Customer Reviews

Addiction Is a Choice

5 star:		(15)
4 star:		(7)
3 star:		(3)
2 star:		(5)
1 star:		(7)

 

 

i have to say that, as an alcoholic, i have mixed feelings about this book. on the one hand, i KNOW consciously that i can turn down a drink of scotch or a 40 ounce bottle of beer whenever i want. on the other hand, i can't escape the feeling that i want (note: i won't say "need") these things more than people who do not suffer from an addiction to alcohol. so what an i to conclude?

well, the truth is probably a middle ground between the two camps. addiction is not a "disease" in the sense that cancer or AIDS is. that's ridiculous. anyone who says that they are the same thing are probably overdue for a good, old fashioned, punch in the face. addiction is not a "disease" in the sense that these calamities are.

on the other hand, people who suffer from addictions, like me, (and like innumberable other alcoholics and heroin, crack or even cigarette addicts) are suffering in a manner that the general populace can't understand. they don't understand the compulsion, the psychological selfishness, the shame, or the sense that one needs a "fix" in order to "be ok".

he (the author) has, in some measure, shamed us. but it's not as though we do not need to feel ashamed. we have made terrible decisions, but we have largely allowed the spector of "disease" to free us from our own moral culpability. in the end, the truth is this, and nothing more:

we are responsible for the choices that we have made. if we are addicts, the choices may be harder, but they are still ours to make. we are NOT powerless. we do NOT need Alcohoics Anonymous, though it may help us to lean on others who have suffered as we have.

but, ultimately, the power does not lie with god, or with the collective group of fellow alcoholics. the power lies with you and with me. seeking out our brethren may a good way to find encouragement...fellow people trying to stay on the right path...but it's not a substitute for being a good, and responsible person. in the end, we are accountable to god (if he exists) but more importantly to ourselves and to our loved ones.

don't let this book keep you from getting help, if you need it. but, at the same time, don't let anyone tell you that you need anything other than yourself if you truly want to get better.

find yourself. find your voice. the ability to heal is yours and yours alone.

signed,

an alcoholic.

"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.

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.

This book dispels many myths about addiction, such as the disease model, which asserts that someone "loses volition" while addicted. As this book rightly points out, people are quite rationally and deliberately able to go to great lengths to obtain more of their "addictions", something which wouldn't be possible if they really were "involuntary", such as a reflex or a seizure. As such, the disease model has no scientific basis.

The book rightly points out that the current models of addiction are tied to our current war on drugs, and thus date back to the Temperance movement.

The addiction treatment industry, psychiatry and psychotherapy, and the War on Drugs, are like three members of a love triangle, all threatening personal freedom and individual liberty (even the freedom to think for oneself). This book doesn't use this metaphor, but mentions all three points.

The book is humane and compassionate towards people who have become addicted to harmful mind-altering drugs. But unlike most current treatment methods, which focus on punishing the addictive behavior itself, this book rightly focuses on "problems of living" which lead to the drug use in the first place. The author rightly points out that punishing an addict for drug use, while not helping to address the underlying problems which led to the addiction in the first place, will not stop the addiction -- it merely replaces it with another one, such as an addiction to 12-step meetings, or an addiction to anti-drug crusades.

The author cites an example of a former teenage addict who was shocked at first, but later relieved, when the author didn't quote treatment industry dogma to her, like all of her former counselors did. He also didn't focus on her addictive behavior, but instead, addressed her problems of living -- problems which led to the addiction in the first place. What a radical concept!

The author advocates complete legalization of drugs, but does not condone their unmoderated use, and fully supports prosecution of offenses committed while under the influence (such as driving under the influence, or murder).

In one of the chapters, the author makes some non-sequitor arguments in favor of mind-brain duality, but this is easily overlooked.

The author questions "either-or" thinking of AA and other recovery groups towards alcoholism and addiction generally, pushing instead for moderation.

This book empowers the individual to make decisions regarding addiction (and everything else), questioning popular opinion which tends to deny choice, and thus denies all freedom and responsibility to the individual, leaving it all up to the state or to the treatment industry.

Too bad the ideas in this book are not accepted more widely, because it would really help curb the "drug problem". It is a refreshing change, in a culture "addicted to addiction treatment".

Unfortunately, when subjects are divisive like addiction, the polarization of debate appears to displace more critical and synthetic thinking. As a good index of polarization, this book has received many five and four star reviews and many one star reviews. That says something. Several other reviews have already commented on the polemical and ideological nature of the author's writing. I'm afraid that this treatment, although it addresses some of the excesses of the simplistic "disease model" of addiction, still doesn't really hit the target of a truly balanced or integrated view of this group of disorders. Obviously, there are tons of problems with any view that suggests that addiction is a disease like cancer or diabetes or heart disease. Obviously, all addiction includes a core behavioral component. The $64,000 question is what is wrong with behavior and what is driving this.

Unfortunately, the author seems to believe that it is a "novel insight" (and against the standard view of addiction) to suggest that addiction is a choice brought in to prop up failing emotion regulation, in other words, that addiction is something that comes on board in the context of a generally dysthymic state in an effort to move towards a more euthymic state. This is bloody obvious to anybody who has ever treated anyone with an addiction and who has ever taken any kind of careful clinical life history for patients struggling with an addiction. Whatever neurobiological issues there are in addiction, and there are a ton of them that the author glosses over or misrepresents, it is obvious that addiction takes place in the context of failing affective regulation. It's extremely rare that someone who really has no major affective challenges and whose life is going along quite well (and not simply superficially well) develops a serious addiction. However this does happen, and this is something for which the author simply does not have a good explanation.

The evidence from tons of work is simply that addiction is an effort to artificially move and activate critical systems in the brain that are centrally involved in emotion. Many if not most addicting drugs directly or indirectly modulate the ventral tegmental dopamine fields, which unfortunately have been misrepresented in large areas of neuroscience as "the reward system" in the brain, when a more concerted review of work in this area (see for example Panksepp, 1998) suggests that this system is part of a generalized motivational arousal system for the SEEKING of rewards. Stimulating the system directly (which has been done extensively in animals and to a much lesser extent in humans) creates a generalized expectancy, a certain kind of euphoric excitement and anticipation of reward. There are other addicting drugs whose primary effects are probably not on this system, such as opioids (although opioids still impact the system) but where the drug effects a peptide neuromodulatory system that has a primary role in mood. The evidence is that opioids are not secondary but rather primary modulators for virtually every form of pain and pleasure that a mammalian brain is capable of.

I believe that the best model of addiction is not that it is a simple "choice" and not that it is a "disease" in which there is no voluntary component, but rather a complex motivational disorder in which one motivational attractor (the addiction) gradually crowds out and even swallows (roughly analogous to a black hole) all the other motivational attractors. This happens for many reasons, including most typically because the addiction comes onboard to regulate dysthymic emotional states for which the person has no answer. However, in addiction, the SEEKING system becomes pathologically `captured' and hinged to a particular drug or activity. Addiction is metaphorically getting this mesolimbic motivational system to `chase its own tail', to pursue things that activate the mesolimbic dopamine system directly (either via chemical or other means). As a clear indication that pleasure broadly defined is not the same as this generalized SEEKING system, people with increasingly malignant addictions will consistently describe that they get minimal to no pleasure anymore from their addiction, but they still can't stop craving the source of the addiction. In severely dysfunctional addictions, what we see is a dramatic separation between pleasure and motivation. As people's motivational spaces are captured by darker and darker activities that yield less and less in the way of joy and increasing amounts of suffering, why doesn't the person "get it" and stop the addiction? Is this really happening because of a simple conscious choice? This underlines how the system for general motivational arousal has been `captured', and that one activator of the system over time wins competitions with all available `natural' activators, rendering them motivationally irrelevant. This eventually results in a totally obsessed person, and of course the gradual and progressive sacrifice of all other adaptive territories to the addiction, with all the usual and attendant devastating consequences.

However, to suggest that this is simply a conscious 'choice' and that there is no neurobiology behind it strikes me as an unfortunate example of the pendulum swinging from one extreme to the other. Indeed, to suggest that any complex human behavior is just a conscious choice simplifies how much of the motivational iceberg is really below the water line of consciousness. It would be nice if everything that we did was really a totally conscious choice. The book however does offer some constructive antidotes to the excesses of the simple disease model of addiction. However, it still falls very far short of a truly integrative synthesis of the literature on this common condition.

Jeffrey Schaler's book is well written and sourced throughout. He makes his argument that addiction isn't caused by a mysterious disease, but that anyone who suffers from an addiction does so because they find pleasure in the use of the substance they are addicted to.

This is a short volume that is packed with useful information. If it had been the only book I read on the subject, I would have given it 5 stars. Instead, though, I've been reading quite a bit on the subject, and found this slender book to be just a bit shy of of the fifth star I awarded some other authors who wrote on this subject.

The truth of the matter is, there have been numerous studies done over the past several decades (many of which Schaler quotes). Not ONE of them have been successful in proving that alcoholism is a disease. Not ONE. Yet, assuming the physicians and organizations that push AA and similar 12 step treatment are at all well-read (and, I assumed so; I mean, they were the 'experts'), they still push this alcoholism as disease concept! If they don't read the current journals and books, why are they in their posts? Is it the massive amount of money poured into the treatment centers? Is it really a benevolent action to encourage (or, in some cases mandate) those with addictions to enter treatment or AA when ALL of the evidence has proven that it really doesn't work? Sometimes, believe it or not, the evidence has shown that AA and 12 step treatment is, in fact, MORE detrimental than no program at all. As confusing as that sounds, imagine being told every day that you are powerless, lack any control, are not responsible for your desire to imbibe, etc. Those that are indoctrinated with this belief system obviously believe they are diseased, permanently sick, permanently and forever in need of meetings, permanently and forever believe they have no control over their behavior, permanently and forever believe they have no power. In fact, they are told and believe that they will ALWAYS be in a permanent state of "recovery". That being "recovered" is nonsensical and elusive. . . their state, always, is "in" recovery-- they will NEVER be better. They will ALWAYS be labeled as an addict or alcoholic. Imagine having that label for the rest of your life.

Additionally, what makes the most sense? If one is trying to eliminate their addiction, does it make sense to hang out pretty much exclusively with other addicts and alcoholics on a daily basis? Or, does it make sense to hang out with those that have healthy balanced lives and don't "need a meeting" on a daily or almost daily basis? Common sense tells us that to BE healthy, one must have balance in their daily lives. Work, family, recreation, etc. How can this take place when AA members are encouraged to attend daily meetings (it's considered a badge of honor to attend meetings daily, or even two to three meetings daily!), to read only AA "literature" (ugh. I use the word literature, because that's what they call it! Did you ever critically read this material? I wouldn't call anything AA or Bill W. has put out 'literature'), to talk to an alcoholic daily, to do service (help other alcoholics), etc.

There is no balance in this type of life. It's indoctrination and brainwashing. Furthermore, it has been proven NOT to be successful. Other more effective ways to curb addiction has been discovered and it is a shame that the very people we've entrusted to help those struggling with their addictions are pushing an outmoded, proven-not-to-work, decades old bit of folklore.

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!

This book "jumped" off the shelf at the bookstore and landed in my hands - right when I needed it to understand more about addiction. I read the first three chapters sitting on the floor of the self-help/recovery isle! After talking with a "therapist" and attending some "meetings" to help me understand my husband's addiction (and those of some of our family members), I just was not feeling "right" about addiction treatment programs. This book offers a fresh, common-sense perspective about addiction, whatever that addiction may be. There is a great deal of sound research cited (although I must admit, I skimmed over those parts and went straight to the meat of the book)and some great examples! Dr. Schaler pulled me right over to seeing his side of things. The only downside to this book is - it left me hungry and wanting to know where I can find practitioners/psychologists/therapists that support this view (practical information). I assume these professionals are hard to find. Thank you Dr. Schaler and PLEASE continue spreading the word!

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!

I was intrigued with Dr. Schaler's theme, and had wanted to buy this book previously but had even more of a reason to after I found out two people I know and care for had abused alcohol.

Essentially, Dr. Schaler's thesis is that its not alcohol or substances (like drugs) that entice people to abuse them, its the people themselves who use them end up abusing them by choice. Oft times, Schaler points out, people will turn to booze or drugs in order to escape the problems they face rather than deal with them.

Himself a psychologist and teacher by trade, Schaler is not saying that people who abuse substances don't deserve compassion, support, help or guidance.

However, he is saying that people need to be taught they are responsible individuals and their self-confidence needs to be reinforced so they are not dependent on others for treatment. They have the will power to stop the destructive behavior(s) they are participating in.

While I found his accusations of Alcoholics Anonymous (AA) being a religious cult a little far-fetched, I do think that his analysis of the failures of AA's treatment program and the history of the group are accurate.

Unfortunately, groups like AA and the 'treatment industry' use the 'victim' or 'devil-made-me-do-it' mentality as a reason to get people to rely soley on them for ending a person's abuse of things like narcotics and alcohol while breeding endless amounts of helpless victims.

More often than not, Schaler says, people can overcome their problems and dump their abuse of substances. But in order to face life's difficulties people need to take responsibility. If they do not, they can excuse almost anything by claiming to be a victim. As a former smoker who quit 'cold turkey' over 19 years ago, I completely agree.

If you are curious about what alternatives there are to AA, I know a few people who have used Objectivism to helped them to successfully stop smoking, abusing alcohol or overeating. If Objectivism isn't your 'cup of tea' an excellent book that is out called "Rational Recovery" by Jack Trimpey or books written by Stanton Peele. Both Peele and Trimpey emphasize self-recovery with planned, permanent abstinence.