Friday, Jul 25, 2008
A new book argues that all addictions are a matter of free will, even heroin and coffee.
Jan 10, 2000 | By simply titling his new book "Addiction is a Choice," Jeffrey Schaler guarantees controversy.
In a society that's addicted to identifying addictions, some -- "Internet addiction," for instance -- are obvious targets for valid criticism. But identifying drug addiction as a choice? It seems ridiculous, even blasphemous; isn't it scientific fact that drug addiction is an involuntary medical disease? According to the White House Office of National Drug Control Policy, it is: "Chronic, hardcore drug use is a disease, and anyone suffering from a disease needs treatment."
Not according to Schaler. A psychologist and professor of justice, law and society at American University, he argues that drug addiction is not a disease. Instead, he says it's a scapegoated behavior that has been incorrectly identified as a physical or mental illness, a victim of bad science and misguided policy. Schaler writes that -- like homosexuality, masturbation and other behaviors once thought to be physical or mental illnesses -- the idea that drug addiction is an uncontrollable affliction can and should be "swiftly discredited."
Schaler admits that these aren't new ideas, but he's arguably the first to put them into an easily accessible form. The book reads like a combination of an academic journal article and a commentary from a local newspaper. While he's certain to have his critics, Schaler presents a coherent rebuttal to an argument many people accept without a second thought.
If addiction is a choice, what is it not?
It is not a disease. And it is not involuntary. And it is not a thing that causes people to engage in certain behaviors. The conventional wisdom is that the availability of drugs causes people to use them. That's one of the big arguments that is used to support what I call "the war on people," "the war on drugs." And the conventional wisdom is also that if you use "addicting drugs," you will not be able to moderate your use of those drugs [or] stop using those drugs.
The conventional wisdom is that there is some power in the drug that makes people keep using the drug. Another part of that argument is that once you use the drug, something changes in your body. And that change -- which has never been identified, only hypothesized -- causes you to keep using the drug. What I have argued is that people use drugs as a way of avoiding and coping with certain existential experiences. They don't want to do what is necessary to change their experience. I'm not saying that's not difficult -- it can be very difficult. For example, Native Americans -- who are the victims of literal and metaphorical genocide -- have major problems they have to contend with; I'm not saying that those are small by any means. But instead of doing what they need to do to change their experience, they may tend to rely on drugs as a way of making themselves feel better so they don't have to cope with those problems.
Back to the power you mentioned earlier -- the power that people say drugs have over bodies. Don't drugs have significant physiological effects on people?
Yes, and this is a point that serves as a red herring for people who maintain that drugs are dangerous. There are two ways of looking at this. We can say, "Do drugs have a certain effect on the body?" Of course they do, and the people on my side who go against the grain [admit that]. However, drug use and addiction doesn't have to do with what drugs do to the body, but how drugs get into the body.
If you take a drug like cocaine, obviously something changes in your body. Every time you think any thought, your body changes. There's always a physiological change associated with whatever you do. Now the question is, "Does that physiological change make you do what you're doing, or do you choose to do that?" If you have epilepsy, and you have a seizure, of course there's a physical change in your body that makes you go into convulsions. I'm not saying that you have a choice as to whether you convulse or not -- that's clearly not a volitional act. But whether you're going to reach for another cigarette or not is a volitional act; it's not the same thing as an epileptic seizure.
But if you take heroin -- and even if that's a conscious choice at the beginning -- once you get "addicted" to it, there's a point at which you might die from the effects if you go off of it; you could have a seizure and die. Does that not prove that the drug actually has a sort of control over your body?
No, but you're right -- there are situations in which you may need to be medically detoxified. And by that same reasoning, we could say that "crack babies" aren't really born addicted in the way we talk about addiction, but they've been poisoned. The mother has been taking the drug, and it's obviously caused something physiological in the infant, and that infant may need some care to antidote the toxic effects of that drug. The same thing with heroin, the same thing with alcohol.
There's lots of evidence that shows that people who have been "addicted" to heroin for a long time give up heroin once their environments change. That's one point, which I show in the [book with the] Vietnam veterans study that was published in 1973. Aside from those who needed to be detoxed because of the physiological effects -- of course, many of those people who are detoxed go back to drug use -- if you ask anyone who's been a long-time drug user how they stopped, they'll reflect for a moment. And they'll say, "Well, I made a decision; it was time for me to do it."
The act and the behavior of using or consuming a drug -- regardless of what it is -- is a choice, and people engage in those kinds of behaviors for reasons. There isn't some power in the drug or in their physiology that causes them to do it. Because by that reasoning, if people committed crimes while they were on drugs, then we'd have to exculpate them; we'd have to say they weren't responsible for their behavior because they were under the influence of drugs, and that isn't the way the law works.
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