Drug Policy

Is Addiction a Chronic Brain Disease?

Drug addiction is not caused by the effects of drugs alone.


After decades of growing acceptance, the concept that addiction is a medical disease (more exactly, a chronic brain disease) is suddenly being linked to the drug war—and being challenged. Most notably, Johann Hari has taken that position in his book, Chasing The Scream: The First and Last Days of the War on Drugs, synopsized in a recent viral piece in The Huffington Post, titled "The Likely Cause of Addiction Has Been Discovered, and It Is Not What You Think."

Hari—a popular journalist—tells a great story, or series of stories. One primary narrative concerns the experimental work Bruce Alexander conducted in the early 1980s with rats and morphine at Simon Fraser University in Vancouver. Titled "Rat Park," Alexander's series of studies found that not only were rats only inclined to become habituated to the drug solution alone in a cage, but when given a choice of the tinctured drug or inert water in a capacious, rich environment in the company of other rats, even previously addicted animals prefer water.

The Rat Park results showed that addiction isn't caused by the effects of drugs alone, even with simple mammals whose additions were thought to prove that addiction is a biological construct. How much more complex, then, is human addiction? Such addiction involves people, their situations, and drugs and other powerful experiences (like gambling and sex). When an individual finds such an experience sufficiently rewarding in that place in their lives, and alternative sources of satisfaction aren't available to them, they may become addicted—although human choice always remains an essential factor in the equation.

That people are not trapped by their addictions was shown by the Vietnam War, where more than 90 percent of addicted soldiers quit their heroin addictions stateside. The natural remission of addiction in ordinary circumstances has been affirmed through surveys of people's lifetimes of drug and alcohol use. Gene Heyman, of Boston College, reanalyzed data from three major national surveys of drug use and mental health in 2013.  His results showed that people quit at every stage of their addictions—thus refuting the progressive and chronic relapsing addiction meme popularly portrayed.

That soldiers withdrawn from the danger, discomfort, and isolation inherent in Vietnam should be able to desist their drug use would not seem to be newsworthy; nor that people quit addictions all the time (think about smokers). And, yet, as I noted in 1975 in my book with Archie Brodsky, Love and Addiction, undersecretary of defense for health and environment and medical doctor Richard Wilbur declared that Vietnam disproved everything that he had learned in medical school—which was that people, once addicted, were irrevocably and permanently hooked on narcotics.  
But the view of addiction refuted by Rat Park and Vietnam is alive and well. Indeed, it has grown stronger since Vietnam and Rat Park.

Last year, an authoritative editorial in the world's leading scientific journal, Nature, declared unambiguously that "Drug addiction is a disease," one it traces to the brain's neurochemically mediated reward system. Nature's declaration is all the more impressive since the journal is published in the United Kingdom, and Europeans are less impressed as a rule by the brain disease model, which is much more ardently embraced here in the United States.

But, Nature insists, "Europe should look to the United States and to inspirational figures such as Nora Volkow, head of the US National Institute on Drug Abuse . . .who regularly testifies on the science of addiction to the US Congress to justify the institute's research budget. . . . Given the technical tools now available for looking deep inside the brain, there is realistic hope that such treatments will emerge from research in the coming decades." (Emphasis added.)

It might seem surprising to read that there is only hope of finding tools to address addiction in the brain in the coming decades. In fact, it's not enough to say that no person in the world today is declared addicted on the basis of a brain scan, or that not a single treatment has been developed out of the brain disease meme. The research itself doesn't relate brain activity to behavior—a scan of a cocaine user doesn't tell us that he is addicted, or that he will go out and use cocaine again now, or ever. 

Most particularly, the brain scan tells us nothing about the majority of people who quit, or cut back or struggle to quit then succeed—which is really the single thing we want to know. This process can only be known subjectively, in terms of the person's values, purpose, motivation, and options, as I describe in my 2014 book (written with Ilse Thompson) Recover! Stop Thinking Like an Addict.

The practical implications are inescapable. We can peer all we want into brains, like mad Dr. Frankensteins, and we won't move a quarter inch closer to helping people deal with the range of addictions they confront. We've proven the futility of the brain-in-isolation approach a million times over. We cannot solve addiction magically, by circumventing people's consciousness and lived experience in society. Instead, we need to use these dimensions of human experience to make people happier, to feel that they belong on earth, and to realize that they are able to control their lives.

The 21st Century, rather than ushering in some miracle brain cure for addiction, can only reaffirm this basic truth.

NEXT: Jacob Sullum on the French Right Not to Be Offended

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  1. we need to use these dimensions of human experience to make people … realize that they are able to control their lives.

    This conclusion seems strangely worded for an essay about drugs.

    1. Why? Drugs are one of the most potent ways for people to take control of their own lives.

      1. That’s the point.

        *** rereads essay, more carefully ***

      2. Only good drugs that are approved by political authority and given out by medical authority.

        Drugs that people choose to take on their own are evil.

        Authority is the difference between good drugs and bad drugs.

        Principals trump principles.

        1. Can we talk (Joan Rivers style maybe) about addiction to Government Almighty, PLEASE? New problem arises… Or old problem gets more serious or gets (exaggerated by) more media attention… Immediate reaction = What can Government Almighty do to “help” us (by growing Guv Almighty powers, by passing more laws)? How about, what can Government Almighty do to help us, by getting the HELL out of our stinkin’ way, Government Almighty DAMMIT?!?! Latter question never gets asked, except by us libertarian whack jobs, sad to say…

          PS, good v/s bad drugs are separated by the magical powers of Guv-Almighty-sanction Doctors’ pens on prescription papers, yes indeed…

    2. “This conclusion seems strangely worded”

      Not only is it strangely worded, it seems to assume that everyone is endowed with an equal capacity to defer gratification. I’m sure this is not the case. Some are less able to control their lives than others. I’m not convinced that this is due to some moral failure on their part.

    3. It’s what AA teaches, essentially. With some quasi religious elements thrown in.

      1. PTSD is a chronic brain disease triggered by bad experiences.


    (never mind that my burned grilled cheese bears a passing resemblance to both Jesus and Mohammed if you’re in the mood to be *looking* for those particular cats)

    Seriously though, there’s a lot of money selling people ‘cures’ to their demon-possession. Why get in the way of a good act?

    1. Lots of money in selling people “the perfect program”. A writer quoting a writer quoting a few weak studies. Talk about moderation therapy!

    2. Butt sex addiction looks the same as drug addiction on a brain scan?

      1. I have both so you can’t really scientifically tell one from the other.

        1. Butt-Drug Addiction?

          (*I actually went looking for some reference to how some people do Ecstasy – ‘crushing it up, wrapping in something, sticking up their ass’ – but that first link was much more awesome)

          1. I meant watching anal-porn on adderall, but your idea intrigues me…

            1. You’d never shut up. It’d be watching anal porn in PeeWee’s Playhouse, while MST3000ing the porn.

              “Hey, do I sound loud to you? I’m sure they faked that. Whoo, back up, cameraman… the camera’s getting smudged. I SAID SMUDGE AHAHAHAHAHA.”

  3. To these people, human choice (or the belief in it) is a chronic brain disease that they are determined to eradicate.

    1. Come on. Only the wrong ones. No one’s saying the right choices are a problem.

      1. When Banzan was walking through a market he overheard a conversation between a butcher and his customer.

        “Give me the best piece of meat you have,” said the customer.

        “Everything in my shop is the best,” replied the butcher. “You cannot find here any piece of meat that is not the best.”

        At these words Banzan became enlightened.

  4. You think Lois `s posting is nice… on Sunday I bought Jaguar E-type since getting a cheque for $9279 this last 5 weeks and more than ten thousand last month . it’s definitely the nicest-job Ive ever had . I began this seven months/ago and straight away was bringing home minimum $79, per-hr .
    why not try here ????????????? http://www.jobsfish.com

    1. since getting a cheque for $9279 this last 5 weeks and more than ten thousand last month

      Is that so?

  5. Personal responsibility?



    Drugs cause addiction! They’re bad! Bad, bad, bad! Just as guns cause murders! Bad, bad, bad!

    Besides, if people are able to shake addiction on their own, how do you justify the war on drug users and all the mandatory treatment? You can’t!


    1. Besides, if people are able to shake addiction on their own, how do you justify the war on drug users and all the mandatory treatment? You can’t!

      *** clears throat ***

      Perhaps *some* people *may* be able to shake addiction on their own, but how many more can not? Anyway, if the WoD helps save the life of just one child, ….

  6. No pathology, no disease. And no, we should not create diseases “by social construct.”

    1. “Oh, alright, then. We’ll create, say, ‘unwellnesses’.”

    2. How do you classify “schizophrenia”?

      1. As a schizotypy?

        1. No, i was actually serious.

          I actually believe there’s a real condition called “schizophrenia” which has very specific requirements…. and that the people who popularlized “spectrum disorder” views on it are entirely mostly wrong.

          IOW, I don’t think that uses that name is actually a ‘continuum’ – i think its an ‘on/off’ switch, and you either have it, or you don’t.

          Admittedly, some people’s demonstrated symptoms are much worse than others, but i suspect that’s just because they deal better with them.

          *note = i have a family member who was graded “A++, case-study, textbook, ‘lets cut his brain open for science’-full-blown-schizophrenic’

          the fact that ‘real schizos’ demonstrate such a consistent set of symptoms at almost exactly the same age (early post-adolescent), and that it kicks in so fast and almost always involves a “break” episode, tends to support the idea that there’s actually something biological/chemical going on. Its just that no one has actually figured out exactly what it is.

          If you’ve ever seen the process up close, its pretty fucking unbelievable how fast they can go from ‘normal’ to ‘accusing everyone of being involved in a mind-control conspiracy’.

          1. Well, if there is something genetic or so causing this stuff we’ll probably find out about it in due time. In the mean time these people get medicated for what purpose? As long as they’re not breaking the law, let live and don’t force anything upon them.

            1. “. In the mean time these people get medicated for what purpose? As long as they’re not breaking the law, let live and don’t force anything upon them”

              Well, 2 things here =

              1) if you really ask “for what purpose”, you’ve never spent any time up-close with people who are completely in the bag schizo.

              while many schizo patients might strongly dispute “there’s anything wrong with them

              ….(*rather, its everyone else who’s been kidnapped by aliens and replaced with robot machines being controlled by Satellites)…

              …none of them describe the ‘status quo’ of their state as anything resembling ‘happy’ or ‘pleasant’.

              The fact that there’s an almost universal belief that they are being ‘persecuted’ or ‘punished’ by everyone else (*the voices tell them so) is one sign that they’re not 100% happy about their condition. the fact that 10% of people diagnosed *kill themselves* within a few years is another sign that treatment might be justified for many.

              2) nothing is in fact ‘forced’; some patients are declared ‘ward of the state’ if family members go to great lengths to pursue that designation (*many do because treatment is so expensive that there’s few other options). But being diagnosed is not by itself an instant-removal of one’s rights.

              I appreciate the philosophical basis for some people’s attitudes towards mental illness; however, i’ve never been satisfied with the blithe way people handwave Schizophrenia away as so much ‘made-up-disease’.

            2. Also =

              “if there is something genetic or so causing this stuff we’ll probably find out about it in due time”

              Not if you insist that its “not a disease” in the first place?

              a) there’s a pathology that we don’t know yet, or
              b) you argue that ‘if there’s no known pathology, its not a disease’

              or can you swap positions at convenience?

              1. I just remain sceptical. It might be that (some) behavior associated with schizophrenia is induced by some physical process, but until we a find a real pathology I would not classify it as a disease. There is ton of human behavior that people might feel quirky or unacceptable, and the way to deal with that is highly dependable on the people surrounding the misbehaving individual.

                1. Your skepticism isn’t particularly scientific – we don’t know what causes Alzheimers either. Do you also think that’s just ‘misbehavior’?

                  i find this attitude towards mental illness is a peculiar quirk of people who seem to think their political philosophy should naturally extend into medical fields… because, uh, well it ‘feels nice’? I think its pretty idiotic, particularly when coming from some people who don’t actually have much experience with ‘actually ill people’ (*whether you’re one of them or not, i don’t know, but it seems a popular POV to have when the ill people are conveniently locked away and not bothering *them*)

                  1. Some of it might be, on the other hand with Alzheimer’s there is at least some indication of a physical process causing it: protein build-up in the brain.

                    I don’t want to see people locked up. The popular POV of locking people up seems to be more prevalent among progressives: because they know what is best for you, even if they don’t know you.

                    1. There is a ton of scientific evidence about schizophrenia, from PET scans to genetic mapping. It is truly a disease, and the symptoms and disease progression, as well as the well-documented risk of suicide in schizophrenia patients (especially within the first five years of diagnosis) were very well explained by Gilmore.

                      I work in an ER where we see many, many people with schizophrenia. These patients are not “locked up” as often as you might think, and they have a lot of rights (different depending on which state you are in, but most commonly the longest you can be held without access to a court hearing and legal representation is rarely longer than about three days at the most).

                      The medications used for schizophrenia currently are much more benign and targeted to symptoms than those used 20 years ago. The vast majority of patients take them voluntarily. In fact, in most jurisdictions medications can only be given involuntarily in case of imminent danger to self or others, or only after a very lengthy legal process that is very difficult to complete (and is quite rare).

                      Even when schizophrenia patients need to be hospitalized, they are usually discharged within 3-7 days.

                      If you saw the anguish patients with schizophrenia have when their symptoms are full — and then saw how happy and thankful they are when the symptoms abate (which I see every day) — you would not be against medications for this terrible illness, a disease you wouldn’t wish on your worst enemy.

                    2. “a disease you wouldn’t wish on your worst enemy.”

                      It feels good to hear someone else say exactly what i’ve always said about it.

                      It really is. When you see someone otherwise normal, healthy, productive… a completely functioning human being, hit with this “random bolt of lightning” which turns their world into broken puzzle pieces which never fit together again…. its a living nightmare. Every now and then you get a glimpse into what’s going on inside their skulls and it horrifies you.

                      re = medications

                      Thankfully, my own family member was “lucky” enough (after a decade or so of experimentation) to have found the chemical solution that undid some of the worst of it. The downside is that it kills white blood cells, and about once a year there’s a major scare when he gets an infection and suddenly is in the ER on life support.

                      FWIW, that particular stuff is actually avoided like the plague by most doctors because of those life-threatening ‘side-effects’; its basically the ‘medication of last resort’. But it really was a ‘turning night into day’ experience seeing it finally start to work

                    3. I’m glad that clozapine is working well for your family member. It is very effective and many physicians knowledgeable in psychopharmacologic treatment feel it is underutilized.

                      The risk of agranulocytosis is a very serious one, though, as it can make you unable to fight off an infection. Thus clozapine is only indicated as an antipsychotic after more conventional treatments have failed. (It’s not unusual for meds to be in this category; the amazing chemotherapy drug I’m on for my bone-marrow cancer, which has had me in remission for two years, was not allowed to be tried by me until I’d failed two other chemotherapies). So I wouldn’t exactly call it a ‘medication of last resort’ — it’s more of a ‘let’s find out if a less dangerous, less cumbersome treatment might work before we go to this’ situation.

                      There has been some relaxation of the regular blood checks and authorization by the clozapine registry in the past few years – when it was re-approved about 25 years ago (it was actually completely prohibited for a long stretch) there was a time that a patient needed a weekly complete blood count (CBC) and a new prescription from the doctor every single week. Given that a major problem in schizophrenia can be compliance with medications, imagine the difficulty in arranging for a blood test, registry authorization and new prescription every week, on top of having to remember what can be very unusual dosing amounts. Fortunately it may even be less onerous in the near future.

                    4. “there is at least some indication of a physical process causing it: protein build-up in the brain.”

                      No = there’s a connection between the protein build up and the symptoms – but there’s no understanding of the process by which those protein buildups occur, or why.

                      schizophrenia is no different = they understand some of the physical processes by which dis-associative/congnative distortions happen… they just don’t know what’s triggering those processes and making them happen in the first place.

                      My point is that you’re singling out mental health for so-called “insufficient understanding of pathology” where there’s tons of things we accept as ‘diseases’ that have as much or even less actual understanding of the biological process that leads to them.

                      You seem to now be walking back the statement about “its not a disease” to “i have objections to how its currently treated”. I’m not sure you understand much about that part either = locking people up hasn’t been in vogue or even recommended since the late 70s, when Carter/Regan decommissioned most of the federal mental health system.

                    5. I don’t care how schizophrenia is treated as long as it doesn’t violate some elementary rule of law. That’s my point all along. If some drug works, fine use it. I just don’t see any point in call it a disease if only someone’s behavior is at odds with societal norms (whatever those might be).

                    6. No one in this day and age (at least not in any relatively free and advanced country) would be given a diagnosis of schizophrenia merely because their “behavior is at odds with societal norms.” There is a whole world of eccentricity and unusual beliefs out there (just listen to “Coast to Coast” on the radio sometime for some examples) which are light years away from schizophrenia.

                      And schizophrenia is far more than unusual beliefs or behaviors. The hallucinations, paranoia and delusions are just one part of the illness (and indeed, these “positive symptoms” are the easiest of the symptoms to treat successfully). There’s also commonly disorganization, withdrawal, loss of interest in pleasurable activities, and failure to care for oneself (“negative symptoms”) that don’t respond nearly as well to medications.

                      And as stated before, no one is getting hospitalized involuntarily (at least not for very long) for unusual or idiosyncratic thoughts. In the USA, you are pretty much free to believe or say whatever you want (that is not imminently threatening) as an adult and you won’t be hospitalized (or if you are, the courts will get you out very quickly). We are asked to assess people with serious mental illness daily and must discharge them, even if against medical advice and over the wishes of family, if they do not pose a danger to themselves or others, or have progressed so far that they are completely unable to do basic self-care.

                    7. As passionate and well-intentioned as your argument it is, Im afraid I have to agree with the other fellow that you have only doubled down on describing additional “symptoms” which are in fact things thay are socially considered to be icky.

                      Regardless of the typing of the schizophrenia, there have been two hallmark symptoms for a loooong time: hallucinations and delusions. Jerry is right to be concerned about a “disease” for which the only diagnostic criteria is that a “sick” person has a differing subjective experience amd set of beliefs about the world than a healthy person.
                      The capacity for abuse of such diagnostic criteria is obvious, and the abuse has been widespread in the US and abroad.
                      That is not to say that schizophrenia is a good or pleasant experience for the schizophrenic.
                      However, comparing schizophrenia to neurogenerative disorders like Alzheimers is not germane. While our understanding of such disorders is slight, physical diagnostic criteria exist for many such disorders that do not, and frankly will never, exist in a similar manner for schizophrenia. Theres also that whole bit that neurogenative illness actually kills people; not due to suicide but literally kills people.

                    8. *Sigh* Jay_Dubya, please point out the physical diagnostic criteria for Alzheimers, or vascular dementia, or alcohol dementia. There are none. They are diagnosed by history, and the same type of mental status evaluation that we use for schizophrenia or bipolar mania.

                      I’m not quite clear why anyone would want to pretend that schizophrenia or mania are not ‘real’ diseases, but are some construct to oppress those with a different point of view. I’d love for you to spend just one day with me in the ER and see what you thought about the poor suffering people you’d see.

                      Those of us who actually care about, and care for, these unfortunate individuals, by the way, never refer to them as “schizophrenics” any more than we’d call someone with heart disease a “cardiac”. They are people just like you and me, who’ve developed one of the most devastating illnesses known to man. And, they have a life expectancy on average about 20 years less than the rest of us. Do you suppose that’s because they are just people with a different point of view?

                      Also, why is it that people with schizophrenia suddenly ‘break’ and develop profound symptoms, most commonly between ages 18-21? If this was just a different person, why wouldn’t they have been that way long before that?

                      Also, your scientific ‘knowledge’ on this is way off, so you’d best quit now. Hallucinations and delusions are not the two ‘hallmarks’ of this disease, in fact, in the classic definition, those are only 1 of the 5 main symptoms.

                    9. Theres also that whole bit that neurogenative illness actually kills people

                      I think you’re trying to say “neurodegenerative” illness, I would think something ‘neurogenative” would actually grow neurons.

                      Neurology and Psychiatry are actually very closely related, and continue to become even more so. Did you know that Board Certification for each one of these medical specialties is by the same organization — The American Board of Psychiatry and Neurology?

                      And I am still laughing about your thinking I was ‘doubling down’ on ‘icky symptoms’ when everything I wrote was cardinal diagnostic criteria for schizophrenia long before there was a DSM.

                      Your understanding of severe psychiatric illness is extremely limited, I wouldn’t make any more proclamations if I were you. You are embarrassing yourself while insulting people with schizophrenia. I don’t care how much you want to embarrass yourself, but please try to be a bit more thoughtful of those with the illness.

                    10. ” I just don’t see any point in call it a disease if only someone’s behavior is at odds with societal norms”

                      You mean like refusing to ever reconsider their opinion, no matter how inconsistent with facts it is?

                  2. +1
                    well said

          2. I agree that schizophrenia a real condition which has a definite root cause, and likely causes a cascade of symptoms.
            Its seems likely that the available meds are only partly effective for many patients who then use pot and nicotine for self medication.
            I’ve seen similar results with cases of depression which is often treated with variants of Prozac even when the cause of the depression is painfully obvious and the meds are ineffective.

            It’s been my experience that nothing drives demand for a substance more than its prohibition.
            Lesson one of bible is that people will throw away paradise for a two bit apple if you forbid them from eating the apple.

          3. Disorganized schizophrenia has a fairly consistent relationship with physical abnormalities in the structures of the brain (enlarged ventricles, etc). More organized cases diagnosed solely around dekusions and hallucinations tend to be med-splained by whatever neurotransmitter magical fantasy is in fashion at the time of your textbooks publication.

            1. You really want to go down this road? Tell me what the size of ventricles does from a pathophysiologic standpoint to cause just ‘disorganized’ schizophrenia, but apparently is not involved in the ‘other types’?

              Which ‘neurotransmitter magical fantasy’ are you thinking of? 5-HT receptors for serotonin? And which of the 5-HT? 5-HT 1a, 1b, 2a, 2b, 3 or others? How about the relative binding affinities for each receptor?

              Perhaps dopaminergic neurotransmitters are more your style? What exactly does a blockade result in? How about partial agonists? No fair in googling.

              You better be careful what you say, because those neurodegenative diseases you were so eager to say were ‘real’ compared to schizophrenia have a lot to do with neurotransmitters. What exactly do you think Parkinson Disease is?

              I’ll just wait here so you can tell me exactly which brain functions are ‘science’ and which are ‘social constructs’.

    1. Quick! More cowbell

  7. I’m shitting blood, I have pancreatitis. my liver is so swollen it makes me look pregnant, I live in a dumpster, and I drove the wrong way on a freeway and killed a couple of people. I suppose I could’ve made better choices. That and exercised stronger willpower.

    1. *** slips Jayburd $5 ***

      1. ***Takes the $5 and buys a bottle of Old Spice.***

        1. Excellent choice!

          1. What’s the word? Thunderbird
            How’s it sold? Nice and cold.
            What’s the price? A Dollar twice..

            Two bottles of Thunderbird should be just what the doctor ordered.

    2. You should have chosen alcohol as your drug of choice, which is legal and perfectly acceptable, instead of the devils’s weed, and you would have been fine.

      See, here’s more proof that pot kills.

  8. The Rat Park results showed that addiction isn’t caused by the effects of drugs alone, even with simple mammals whose additions were thought to prove that addiction is a biological construct.

    You mean to tell me that simplistic, reductionist answers to the fundamental questions of existence, behavior, consciousness, intentionality, and suffering are inadequate? Knock me over with a feather!

    That addiction as a “brain disease” ever got off the ground is as much an embarrassment to psychiatry as the idea that homosexuality (or liking Fleetwood Mac, or whatever else was out of fashion among the right-thinking social-scientific elites) is a disorder.

    As much good as reductionism has done for the world in physics and chemistry, you’d have a hard time convincing me that it hasn’t had nearly as great a negative impact in sciences where positivism is the handmaiden to ideology.

  9. None of these facts are going to matter.

    In order to loot money from public health systems, these witch doctors need to be able to say that addiction is a disease.

    That means that addiction will be found to be a disease, no matter what the facts are. Because nothing matters other than witch doctors getting paid. Nothing.

    1. It’s going to be a glorious utopia when the statists finally take complete control and they can stop pretending about things like drug addiction as a disease, global warming, and other fake control mechanisms and just say ‘look, peasants, we are in control, now do what the fuck we say or it’s off to the camps’.

    2. Note that cannabis dependence is a MANDATORY TREATMENT condition.

      Nice to know your thoughts don’t matter…

  10. It’s fairly simple really. But government doesn’t like simple, they need complex so that they can claim to be the only solution, since the peasants cannot understand complex and therefore cannot understand the solution.

    Drugs can be addictive. Some a lot more than others and some people are more prone to addiction than others. It’s all just chemistry and biology.

    Drugs can make you feel euphoria, relax, and help you forget about all the problems of life in an increasingly complex world. So there’s the trigger, it’s why people use drugs. Then they may become addicted. Some drugs are physically addicting as well, which makes them harder to quit. And yes, some people are prone to making poor decisions and some people have a lot more will power than others.

    It’s really just that simple. Drug addiction is not a disease, but addiction can be very difficult to overcome for a lot of people.

    But government wants people helpless and for them to have some incurable disease that must be treated. The entire forced treatment thing is one of the biggest scams ever. You can’t force someone to overcome something, they have to want to do it.

    If someone is addicted and wants help, they can get it. I’ve seen this too many times, you cannot ‘cure’ someone who does not want cured, it’s a lesson in futility. But let’s just waste a few billion of tax payers money on it, why not, else we’d just spend it on something else.

    1. Pretty much what you said.

      I’m fine w/ drug addiction being treated medically (for those who want such help), but pathologizing drug addiction would be a mistake.

    2. Saying that some people are more prone to addiction than others isn’t fair. It puts responsibility on the individual, and that’s not fair. What’s fair is treating everyone like the lowest common denominator, so anyone who uses drugs is treated like the worst addict.

      1. By far the majority of people who wind up in court ordered drug treatment programs aren’t even addicted, they just made a bad decision at some point, like getting caught with a DUI. Then faced with the choice of forced treatment or jail, they take the treatment.

  11. They could have just ask me.

  12. Years around drugs and drug people and people who’ve gone into rehab have shown me in the current model of drug rehabilitation you are always a drug addict. Or a former drug addict. Of those friends who got serious with heroin were probably out of control on it for about 6 months and spent the last decade or two on methadone. Methadone is just as addictive, potentially fatal, stigmatizing, and ritualized…just none of the short bursts of euphoria, sense of well being, or heightened sensitivity or creativity that actually might bring a little happiness.

    That’s why the disease model scares me. It’s not only that it’s demonstrably false it’s that it teaches you to define yourself by drugs more than drug use itself.

    1. The people you describe are the drug equivalent of alcoholics.

      Not everyone who drinks is an alcoholic, and not everyone who uses drugs is an addict.

      I believe that the vast majority of drug users can use them in a responsible manner. In fact I bet that you have successful friends and family members who are closet drug users.

      1. I agree. I’m not sure if my crappy proofreading made it seem otherwise.

        I think it’s even greyer an area, because being out of control for extended periods is often based on a zillion other factors. And really, I have no grand moral qualms with daily drug/alcohol use if you’re responsible for your own bills, families, and you accept the drawbacks and trade offs and don’t make it everyone else’s problem.

        But I’d say even serious alcoholics/drug addicts are boxing themselves in with modern rehab philosophy. In the short term, if you think it’s really a problem and you really need help, by all means do what you have to do. But teaching someone *this is forever* can have seriously negative effects in the long run. I’ve seen multiple cases of people who were just going through a rough patch like everyone does, totally brainwashed into thinking any false move could avalanche into some sort of binge because they’re taught they’re not in control. And then they acted the part the second they had a bad day. What you get is this binge and purge wheel that propels itself.

        I’ve seen teenagers get carted into rehab because they smoke a bunch of pot and play video games (like a huge percentage of teens), basically being groomed for prison by these places (Which pretty much are low security prisons).

        1. Wasn’t there recently a study which showed a surprising number of Americans who drank X drinks per week and so met the psych diagnosis of alcoholism (or alcohol-dependent, can’t recall exactly), did not in fact show signs of true addiction?

          My search-fu is weak today. All I’m finding is links for DrugFreeAmerica and shit. But I’m sure I read something like this, during the past month, maybe?

          1. My wife was warned of drinking 2 beers a night three nights a week.
            This was considered semi-binge drinking behavior for female.

            I think the problem drinking trigger is 1 drink a night for women or 2 drinks a night for men.

            Doctors are told to ask their patients and record the results in your med recs.

        2. I’ve seen teenagers get carted into rehab because they smoke a bunch of pot and play video games (like a huge percentage of teens), basically being groomed for prison by these places (Which pretty much are low security prisons).

          Funny you say that. The people I’ve known who got roped into mandatory treatment seem to do worse than those who did not. I don’t know it’s correlation or causation. Perhaps the poor decision making skills that got them caught also led to them abusing drugs down the line, or if the brainwashing in the institution taught them that once they start using that there’s no point in exercising will power to stop.


          My mother quit drinking with the twelve step program. Hasn’t had a drop in over thirty years. But on the other hand she because a Jesus addict. I guess I’ll take a proselytizing Christian over a violent drunk.

          1. I think much of today’s drug treatment can be dangerous by leaving patient feeling unworthy for falling off the wagon.
            Dr Drew’s celeb rehab program had a mortality rate in excess of 10%, and this was considered a good because addiction is a fatal disease. So is life.

            Robin Williams committed suicide after returning to rehab.
            George Carlin died about a year after rehab.
            Patrick Kennedy lived but came out brain-dead, dedicated prohibition and rehab or jail for all.

            (I think Pat would be less supportive of jail if he’d spent 6 months getting buggered by the guards instead of rehab)

            Rehab is often just a way for the affluent to get better treatment by the courts by owning your problem.

            1. So maybe we could say getting addicted to 12-step programs and constant self-flagellation and sucking butt with therapists, and the Guv-Almighty-subsidized therapeutridtrons, is a worse addiction than getting addicted to booze or drugs or sex. Ya wanna make that motion? I will second it, amen…

  13. As Stanton Peele explains, if you actually look at the brain scan of a cocaine user, it won’t tell you whether or not that person is addicted, nor will it tell you whether or not that person will go out and use cocaine again now, or ever.

    Of course not. How this ever got even marginally accepted, I have no idea.

    Addiction is a behavioral issue, created by various circumstances and stressors in an individual’s life.

    If anything appears “hereditary”, it’s mostly likely because behavioral patterns, through example and experience can be passed down through generations.

  14. Hmm, this one appears to hit all the bullet points:

    Dog shot, explosives used, sniper killing the guy while he’s got his 4-yr-old in his arms. Oh yeah, nothing else happened.

    Thomas, 30, drunk and despondent over the sudden death of a childhood friend, had been holed up for hours with his 4-year-old son after his mother called Fife police following an argument. A police negotiator had finally convinced Thomas to let the child go home with his grandmother for the night ? which is what Thomas and his mother had fought about in the first place.

    Once the child was safe, the negotiator and a SWAT commander figured officers would just let Thomas sleep off a bad night and come back later to deal with a misdemeanor domestic-violence allegation stemming from a tussle over his mother’s cellphone while she was talking to 911, according to police reports.

    That isn’t what happened.

    As a skittish Thomas led the boy onto the front porch to send him down the sidewalk to the child’s waiting grandmother, members of a SWAT assault team used explosives to blow open a back door, forcing their way in and killing the family dog with a burst of gunfire. Thomas ? who was unarmed ? reportedly lunged for his son, and he was fatally shot by a police sniper as he held the boy.


    1. Did the officers go home safely? Because that’s all that matters.

    2. “Annalesa said she slapped Thomas to try to calm him down, and then called police.”

      Not sure I would’ve admitted such blatant idiocy after the fact.

      “A post-shooting review could not confirm the suicide-by-cop information or identify its source.”

      In other words, they made it up.

      “Thomas was hostile toward police, [but] … he never threatened officers or the child.”

      Obviously sufficient to use lethal force against him.

  15. This article is “debunking” a strawman, a super-exaggurated version of the actual biological-addiction argument.

    No one ever said there is no other element to it (addiction), which could include everything from circumstances to the genetics of different people.

    But, addiction DOES exist. And it DOES largely circumvent what we would normally call “free will”. In the long run an addict can learn to work around that (think of alcoholics completely teetoaling, or things like The Kitchen Safe),so it’s not COMPLETELY hopeless, but in the short term there is a diminished free will element.

    And anyway, what’s the point? What does any of this have to do with policy? Even if all the professionals were claiming it’s solely biological and simplistic, that wouldn’t change the fact that outright bans are shitty ways of dealing with drugs societally.

    Which brings up the second point, which ism, again, the author is attacking strawmen. He’s pointed to a FEW people taking the addiction-is- solely- biological argument as a reason to maintain shitty drug policy. Like three freaking authors does not the entire psychological profession make.

    You guys are wandering dangerously close into making yourself look like idiots like John did when he outright denied the existence of addiction.

    1. Though, I suspect the issue here is that the cosmotarians don’t want to admit that the conservatives’ anti-drug stance isn’t as shitty as all of the left/progressive’s stances. At least it has the element where they recognize that addiction somewhat circumvents free will, and a drug dealer selling to an addict is not a simple “free exchange”. The conservative’s may not be able to clarify in his mind exactly that concept, but at least their anti-drug stance, however shitty in policy, comes from a good place.

      Whereas liberals/progressives are just outright fucking fascists, and all their policies come from deeply fucked up places.

      The cosmotarians don’t want to admit that. They want to be able to look “tough” or whatever snidely mocking red-state conservative types.

      1. Conservatives have always lived entire lives addicted to consecrated reality. Any claim otherwise emanates from a person who is playing on the fence and there really are very few things worse than people who play on the fence. They are often soft, weak, uncommitted, and dry.

      2. Conservatives have always lived entire lives addicted to consecrated reality. Any claim otherwise emanates from a person who is playing on the fence and there really are very few things worse than people who play on the fence. They are often soft, weak, uncommitted, and dry.

        1. Well, a double post seems improbable…

        2. uhhhh…. What?

        3. I understood that. I disagree, but I understood that.

          You’re slapping that broad brush around so enthusiastically, Tom Sawyer, you’ve done hit the fence AND the barn, the cat, half the sidewalk and your aunt’s best hat.

          In regards to individuals, though, I think this is remarkably astute.

      3. In other words, so-called “conservatives” are morally superior because Edwin says so. Really, you’ve got nothing on offer here except special pleading.

        Let’s suppose your argument that addiction somehow deprives a man of free will is true. We’ll even set aside the pretty obvious conundrum that, regardless of what a drug does to a person after the fact, the choice to take it the first time is itself an expression of free will.

        What can the state do about it? The state has one tool: violence. It is the institution charged with the violent defense of our liberties. If this was not so, then stateless anarchy would be unarguably superior.

        This fact is not a product of ideology. It does not matter if you are liberal or conservative, communist or laissez-faire. You are not immune to the consequences of deploying this instrument simply because of the nobility of your intentions. Once you have said that violent action is acceptable, you cannot whine that you did not intend for the outcomes to be “shitty”.

        And so, as much as you might wish to apologize for “conservatives” and chastise “cosmotarians”, your words are hollow. You are just playing the “but I never intended!” card, but that can be played by Marxists and National Socialists and ever other well intentioned monstrous ideology.

        That nice face you put in front of your ideology is no less a mask.

  16. I recently went to a talk about this and the way the MD described it seems pretty reasonable. Basically drugs bind to receptor proteins in the brain and elicit responses. Many different genetic isoforms of said proteins exist. Thus, between people you can get dramatically different neurological responses to the same drug. Recent research seems to indicate that those who become easily addicted tend to have isoforms which bind stronger to various drugs and thus elicit stronger responses. Thus these individuals have a much stronger urge for drugs than others, and while they still have more control over said urge than say, the urge to breathe, they have less control than those with isoforms which bind the drugs less tightly. So I think there is a biological element to addiction wherein people may be predisposed to addictive tendencies based on their genetic profile.

    1. Honestly the implications of this kind of research are fascinating. There’s an old adage about men who become slaves to their drink. Think about what that might actually mean for some people.

      A literal slave has free will, but he risks physical violence and retribution of his master if he tries to break free from his shackles, disobey, run, whatever. There is an element of coercion which reasonably precludes many possible actions he might take.

      A slave to drugs or drink still has his conscious mind, and thus theoretically has free will, but his “master” is this case is his own body working against him, creating a neurological urge for more drug. In the same sort of way, such a strong urge might for all practical purposes preclude many possible actions he might take. He might exhibit elements of tunnel vision; his body is telling him to seek out and acquire drugs, even if that might not be objectively his best choice. Does he still have free will in the way we traditionally conceive it? Is that biological urge comparable to a form of coercion?

      I think brain studies down the road will have so much impact for political philosophy and it’s just fascinating.

      1. ++++++++++++++++++++++++++++++++++++++++++++++

      2. im an alcoholic who also happens to have MS and they’re very very different things. no matter how hard it is i could still make the decision to not go to the liquor store, but events just transpired to put me in the hospital for a bit. not really anything i could do about that

        1. Eman|3.8.15 @ 7:22PM|#
          “im an alcoholic who also happens to have MS and they’re very very different things. no matter how hard it is i could still make the decision to not go to the liquor store, but events just transpired to put me in the hospital for a bit. not really anything i could do about that”

          ^ what Eman said.
          Wanna quit smoking? Don’t go to the store and buy ’em; you can’t smoke what you don’t have.
          Wanna quit a disease? Good luck.
          (Gilmore, I make no comment regarding your circumstance at this point)

  17. Addiction is a dysfunctional relationship with a substance or thing, that is perceived by the user to be anxiety and/or stress relieving, where in actuality, it provokes further anxiety and stress through declining health and/or mental fatigue, which then further provokes the user to continue the dysfunctional behavior even more.

    Addiction is a dysfunctional relationship where the user believes that they can peacefully coexist with a behavior that makes them sick.

    Nicotine for example, relieves the anxiety that comes from nicotine withdrawal, therefore creating the false perception that nicotine relieves anxiety.

    1. Addiction is a dysfunctional relationship where the user believes that they can peacefully coexist with a behavior that makes them sick.

      That observation’s not too bad.

  18. I am addicted to specular highlights and things that go crunch in the night and April and December and clean spaces and pussy and air and soft smooshy things and farts and alternative lifestyles and skeptic ruminations and Bertrand Russell and magic mushroooms and high gravity philosophy and stout and my dick shooting sperm and the woods and parties and poetry and art and colors and air and… and….the whole dictionary of life…

    Why not… all those fucking ninnypops worried about all the addicts will be lucky if they live as long as me and my hordes.

  19. I was raised in spiritual altar calls. Where the lord ‘spoke’ through the various always ‘men’ to call unto them the lost and addicted and worldly…

    The altars in Michigan and upper and midwestern Ohio in the 80’s and 90’s swarmed with the ‘lost’ and ‘dysfunctional’. The Lord started to realize that with all this swarming and lost perhaps elites in local government and the religions could combine to create a lost ‘class’. Combine the soup kitchen with the revival and maybe communists/socialists/twitter life coaches who hate drugs and altered states would be interested….

    Hence… the rebirth of big religious and political industries who ‘hate’ the free spirited….

  20. Humans live as intergalactic dust… in spite of long and short lives… humans will die… we love our moms who will die… we love to be lauded and successful in the various restaurants with associates and we all die… we all live as billionaire wanting nothing and we die… and we live as a closet prayer warrior hoping for rapture and we die… and we live as gentrified society for a time and we die… and we live as the ‘in’ society and we die…. we live as the bikers and we die… we live as the druggies and druglords and we die… we live as those invested planning the best futures for greater society and we die… we live a pastors, priests, and popes teaching parishioners about the great future and we die…

    Humans die… legislatures seem to forget this.

  21. I used to hang with fellow I called Mr. McStinkerton… he was a special needs child who could magically identify every fucking big rig from miles away and we never wrong. He was obviously retarded and gifted and I’d ask Mr. McStinkerton aka Billy Wads what was that truck a million blocks a way and Mr. McStinkerton would guess FREIGHTLINER! and he’d be right.. next truck billions of blocks away… KENWORTH!!! and he’d be right…

    Mr. McStinkerton aka Billy Wads was not wrong a single time over his entire lifetime of friendage. Not once. ever. The dude squad made up of fucking morons started to realize this after I called a meeting in Mr. McStinkertons bikini clad poster bedroom one day in 1987. I told the fucking idiots that Billy Was aka your Stinkerton guy is really fucking gifted so let’s try his fucking brain weirdness out…

    He was not wrong once in 10 years… even while Phat Chong got fucking punched in the nose by a horrible fucking dickfuck he stood there and called a semi perfectly right…..

    Billy Wad aka Mr. McStinkerton I apologize for allowing my friends to handcuff you to Laurie’s porch in 1998…..

  22. I used to love a viet cong kid in a really fucking horrible junior high school. His art was brilliant. His mood was inexplicable… I never could grasp the viet cong transplant but my life was changed by one… his art. His asian-ness. I can’t forget it. As a kinda poor sorta gangsta ultra cult religious numskull I looked and Phay and learned and got his back… I wasn’t there when he was attacked in front of the candy shop and his blood filled the sidewalk…. I told Phay I would’ve helped and he understood…

    Phay painted, oddly, american attack choppers…in 1985… I loved Phay… his vietnamese energy was sweet and lonely and gifted… his family barely escaped the Vietnam and his lonely art was etching its way into the mind of a thinking child in the late 80’s…

  23. People do drugs because they’re fun and they stop when they’re not fun anymore. Any claim to the contrary is a lie. But it’s a very practical lie because you can use it to abuse and exploit newcomers at your local 12 Step meeting. Generally they are vulnerable people who may be self medicating with drugs and alcohol and may be suicidal, and that makes them easy targets for the psychos and liars in the rooms. The ultimate goal is to bully into suicide using their insane psychotic religion called the 12 Steps (that they call ‘spirituality’). And if you dare challenge their sacred dogma they are quick with abusive insults to defend the cult and either accuse you of killing ‘still suffering’ alcoholics or else you are ‘crazy’ and a danger to yourself and those around you. This truth will become more obvious as the drug war dies down and fewer people are coerced into ‘treatment’.

  24. Federal courts define addiction as “something you keep doing when you know you shouldn’t,” which could apply to donuts. Addiction is caused by barbiturates and opiates–and nothing else. Articles that bandy the word about while avoiding a definition transmit no information whatsoever. Addiction is a degeneration of a body’s ability to produce natural painkillers. It is atrophy. To blur the distinction between narcotic-induced atrophy, donuts and a million other drugs is not science; it is the mystic’s pipedream of eventually finding the Satan they so desperately need to believe in. –libertariantranslator

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