Pleasure has been confused with addiction for the last 5000 years. The reason for this is that common forms of addiction, like drinking alcohol, taking other drugs, gambling, and seeking sex, are often pleasurable. But the notion that addiction is about pleasure is completely wrong.
Nobody likes people who say "I'm right and you're not." We've all learned to be diplomatic, so nobody's feelings get hurt. But science is different. It's about getting to the truth, not trying to find a way to include everybody's views.
The rehabilitation industry in our country is, unfortunately, filled with false claims and bogus treatments. Virtually none of the major rehab centers even study their patients' outcomes, despite claiming fabulous results. And, sadly, rehab treatment usually fails.
Our scientific examination of AA has led to heated, poorly thought-out responses from both some AA members and a few academics whose careers have involved supporting AA. Challenges to accepted wisdom are always met with resistance, but it would be better to have a less personal, more reasoned discussion.
When doctors don’t know the cause of an illness, they're stuck having to “diagnose” only its symptoms, not the source of the problem. That is just where we stand today with substance abuse, and it’s ruining our chance to treat it effectively.
We have all heard the “One day at a time” AA slogan. Its purpose is to keep people from feeling overwhelmed by the prospect of never drinking again. It may be useful when folks are teetering on the brink of having a drink: “Tough it out, you just have to get through today.” But aside from those moments, it is terrible advice.
Old and ineffective treatments for addiction are still around, at great cost to people suffering with the problem. Holding on to old ideas is common in human history, but it is especially wrong when taking care of others.
Readers of this blog know that addiction is a psychological symptom, a compulsive behavior driven exactly like other compulsions, and readily understandable and treatable. This perspective can be helpful in thinking about the recent election, in which two states legalized the recreational use of marijuana.
This question comes up fairly often. It is the kind of question that cannot be answered if you look only at the surface of addiction: at the behavior itself. But if you peek beneath the surface, the question and its answer becomes obvious.