an in between position. Not complete loss of control, but not normal decision making either. But since I don’t think the brain functions optimally I clearly lean towards disease.
I like Ryan’s May 18th comment. I did not read the article,. just the title. I don’t read a lot now days. Long ago, I used to read Maslow and Rollo May. Anyway; For me at the start it was strictly an issue of garbage in and garbage out. From age 6 to perhaps 15 years of age I remember my initial significant personal sociopolitical conclusions about the human race; I was very wrong. In a nut shell I concluded that most of my piers and the human race were corrupt, and so I concluded; corruption is the new normal. Add a few big mistakes and it becomes like a snowball ride down hill headed for hell. So I spent 30 years trying to figure out what was wrong with me. The problem began with self programming. Early self doubt along with drugs and cognitive delusions about the failing sociopolitical fabric of society; undermines the integral fabric of one’s higher faculties of mind. However you define the higher faculties, it seems to be one logical parameter for our encoded DNA, and emanating from our DNA; is our innate guidance system. Thus if our choices can impact our DNA the way a disease does then perhaps it can be classified a disease; and drugs can cause those distortions to become semi permanent scars on the fabric of one’s psyche. In short we have to find some means to believe in ourselves, and value ourselves, and to ultimately see ourselves fitting into the big picture of life; despite a mountain of perceived evidence and the naysayers. I thought this was going to be like 3 sentences. Well that’s what I think.
Thanks goes out to everyone who give of themselves.
I like Chuck ‘s May 18th comment.
But, I did not read the article. I don’t like the vibrations, so to speak.
At around 8 years old I concluded that many of my piers were living under some form of denial. One does not have to be an addict to be in denial.
“Aught we respond to another human being.”
Chuck C. And others,
Thank you for your input; it has definitely been helpful. This website contains so many opinions, with each one being as valuable as the next. I feel as if telling what side I will write in favor of will cause conflict, so I decided I will not tell. However, here is my personal opinion on addiction:
I believe that choosing to use drugs is a choice, and I believe that when one becomes dependent on a drug, it may be considered a disease. But what about addiction? Addiction is usually that bridge between the two, so if you were to build a bridge between France and Germany, who would it belong too? France could say that they were the ones who came up with the clever idea to build it, and supplied the resources. Germany could say that they were the ones who did all the labor and planning. (For you information, this situation is entirely synthetic; I do not mean to provoke anyone if this offends them). You see, as a neutral party, it would be impossible to decide fairly on whose bridge it is. As a resident of either France or Germany, such a decision would obviously be easier. Addiction is that bridge between the choice to use the drug and the utter physical effects and dependence of/on the drug. As a neutral party, I have no right and every right to make a decision,;while each of the sides has a certain right to answer the question, they also have a certain bias. A neutral party has a fair mind in this situation, but what right do they have if they have no experience? This is the dilemma for me, and I must say that to certainly answer this is physically impossible, nor can we settle on a fair answer. I believe, personally, that addiction is not something that only starts or ends something, but is a process. Addiction is a series of events: what happens in those events may go under disease or choice, but the concept of the events is the true addiction. Through this definition, both sides are equally right and wrong. The person knows what is coming, but chooses to keep using anyway, thus addiction is a process of choices. Another way is that the disease forces the person to keep using, making addiction the process of a disease.
If my answer should not prove satisfactory, I am content with at least having you hear it. It means more to me that you are bright and open and willing to take the time to what might seem like an inadequate answer than it does for you to agree with me. If you do agree, then what am I supposed to say: Congrats? Considering my answer is a neutral answer, I can’t really fight anyone, and I won’t. I probably will change my mind myself! But thank you for helping and understanding.
Have a great day!
| Ryan ~
Ryan,
Addiction is commonly defined as continuing to use despite negative consequences.
http://www.asam.org/quality-practice/definition-of-addiction
Steven the website owner says there is no such thing as addiction. And honestly our government is moving away from the words “disease” and “addiction” as they can be charged with controversy. Instead our government is describing substance abuse as a disorder, and we can think of it as similar to a eating disorder. For alcohol for example you answer some questions regarding your drinking and they classify it as mild, moderate or severe disorder. Important to note that these are considered mental disorders, not physical disorders although physical dependence is definitely a concern it is not primary to the disorder.
http://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/alcohol-use-disorders
Dear People of this Site,
Thank you so much for all the input and advice. You have all been very helpful and kind; especially you, Chuck C. You always managed to answer my concerns in a day, and it has been a pleasure communicating with you. Thank you as well for the web links. Steven, I hope you understand that you have created far more than a website: you have created a community of minds who can all give their part in how to treat addiction, or if it truly exists. Please know that if I gave in any way or form that your site was ineffective, I greatly apologize; before I came to this online domain, I had only considered addiction a disease, and never considered it to be a choice. When I read your article alone, you managed to balance the scale instantaneously.
As I have stated before, I will never tell who’s side I picked-mainly because that I didn’t. I was too conflicted, so it was decided with the roll of my lucky die. Do know that, whatever topic you believe I am writing on, know that I will just as willingly and efficiently go the other way. I do understand this website is based that addiction is a choice-so I choose not to tell. (I hope you know that’s a joke; it would be embarrassing otherwise to hear those symbolic crickets). Do know that everyone on this website has been helpful to me, and thank you all once again.
I am sorry to say I am done with research, and that is a rare occurrence for one to be sad about the end of such a thing. However, you all opened my eyes, and I will say this is one of the most open and wonderful places on the Internet. I now must go, but you never know; one day I may be back once more.
Thank you everyone, and goodbye!
Sincerely,
| Ryan~
Jeff,
I have never doubted the quality of information and research here. I have in the past disagreed with some of the analogies and the style in which it is presented. I wanted to address your reply to Chuck C., in regard to the broad topic of choice. I once argued that, and later retracted, that science is exact. Your statement “science rarely ‘proves” things” is in alignment with the idea science is indeed, not exact. Scientific research renders a hypothesis, as you stated, and such evidence is usually objective. I suppose when I speak of how information here is presented, one part of that could be a subjective, or as I have many times called it, a personal component.
Now, I’m no rat, and if I was, I wouldn’t be able to tell you how I feel while I’m being subjected to experiments and drugs. All that’s observed is the action of the rats, and because those actions observed are objective, one can make a hypothesis. Let’s say I’m an unobserved subject, and what I report to the researcher is my experience. That data is subjective. Stanford Encyclopedia of Philosophy defines scientific objectivity as “a characteristic of scientific claims, methods and results. It expresses the idea that the claims, methods and results of science are not, or should not be influenced by particular perspectives, value commitments, community bias or personal interests”. Basically they’re saying that evidence, findings or hypotheses as a result of experiments are found without any subjectivity at all. So, we can all agree that science is not exact, and if Stanford’s statement is true, any objective hypothesis cannot be claimed to be true and correct because one important element is not considered: subjectivity.
Research on the specific topic of choice has been going on for years. I’m not a scientist or scholar. I have a degree in Healthcare Administration and currently work in the field of my study. I am also meth addict who’s been sober for almost 7 years. I’ve read scientific data found in hundreds of different websites. I’ve read countless books based on varying opinions and findings. The first thing I “learned” in 12 step programs is that I have a disease, and I never really bought into that concept. Curiosity about that theory is what brought me to this website, and for quite a while I ranted and raved, often times without making much sense. Now I can respond intellectually, and also challenge respectfully.
In response to your reply to Chuck, you referenced one hypothesis and one null hypothesis. To both points, the lack of objective evidence that severe drug dependence (I include extended periods of dependence) limits or hinders the ability to make a choice to stop using, I want to say this: not having objective evidence does not make the ability to make a choice or not any less valid. And since this evidence cannot be challenged with a subjective point of view to make it a null hypothesis, any subjectivity to the contrary cannot and should not be discredited. I guess one could say that hypotheses are almost like opinions: not fact, unproven and only relevant to the experiment itself, and not any one individual. I understand that scientifically, in order to find a hypothesis null, there has to be contrary substantiating evidence. What I am suggesting is that hypotheses, at least specifically to addiction and the matter of choice, are weak for the mere fact that people are not laboratory animals, experiments and data on spreadsheets.
Personally AND subjectively, every time I used I knew that negative consequences of one degree or type would happen, yet I still used. I knew that if I didn’t go to work, I may not have a job. If I spent $100 of my rent money on meth, I couldn’t pay my rent on time. And when I spent countless hours wandering the streets in the early morning hours, I could be detained and arrested. It wasn’t so much that I didn’t know I had choices, it was that I didn’t give a shit. Steven hates this word, but for lack of a better one, I was compelled to seek the drug, act and behave against all logic and good sense, go places that I would never even consider going to today. I will tell you this, when it came to wanting to stop using, not to live a subhuman life, to not be so paranoid that I thought every law enforcement agency was out to get me, I didn’t know I HAD a choice. It was never not having a choice. The life I was leading was the only one I knew. Any thought other than seeking, using and doing it all over again and again, rarely became a cognitive thought. I promised myself and others many times I was going to quit, and every promise I made was broken.
I, like almost all meth addicts, stayed up for nights and days on end. We have Tic Tacs for dinner, don’t drink enough, don’t take prescription medication, and if we do, the meth makes them null and void. This causes severe dehydration, psychosis, hallucinations, paranoia, anxiety…..the list goes on and on. The addict with a dysfunctional brain, mind and body knows only one way for all that chaos to stop: USE! Any lay person, and especially people who do these scientific experiments and research would have to be blind, deaf and dumb not to see what effect this would have on healthy decision making.
So, for me, subjectively speaking, I didn’t know I had a choice. That was until December 13, 2009. Actually, it wasn’t realizing that I had a choice, it was coming to the realization that I had been curled up on my apartment floor for two days in a fetal position, praying and pleading to god to just let me die. And damn if I didn’t die. Now what? I called a friend, went to a meeting, and almost 7 years later, sitting here wondering why people, with all the information available that provide hypotheses for both sides of the coin, insist that theirs is the final word. What I think needs to happen is that some of these highfalutin doctors and scientists need to get real, do some subjective research, and allow their rigidity to become a little more dynamic. Some things are absolute. In my opinion, the science around addiction is not even close. What is a little unsettling to me is that we all can’t just let people have their opinions. Not so much as having a robust debate or discussion, but the volatility that erupts when someone disagrees with another. There’s no room for error or discussion. They’re right or wrong, black or white. I personally believe my concept of allowing subjective data to have an influence on objective data is a completely plausible one. It might be too simple for some to grasp, I get it. At least for me, I don’t have to use or drink over it. Anymore.
A lot of what has been said here, and on this subject is very interesting and informative; however, I cannot agree. I am an addict. I am telling you that I have lived this almost all of my entire adult life. No, I am not a scientist and I cannot explain it. I do know that addiction runs rampant in both sides of my family although neither of my parents were addicts. From the first severe injury I ever sustained and was given pain medication for, a broken wrist, something ‘clicked’ in my brain. Although it was years before it consumed my life, from that day forward there was something different that I could feel about myself but couldn’t put my finger on. Years later, when I was prescribed more pain medicine for a fractured vertebrae during a car accident I became addicted. When my tolerance built up to the point that what I was prescribed wasn’t enough to help anymore, I sought out buying pills illicitly. I eventually joined a methadone treatment center to try and get some sort of control over what I was doing as attempts to stop completely failed numerous times. While I don’t like that I still take ‘something’, it’s a maintained amount, a daily dose, and I am drug tested for anything else and that I am taking it as prescribed. It has been the only way I have been able to maintain any semblance of a normal life. I am here to tell everyone, if this was all about WILL POWER, I would have stopped a long time ago. It tore my life apart. I had young children and it was huge part of me not being the parent I should have been. MY being an addict has kept me from being able to hold a job, even a menial one. I isolate and don’t have any friends to speak of. I prefer to be alone and just read books because I always know that I don’t fit in, Im different than everyone else in a very very shameful way. I once had almost 3 years without any meds and then I slipped off of the front porch in a rain storm and broke 3 more back vertebrae. I couldn’t move, I couldn’t stand, and I ended up on pain medicine once again and the cycle started over. I am now back on the daily dose of methadone, in order to have as much normalcy as I can muster in my general life.
I would just like to reiterate, IF IT WAS A QUESTION OF WILL POWER, I WOULD HAVE CHOSEN TO QUIT A LONG TIME AGO. IT WAS MY WILL TO STOP, I COULDNT. I wish I were different. I don’t like who this addiction makes me. I have tried numerous help centers. With growing older we all face a risk of needing pain management drugs which made it that much harder to quit. It’s not like crack cocaine. Opiates mess up your mind, you cannot stop it. I have the disease of addiction. No one else has to believe it and until you have lived it, please, do not think to understand it no matter how much and how well you analyze it. And knowing what I know, and that being addicted is the only way to fully understand…I truly hope that none of you ever do fully understand. I would rather you remained unaware, ignorant of what it really is, be it disease or bad choice. I hope you never know for yourselves.
Sincerely,
debi
PS For every scientist and ‘expert’ that claims that it’s not a disease, you will find one that believes it is a disease.
Debi,
I wonder whether it makes it “a disease” just because one could not find the “will power” to stop. I think it involves proper LEVERAGE. For whatever reason, drugs provided such a missing puzzle piece to my identity that the idea of letting it go was UNTHINKABLE. But it’s not that it was UNDOABLE. I couldn’t follow others’ logic on why I should quit. I mean, I understood it intellectually, but they and I were measuring using different scales. They mentioned things like family or livelihood or self-respect, but I heard things that sounded like still a second place finish compared to the newfound identity and release I had found in drugs.
If addiction is a disease, I think it hits the brain in some basic center where all other concerns are moved down the priority list of reasonable reasons to stop. The first thing under drugs on the priority list, for me, was “Following logical arguments.” Even following logical arguments had become less of a priority than drugs. If drugs are some kind of disease, it’s in this vicious area of brain hijacking. Then when I make my choices, the value system has been thrown off, so then it is a CHOICE and a DISEASE.
A Diseased Choice.
Hi Debi,
I am the author of this article and this entire website. As you can see, I allow almost everyone to post their opinions here. Your opinions are certainly welcome too. However, there’s one thing I take issue with: people arguing against the points in this article by arguing against things I haven’t said. One of those things that I haven’t said is that people should stop by willpower. In fact, if you had read the article you would’ve seen that I explicitly stated that I do not believe this is a matter of willpower, in the section headed “On willpower”. Maybe you should give it a read.
From the beginning of this blog in 2010, I have never said this is a matter of willpower. In 2011 I wrote an article explicitly describing my issues with the concept of willpower, titled Choice and Willpower.
Further, I address the concept yet again on my FAQ’s page. Here’s an excerpt of that:
I bring all of this up because you made 3 rapid fire comments to this page where you act6ed as if the argument here was about willpower, when in fact it is not. First you argued it here in your general response to the artcle, and then you argued it again in response to 2 commenters, neither of whom asserted that this is a matter of willpower. It’s worth mentioning also that you were quite emphatic, putting WILLPOWER in all caps twice.
One of 3 things are going on. Either you’re purposely arguing against a strawman, which I doubt. Or you didn’t read the article or the commenters to whom you responded. Or you are so used to thinking of this issue as a matter of disease vs willpower that you can’t imagine it could be something else. I think the 3rd option is the one. If so, I hope you’ll listen to what I’m about to say:
You can, by changing your opinions about substance use and addiction, reach a point where you legitimately don’t want to use substances recklessly. When you do that, it takes no special power or strength to not use substance recklessly. There is no need for support, treatment, meetings, or any kind of daily battle against addiction at that point. You simply move on with your life, and feels wonderful. Maybe if you check out my recent article about making change a win, you’ll get a bit of an idea about how this works. Or maybe, you’re already fully there, idk. But I do know I don’t endorse willpower as the answer to substance use problems. Back when I was a reckless heroin user, trying to resist my desire was painful and never lasted long. Changing my desire was what made quitting easy, and I didn’t need to wait for a higher power to do it for me – I did it by believing there was better stuff out there, and realizing the smallness of heroin.
Best,
Steven Slate
Agree. It’s a brain disorder that affects choice. Doesn’t make it compulsive. Definitely doesn’t rise to the level of powerlessness, which I don’t believe in. But the normal reward system that weighs the pros and cons of substance use becomes dysfunctional.
Whatever the addictive behavior, I believe one of the first steps to fixing the problem is to realize that your own brain/mind is not making good decisions partially due to changes in the reward and control systems of the brain. “Addicts” become confused and even suicidal because they don’t understand why they repeat these destructive behaviors. It’s because the decision making system is dysfunctional, i.e. not operating normally or optimally.
Realizing you have a brain disease doesn’t give you a license to use, but an understanding of the work you have to do to understand and overcome the addiction, and the fact that you can’t trust your own thinking where substance or addictive behavior are concerned. That you must work to change the value you have put on substances and realize you have minimized the risks/consequences in an unhealthy way. I think of it as rewriting the decision making program that operates within your brain. This can be done in a number of ways.
Alright, then, if the writer of this article would like to get down to the bottom line…it’s this; The reason so many people use drugs is because we’re surrounded by morons!!
Brain disease, personal choices, bad decesions…c’mon already, I mean does anybody even give a shit?? I don’t know about the other “addicts” but everytime I get a glimpse of how completely retarted even the smartest people of the world are….that shit sends me to drugs faster than withdrawal does, by God!!
Put clean, pure heroin & cocaine for sale behind a pharmacy counter (and quit drug testing for jobs!) and watch how fast addicts go from being lowsy bums on the street corners to functional, productive members of society….that’s the easy part…..then you’ll see how fast the shit flies off the shelves, welcome to the hard part!
But seriously it’s like this people; life sucks…nevermind getting what you want in life, just to get what you NEED takes a lot of hard work, time, and PATIENCE.
Addicts have demonstrated, for centuries upon centuries, that they don’t have the PATIENCE to fulfill many short-term goals, never mind long-term goals!
Goals are fucking important, duh!
I’ve known lots of good people with lots of various goals, but not me…noooooosireee, I never (that’s right, dipshit, even before taking drugs) made any long-term goals….why, you ask?
Since I know you’re dumbass STILL hasn’t figured it out i’ll break it down…yet again, for you slow pieces of shit that are still reading this; I’ve always been a procrastinator….why? Idk, probably because I’ve always been unmotivated? WHY HAVE I NEVER BEEN MOTIVATED, then seems to be the $1,000,000 dollar question, correct? Correct. I’ve never been motivated in life, because the things I want most in life are just so far out of reach (don’t teach your kids to “dream big”, lol) that, even if I do see the “point”, as it were, I wouldn’t have any CLUE where to begin pursuing my goals.
Naturally, I put things off, way off, until the very last second….what happens at the last second?
You pretty much (in many instances) are forced to make a last second decision. And of course you say ” oh shit, Rick, well waiting till the last second and being forced to make a decision sound really stressful”
But that’s whats so great, it’s not stressful at all, knowing that I’ve input the absolute minimum amount of effort to achieve an equal(often greater) reward than others who could have wasted hours upon days….the only difference between them and me is that I just don’t give a shit, not like they do. Either that or I just make better split-second decisions than I do when I sit there and think the shit out of it…what good could that possibly bring?? It’s like prolonged hesitation, that nasty feeling that you could make the wrong choice….well, when you procrastinate, you don’t get that….it helps to assume you’re wrong anyways though.
I don’t know exactly why I don’t give a shit….it is my life here, after all. Maybe all I really know is that when all of my goals are completely unattainable, I can still score some good, pure, clean dope(or in a pinch, some tasty booze, sure), and put my aching existence out of it’s humble misery for 4-10 hours.
Like the late, great Merle Haggard said; “No, it’s not love,….but it’s not bad”.
So, until my goals are more clearly in sight…more reachable..until I find a way to get what, or who I NEED….the drugs will be there for me. Untill I get what I need, the drugs will keep me going….and when I finally (if ever) obtain what I NEED, i’ll pick up where I left off before drugs..
Anybody that says withdrawal is why they’re still on drugs is either a liar, or a total fucking pussy….and I mean, I consider myself a pussy, so whoever claims withdrawal is the real “challenge” is a complete, and utter crybaby piece of shit.
Life is the real “challenge”….nobody asked to be born, and if they did..well once they got here, I bet they changed their minds damn quick!
Maybe don’t make any long term goals but make a very short term goal that is achievable that you feel will be of some benefit to you. Hit that easier short term goal, see if you like the results. Then do it again.
You might like the results of making very small simple improvements in your life. And that can lead to making some longer more significant improvements. Start small, simple and easy. Make your life slightly better. Go from there.
When we talk about the inability to choose, we are not referring to controlling our motor functions, like raising an arm. We are talking about the processes in our brains. I am an alcoholic and have found a remedy in the 12 – Steps. My only research is on myself. It really does not matter to me which the pros and cons these theories conclude. The brain is so complex that we will be researching and finding new answers far into the future. The best way I can describe it, based on my own experience, is this – If you have ever had a resentment, a lingering thought, that you just cannot get out of your head. Maybe you have thought about this situation, where someone may have wronged you, for hours, days, maybe even weeks and months. Perhaps you have even, as they say, lost a night of sleep over it. My guess is that you did not choose to have this happen. That you just found yourself mulling over this topic and not realizing or being able to rationalize why. Why does this bother me, it’s not a big deal. Do you choose to have this resentment keep you up all night. I would say no, not me anyway. I would even say I am powerless to keep these resentments from my mind. Alcohol affects some of us in much this way. The obsession to drink is not a choice. Sure picking up a beer with my hand and putting it in my mouth is clearly a choice of my motor functions, one to relieve the pain. But the obsession to do so is not. And the craving that persists after even just one or two drinks is a symptom of my metabolism. Science has actually proven that my liver enzymes process alcohol different from those who can control their drinking. These cravings are so powerful you cannot stop.
I have found relief in the 12 steps. Maybe it is not for everyone, but I know a lot of people who they have worked for. Don’t knock it till your try it, as they say. Anyway, it would be a waste of time for me to review all the literature of different research, when I already know how it affects me. A problem I fought, concealed for some 30 years. I am glad to be sober now. But I continue to work the steps to stay that way. I never would have thought it would work. Actually thought it was a bunch of BS. Until for some reason it worked for me. They just said give it a chance, be willing. Or good luck and your always welcome, drunk or sober. What a dreadful program, right. One that has helped millions (proven). All of you that do not suffer from addiction or alcoholism, please keep an open mind. It’s a real interesting topic. But you can never fully understand the complexities unless you actually suffer, or science finds some way for you to feel the pain and anguish for even a brief time.
After a good night sleep and allowing all this to sink in, there are a couple of other very strong points that have been missed here.
In this day and age, there is no excuse for addiction. The same way there is no excuse for unplanned pregnancy. Come on people!!!! We are in the 21st century! We have education and knowledge at our fingertips!!! We know how this stuff happens! We learn it in grade school. “Say no to drugs!” Nancy Reagan spent years campaigning this. And if you didn’t go to grade school then you learned it from tv. And if you didn’t learn it from tv then you learned it in a brush with the law. You have to be from a different planet not to know that drugs and alcohol are addicting and that repeated use leads to addiction. Here is the point…If you choose to pick up the drug or drink (that you have been taught from youth you can become addicted to) then you are making a choice to possibly become an addict.
Cause and affect. For every action there is a reaction. You all know the war on drugs people. Stop using excuses for why you are addicted. You did it to yourself. No one forced you to drink or do drugs. You made an educated choice to use knowing the possibility to become addicted. Seriously. This is not rocket science. Same as unplanned pregnancy. If you have sex, you run the risk of pregnancy. We all know it’s a possible out come when having sex. You make the choice to have sex at your own risk. Not even protection is full proof. It’s no mistery here. These are some of the first lessons we learn in life. No excuses. You may have other illnesses or diseases (such as mental health issues) but addiction is not a disease. It’s a choice. An educated one at that. Stop the excuses! Knowledge is power and you were all informed from youth.
And yes, I have used drugs and alcohol as a teen. I started smoking, drinking and using marijuana at age 13. By 17 I was using meth. By age 19 I grew up and made the choice not to use them because it was not a path I wanted to take nor the kind of lifestyle I wanted to live. I chose to set a better example for my kids and be responsible. I have 4 kids (two adults, 2 older teens) of which not one of them is addicted to drugs or alcohol. And I was raised in a single parent home with no money and an alcoholic father who abandoned my mom with 4 young kids to chase his drug and alcohol career. So I am not free of my own issues and self struggles. But I still made the choice (an educated choice) not to touch the stuff because of what it does and where it takes people’s lives. No one today can say they didn’t know. Drugs and alcohol, along with other poor choices, can and does lead to diseases. But it itself is not a disease. Mental health issues are a disease that may cause you to want to turn to drugs and alcohol but again, that is a choice you make to self medicate instead of getting proper treatment. Addiction is not a disease. It’s a choice. Addiction can lead to diseases but addiction is a choice. And to stop is also a choice. It just depends on how high your personal price becomes to get you to stop.
Drugs are not addictive. There is no such quality, because there is no such thing as being compelled to use drugs (addiction).
Nobody “gets addicted.” No one.
The use of some drugs can create temporary bodily changes that then result in withdrawal when the drug usage is ceased – but this is not addiction, it is withdrawal syndrome – and countless millions of surgery patients have gone through this withdrawal symptom millions of times without feeling compelled to seek out drugs. People crave and seek drugs because they think the usage of those drugs will make them feel good. They do not seek drugs because of withdrawal syndrome until they are taught to connect withdrawal and craving by the recovery culture. This was discovered and documented by Alfred Lindesmith in the 1940s and it still plays out this way today.
Again, no one gets addicted to drugs, because no one is compelled by drugs, or even by the withdrawal syndrome that can result from some drug usage, to crave and seek drugs.
” Nobody “gets addicted.” No one.”
I’m sorry but this is absurd and incredibly ignorant, not at all surprising from you though considering it describes most of what you write.
Addiction as a neurological process has not been a controversial idea for about 30 years now. You are to neuroscience what creationists are to biology or what global warming deniers are to climatology. I wouldn’t be at all surprised if you were both of those things as well because the science here is incredibly clear and has been for decades, not that this has ever stopped uneducated hacks like you from expressing opinions on subjects you clearly know nothing about.
Are you of the opinion that all of those brain scans and all of that research done over the last few decades is… what, exactly? All photoshopped? Was it done by the same people who faked the moon landing? Does it involve the same shadowy cabal of evil scientists who are plotting to mislead the world away from god into the path of that dastardly evidence?
Sorry but adding ignorance and strong opinions just doesn’t produce the same results that adding education and evidence does. The problem is that the ignorant are just too ignorant to understand how little they actually know and mistake conviction for evidence.
Fortunately people like you are left to proselytize to the gullible in your dark corners of the internet, far away from the credible experts and the policy makers, so the damage you can do is ultimately inconsequential except for aggravating those who are informed and educated enough to be irked by your tiresome nonsense.
Wrong! Wrong! Wrong! Nobody can say that drugs are not addictive, of course the degree of addiction varies from person to person. The information you accessed may have stated drugs are not addictive, but it goes much deeper than that. Your statement may also be from personal experience, but I’m fairly certain you have absolutely no experience with crystal meth. There is as much information stating that drugs are not addictive as there is stating that it is. Check out this article, there are plenty more where that came from.
http://www.medicalnewstoday.com/articles/23207.php?page=2
I am an ex mental health patient that used to take eleven psychotropic and anti depressant medications when I was eleven. I went off cold turkey at 20 years old (now I am 23 years of age).
As I know now my parents were narcissists who verbally and emotionally abused me. They took me to get a “mental health diagnoses” as a tactic to use against me when the family went into emotional or financial shambles. I was the scapegoat of the family, so it was easy for them to use my “mental illness” as a reason why my parents or siblings suffered emotionally or socially.
I get sick and tired of people in ex mental health/ alternative medicine culture “victimizing parents” as if they had a psychical gun being put at their head by a “pharma goon”. Most cases, parents get their kids diagnosed because it’s a choice, so they can be looking for a way to put blame on somebody else, when they make poor decisions in life. Yes, I heard about all the alternative health websites, promoting tabloid like writings about innocent people being murdered by wicked voodoo pharma goons (that is psychiatrists).
Yes, I hate mental health and psychiatry with a burning passion. My experience was dehumanizing, and I’ll never seek treatment from them again. However, I’m still wondering why the anti Pharma militia hasn’t came out of the woodwork yet? I mean, I hear anti psychiatry tabloid websites talk about defending yourselves from Monsanto and Big Pharma. Still haven’t seen militaristic attacks on Pharmacutical companies, or psychical assaults on psychiatrists in the newspapers yet. Maybe they’re all hat and no cattle, just like I expected.
So sorry. Instead of being sympathetic to these “parents” people victimize on a casual basis, I’d rather y’all realize these parents are narcissists who need an enabler to back up on their bullshit (psychiatrists are their favorite enablers).
I’ll still wait on the anti Pharma militia to come out of the woodwork, but I won’t hold my breath for them.
I just have one question for slaTe. Are you a christian or of Any other denominational faith?
I am not religious, and I am not a believer in God.
It seems to me that the majority comments here ARE not negative and agree with you. Therefore, I’m assuming this comment will probably be deleted but I can’t bite my tounge any longer. Why do you care so deeply about this? Does it bother you when people do not agree with you? Or is it that not everyone does what you tell them to do? To me, it does not seem as though you ever dealt with addiction. If YOU have, you would not want to be bringing others down because their choice of recovery doesn’t match YOURS. If others are recovering and changing their lives, support them, be a decent human being! I will pray for you.
The problem is the use of the word “addiction”. ADDICTION IS NOT A DISEASE. The definition of the word “addiction” has been defined for years and never included disease and shouldn’t be changed by any movement. Part of this problem is that anyone can be addicted and everyone knows it. Therefore trying to change the definition of addiction to include disease adds to the social stigma surrounding the problem. The disease of addition is exactly the same as alcoholism. If addicts don’t want to call it alcoholism, then make up your own word for the disease of addiction. Some possibilities could be; Drug Disease, Addicism, Opioidum or Heroinism. As long as the misled ego of the addiction movement insist on using the phrase “Addition Is A Disease” it will continue to add to misunderstanding and public stigma that this thing is a character defect. ADDICTION IS NOT A DISEASE and everyone knows it, stop trying to force it down are throats. I have 40 years experience of working with alcoholism and know that addition is only a very small part, almost unmentionable part, of the disease. Please stop trying to change the dictionary.