Addiction Is a Choice

In polite society, one does not question the medical model of addiction. To do so is considered unkind and unscientific.

Jeffrey Schaler shows his irreverence for conventional thinking in his book, Addiciton is a Choice. Schaler gives science, logic, and empirical observations to show that addiction is, in fact, a choice.

The Medical Model Stigmatizes

Schaler shows how the medical model of addiction can be used to stigmatize virtually every human behavior. Too much sex, gambling, smoking, drinking, internet, marijuana, or eating – virtually any behavior can be stigmatized by calling it an addiction. For Schaler, the word “addiction” is used as a weapon to stigmatize certain behaviors.

Hundreds of years ago, people exhibiting certain behaviors and minor skin lesions were ‘diagnosed’ as witches. That didn’t mean and doesn’t mean they were actually witches. Anyone is “diagnosable”.

Habits Can Be Hard to Break

Schaler recognizes that bad habits that can be hard to break. But this hardly means that addiction causes a person to lose his free will. Schaler points to studies that show that so-called “addicts” can routinely modify their behavior if incentivized to do so.

For example, in recent decades it has become unpopular to smoke cigarettes. In light of the popular opinion, millions of nicotine “addicts” have voluntarily stopped smoking, without any help whatsoever. How can this be?

Another example is veterans returning from the Vietnam war. A high percentage of them used heroin on a regular basis in Vietnam. The US government was concerned that these heroin addicts would have trouble transitioning to civilian life. It turns out, most of these heroin “addicts” simply modified their behavior when they returned from war. They voluntarily gave up their addiction.

The Loss of Control Theory is Incorrect

One of the main tenets of the medical model is that addicts lose control over their behaviors. This “loss of control hypothesis”, however, has never been shown in research. Schaler points to the voluminous research on alcohol that shows that alcoholics can moderate their drinking when they choose to.

In one study, alcoholics were rewarded with better living conditions if they moderated their alcohol consumption. This was despite the fact that alcohol was freely available at all times. The authors concluded:

Substantial evidence exists that loss of control following the first drink is not inevitable, even when the alcoholic has the opportunity to drink amounts of alcohol that approximate his customary intake outside the hospital.

People Make Poor Choices in Life

One may wonder, “if an addiction isn’t a bonafide medical disease, why do some people choose to drink to excess, smoke, take drugs, etc”?

In Schalers words:

It’s evidently hard to face the truth that millions of people endowed with free choice can make serious mistakes and screw up their lives 1.

For many of us, it is difficult to accept that some people simply prefer to live life in a way we find destructive. The key to understanding human behavior, says Schaler, is to realize that people have reasons for their choices. A person may take drugs to avoid dealing with a difficult situation, to improve their cognitive abilities (think Ritalin), or to silence their destructive inner self-dialogue.

The Medical Model is Existential Murder

I oppose the use of heroin for the same reason I oppose the use of Prozac: I think relying on these is an existential cop out – a way of avoiding coping with life2.

Schaler takes the existentialist view, that life is a challenge and we must find a way to deal with it. Life problems cannot be dispensed with under the guise of a medical model which views drug addiction as something that simply happens. Addiction is something a person chooses.

The medical model of addiction existentially murders the person. It turns the person into a Zombie, a neuronal soup of chemicals directing one’s life. It sees addiction as a happening, rather than a willful choice.

For the existentialist, the addict chooses drugs rather than choosing the more difficult existential challenge of creating meaning and becoming an authentic person.

tl;dr

The medicalization of addiction destroys the concept of personhood, creating a Zombie incapable of change. Schaler gives science, logic, and empirical observations to show that addiction is, in fact, a choice.

Listen

For more on the choice model of addiction, check out this podcast by Philosophy for Our Times, where psychiatrist Theodore Dalrymple argues for the free will model of addiction.

Leave Your Comments

Now it’s your turn. Do you think addiction is a choice? Leave your comments below.


  1. Addiction Is a Choice, pg. 119, paperback. 
  2. Addiction Is a Choice, pg 129, paperback 

2 thoughts on “Addiction Is a Choice

  1. Obviously it’s not a choice if one is born addicted to a substance, as I was, but having had huge problems with amphetamines and minor issues with opiates and alcohol when I was younger, I feel society has much to answer for. Humans have taken a beautiful enviroment and turned it into a cesspool of trash, corruption and depravity. Societies exist today for the sole purpose of serving the economy, and theres no love in that. I feel my addictions in my younger years were born out of the need to escape a hostile world and reality I had never truly understood, and it helped mask my insecurities, and that was what I found addictive, being able to integrate on the same level as everyone else. But, many of my friends/associates appeared to revel in the fact that they had drug issues, almost like it was a badge of honour, like it exonerated them from responsibilities, and that disturbed me.

    Great post, and sorry for the babble, you make many interesting points in your posts and I look forward to reading more.

    Be well, E

    Liked by 1 person

    1. Thank you for your comments E. I like how you said that your addiction helped you mask your insecurities. I feel that people often only focus on the negative aspects of drugs. They ignore the fact that these substances have been used since the beginning of time to help people cope with life. I don’t think we can blame our addictions on society. Life is difficult and always has been. In some respects life is better than any other time in history. But in other respects, we may face more alienation and loneliness than other times.

      Liked by 1 person

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