Addiction to cupcakes, coke, drink or the horses is not a disease, but a choice, says a reformed alcoholic.
Damian Thompson’s The Fix: How addiction is invading our lives and taking over your world is a compulsive read. This might be partly because I already have a small addiction to print, but also because of his thought-provoking thesis. This is, that “more and more of us are being pulled towards some form of addiction” – whether in its old forms, such as drink, gambling or drugs, or in its new forms, such as sugared and junk foods, internet pornography or constantly checking one’s iPhone.
Thompson, a columnist for the London Daily Telegraph, defines addiction, intriguingly, as “the progressive replacement of people by things” and according to this definition he thinks people are more addicted than they were 40 years ago. I suspect this is probably true: humans are not naturally very self-controlled; there is less religious authority or parental authority around to do the hard work of instilling self-restraint; and beguiling new technology – the internet, iPhones and so on– make it all too easy to create an addiction and then to feed it with little effort. That’s the bad news.
The good news, according to the author, is that addiction is not a disease. He accepts that some people are more vulnerable than others and that, for instance, alcoholism can run in families, but “trying to draw the line between genetic predisposition and environmental conditioning is an impossible task.” He is honest about his own past history of alcoholism and pays tribute to the power of the therapeutic community in Alcoholics Anonymous (AA), which he admits probably saved his life.
However, even in his worst moments he never accepted a central tenet of AA, stated at every meeting he attended: that members are powerless to change their drinking habits. They are not. “Powerful desire doesn’t lobotomise us” the author argues; addiction is “a disorder of choice.” We have free will. Even if addicts “may be influenced by their disordered brain chemistry to make bad choices”, nonetheless “they are choices”.
That’s the good news and I was heartened to read it. If we describe addiction as a disease, as we would describe cancer, we become victims. We are persuaded that the addiction has “invaded” us against our will and we are helpless in its grip. But Thompson emphasises that “however intense the craving that a drug addict experiences, the decision to take the drug involves uniquely human, rational functions” – that mysterious interplay between need, wish, desire, will and wilfulness that we all experience.
He relates the story of two of his friends, both once addicts like himself. One finally committed suicide after years of a fluctuating, self-destructive lifestyle while the other eventually broke his addiction entirely on his own. AA finds it difficult to accept that this can happen, arguing that people who do go it alone are obviously not true alcoholics in the first place.
As it happens, I also know someone whom the textbooks would describe as a classic “addictive personality”, whose life was dominated by a long-term combination of drugs, drink, impulsivity and heavy smoking. He became a Catholic and has subsequently turned his life around without group therapy. He still struggles – but willpower, grace, the decision to avoid old haunts and triggers to his cravings, choosing a different group of friends and resolving on a more healthily structured daily round, have gradually transformed his life. This is not to criticise the excellent work AA does in the rehabilitation of long-term addicts, but to recognise the variety of the “crooked timber of humanity” and the likes of bolshie, determined people like my friend who is too argumentative and non-conformist to fit into the AA ethos.
There is also the matter of availability of the drug, which is not emphasised enough in Thompson’s view. When addictive substances are easily available (as with US soldiers when deployed in Vietnam) people tend to succumb; when availability is removed (as when those same soldiers returned to the US), the addiction generally stops. The same was true of the 18th century gin epidemic in London. The author further comments that in earlier times alcoholism was seen as a sin, with temperance as its opposite virtue. Nowadays “addiction” has replaced the concept of “sin” - but unlike sin it has a tendency to absolve us of responsibility for our behaviour. A sense of sinfulness induces guilt; guilt demands self-reflection and responsibility; this can lead to a decision to change: a road to Damascus moment.
The author warns that modern technology has also changed the terms of the debate. The distinction between legal and illegal drugs, for instance, when the latter can so easily be bought over the internet, is now, for many people, an irrelevant discussion. And there is further alarming news: “Internet porn has displayed a powerful capacity to interfere with the chemistry of the brain” – making it harder to break free from the destructive images downloaded and stored in the human memory.
Thompson’s last chapter is entitled “Deliver us from temptation” – a slightly ironic usage of an ancient prayer to God for help. Yet he does not suggest effective ways in which democratically elected governments can combat their citizens’ negative appetites; after all, are we not all addicted to the idea that as adults we are free to live as we please without interference?
Francis Phillips writes from Buckinghamshire, in the UK.