The Meaning of Addiction
The conventional idea of addictionthat a substance or activity can produce a compulsion to act that is beyond the individual's self-controlis a powerful one. In The Meaning of Addiction, I explore the social and personal meanings of this idea and its relevance to human behavior. This exploration includes histories of narcotic addiction (chapter 1) and alcoholism (chapter 2) in the United States, histories that explain recent theoretical developments in these fields. I judge the efficacy of prominent theories of drug and alcohol addictionalong with current models of overeating, smoking, and even running and love addictionsand analyze their flaws in a larger intellectual and psychological context (chapter 3).
In the course of this book I review a large body of epidemiological, historical, experimental, life-span, and clinical research about human drug use. I also address the literature on animal drug use studies, along with ideas about infant addiction, because these hold such a large place in contemporary views of addiction (chapter 4). In addition, I present the results of systematic experimentation on animal opiate use conducted by Dr. Bruce Alexander and his colleagues, which correct inaccurate popular notions about how animals respond to drugs. The purpose of these animal data, in common with much of the material in this book, is to puncture simplistic, often magical visions about the nature of addiction.
My major endeavor, after establishing a suitable level of analysis for addiction, is to create a framework for understanding addictive behavior (chapter 5). I evaluate the factors that cause addiction and describe the nature of self-perpetuating, self-destructive behavior. I construct a model of the relationships among cultural, social, psychological, pharmacological, and other components of addictive motivation, based on the idea that addiction is a response to socially and individually conditioned needs for specific psychophysiological, or experiential, states. This model is designed to apply equally well to all areas of repetitive, compulsive behavior, from self-destructive running to narcotic addiction.
I draw further implications from my analysis (chapter 6), including an understanding of the current high levels of addiction and of the failures of treatment and public policies for addiction, and I propose a direction for reasonable therapeutic and prevention efforts. Moreover, my analysis offers insights into the process of scientific definition and into some core social and psychological themes of our times: namely, the designation of new categories of psychic disease and their impact on our image of the sources of human conduct. The idea of addiction, I make clear, has always expressed central cultural conceptions about motivation and behavior. Now, in an age when science and health magazines have become our bibles, ill-founded psychological generalizations presented as scientific wisdom dictate our collective decisions about children, criminals, and ourselves.
Our conventional view of addictionaided and abetted by sciencedoes nothing so much as convince people of their vulnerability. It is one more element in a pervasive sense of loss of control that is the major contributor to drug and alcohol abuse, along with a host of other maladies of our age. We feel we must warn people against the dangers of the substances our society has banned, or attempted to curtail, but cannot eradicate. This book argues that our best hope is to convey these dangers realistically, by rationally pointing out the costs of excess and, more importantly, by convincing people of the benefits of health and of positive life experience. Otherwise, the idea of addiction can only become another burden to the psyche. Science cannot increase our understanding of ourselves and our worldnor can it show us the way to freedomif it is held captive by our fears.