In an op-ed in the Financial Times Christopher Caldwell tells what I think is a bald-faced lie:
Addiction is voluntary. The idea that addiction is a “chronic, relapsing brain disease†may be well-meaning but it is false. “Everyone,†Mr Heyman writes, “including those who are called addicts, stops using drugs when the costs of continuing become too great.†We need to make clear, though, what Mr Heyman means by “voluntaryâ€. He does not deny that addiction is an enormous problem that can wreck a life, or several. If you drive drunk or embezzle money to pay for your coke habit when you ought to be studying, the consequences can be permanent and devastating.
But addiction is not the kind of problem that most people think it is. It is not so very far from setting interest rates, devising depreciation schedules and other economic problems of “intertemporal choiceâ€. It involves weighing the value of a current good (intoxication) against the value of various future ones that are shrouded in uncertainty. Mr Heyman shows that the ordinary dynamics of human decision-making are sufficient to bring addiction into line with what we know about other, non-addictive behaviours.
I think this is an utter misunderstanding. People choose to use drugs. They do not choose addiction, that’s something that happens to them as a side effect of the choice to use drugs, and they have absolutely no control over whether they will become addicted or what effect addiction will have on them, their lives, or the lives of their children and those close to them.
And as suggested in the remainder of the quote above people don’t have the information to evaluate the opportunity cost of drug use until they’ve already assumed the costs.
I don’t know Dave. I’m not saying I think Heyman’s view is right (I get visions of “rational actor” nonsense when I read it.) However, there is something about the “addiction = disease” that is more loose analogy rather than fact.
For example, John Lennon was addicted to heroin, and then he wasn’t. How did he shift from being an addict to not? He stopped using. How did he stop using? He decided to stop using, with all the Cold Turkey consequences of such a decision. He didnt have a surgery or take a medications or anything else…he made a decision. THis points to a weakness of the disease analogy, and the drawbacks of the disease analogy. I cannot say “I choose not to have Cancer” once I get diagnosed. All I can do is live with the consequences of my disease. I could be 100% committed to beating Cancer and still have it kill me. But if I was battling addiction then 100% commitment would equal about 100% success in kicking the habit (as tens of millions of smokers have proven over the last few decades.)
Calling addiction a disease seems to de-emphasize the power of human volition to no good purpose.
I didn’t call addiction a disease. What I said was that nobody chooses addiction and I stick to that.
Additionally, I think there’s reason to believe that the statistics being quoted are hooey. The death rate among addicts is known to be high, something like fourteen times that of the general population among heroin addicts (the group being cited). That means that a large number of those who’ve “chosen” not to be addicts have actually died.
“I didn’t call addiction a disease.”
True. But the question becomes, what IS addiction for you? How is it related to our choices exactly? You make a distinction between the choice to use drugs and the non-choice to become an addict, but is that a workable distinction? At the extremes it sounds a little like saying “I chose to drive my motorcycle off the cliff, but I didn’t CHOOSE to hit the ground below.”
Now someone might say, “Gee, I’d love to take heroin, but I don’t want to get addicted to it!” But, if they take the drug and become addicted I have a hard time seeing how the addiction didn’t result from the choice to take heroin in the first place.
Common Sense Observation: Everyone who chooses to try a “guilty pleasure” (narcotics, sex, in my case ice cream and chocolate) knows he runs the risk of being that 1 in 30 (or whatever) who becomes addicted to it. Ergo, make an EFFORT to avoid the high-risk addiction substances (heroin, etc.) because YOU are responsible for assuming such risk, and you don’t get to transfer the cost of that risk to me (just like low-class slobs who don’t want to lose 15% sexual sensation by using condoms transfer their unwanted pregnancy and ensuing welfare costs to me and the rest of society). So at most I’d cut the addict one break: One free round of de-addiction medical care. After that, no mercy. Arrest and send to prison with hard labor to pay for all the damage the little slug did by stealing from me and my neighbors to feed his habit. Or, join LEAP, declare the war on drugs a sham, and surrender (decriminalize them, but again, provide NO medical care or welfare because individual responsibility is what made this country great and I have NO empathy for those who slob-istically destroy a healthy body for simple pleasures). Meantime, don’t call it a “disease” because to do so is to simply medicalize crime — against one’s healthy body — and thus enable un-responsibility.
John did use methadone. He said he quit heroin in three days but it took five months to quit methadone (at least).
Dave Schuler,
Had you read the book, you would be able to see documentation of all the studies from which the statistics come and explanations of how those studies were conducted. Co-morbidity also highly influences the death rate of drug users. Obviously, nobody would choose voluntarily to be addicted. Again, if you read the book you would be aware of one of the central arguments of Heyman’s book, which highlights the distinction between making decisions with short term or long term benefit in mind. The best choice in the short term is to use the drug, but in the long term to NOT use the drug. It is very naive to say that nobody can understand the consequences of drug use until they are already an addict. Whose fault would that be? Everyone understands the potential consequences of driving drunk or walking on broken glass without having experienced it themselves.
When you write that those addicted to drugs “have absolutely no control over whether they will become addicted or what effect addiction will have on them, their lives, or the lives of their children and those close to them” this is completely inaccurate. Because the majority of those who at some point in their lives fit the criteria for drug addiction DO stop using drugs and stop fitting the criteria for addiction, it is overwhelmingly obvious that addicts DO have control or the definite capability to develop control over aspects of their lives.