| | MSK,
It was an interesting article. I think you clarified your position very well, and you were able to communicate what an addict goes through pretty well.
I do have a number of large disagreements with your analysis, however.
First, let's talk about disease. You started off with a definition. “An abnormal condition of an organism or part, especially as a consequence of infection, inherent weakness, or environmental stress, that impairs normal physiological functioning.”
Now how does it hold up as a definition? What kind of things get included? I jokingly mentioned to Lindsay that with that definition, homosexuality could be considered a disease. I can think of a phew phellows that would phind this phunny (they of course think it's just immoral).
The major problem I see is that evasion could count as a disease. I'm not joking here, or trying to twist your words. Your descriptions of addiction actually sound a lot like evasion.
Think about James Taggart. Certainly he's got an overwhelming emotional stress that hits him like a truck, preventing him from thinking clearly about anything. There's an absolute terror involved, probably part of his self-identity as you mentioned, there's the atrophy of long term thinking, and there's a quick fix. Reading your description of addiction is like reading those parts of Atlas Shrugged all over again.
One of the biggest sources of irrationality that I've seen is a short-term focus, almost hedonistic. In my "Path of Most Resistance" article, I talked about "Bob" avoiding breaking up because the short term pain is immediate, and it's easier to keep going. Most irrationality is that way. It's a selective focus, ignoring the larger consequences.
So when you talk about addictions in terms of short term incentives, and long term costs, the problem is that most irrationality is like that. And like my article discusses, the more you participate in the irrationality, the greater the long term consequences and the more stressful it would be to start acting rationally.
So is your definition inadequate? Well, it certainly seems to be. It lumps in conventionally viewed addictions in with all manners of evasion. So then, what is the point of the definition?
One possible point would be to show that since addiction fits into the definition of disease, it must have the characteristics of that concept. Typically, disease is seen as something outside of your control, not something you can be morally blamed for. The reason people normally associate addiction with disease is to prove you are not morally culpable for your continued use/actions by asserting you have no choice in the matter. Or, if you prefer, you're mostly not responsible for your actions. You can blame the addiction, and not yourself.
This fails completely with your definition/description of addiction, since evasion in general would count. Evasion isn't an impairment of volition. It's a use of it.
This brings us to the fundamental problem with this essay, as far as I can see it. You've done nothing to really distinguish your description of addiction with simple evasion and bad choices. Those who argue addiction is a behavior, not a disease, don't argue that you make the choices to act that way without influence. There's recognition that there may be a physical component, like making you very sick when you don't take the drug, and feel very good when you do. They recognize that "addicts" may see it as part of their identity. They recognize that it may be easier to stop acting that way with support from others. And on and on. You've clarified what someone goes through when they're addicted, but it doesn't contradict the arguments of the "addiction is a behavior/choice" group.
Well, there is one part where your description would disagree with theirs. You discuss volition as being impaired by the addiction. That is the significant argument you are making for your view of addiction as a disease. I for one don't think you've made a case for that.
Let's start off with some simple thoughts. Whenever we make choices, we have emotions and influences. The stronger those influences, the tougher it is to go against them. But does that mean volition is being impaired? No, it doesn't. I can't imagine what kind of platonic view of volition would be necessary to make this kind of claim. It would amount to saying that volition can only really exist when there's no choices, or the choices are equal (in other words, you can only choose when there's no real choice to make).
Volition is the ability to choose, and suggesting volition is prevented means that either no choices are being made, or that the "addiction" is making the choices for you. Sounds colorful and metaphorical, but it isn't accurate. Your addiction doesn't drive you to a liquor store. Your addiction doesn't pull money from your wallet and give it to the clerk. You do.
So again, we would need to look at what you're trying to say. Are you saying that addicts have really tough choices ahead of them? I don't know if anyone disagrees there. But the way you phrase it means that one's ability to choose actually ceases.
And this brings us to the heart of the entire debate. What's the real issue? I don't know anyone who's saying that drugs can't create a physical reaction, or adverse reactions when you quit. I don't know anyone who claims that quitting a physically addictive drug is simple and painless. I don't know anyone who disagrees that certain drugs can cloud your judgment temporarily, or do serious brain damage over time. These certainly aren't the matters being debated.
The disagreements involve whether or not the addict still has control. The "addiction is a disease" crowd suggest that the addict is not making choices, is not morally culpable for his actions, and can't possibly quit on his own. They suggest any strong influence, like physical withdrawal pains, make it impossible for the addict to do anything about it on his own, and he needs to be treated like a victim.
I think the primary motivation is to avoid making the addict look like a bad person. If he thinks he himself is bad, he might just stay in his short-sighted world. If people tell him they don't blame him, and the drugs did it to him, he won't have shame pulling him down. That's the theory.
As an aside apply that view to evasion in general. If someone is horribly irrational, does it pay to tell them that they're irrational? Sure, they may not want to listen to you because it makes them look bad, but can they ever change if they don't identify and address the primary cause? But back to addiction.
So the big argument is that the addict is helpless. Maybe, just maybe, one could argue that it's a useful strategy, even if you don't believe it. Suggest the helplessness as a way to excuse the addict, letting him know that if he does kick the habit, he'll be forgiven. Maybe you can think of it as a white lie...for his own good.
The dangerous part is that the addict believes it. If he considers himself helpless, he's always got a convenient excuse to go back to it. Certainly he'll feel he can't overcome it himself, and becomes a sucker for anyone willing to sell him a "cure" for his "disease" (there are plenty of people making a buck, preying on their insecurities). If he does manage to kick the habit, he doesn't gain pride in his accomplishment since it wasn't his (except the weird altruistic pride that comes from being a victim). He'll have to live fear of the dreaded substance. His own mind will be attacking his efficacy, shouting that he's weaker than the addiction. Run away and hide from it. You have to substitute one form of evasion for another.
What's worse is that once the door is opened for drugs that have physically addictive properties (i.e., you have physical withdrawal pains), then it gets pushed open a little more for things like addiction to sex or gambling. And then it's eating chocolate, stealing, being rude, etc. Whatever you want to excuse, you've got a ready excuse. You only have to show that you're the slightest bit motivated to prove that you're helpless, and of course, free from moral judgment.
This debate is fundamentally a philosophical debate on the nature of free will vs. determinism. Those who uphold determinism (that choice is an illusion, and we're controlled by our genes, environment, etc.) have become mainstream in discussions of addiction. Just as people recently said crime was a disease, and the criminals were victims of society. Or "TV made me do it". It's all the same argument...free will is an illusion because we don't live in a world free of influences and motivations. The rest is just nitpicking over degrees.
I can't hope to respond to every one of your points in the article, although I think I've hit the most important ones. If you think I missed something crucial, feel free to let me know. I had some other minor disagreements as well, but nothing at this level.
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