Addiction Is a Choice

Rating:
Summary: Addiction is a Choice Successfully Challenges Disease Theory
Review: "Addiction Is a Choice," by Jeffrey Schaler, is a refreshing look at a subject endlessly discussed in today's media. Open a newspaper or a magazine today and you are likely to see at least one article on the horrors of drug addiction, and how this terrible "disease" strikes people down, leaving them sick for life, with no chance for anything but a temporary remission. This sort of drivel fuels the Drug War.

The idea that prohibition is necessary because "once someone makes the decision to use an illegal drug all capacity for rational thought disappears and force is the only thing that will save them" is so often repeated that it is accepted by a large number of the public who ought to know better. Jeff Schaler does know better and makes his point effectively.

Schaler tells the frightening story of a teenage girl, brought to him by her mother. The girl was suspended from school and had been in trouble for drug use. The parents were worried. She had been to another doctor, but she continued to use drugs. She had been told that she suffered from the disease of drug addiction and felt helpless and depressed. Schaler told her that addiction was a choice and she had control over her life. The girl believed him and, during treatment, took back control of her life and stopped using drugs. Then, to avoid the peer pressure in public high school to take drugs, she applied to a special school for students who had used drugs. The principal would not admit the girl to the school because the principal believed that the girl was in denial about her "disease."

Schaler spells out the dangers of adhering to the disease model of addiction. "Teaching people in `treatment' for addiction problems that they `don't know they have a problem' may create a problem for them," he writes. "Teaching them that they cannot control themselves may convince them that they cannot control themselves. Teaching them to believe that `treatment is the only solution to their problem' may persuade them that they cannot solve problems on their own. It reinforces dependency..."

"Addiction Is a Choice" looks like any one of a number of "self help" books on the market, but it certainly doesn't read like them. It tears apart the victim rhetoric so prevalent in today's discussions about addiction, but in a calm, non-threatening way. Schaler sounds as though he's probably as good a psychologist as he is a writer. Understanding the nature of addiction is imperative if we are ever going to deal sensibly with drug use in America. This book does much to help us in that quest.

Rating:
Summary: "CHOICE", "RESPONSIBILITY" OR CULTURE
Review: "Addiction (which at one time meant only devotion or dedication) has come to mean ``any activity which individuals engage in, deliberately and consciously, and are PHYSICALLY UNABLE TO STOP THEMSELVES FROM PURSUING [my caps for emphasis]." Rejecting such a definition out of hand, Schaler maintains that "people are responsible for their deliberate and conscious behavior."

In this context, without getting into a long discussion, it is obvious that addictive behavior is culturally based and "choice" tenets are culturally set and only certain "conscious behaviors" will be considered to be the responsibility of individuals in society, and I might add, only certain individuals in society.

We live in a culture today that endorses "personal responsibility," so we will have these positions that will argue for setting cultural tenets for it.

So this means that we will deliberately and consciously admonish, punish, even execute individuals who fall prey to cultural manipulations and pressures resulting from cultural constructs. Punishing individuals who do not meet the ideals may be an addiction our American society has and should take responsibility for.

We can form tenets for or against certain behaviors. We know that a man consciously and deliberately beats his wife but do we know when it becomes addictive behavior? Is there cultural tenets for that, and against that? We know that men consciously and deliberately molest children but at what point do we know when it becomes addictive behavior? We know that the mind can consciously and deliberately pursue not eating but can we say that the addiction is not a result of cultural cues and metaphors? Does addiction occur without culture and does culture occur without addiction? Isn't culture the result of addiction? Isn't cultural "conditioning" addictive? Doesn't conditioning produce conscious and deliberate acts that are physically pursued so that one can't stop from doing them? And, isn't the purpose of conditioning to insure that people are unable to stop themselves (or find it impossible to stop) from pursuing acts that are contradictive to the conditioning? Don't we try to condition (i.e., addict) people to certain conditioning like the Ten Commandments? And, aren't those cultural tenets?

So there are good addictions and bad ones -- but culturally based.

Why does the addiction occur? Is it culture to do so or is a response to cultural pressures to do so? Are addicts the result of culture or do they create it? When does society take its responsibility for its contribution to addictive behaviors? These are questions neither asked nor answered. To say that individuals" (certain individuals under certain circumstances) are "responsible" for their "conscious and deliberate acts" is culture. The belief can change tomorrow.

Schaler might consider writing about addiction to "poverty" and explain that these are "deliberate" and "conscious choices" that "people are responsible for." Addiction is NEVER a "choice" (a cultural tenet requiring conditioning), but it can be reconditioned out of practice.

Please note that some alcoholics and other drug users, including tobacco addicts, are educated professionals with family and position and even wealth. So "poverty" would have to be redefined (for our reality) in such a way to accommodate these individuals when they pursue it "deliberately" and "consciously" especially when we act to hold them "responsible" for it.

Rating:
Summary: Disappointed
Review: After hearing Schaler on a radio interview, I was excited about reading this book. For several years, I have maintained that alcoholism was not an illness and have had discussion surrounding this topic many times with many different people most of whom disagreed with me.

When I actually read the book however, I was disappointed on several levels. I will try to give some examples.

Accuracy - On page 63/64, Schaler refers to a book published by AA and lists it's title as "The Big Book." This is not the title of the book. It's real title is "Alcoholics Anonymous." "The Big Book" is what it is euphemistically referred to by AA members, but it is not it's name. It really caused me to be quite skeptical of many of the other details in the book.

Non-truths - Also on page 63, Schaler states the requirements of joining AA and lists these as admitting weakness and inadequacy, and acceptance of a life dependent on a power greater than ones own self. This is just simply not true. In the preamble read at almost every AA meeting, is the tenant "the only requirement for membership is a desire to stop drinking." An AA member is free to reject the disease model of addiction, any belief in a higher power, and even the 12 steps if he so choses and these beliefs will not jeopardize his membership in AA.

A bias against AA - On page 129, Schaler states "It's only by talking about their problems-in-living and encouraging them to confront and solve those problems-in-living that the drug use subsides." That sounds to me like a good description of what AA meetings are and do. Schaler neglects to give credit to AA for providing this service (virtually for free) to the general population.

Stating the obvious - On page 84, Schaler uses a quote, I assume because it says what he is trying to get across, and in the quote it states that the expressing of views opposite to the groups model of treatment is discouraged in AA. For an example of one of these opposite views, the authors use the "concept of controlled drinking." Well, no kidding! If the membership of AA is contingent upon a desire to stop drinking (as stated above), then it's a little naive to think that they would want to entertain the "concept of controlled drinking." After all, I would never go to a Chevrolet enthusiasts group and expect to be warmly welcomed if I were to start talking about my wonderful Ford. This is hardly scholarly material.

Poor logic - One spot (sorry, I failed to note it and cannot find it at the moment), compares alcoholism to diabetes and makes the point that if you take insulin away from a diabetic, they get sicker but if you take alcohol away from an alcoholic, they get healthier. This is misleading logic. A more accurate comparison would be to compare taking away insulin with the taking away of whatever it is that is allowing the "alcoholic" to choose something other than his alcohol addiction.

All in all, it seemed to me that Schaler had broader goals for this book than just proving that addiction was a choice and not a disease. Spending much time talking about his views on civil liberties and comparing drugs to religion only watered down what little actual meat I found there. This book provided entertainment for me but that's about it. I don't consider a real scholarly work.

Doug

Rating:
Summary: not a choice
Review: Anyone concerned about addiction needs to seriously look at this book. Dr. Schaler picks apart the disease model of addiction. This book is a thoughtful journey exploring the myth of the disease model of addiction. Here, Dr. Schaler explores the cults of AA and NA showing how religion and psychotherapy have intertwined in such a way as to take unsuspecting members down a terrible road. These cults remove a person's liberty by diminishing their responsibility for their actions. These cults attempt to replace a person's "addiction to drugs" with an "addiction to religion." The reader clearly sees these programs forcing people to believe they have no control over their lives and put their lives in the hands of a "higher power." A program designed to teach a person to allow some abstract "Supreme Being" to guide them to recovery. It is truly scary and disgusting when you see it in the moral and ethical spotlight that Dr. Schaler shines on these programs. We see how the "War on Drugs" is really a "War on People."

Before anyone considers a program for drug-related problems, read this book!

Rating:
Summary: Another expert relying on evidence, not pop psychology.
Review: Dr. Schaler has been called a "libertarian." Perhaps he is that. But if you've ever been subjected to an "intervention" (a human rights violation not yet addressed by Amnesty International), or forced "treatment," believe me, those experiences lead one to that libertarian approach.

It's amazing how we accept as fact that which is shouted the loudest. The disease model has been blown from every bullhorn since the temperance movement, therefore we accept it. There are a few rebels, those who rely on facts--evidence--rather than the platitudes of the treatment gurus and 12-step addicts who've captured the market. So addiction is one of the leading buzzwords of the day. It's also a means of making us all alike. You know, I may have a bank balance of a billion, could buy Iran in a quick real estate deal, but I'm addicted to such and such, so I'm in the same boat with you, poor moron, who lives in the city and doesn't stop complaining. On that concept, another book has yet to be written.

The "treatment" industry thrives, wasting untold billions of dollars of our insurance premiums on little more than religious sayings. In the meantime, tobacco companies shell out millions for the victims of tobacco "addiction." (Can I get some of that loot? I quit smoking over 20 years ago! No treatment; no 12-step bumper stickers!)

While we most often don't see the 12-step programs as a religion, Schaler does. I know from experience with its adherents--even in "treatment" into which I was coerced--that they claim they're not responsible individuals but victims of genetic circumstance, the propensity for addiction over which they have no control. They MUST rely on their "higher power," whether one calls that power God or anything else. That's not religion? And the 12-step-aholics denial (!) of that is another symptom of the anti-intellectual nature of the "movement."

I probably should state that--and I believe Schaler would corroborate--if a person feels comfortable with a 12-step program, or for that matter with Scientology, he or she should have the freedom to attend whatever meeting(s) s/he likes. But when we're forced by courts to attend such congregations against our will, then there's something wrong. (Fortunately, these forces are being challenged in court, on grounds of religious freedom.)

Schaler is wise too in pointing out that:

(1) many users of allegedly "addictive" substances never become addicted to them;

(2) many an allegedly incurable addict recovered on his or her own, particularly those returning from Vietnam. (So the stupid movies we were shown in high school showing people strung out on this or that demon drug were laugable; those who recovered on their own--and there are many--laugh at that D-grade propaganda);

(3) There are many "addictions," to religion, to fads, what have you. It's just that some are socially acceptable and some are not.

He also challenged the prescriptions of the contemporary panaceas: the antidepressants such a Prozac. (See "Toxic Psychiatry," another good reference on that subject.) During the early to mid-1980s, Valium was the most prescribed drug, given out like candy. By the early 90s, it became one of the demons of the treatment industry. When will Prozac and its cousins fall into the bottomless pit of condemnation by the temerance crowd and that drug's manufacturer start paying their ransom for the concoction now seen as relief for a couple of bucks a hit?

I wish Schaler spent more time commenting on the economics of "treament," face it, the real reason the industry exists. He comments vigorously on the fact that the treatment is a religion, but the emphasis on the monetary motive is one he doesn't stress.

The only other criticism I have is minor but notable. Schaler spends an inordinate amount of space, I felt, commenting on his problems with Moderation Management. While the problems were formidable, the amount of focus on MM reminded me of Carl Sagan's near obsession with Velikovsky in "Broca's Brain." It was a fine book, but the excessive comments on that other author's foolishness distracted from the quality of Sagan's text.

Aside from those minor infractions, I highly recommend the book. Let's those of us who object to the disease model and all its offshoots, including the expensive (And you're paying for it, folks!) "war on drugs" and phony populism (i.e., all of us who are prone to addiction are in the same boat, despite the superficial difference between my immense wealth and your squalor) use information like that in this book to fight the propaganda of the industries capitalizing off of them.

Rating:
Summary: Restored my confidence
Review: Dr. Schaler has been called a "libertarian." Perhaps he is that. But if you've ever been subjected to an "intervention" (a human rights violation not yet addressed by Amnesty International), or forced "treatment," believe me, those experiences lead one to that libertarian approach.

It's amazing how we accept as fact that which is shouted the loudest. The disease model has been blown from every bullhorn since the temperance movement, therefore we accept it. There are a few rebels, those who rely on facts--evidence--rather than the platitudes of the treatment gurus and 12-step addicts who've captured the market. So addiction is one of the leading buzzwords of the day. It's also a means of making us all alike. You know, I may have a bank balance of a billion, could buy Iran in a quick real estate deal, but I'm addicted to such and such, so I'm in the same boat with you, poor moron, who lives in the city and doesn't stop complaining. On that concept, another book has yet to be written.

The "treatment" industry thrives, wasting untold billions of dollars of our insurance premiums on little more than religious sayings. In the meantime, tobacco companies shell out millions for the victims of tobacco "addiction." (Can I get some of that loot? I quit smoking over 20 years ago! No treatment; no 12-step bumper stickers!)

While we most often don't see the 12-step programs as a religion, Schaler does. I know from experience with its adherents--even in "treatment" into which I was coerced--that they claim they're not responsible individuals but victims of genetic circumstance, the propensity for addiction over which they have no control. They MUST rely on their "higher power," whether one calls that power God or anything else. That's not religion? And the 12-step-aholics denial (!) of that is another symptom of the anti-intellectual nature of the "movement."

I probably should state that--and I believe Schaler would corroborate--if a person feels comfortable with a 12-step program, or for that matter with Scientology, he or she should have the freedom to attend whatever meeting(s) s/he likes. But when we're forced by courts to attend such congregations against our will, then there's something wrong. (Fortunately, these forces are being challenged in court, on grounds of religious freedom.)

Schaler is wise too in pointing out that:

(1) many users of allegedly "addictive" substances never become addicted to them;

(2) many an allegedly incurable addict recovered on his or her own, particularly those returning from Vietnam. (So the stupid movies we were shown in high school showing people strung out on this or that demon drug were laugable; those who recovered on their own--and there are many--laugh at that D-grade propaganda);

(3) There are many "addictions," to religion, to fads, what have you. It's just that some are socially acceptable and some are not.

He also challenged the prescriptions of the contemporary panaceas: the antidepressants such a Prozac. (See "Toxic Psychiatry," another good reference on that subject.) During the early to mid-1980s, Valium was the most prescribed drug, given out like candy. By the early 90s, it became one of the demons of the treatment industry. When will Prozac and its cousins fall into the bottomless pit of condemnation by the temerance crowd and that drug's manufacturer start paying their ransom for the concoction now seen as relief for a couple of bucks a hit?

I wish Schaler spent more time commenting on the economics of "treament," face it, the real reason the industry exists. He comments vigorously on the fact that the treatment is a religion, but the emphasis on the monetary motive is one he doesn't stress.

The only other criticism I have is minor but notable. Schaler spends an inordinate amount of space, I felt, commenting on his problems with Moderation Management. While the problems were formidable, the amount of focus on MM reminded me of Carl Sagan's near obsession with Velikovsky in "Broca's Brain." It was a fine book, but the excessive comments on that other author's foolishness distracted from the quality of Sagan's text.

Aside from those minor infractions, I highly recommend the book. Let's those of us who object to the disease model and all its offshoots, including the expensive (And you're paying for it, folks!) "war on drugs" and phony populism (i.e., all of us who are prone to addiction are in the same boat, despite the superficial difference between my immense wealth and your squalor) use information like that in this book to fight the propaganda of the industries capitalizing off of them.

Rating:
Summary: Schaler Misses the Boat with Either/Or Fallacy
Review: I came into this book really wanting to like it. The title suggests that this will be a rigorous refutation of the weak-minded victimization that afflicts our society. Addiction is, after all, a choice and we are morally accountable. While I agree with Schaler that we are accountable for our bad choices, these bad choices are, contrary to Schaler, indeed the result of a "diseased" individual whose will has to be subordinated to a new set of values, a change that many people cannot perform on their own volition. Schaler's "Free-Will Model" is partly true and helpful, but ultimately an oversimplification that denies that diseases can be more than literal, scientific afflictions like syphilis. Diseases can, contrary to Schaler's thesis, be of a spiritual origin. For example, a husband who watches internet porn for several hours every night and ignores his family has both made a bad choice and at the same time is demonstrating a diseased spirit. Why can't Schaler see this? And why must Schaler use unimpressive demogoguery to refute his opponents, as he does on page 9, where he writes that if you find his "Free-Will" Model of addiction "ludicrous or outragous, you are addicted to the disease model." Sorry to disappoint you, Dr. Schaler, but I find the disease model, in its extreme, as morally repugnant and illogical as you do. However, I find your extreme free-will model to be an equal oversimplification. The truth is somewhere in the middle. But to force your thesis and your Procrustean cure for addictive behavior, you create an either/or dichotomy, which is not sophisticated or convincing argumentation.

Rating:
Summary: Sometimes CONTROVERSY is good!
Review: Jeffrey Schaler lays out a different paradigm for addiction recovery in this book, holding alcoholics and addicts responsible for their own choices, which is refreshing and empowering. While taking on the AMA and other forces with financial agendas is risky, Dr. Schaler courageously cuts through the baloney and "tells it like it is". His bibliography is comprehensive and a compelling case is made for abandoning current treatment menthods.

For those people with substance abuse problems who cannot buy into the "disease model" promoted by AA and most recovery institutions, this book is welcome relief! To be held accountable for one's own actions (as any OTHER adult is in this society!) is a GOOD thing! While AA may be helping some people recover, there are plenty more who don't "resonate" with AA teachings and beliefs, and for addicts and alcoholics to reclaim the power to abstain, after professing "powerlessness" in 12-Step meetings, is a blessing indeed!

Rating:
Summary: Sometimes CONTROVERSY is good!
Review: Jeffrey Schaler lays out a different paradigm for addiction recovery in this book, holding alcoholics and addicts responsible for their own choices, which is refreshing and empowering. While taking on the AMA and other forces with financial agendas is risky, Dr. Schaler courageously cuts through the baloney and "tells it like it is". His bibliography is comprehensive and a compelling case is made for abandoning current treatment menthods.

For those people with substance abuse problems who cannot buy into the "disease model" promoted by AA and most recovery institutions, this book is welcome relief! To be held accountable for one's own actions (as any OTHER adult is in this society!) is a GOOD thing! While AA may be helping some people recover, there are plenty more who don't "resonate" with AA teachings and beliefs, and for addicts and alcoholics to reclaim the power to abstain, after professing "powerlessness" in 12-Step meetings, is a blessing indeed!