Addiction is a disorder of Choice

Addiction is a disorder of Choice

The same drugs have different effects on people that depend on cultural context

Across time, culture and place, the reactions to the same drug are markedly different. If drug abuse were a biological reflex, this would not be the case. Of course, some of the “cultural contexts” listed by Heyman (smoking versus injecting heroin, for example) can dramatically influence the metabolism of the drug, which is a biological context that can influence receptor binding, etc.

The more interesting piece of this argument was that studying only those in treatment for drug addiction biases many studies of drug addicts. These people have higher co-morbidity with other mental illnesses and are more likely to relapse. For most people, a drug habit runs a natural course, beginning in a person’s late teens to early twenties and ending by age 30. Heyman profiles the majority population of invisible “successful addicts” who start and end drug-taking behavior as free choices.

The right motivations get just about anyone to quit

When people are given enough motivation, nearly all can quit taking drugs. 85% of drug addicted doctors and airline pilots faced with the possibility of passing all future random drug tests or losing their jobs will quit taking drugs. “Change your incentives, change your behavior, change your brain”.

The genetic basis for addiction is not compelling.

Heyman uses religiosity and twin studies to prove this point. Religion is a learned and voluntary behavior, and twins tend to have similar degrees of religiosity. However, the religiosity data only show a 0.3-0.4 correlation between even identical twins, so I agree with Heyman that the argument is a little weak.

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