CTV News | Addiction is voluntary, author contends in new book

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Addiction is voluntary, author contends in new book

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Canada AM: Gene M. Heyman, author

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CTV.ca News Staff

Date: Wed. Jun. 17 2009 10:08 AM ET

The idea that addiction is a disease and that addicts do not have control over their disease, has been a pillar of belief of the psychology community for decades. Yet Gene Heyman, a lecturer in psychology at Harvard Medical School, has set off a firestorm by questioning this time-honoured assumption in his new book, Addiction: A Disorder of Choice.

Heyman argues that addiction is very much governed by personal choice and is not an involuntary illness. He says the long-held belief that addicts cannot control their addiction may be well-meaning but is ultimately wrong.

The proof, Heyman says, lies in the number of people who are able to beat their addiction and the reasons they do.

"When people say that addiction is a disease they mean that drug users have become involuntary, that they simply can't say no," Heyman told Canada AM Wednesday.

"I asked the question: What factors influence drug use to halt in addicts? Things like values and laws, being worried about being arrested, financial matters and respect from family -- these are the things that influence decisions.

"And so I looked to see if those factors influenced drug use in addicts. And it turns out when you look at the literature broadly, that's exactly what happens. So I take a different conceptual framework."

The problem with the field of addiction is that people have restricted their analysis, says Heyman. They contend when you consider the terrible toll that addiction takes on the lives of addicts, "no one would choose to be an addict."

Heyman agrees that yes, addicts are self-destructive, but this does not mean they will not change their behaviour once the costs of continuing their addiction become too great.

"I began looking at biographies, at the epidemiological literature, at studies where anthropologists lived with addicts, and what we see again and again is the pattern of behaviour where the factors such as the desire for the respect of children or parents or worries about finances lead addicts to stop using drugs. So that's the real test," he explains.

He says when addiction experts tell addicts their addiction disease is "involuntary," it doesn't help them. If anything, it may give them a crutch to enable them to continue.

"What the data show is that most addicts actually quit. And this is encouraging. To be told that you have a chronic relapsing disease that has no cure cannot be helpful -- but especially if it's not the truth," says Heyman.

"But the truth, when we look at the data, is that most addicts quit, and they can be encouraged to quit much sooner. I think what is required to help someone quit is the knowledge that it is possible and that there's a better life once you do quit.

"Smoking is an addiction. And since the 1964 publishing of the U.S. Surgeon General's report, about 80 per cent of smokers have quit, and they typically quit on their own. So we know that people can quit an addiction."

Comments are now closed for this story

Rene
said
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No one and nothing can harm you unless you choose to allow it.


R/H Ontario
said
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After being a smoker for fifty years, I QUIT. Now was I an addict or not? Quitting was NOT easy but now that I have been smoke free for almost eight years, life is way better. Food actually has a taste, there is more air space in my lungs and a whole host of other benefits. Only drawback now is that I cannot stand to be around smokers. They STINK, just as I used to and did not know it. Yuk!


ADM Saskatchewan
said
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Sure no chooses to become an addict but to say it is not an involuntary illness.... The article did not say what statistics were used for the author to write this book. Lots of people quit their addictions on their own but the road to this is long and very hard. Just like recovering from a illness.


A former addict
said
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Finally, A study worth while.

Its time for individual responsibility and accountability for personal choices.


Laura Langstaff
said
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Recovery is a choice, disease is not.


Debb
said
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Tell it to the crack babies and the babies born with fetal alcohol syndrome.

You can be born addicted.


addiction and mental health worker
said
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This is a terrible example just further promoting the stigma of treating this disease. It was not too long ago we believed psychosis, schizophrenia and other mental illnesses were just a figment of the imagination....and here we are again. What makes it worse is that the Harvard name is attached to this study- they should be ashamed. I will just hope that the readers of this article and the study have the brains to recognize when they encounter a cheap ploy for fifteen minutes of fame, which is clearly all this is. Shame shame.


graham from TO.
said
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addiction is a problem.. nobody doubts this. i've long maintained though that if we're going to use the word 'disease', we need to come up with a new word for things like Cancer and Diabetes - where there is no element of choice or willpower in a cure - because to compare them to addiction isn't reasonable..


Adam from Vancouver
said
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This guy is bang on. It's time society stops giving people excuses for their behavior and people started taking personal responsibility again.

At the end of the day the only person who can change one's life is himself.

People must be held to account for their actions and telling them "It's okay, it's not your fault" isn't doing anyone any favors at all.


Karen
said
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I agree, The only question addicts need to ask themselves is "do you want to live or do you want to die". Addicts are selfish people, to them it is all about 'me', they were selfish before they were addicts and that does not change when they become an addict.


Spike
said
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Finally, someone telling the truth. Addiction is self inflicted nothing more nothing less.


Joe
said
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I agree with the author 100%.
A person's self-will is a matter of choice, and given enough determination and will-power we all have the capacity to overcome any addition. To believe otherwise or that it is in your genes is mere rubbish.


Joe from Ottawa
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I agree with Mr Heyman.
Addiction is hard to quit, but it's not impossible. Physical withdrawal symptoms are not indications of disease, they are indications of chemical dependence.
Physical addiction is a disease by definition; an impairment of the body causing abnormal functioning. But to say it can be fixed without willpower or cooperation of the addicted person is asinine. The willpower is stage one, the intermediary withdrawal-coping drugs are just an aid.


Concerned Canadian
said
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When is addiction not addiction?

This is an argument based on semantics. Addiction is not a "disease" in the sense of being caused by a virus, but it does depend on a physiological change in the way the body functions, so that substances like nicotine, heroin, methamphetamine and alcohol start to be used by the organism biologically.

Withdrawal from these substances is so painful and difficult because the body is literally starving for the drug.

But of course physiologies differ, and one person's addiction may be another's part-time recreation. Thus some people may be able to drop the drug while others cannot.

So when is an addiction not an addiction? If someone can stop using a substance, it could be argued that he/she was never an addict in the first place.

Without some objective way of defining "addiction" this study only proves that those who can stop using a drug can stop using a drug, and those who can't, can't.

This hardly seems like ground-breaking information.


Matt
said
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Deb,

Fetal alcohol syndrome isn't an addition, it's a severe amount of damage inflicted on the fetus.

Nobody is arguing that addiction isn't real, or that it isn't a physiological reality.

What is being suggested is that the behaviour of continuing to feed that addiction is a choice.


Will
said
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I still lean towards the idea that addiction is a disease, but a curable one at that. So I would support stop smoking campaigns, but not methadone clinics. One helps "cure" the addiction, the other just enables the addiction.


Buba
said
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This is total BS. Just look at the people with addictive personalities and ask yourself if they chose to be that way.
As Debb says too - ask the crack babies if they had a choice.


Take Responsibility For Your Actions/Choices
said
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It's about time, a renowned psychologist has finally started to be vocal about this!!!!

Anything one puts into their body is a choice by them to do so. They have the same choice to stop! Disease based models for addiction have been proven they don't work!!! Over 90% of AA members relapse. Relapse is expected, and everyone is told they are going to relapse. This gives every recovering addict following the disease model a reason to "get out of jail free" when they do!

Don't get me wrong, of course the brain is changed when one abuses drugs or alcohol. However, this was a choice, not something that just creeps up.

Thus being a choice, the responsibility still lies on the addicts shoulder, rather than putting the blame on a non-existent disease.

After having been addicted to meth, family members who took years and a broken marriage to quit meth, and my husband quitting heroin without the aid of NA, I KNOW this is not a disease but rather a consequence of choices.


An open mind
said
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I am pleased to see a researcher challenge the establishment. It takes courage, and it promotes discussion. How many young researchers and practitioners have been guided by lecture and book to one conclusion. The discussion this will create will force a rebalancing of knowledge. Others with results afraid to speak up will do so. It may not be a universal truth, but this will be peer reviewed and it the truth will be distilled. To slam this researcher is to have a closed mind and be harmful to all of us. Show him as much compassion as you would a recovering addict.

As for the babies born afflicted due to the choices of their mothers - yes, very sad, but they are not addicted in the same sense. I work with some of them. They do not deserve to be unfairly labelled as addicts. They were damaged as they developed in the womb. They do not need a fix to carry on every day, and were weaned off the drug quickly if they ever were. Their challenge is the stigma society applies to them. Again an open mind and some compassion applies.


DTD
said
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I had done hard drugs between the ages of 19 and 23 and had no trouble quitting. Did it cold turkey, because it was time to GROW UP. This was 5 years ago; the people that I hung around with still do them. I think now that maybe I wasn’t an addict at all. I do believe that addicts are weak.


William
said
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Its about time we had this debate. There is no doubt that in the case of a drug addict the chemicals have a severe influence over their body. That is why we have a mind, so we can think and control the body. If the mind/intellect has been damaged to point where its no longer able to think rationally then the person needs to be treated because they are beyond the point of self help. There are various degrees of this scenario, in the case of cigerettes, I dont think there intellects are effected to the point where they are no longer able to control their bodies and likewise in the case of eating disorders. So its not straight forward but a lot of what people are now naming as addictions are just weeknesses that need to be controlled by the subject.


Brian fr Langley
said
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Like beasts humans often endure hardship and adversity.
To suggest addictive behaviour is beyond our control leaves us on that level. Our choices are what makes the human condition transendant. Or not.


Rob W.
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Choice has always been a factor in recovery and something utilized by health professionals in treating addiction but their is no definable, universal baseline for the element of "choice" in the addicted individual. In virtually every case, choice or rational decision making only comes about as a result of a serious health incident in which the addict is hospitalized, very often near death or has piled up very serious consequences. "Choice" perse does not enter into the equation until the addict is successfully detoxed. While the addict is practicing, the frontal lobes, rational centers have been completely subverted to the will of the lymbic system to the point they will consume a drug of choice to the point of death. This is the point of departure and the wake up for the "lymbic" imperative, after which higher brain functions have a chance to assert their influence. Both circumstances, using to the point of death and increasing personal consequence, are "lymbic" criteria and are a threat to the individual's ultimate survival (ie. ability to feed themselves, have shelter, reproduce, etc.)

Dr Heyman also seems to make no distinction between the addict "types", a long held standard in the addiction field that most attribute to physiological differences, in addition to personal circumstance (ie. extreme abuse, neglect in early life, a severe trauma.) The classic "addict" or type III clearly has or indicates a very different physiological disposition than type I and has altered 5HTP and other receptors to the point where the overriding, survival enhancing reward mechanism of the brain for drugs has become indistinguishable from other reward behaviours such as eating, sleep, sex and even breathing. What Heyman, possibly in an unscientific fashion, is observing is studies done on individuals well after successful detoxification and restoration of brain function. While the addict is using, they simply will not have a choice for up to 48-72 hrs following their last use. (which is why they need to be locked down for this period and their movements strictly monitored and controlled.) After this period, "Choice" becomes a gradually increasing element. The reason for informing the addict that they have a progressive, incurable and fatal disease that they have no "personal" control over is describing the state of the individual under its direct influence, not entirely their state of mind in recovery and that they stand a strong chance of dying while in this state of overwhelmingly compromised judgement. The "progressive, fatal and incurable" tag is meant to describe what is likely to happen if the addict has even one exposure to their drug of choice, not their state of mind or abilities while in a state of recovery. There are a significant number of addicts, an entire class of addicts, who simply continue using to the point of death despite repeated visits to hospitals and stays in ICU's and eventually die with no discernable time in recovery.

Additionally, for the last 2 decades, they have known that addicts produces radically different substances in their bodies that may account for the "overriding" compulsion, called beta-endorphins (opiates) which are 300 times more potent than standard endorphins, that simply aren't found in non-addicts. (A coroner in the US accidentally stumbled upon what appeared to be sever opiate damage in brain sections of indigents who were known to be lifelong alcoholics.) This is why Naltrexone, an opioid antangonist, something used for heroin addicts, has such amazing success with alcoholics.


One of the overriding goals in recovery is to prevent even a single re-exposure to the addict's drug of choice. Even in successful and long term recovery, choice is somewhat compromised and regularly subverted by standard healthy mechanisms of the addict's mind (such as rationalization, censoring, memory blocking) periodically during their recovery in response to stress, daily pressures and emotional upheaval. These are well documented processes described variously as "ego, superego and id" and their struggle for integration. The "id" in the addict is now permanently marked by the pleasurable experiences and intensity from their time as addicts and the superego and ego can fall prey to it's influence (hence the need for constant outside support and counsel, sponsors).


There are some suprising oversights made by someone supposedly immersed in addiction study but can only guess he has not experienced addiction from the inside.




Niagara George
said
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Another bandwagon for the blame the guilty, right-wingers to jump on.

By definition, a person is addicted when the actions they do become their normal life. When cocaine, heroin or even tobacco become your normal, you are sick.

Perhaps not physically sick, although even that is questionable. But, certainly you are mentally sick.

Mental illness has been accepted as disease for many years. Let's not open that debate!


Al
said
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I agree with this study. The addiction itself is not a disease, but it is a symptom.. The reasons why someone chooses to use the drug or drink may be though. Mental health issues are something entirely different and I think alot if not most addicts have underlying issues, whether it be bipolar, anxiety or something else. The addiction itself is simply a coping mechanism. Bravo for standing up against the status quo.


Pip
said
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Like R/H, I beat the smoking addiction after half a century of a pack a day. Like him, I found it hard, but I've been clean for eight years too. During that time, I simply smoked. When I quit - the result of just one more hike in the taxation rate on tobacco - I quit: no aids, nothing. It took time for the urge to smoke to disappear, but it did.

My question has always been with regard to new "diseases" - especially those defined by psychiatrists - "who benefits"? If the main benefit goes to a drug company, as opposed to the patient, should the "condition" have ever been elevated to the status of "disease"?

Just yesterday, it was reported that there is danger of sudden death from taking Ritalin, yet that drug has not been withdrawn. Ritalin is used to treat ADHD among children. To what extent is a diagnosis of ADHD the result of a teacher wanting a quiet class, and using what I consider to be suspect tests to achieve their ends? I have no empirical data, only the observational experience of 38 years in the classroom. I have not noted any child who was physically active - on the play yard, in active play and sports after school - who was considered to be ADHD by our shared psychologist. Diagnosis was far more common among those who had regular parental notes to avoid phys. ed, and who were never seen out at play.

In the case of ADHD and alcoholism, Is it more a matter of "Mens sano in corpore sana"? Would proper care of the body - including regular exercise - go a long way towards satisfying the need for the addictive substance?

Just an opinion.


beverly - alberta
said
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It's like giving a child a toy or book to stop a tantrum or bad behaviour in public - instead of dealing with the real problem - that being that child's feeling of entitlement to bad behaviour.

It's so very refreshing to see a professional in the field actually suggesting that we are indeed responsible for the choices we make every day..........as well as the resulting effect those choices have in our lives and the lives of our families.


No such thing as illnesses
said
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I can't believe that people would think this way? I take it that you people also think that Mental illness is not an illness iether. Addiction is as much a mental illness as Bi-polar (which by the way one of the symptoms is falling into addictive behaviours)


beverly - alberta
said
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..........and to ADM in Saskatchewan, no one is saying that it is not hard. The easy part was passed by when the choice was made to enter into the destructive behaviour.

The hard part is choosing NOT to continue. We all make choices - unfortunately others live with our choices as well.


Karen
said
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Disease?

My husband has an incurable, progressive disease. He did not voluntarily start a habit that developed into a problem. Please do not equate his legitimate illness with addicts who made poor choices and don't want to be held accountable for it. It diminishes those who really are sick.

Thank you for being brave enough to publish an article that calls it like it is.


nc
said
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I agree with this study to a point.
The true fact is that an addiction to anything is insidious. By this I mean that the process is long and varied. This is the same as someone finding out they have cancer or any other illnes. The process started years ago before the effects of the illness show up.
The addicted person has to find the way to return to a healthier state. The catalyst may be the things that Mr. Heyman stated. The addict has to accept that this is a better way of living. In all cases the addict has to develop a whole new social network.
If I were to tell a friend that you should not start smoking because you will be addicted. In the early stages that friend would tell me to bugger off. To them their is nothing wrong.


Steve in PEI
said
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This guy is just another publicity hound trying to garner attention by "being a rebel."

Think about it. Pretty much no one has been saying that you can't choose to recover, in other words, that *using* is a choice. All those earnest people spouting "addiction is a disease" platitudes do want people to defeat their addictions and honestly believe that it's possible.

The point of viewing addiction as a disease is that addiction has potent psychological and physical components and is *not easy* to beat and keep beaten. Just ask any smoker. It's not like snapping your fingers and saying "ho hum I think I'll stop being addicted to nicotine today," and then you throw out your cigarettes and live happily ever after, but that's what Dr. Heyman makes it sound like in his sound bites. Deliberately so, because it incites controversy and garner's people's attention for himself, so he sells books and gets rich.

By viewing addiction as a disease we appropriately acknowledge its seriousness and help people take appropriate measures to get clean and stay clean. Sending the message that overcoming addiction is like snapping your fingers because *addiction* is a choice we make sends the wrong message and fails to prepare people for the real difficulty of the task.

Not to mention, just because you have succeeded in quitting, say, smoking does not mean that you are no longer addicted to nicotine. In that sense it is *exactly* like a disease.

In a nutshell:
- Starting is a choice. Using is a choice. This is the realm of personal responsibility.
- Addiction itself is a disease. Being addicted is not a choice so an addict must take special measures that a non-addict doesn't have to to avoid falling into destructive patterns.
- Dr. Heyman is a cynical poser who isn't really all that special.


Polly Wanna
said
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To Mental Health Worker: Sorry, but this guy is bang on. I know how tough that must be when the only approach to a cure is based on the diagnosis that addiction is disease...but yu cannot deny his facts: most addicts quit as they get older due to a choice they make. "Sick and Tired of being Sick and Tired"

I've been in the rooms, I hear the speakers talk, that is all good therapy, and for sure, once you have developped a dependence, it is a real tough go to quit, but it can and is being done.

I did it. The rooms helped "raise my bottom" no question.

As far as crack babies, they had no say in the behavior, so you really can't include them, plus they are weaned off, and don't relapse...its not like a 5 year old, clean for 4 years, is looking to score.

SO, sad to say, you should embrace this as evolving science and progress, and work with it. Rather than condemn it with references to out of context half truths.




marat
said
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Way back in 1960, Thomas Szasz, Emeritus Professor of Psychiatry at Syracuse University, N.Y. shook up the psychology/pychiatry world with a major book--"The Myth of Mental Illness." He forcefully argued against the "medicalizing" of behavior. A true disease (e.g. swine flu, polio) has a known pathogen and a generally predictability of symptoms. "Schizophrenia" does not. Neither do ANY addictive behaviors. The public is generally unaware that psychiatric "disease" categories are so labelled and included in the Psyciatric bible of mental diseases BY A VOTE OF MOSTLY MALE PSYCHIATRISTS. Its a sham. I am not saying labelling isn't necessary to help individuals in institutions. But there are huge, huge dangers to removing personal responsibility. HOMOSEXUALITY WAS a "diseases." But psychiatrists VOTED it out!!! A few years ago they wanted to include PMS as a new "disease" category. As has been said, psychiatry is a field that "mines new territory for itself." I'm a Ph.D. and met Szasz many years ago--check out your libray for his views/works. I founds his arguments to be self-evident to me. BTW, most heroine addicted Vietnam War veterans kicked the habit before returning back home--they knew they'd be tested. Try "kicking" polio....


Leah, Medicine Hat
said
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It seems like this writer has completely forgotten about or failed to consider the amount of change that happens in the brain when someone experiences addiction. Much of the brain damage that occurs as a result of addiction is irreversible; the irrational and faulty beliefs are so deeply ingrained. These, along with many other factors, make it extremely difficult to overcome addiction. The obsession and compulsion is so strong for people that they 'simply can't say no'. Nothing in the the field of addiction is simple.


JFC
said
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I think its a combination of the two which varies in different people. The more depressed or mentally damaged the person is at a particular moment the less voluntary control a person will have over something like an addiction and vise versa. Eg: its going to be allot harder for a person to quit cigarettes during a divorce or just after a family death then if they just won the lottery. duh! Its ultimately a mental health issue... strange how the views that seem to get the most attention are always the most extreme... the more intelligent person always sees things as a balance that shifts with time and circumstances, not simply as white or black, my way or the highway.



Matt
said
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I disagree with Karen completely and think that it is terribly unfair to label all addicts as selfish individuals. I used to smoke and I would have considered myself an addict and I don't think I'm a selfish person at all. I smoked because at the time I thought it was fun and cool, and to be honest I still think it is, but at the same time I know it is bad for me and as I got older eventually my desire for greater health outweighed my desire to smoke and I eventually and reluctantly quit, which was hard, but I did it. I would say that addicts are more desperate people than selfish. I could argue that I was desperate to fit in with friends and add some fun to my otherwise dull life and that's why I began to smoke. If I had never gotten over that desire to fit in and have some excitement I’d probably still be smoking today. So I guess I would have to argue that addiction is most defiantly a mental disease, in my opinion it’s a person trying to fill a void in their life, and a mental change needs to happen before they can quit, you simply can’t tell them to stop because then that void is then left open.


Chinese Proverb
said
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The man took a drink. The drink took a drink. The drink took the man... Father J. Martin


Phillip M
said
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All you people putting "thumbs up" to others' comments that support this media publication; you are obviously not an addict. I am an alcoholic; since the age of 12 when I had my first alcoholic drink and I learned that I am not like my friends or my family where they seem to drink without any problem. Today I am 40 years old. The problem is the scientific community seems to put out some kind of report every other year going to one extreme or the other. Addiction is a combination of self-choice and inability to choose. I like what this author writes; that often an addict will stop if there are pressures like values and laws; respect from family and community (their direct involvement and intervention etc.), there are many cultures that had and have highly developed customs to "shame" pressure people to conform and in those societies, you did not see the levels of addicted people because those addictions often were not tolerated but families and friends and communities all pitched in to help those few individuals that were addicts of all sorts. Today, we don't chip in to help. Rather we read reports and media stories and we have nothing but negative things to say. Shame on all you.


Matt
said
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Niagara George,
"Another bandwagon for the blame the guilty, right-wingers to jump on."

Of course I blame the guilty.
Beats the Liberal habit of blaming the victim and the innocent.

Mental illness is a serious problem, one that is often misunderstood. We do a horrible job of treating it, and those affected by it.

The question is at what point does a desire become an uncontrollable compulsion?
Thinking about this from a different angle consider the following.
I often scratch mosquito bites, I try not to but some times I can't resist, other times I don't even notice I'm doing it.
Am I mentally ill? Is this really uncontrollable, or am I giving in?
Where do you draw the line?

I'm not saying addiction isn't a real problem, or that the need to fulfill it can't be extreme. What I, and others, feel is that feeding the addiction is more often than not a choice, you physically choose to go buy a pack of cigarettes, and you choose to smoke them, or to continue to smoke them if you didn't notice you did it.

This isn't meant to belittle the difficulty of overcoming some addictions, which for many addicts is almost an insurmountable task. But with health and effort addicts can choose to stop.


Joy
said
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Unlike babies who are born to addict mothers, and then may be 'born addicts'... most addicts initiate the addiction - whether it be cigarettes, alcohol, crack... it's not like other mental illnesses that can affect anyone, regardless of their actions. And alcoholic wouldn't be one without first drinking alcohol would they?


Kathleen
said
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Many of the foods that I'm allergic to I am addicted to - my body craves them something like you could never understand unless you are addicted to something. When I choose NOT to consume them my allergies subside (systemic allergic reaction generally) and with each passing day I can handle it better than the day previous. Occasionally I fall off the wagon but it is MY CHOICE knowing full well what WILL happen to me. Yes, I do agree that addiction is a disease, however I feel it is a disease that we can CHOOSE to give in to or CHOOSE to fight against. We all have a choice.


Ben
said
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With some exceptions, I think that everybody makes their choice regarding addictive substances. There will always be an exception to the rule, but looking at the population as a whole, I think you'll find the overwhelming majority of addiction cases are formed when an individual makes an individual choice.


Dana
said
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Hang on a second here. The reason why psychologists have come to the conclusion that addiction is a disease is because once you've overcome it, you're still an addict because you can easily fall back into it if you're not constantly on your guard. Sure, some people use that as an excuse. Those are the ones who aren't ready to kick the habit. Some people reach that point, while others don't. For example, if you didn't have that great a life before you became an addict and that was the reason you did, then what have you got to look forward to if you quit? Back to the same thing.


Jim BB
said
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I concede that some people are more prone to act upon addictions or have weaker will power. We all have our vices. But we make choices which hopefully are best for us and the people around us. I think this same thinking can be applied to some eating disorders as well. Some just want the instant self-gratification without worrying about the future or the impact on others. For example, I know some heavy smokers who refuse to accept the dangers of second hand smoke (for example) – they feel their right to smoke out-weighs another person’s right to clean air. Is being a selfish jerk a disease?


Dean
said
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I agree with the author. While I also agree that some babies are born addicts, this was in fact forced upon them by their addict mother. Alcohol and drug addiction is a lifestyle choice and not a disease. It isn't caused or at least hasn't been proven to be caused by mutant genes and the like. Drug and alcohol addiction can be cured by stopping the behaviour. A real disease cannot be cured this way. When will this society decide to be responsible for its actions and stop blaming everything else for their misfortunes? When we fully become a "no-fault" society, then we are in serious trouble. Everyone squawks about government intervention into our lives but, if we don't like this, we must be accountable for ourselves. The more we aren't, the closer we get to the "big brother" spectre.


Mo
said
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It's a combination of both, and there's no need to dispute nor debate it. This is just publicity to help sell the book. It's been shown for ages that addiction, dependence, withdrawal are real, and it's something that's not easy to fight. Just ask those trying to quit smoking. Willpower obviously plays a role, but you can't discredit how challenging it is to overcome an addiction. Sure initially it MAY have been the person's choice, but after that, it's a lot harder to argue the same.


yram
said
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Finally the truth, it's a choice.Accountability is severely lacking in today's society, it comes from being so assertive "it's all about me."We see the results.


Peter
said
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The choice to use drugs or alcohol initially may be voluntary, but once the person becomes addicted, there is no longer a choice. That is why it is called an addiction. Brain cells with prolonged exposure to morphine, for example, shrivel when that substance is removed. So tell me it is a matter of choice. No, its a mattter of survival.


James (Guelph, ON)
said
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This doctor should be ashamed of himself, not for presenting an alternative theory on the causes of addiction, but for using society's ignorance and naïveté on the subject to sell his book. Much of society believes that addiction is a character flaw. I will admit that I used to think that way myself. Actual exposure to dealing with addicts changed my mind. Addiction is not a switch that can be turned off and on. Addiction changes the brain's chemistry and more often than not, the addict literally lives to feed the addiction.

Addiction is not a disease that you can "catch" like HIV or Hepatitis. But all doctors, even this one, will agree that addiction results from a toxic change on brain chemistry. And if one were to look up the definition of the word "disease", they would see that among other things, it includes any chemical toxicity that causes an organ (like the brain) to function incorrectly.

In any case, this doctor's statements will do little to reduce the effects of addiction on our society. In fact, I suspect that by feeding society's ignorance on the subject, a few more addicts will not get the help and support they need from friends and family. Instead, those who should be helping the addict will instead blame the addict for creating the problem and thus drive the addiction further underground. Such a waste.


MRC in Ontario
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Someone with common sense and speaking plainly that you can only fix your own problems yourself & rise above? Wow, this is so refreshing!!!


RS, Toronto
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So is the author purporting that those who we know as addicts are so because they choose to be addicts and choose to lead a sordid life of addiction and poverty because they love it?


Anne M
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To the poster who said that addicts are selfish people, you are bang on right.
My Dad was an alcoholic, and many times his kids went to sleep hungry, because to him it was more important to have his bottle, than to feed his family. We kids were raised in poverty, while he came home drunk every night.
When he died, he had nothing left to leave us, while our cousins inherited lots of land and money. Their Dad's took care of them.


Doug BC
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I think this man is right on the money.Even those with addictive personalities have to "choose" to take the first step in order to become addicted to any of the most common addictions.
Then,at some point,an addict has to accept some responsibility for dealing with his/her weakness,and find a way to eliminate the temptations.As an ex smoker I recognized that I could not have "just one".I had to "choose" not only to not have just one more,or one per day,but also to not have them in my home.When my late uncle was recovering from alcoholism,he could have just "one more" for good luck.He had to entirely eliminate alcohol from his life.
One problem seems to be that few pwople recognize they have addictive traits until AFTER they become addicted to something.Then the challenge becomes even greater.I seriously doubt that most addicts start out with a goal of becoming addicted.And many fool themselves into believing they can quit any time they want to.Just try doing that my friends.It is much more difficult than most think.
Maybe it could be defined as an illness,AFTER a person becomes addicted.But I think starting is a matter of choice.And I do find it a bit troubling to place addicts in the same category as people inflicted with cancer,or diabetes,or any other ailment we have traditionally defined as a disease.Those people had no "choice" at all.
One thing seems clear.Few addicts will beat their habit until they accept their weakness,and make a conscious "choice" to beat their addiction.Those with illnesses that fall under the traditional definition of disease,have no such "choice".


Plabo
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I believe this study is near sigthed. Unbelievable when considering the source. We have to separate addiction into two categpories. There are drug induced addictions. Nicotine and heroin use for instance. Second category is one's own non drug induced addiction. Gambling and sex addiction for instance. Addictions created from external sources can be overcome. Not easily but they can by eliminating drugs or poison from one's body. Addictions created from personal cravings are different. I read somewhere that a gambler's brain actually reprograms itself to help justify the addiction. I may be right and again I may be wrong but it's pretty arrogant to classify a condition in one category.


Marty
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I know many will say it is about time that someone spoke up and started blaming individuals. But most people that say this probably have never experienced addictions (personally or in someone else). On the other hand, those who won't listen to this professor are as equally wrong and are those who want to empower addicts to continue in their addictions.

The truth is that addictions are often the result of both. That is why intervention should take into consideration both the "choice" and "disease" factors.


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