Ask 10 Americans what addiction is and what causes it and you might get at least 10 answers. Some will insist addiction is a failure of morality or a spiritual weakness, a sin and a crime by people who won’t take responsibility for their behavior. If addicts want to self-destruct, let them. It’s their fault; they choose to abuse.
For the teetotaler and politicians, it’s a self-control problem; for sociologists, poverty; for educators, ignorance. Ask some psychiatrists or psychologists and you’re told that personality traits, temperament, and “character” are at the root of addictive “personalities.” Social-learning and cognitive-behavior theorists will tell you it’s a case of conditioned response and intended or unintended reinforcement of inappropriate behaviors. The biologically oriented will say it’s all in the genes and heredity; anthropologists that it’s culturally determined. And Dan Quayle will blame it on the breakdown of family values.
The most popular “theory,” however, is that addictive behaviors are diseases. In this view, an addict, like a cancer patient or a diabetic, either has it or does not have it. Popularized by Alcoholics Anonymous, the disease theory holds that addictions are irreversible, constitutional, and altogether abnormal and that the only appropriate treatment is total avoidance of the alcohol or other substance, lifelong abstinence, and constant vigilance.
Absolving The Diseased
The problem with all of these theories and models is that they lead to control measures doomed to failure by mixing up the process of addiction with its impact. Worse, from the scientific standpoint, they don’t hold up to the tests of observation, time, and consistent utility. They don’t explain much and they don’t account for a lot. For example:
- Not all drugs of abuse create dependence. LSD and other hallucinogens, caffeine, and tranquilizers are examples. Rats, for example, which can be easily addicted to heroin and cocaine just like humans, “just can’t appreciate a psychedelic experience,” notes Childers. “The same is true of marijuana and caffeine; it’s hard to get animals to take them. People take these drugs for different reasons, not to feel pleasure.”At the same time, rats and other animals can become physically dependent on alcohol, but won’t seek out alcohol even when they are in convulsions of withdrawal. Says Jack Henningfield, Ph.D., an addiction researcher at the National Institute of Drug Abuse in Baltimore, “we can get rats physically dependent on alcohol and even get them to go through DTs by withdrawing them. But we can’t get them to crave alcohol naturally.” Apparently, they have to learn, to be taught to want it. “Only when we give them the rat equivalent of smoke-filled rooms, soft jazz, and other rewards will they seek out alcohol.”