Wednesday, May 2, 2007

Addiction is A Choice?

One of my textbooks for a summer class I'm taking (Addiction and Codependency) is called Addiction Is A Choice by Jeffrey Schaler. I just finished reading it and it was very interesting. Schaler makes several points:

1. The dominant conception is that it addiction is a disease that needs to be treated. However, there is no proof that alcoholism/chemical addiction has any biological causes. Neither can they be classified as a mental illness.
2. No known treatment of addictions shows any significant gains over control groups who are not given any treatment. Translation: addiction treatment doesn't work.
3. Alcoholics Anonymous (the most well known and "successful" anti addiction program) actually makes it more difficult for people to choose not to change by requiring the addict to believe that they have lost control and that once addicted, they will always be an addict. Schaler sees this as a most devious form of self fulfilling prophecy. Tell someone they don't have control and they won't have it!
4. The concept that alcoholics/substance abusers experience "lack of control" is false. Though it may be very difficult, millions of people become addicted to substances and eventually grow out of the addiction or choose not to overindulge. No studies have ever proven that a substance has caused someone to experience total "loss of control" of their ability to choose.
5. Total abstinence as a cure for alcoholism/substance abuse is not beneficial to addicts because it reinforces their powerlessness and robs them of the ability to determine their own destiny.
6. Contrary to the idea of abstinence as a necessity to grow out of alcoholism, many alcoholics (and other substance abusers) manage to practice moderation and that moderation can be both positive and healthy for past addicts.

I'm not sure if I swallow all of this, but the premise is certainly fascinating; addicts have free will and can (and do) choose to stop feeding their addictions (if they want to). Instead of telling addicts they are powerless to fight their addictions (A.A. and most other treatment programs) we should instead teach them that they can control themselves and help them to work on their "problems in living"/interpersonal problems/environmental problems that are influencing them to overindulge. I like the idea of empowered moderation (for legal addictive substances) as opposed to an incredibly difficult to achieve total abstinence.

Alcohol and drug addictions are a huge source of misery for many individuals and families and I realize this is a touchy subject (painful to many) but I think that we need to see the truth; current treatment isn't working. Maybe we need to change how we look at these things. . .

May Light increase!


Anonymous said...

Hey Mark...

While I do agree that everyone has the capability to choose to practise moderation and not overindulge, I think this becomes a difficult choice when dealing with alcohol or drug addiction because consuming these products causes an altered thought pattern. When your thought processes are altered, you think you can have "just one more" drink, hit, whatever.

Speaking as someone who lived with an alcoholic, I've seen that thought process at work. As good as the intentions may be, it is difficult to make a judgment call once impaired, and yes, even one drink, or one hit, or one drag, can cause that impairment.

I'm still of the mind that total abstinence is the only way to go. Not only for yourself as the addict, but for your family who cringe everytime they see a drink in your hand, because they've seen the effects of overindulgence.

Just my opinion...


Chad said...

remember that time that i was "smoking" at camp and you had to come talk to me then i showed you it was just a mosquito coil and you didn't think it was that funny but it really was pretty funny
glad to see that you would confront me if i had a unhealthy addiction at camp

i just kinda went off on a tangent right there hope you don't mind

now a serious response to your post

i think we all have addictions at the current moment, just some are more noticeable than others. im not one to believe that there are "healthy" addictions though you might argue that being addicted to God is good. "unhealthy" addictions are something that we all fight, something that i struggle with.
but i think all addictions as little as they may seem can be a stumbling block.
i dont know if any of this makes sense but its my 2 cents on addictions

Jobina said...

I think it's funny that the ads by Google on your blog as I'm sitting here are for rehab which, I'm guessing, is contrary to your post. teehee. Anyway, I'm brainwashed with choice theory on almost a daily basis and am actually starting to believe it. I keep finding myself using it on our children. Hmmm. I wonder if it really could work for alcoholics and drug addicts. Has it ever been tried?

Mark said...

Michelle: Thanks for your comments, especially as you shared about your own experiences. I agree that alcoholics and substance abusers do lose their better judgment when impaired. However, science has not been able to show that they lose the control to choose to indulge (before they are inebriated). Is their a predisposition to addiction in certain people? If so, does that mean we should let them off of responsibility for their actions? Abstinence may be necessary for many people but I don't think for all people. Is it easier to just tell all addicts they must abstain? I think it is. Just as one drink may be too much freedom for some, no drinks may be too little freedom for others and I wonder if they will simply rebel against this "injustice" (I can moderate myself, but I'm told to totally abstain) by getting drunk again. Hmmmm . . . obviously I need to think about this more.
Chad: Yes, I remember your practical joke - you and Andrew got me good! As for your point about addictions, yes, we definitely all have addictions and some of them would seem to be quite healthy. Addictions as a term is a modern phrase which now we take to mean something where we are powerless or near powerless to do do anything about (ie/ alcohol addiction, sex addiction, porn addiction, even chocolate addiction). Using the term addiction is disempowering I think.
Jobina: Yes, choice theory has been used with addicts (especially tough cases) successfully. I'm not sure how successful overall it is though. And yes, my google adds are ironic!

stacey said...

I'm really sick of the word "addiction". I think it's overused and it sounds like a cop-out. I think people love to throw around that word to justify a choice: "I'm addicted to carbs" and that's why I'm overweight. "I'm addicted to Pina Coladas" and that's why every time I drink them I overindulge and get stupid. "I'm addicted to Grey's Anatomy" and that's why I can justify to be a lazy couch potato on Tuesday nights. :)

I think this word convinces people that they have an excuse for their poor choices. Whenever we make a choice there is some pay-off. We tell ourselves we need this because it relieves stress, or helps us not to deal with reality, or a fear, or ourselves. That may be the first few times. Then we allow ourselves to be seduced... pulled in... and "lose control".

I don't know about statistics but from stories I've heard rarely have I heard about an alchoholic that was completely "cured" after conquering the booze. There is something else behind that mask. Something else going on in their lives that needs attention.
If what lies beneath isn't dealt with the likelihood of them going back to the alchohol (or choosing another vice) is almost guaranteed.

When I was taking my writing course I decided for my fiction project I wanted my character to be addicted to drugs (I felt the need to write about something very dramatic back then :). Having never experimented with drugs in my life I had to do a lot of research in order to write a believable story. I wish I could remember some of the books I read. A lot of differing theories out there as you know.

I appreciate what Schaler is saying about choice. I believe this too. But I think to begin to change one must completely abstain. I think we as human beings are weak to the seduction... and if you want to find your power you wouldn't test your weaknesses at the beginning of change or while you're breaking your old patterns. Whether some ppl can once again dip their toes in the pools of their once 'addiction' I don't know. I suppose it's possible.