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."
