Reddit reviews Addiction: A Disorder of Choice

>Once you become addicted the chemistry in your brain changes and then you become reliant on the drug to function at baseline. That is the disease model of addiction.

According to this reasoning, falling is love is a brain disease. The "brain changes" are due to LEARNING; not disease. Yes, choosing to smoke crack affects your brain. That does not make it a disease. Of course, the entire "recovery" industry is predicated on the idea that addiction must be a disease. Drug abusers LOVE the idea that addiction is a disease, because this belief enables them to avoid "internalizing the shame and despair" of making selfish, myopic decisions. It is healthy and normal to feel ashamed & sad, when you selfishly choose to get high/drunk again even though you realize you're causing problems for yourself and the people around you.

Do they teach you anything about how "treatments" for problems are supposed to be actually based on evidence? Where is the evidence that putting someone in rehab and teaching him that he has a brain disease, and does not have power to simply choose to stop drinking or doing drugs...where is the evidence that this is actually helpful? Is there ANY? Don't you see how the "disease model" (1) is good for business and (2) is not good & very probably bad for people with addictions?

>...only 10% seek treatment and of those 60% relapse.

But how many people actually get sober? According to Addiction: A Disorder of Choice, the overwhelming majority of people with an addiction to drugs/alcohol will quit between the ages of 20-30, without treatment. From Psychology Today:

>The very word addict confers an identity that admits no other possibilities. It incorporates the assumption that you can't, or won't, change.
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>But this fatalistic thinking about addiction doesn't jibe with the facts. More people overcome addictions than do not. And the vast majority do so without therapy. Quitting may take several tries, and people may not stop smoking, drinking or using drugs altogether. But eventually they succeed in shaking dependence

10% seek treatment because the other 90% realize that they are perfectly capable of quitting, and it's in their best interests to quit.

By all means, people who are struggling with an addiction to drugs/alcohol may seek help. But there is absolutely no evidence that it is "helpful" to promote ideas like:

- People who drink/use drugs problematically should accept the "addict" identity

-"Addicts" should view themselves as diseased

-"Addicts" should accept that they are incapable of choosing to behave differently

-"Addicts" should go to rehab, because that will help them become sober

The "addiction recovery" community actually promotes thought distortions:

"If you've drank too much in the past, you can never learn to behave any differently in the future."

"You've had trouble with self-control, therefore you can never learn self-control."

"You can never have just one beer."

This is like telling someone who struggles with depression: "You're feeling miserable now, therefore you'll always be miserable." WTF kind of "treatment" is this?!

> Alcoholism is not a phase. It’s a chronic, incurable, and PROGRESSIVE disease

Neuroscientist & former drug-addict Marc Lewis does not agree that addiction is a disease:

>…is addiction a disease?
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>This book makes the case that it isn’t. Addiction results, rather, from the motivated repetition of the same thoughts and behaviours until they become habitual. Thus, addiction develops—it’s learned—but it’s learned more deeply and often more quickly than most other habits, due to a narrowing tunnel of attention and attraction. A close look at the brain highlights the role of desire in this process. The neural circuitry of desire governs anticipation, focused attention, and behaviour. So the most attractive goals will be pursued repeatedly, while other goals lose their appeal, and that repetition (rather than the drugs, booze, or gambling) will change the brain’s wiring. As with other developing habits, this process is grounded in a neurochemical feedback loop that’s present in all normal brains. But it cycles more persistently because of the frequent recurrence of desire and the shrinking range of what is desired. Addiction arises from the same feelings that bind lovers to each other and children to their parents. And it builds on the same cognitive mechanisms that get us to value short-term gains over long-term benefits. Addiction is unquestionably destructive, yet it is also uncannily normal: an inevitable feature of the basic human design. That’s what makes it so difficult to grasp—socially, scientifically, and clinically.
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>I believe that the disease idea is wrong, and that its wrongness is compounded by a biased view of the neural data—and by doctors’ and scientists’ habit of ignoring the personal. It’s an idea that can be replaced, not by shunning the biology of addiction by by examining it more closely, and then connecting it back to lived experience. Medical researchers are correct that the brain changes with addiction. But the way it changes has to do with learning and development—not disease.

For more information on this subject, read The Biology of Desire: Why Addiction Is Not a Disease by Marc Lewis.

If you want to read another book by another doctor that refutes the “disease” idea, I recommend Addiction: A Disorder of Choice by Gene Heyman.

There's this one behavioral economics book you might like, Addiction: A Disorder of Choice. It's a great intro to behavioral economics and approaches to assigning measurable value to pleasure.

Heroin isn't all that pleasurable. As demonstrated by the number of people who have had it destroy their lives, relationships, careers/health, etc. It may be extremely pleasurable during the high. But the overall pleasure of something must be measured by it's lifetime effect on you, not just the effects of one particular moment.

The ultimate pleasure machine is a bit of a paradox that everybody seems to miss. They argue things like you just did, that it might be great temporarily, or that it might feel nice but would not be satisfying because it wasn't "genuine" enough pleasure, or that it would cause the collapse of society. The problem is that the thought experiment requires that the ultimate pleasure machine, if it really is the ULTIMATE pleasure machine, will have no consequences that effect your overall lifetime levels of pleasure in a negative way. So if all of society dying off would negatively effect your pleasure, it would not then be the ultimate pleasure machine, it would just be a pretty good pleasure machine. The Ultimate Machine would say, find a way to continue the prorogation of the species, maybe even allow it to grow much faster, because that is what people would find to be a pleasurable idea.