Addiction a Choice, Says Psychologist
Those of us who keep up with the field of adolescent substance abuse, as well as substance abuse treatment in general, are well-versed in the idea that addiction is a chronic, relapsing disease, and that it is not a choice.
Psychologist Gene M. Heyman says in a new book from Harvard University Press that addiction is not a disease, and it's not involuntary. Instead, he says, it's a choice. He doesn't mean that individuals choose addiction, but that every time they use, they're making a cost-benefit analysis -- i.e., a choice. And furthermore, he argues, most addicts quit without treatment once the costs outweigh the benefits.
This is certainly a provocative thesis. I'm curious what someone like Thomas McLellan, Ph.D., would say. McLellan was lead author on the seminal article in the Journal of the American Medical Association (JAMA) that made the case that addiction is a chronic disease.
McLellan might also be intrigued by a review of Heyman's book in New Scientist, which implies that the disease-model is the result of a cynical attempt by doctors to get alcoholics to come to them with their problems. However, now that Mr. McLellan is deputy director at the Office of National Drug Control Policy (ONDCP), he's probably other things on his mind at the moment.
So what do you think? I'd be particularly interested in how you think Heyman's argument might apply to research on adolescent substance abuse. Leave a comment.