Here is a remarkable yet rarely remarked fact about addiction. Only a very small portion of drug users are drug addicts. About 15 percent of people who drink develop alcoholism; about 10 percent of those who experiment with drugs become drug addicts. (See Heyman's book for the references.) Why is this? What governs these outcomes?
Genetic and neurological factors may play an important role. But perhaps there are other choice-related factors that play a role as well. Here's a possibility: as Heyman informs us, the majority of addicts are single; moreover, no one is better positioned and more motivated to resist the addict's problem than his or her spouse. Having a spouse raises the costs of addiction and may be a factor, a choice-pertinent factor, in predisposing someone to avoid the trap of addiction.
It may even help the addict break free from addiction. For there is a second remarkable but rarely noticed fact about addiction (again, see the book for the details). Despite the oft-chanted dogma that addiction is a chronic incurable disease of the brain — “once an addict always an addict” — the best data available clearly demonstrates that more than 75 percent of hardcore drug addicts will eventually cease to take drugs and that they will do so without having received treatment. How can this be? What could explain this? And what determines who breaks free from the trap of addiction and who fails to do so?
If Heyman is right, we might hope to find the answer to these questions by turning our attention not to the nervous system of the addict, to his or her internal life, but rather to the pattern of needs, options, values, preferences and pressures that structure the person's ongoing life in a community with others.
|Still curious? Read Addiction: A Disorder of Choice.|