Nora Volkow, the world’s leading disease propagandist is scheduled to appear at a conference on prescription drug abuse next year. But that’s insignificant. What’s more interesting is an idea exposed in a report about this event:
Dr. Nora D. Volkow, director of the National Institute on Drug Abuse (NIDA) at the National Institutes of Health, has conducted extensive research that demonstrates drug addiction is a disease of the human brain – not merely a criminal problem caused by poor choices – and thus much more difficult to overcome.
It should be clear from the premise which slipped out in this relatively unbiased news report that it’s pretty intuitive to believe that addiction is “much more difficult to overcome” when it’s viewed as a disease. Nevertheless, people tell me via hate-mail and online discussions all the time that this is an absurd conclusion to draw from the disease message. Given that Volkow hasn’t really proven addiction to be a disease or compulsion (involuntary behavior), I would (and actually did) choose to view it as a choice, and less difficult to overcome – giving me more motivation and real power to change my habits. What good does it do to teach people that it’s gonna be very difficult to change when when that change depends upon them believing they’re personally capable?
For the record, I disagree with and reject the part of the quote above which couples the choice view with a view of substance use as a crime, and then places it in a false dichotomy with the brain disease view. This says that either you’re a judgmental meanie who wants to put people in jail, or you’re a compassionate person who recognizes people as suffering from a disease. Neither needs to be the case.
You hit it on the head. The premises are false, but accepted blindly with terrible consequences. When you’re told that it’s all a disease and getting yourself straightened out is really rare and damned near impossible…well it takes a lot of deprogramming of that “stinkin thinkin'” to make any headway. I’ve gotten much more traction and honest (as opposed to false) hope out of reading your blog and guys like Stanton Peele than I ever got from a tour of the 12 Step dungeons.
Hey, Steven–
Curious what counter-arguments you’d find to the argument this doctor is making for the “disease model” in this video series on youtube:
http://www.youtube.com/watch?v=ekDFv7TTZ4I&feature=player_embedded
Essentially, I think he’s setting up a strawman version of the choice theory of addiction by stating that the choice argument says “If you pour a drink for an alcoholic and give him a choice about whether to drink or not while also pulling out a gun and telling him you’ll kill him if he takes the drink, most alcohlics will choose not to drink.” Then, after going through the science on the neurochemistry and biology o f addiction (including the unproven assumption that it is “genetic”), he then says that addiction is a disease because while the addict can choose not to drink or do the addiction (control his or her behavior), he or she can’t choose NOT to have a craving for the drug once it is offered to him/her. I can see some flaws in that argument, but am curious what your response to that is.
Incidentally, I’ve been reading and listening to Mccauley’s stuff for a while, and I even contacted him recently to give him a chance to preemptively rebut a criticism of one of his papers that I’ve been working on. But I’ve received no answer.
I think he is using a bit of chicanery in his portrayal of the choice model. He associates it with the use of external methods of control – such as holding a gun to someone’s head. Paired with other things he says, he essentially defaults to the false “treat em or jail em” dichotomy – as if acknowledgment of addiction as a choice must be accompanied by support for heightened punitive measures.
Amazingly though, he concedes that you can choose – which goes against all of the leading experts in the disease camp, and somehow cites craving and suffering as the evidence of disease. I suffered a lot when I broke up with my high school sweetheart – I wanted the relationship back desperately, and thought about it often – was that a disease? I don’t think so. But guess what happened? I dated some more, and I thought about her less, and I got over it. I found relationships which I enjoyed more, and the old relationship became obsolete in my mind.
I think Mccauley takes the view that the cravings stick with you forever. Newsflash – they don’t. I know that’s probably hard to believe if you build your change on the belief that you’ll always crave.
Yep. That’s exactly the faulty logic I saw, too. Even if cravings occur periodicially for the rest of your life, that STILL wouldn’t make it a disease. For example, I have this really curious quirk where every single day I end up “craving” food. That doesn’t mean eating is a disease.
I’d be interested to read your paper when you’ve finished it. There’s certainly not enough of the logic and choice rebuttal to these misportrayals of the philosophy out there. For every Stanton Peele or Jack Trimpey, there is a million Dr. Drews and so-called “addiction therapists” promoting a model that keeps people struggling and struggling, and paying through the nose for years with nothing to show for it.
Your post is absurd!!! It is not the craving that makes it a disease. It is the fact that we can not stop once we start!!! Whether it is food, alcohol, drugs, gambling, it does not matter! That is what addiction is. I can not control what happens after I take that first drink. Your comment, “I have this really curious quirk where every single day I end up “craving” food. That doesn’t mean eating is a disease.” is a case of being hungry, and that is a pretty weak comparison since we need food to live!!! Once I begin to eat, when do I stop and do I have control of it to stop. I do not need alcohol to remain alive, but I did during my addiction. I certainly have a FATAL disease and my treatment is AA. If I do not work my program to the fullest, I will not survive!
You should slow down and read things a little more carefully Matt. Max and I were discussing Kevin Mccauley’s explanation of addiction. The view that “craving” is what makes addiction a disease is a view that neither of us were supporting – we were criticizing it.
Matt’s point is very interesting to me. I asked a lot of questions at meetings, especially of the old timers, to understand addiction and why I did it. Some alcoholics and addicts in AA and NA told me that once they stop, they cannot stop. They had tried many times to have just one drink, to stop before blacking out, and it never worked. What is that about?? A few people with over 20 years clean tell me they attend NA because it is for “addiction”, not just drugs. A couple super guy in the freethinker AA (for atheists) told me he knows he is an alcoholic, because he has tried many times to stop after one drink and he cannot. They don’t buy my choice argument. On the other hand, there are those guys who freely admit they drank to get drunk. So what about those guys who are convinced they lose control after one drink? What about their belief/experience that they just could not stop once they started?