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Providing straightforward information pertaining to drugs, drug use & drug policy. The Grey Pages promotes drug-related literacy and advocates a system of viable and tolerant drug policies. This is my personal collection of commentaries, essays, tid-bits, and other such writings on everything ranging from drug use, drug policy and drug-myths, to drug-science, addiction, human behavior, and the workings of the human brain. I started this blog with a particular focus on opioids, and over the past year have found my interest gravitate toward the intriguing, ever-changing world of designer intoxicants (i.e. "research chemicals" or "designer drugs").

Monday, April 4, 2011

Personal Motivation & Priorities: A Constructive View on Addiction

Introduction:

The many intricacies contributing to drug addiction and its characteristic behaviors are vastly encompassing and complex - it is neither practical nor possible to thoroughly articulate each and every psychological, environmental, emotional, and psychosocial force underlying the manifestation of addictive drug use without publishing an entire book, which at this point I lack the time, resources, and credentials to do. The underlying concepts, which I discuss herein, obviously serve as little more than a summarized overview of my own theories and observations thus far, which in time I will continue to build upon with further experience, research, study, and formal education. Much of this review is premised upon the simple question; "Why do some people continue using drugs despite harm to themselves or others?"

I should first clarify exactly what phenomenon, in this essay, I am referring to as "addiction". For these purposes, we will conceptualize "drug addiction" as a behavioral pattern involving habitual drug use which continues despite causing harm to oneself or others. 

Traditional Theories of Addiction:

(1) Disease or Medical Affliction? 

I myself, and many seasoned experts (Peele, Shaler, Szaz and others), have long made the case that addiction is not a disease. Substance dependence is no more a medical illness than is a romantic relationship or any other passionate devotion to any device or fellow human. Here I distinguish the so-called "disease of addiction" from other diseases such as cancer or diabetes. See here for a collection of background literature on the disease model of addiction, and see here for a thought provoking examination of opioid addiction (which I highly recommend, as it paints a relatively straightforward image of how the brain works in the case of drug dependence)

(2) Moral failure? 

I don't believe that drug use or habitual drug use in itself is a moral failing, nor do I believe that addiction to a drug is any direct indication of moral weakness. This is not to say there are no addiction-related behaviors that are immoral, but simply to point out that casual drug use or drug dependence itself is not inherently immoral, nor do these specific behaviors inevitably lead to immoral behavior.

Absolute morals vs arbitrary morals...

It is important to emphasize that there are different types of morals, that not all morals dictate "right and wrong". Absolute morals are those values which most everyone shares (with the exception of sociopaths); most of us arguably know that it is wrong to kill, steal, and otherwise inflict harm or impose onself on others. Arbitrary morals, on the other hand, are subjective values to which individuals adhere; many religious morals could be considered arbitrary - for instance avoiding meat, abstaining from sex, wearing a veil or scarf in public, avoiding non-kosher food, and avoiding certain drugs, gambling, or self-indulgence in otherwise hedonistic pursuits.

Further on I'll explain how it is not so much drug use or addiction itself that is "immoral", but rather many of the damaging behaviors often associated with the careless or compulsive search of pleasure and self-satisfaction.

(3) Weak Will? 

Will power seems to be a loosely used term with no clear definition (at least not any definition that makes sense upon critical examination). Those less familiar with use of our english language might assume that "will power" denotes one's ability to act out on his desires (to act out on his will). But for the most part, we popularly use the term to describe the ability of one to resist his desires (i.e. to resist his own will) - therein lies the problem, how can someone who resists his own desires be said to have a strong will? Therefore, by its popular definition, I don't acknowledge the term will power; as arguably (in most cases) most individuals will do what they want, or what their "will" desires. An exception being those cases in which the pursuit of a particular desire conflicts with the safety and well being of ourselves or others - in such an ethical dilemna, we must make decisions - ideally using restraint and our own values (i.e. often times either absolute or arbitrary morals). 

In the case of addiction, addicts use drugs because they want to use drugs. In fact, as I and others argue, the will to use drugs is generally rock solid, and in severe cases might not even be broken by the prospect of serious illness or death. Just as people act on a desire to continue using drugs, the same can be said to the contrary. Those who want to abstain from drugs will abstain from drugs. Furthermore, those who want to use drugs moderately will use drugs moderately. Even in cases complicated by an unpleasant state of withdrawal upon discontinuation, those who genuinely want to make behavioral changes or abstain altogether will ultimately commit to doing so. 

Almost universally, we tend to perceive "drug addicts" as those who continue to use drugs despite its conflict with his or her own well being, or the well being of others. Being human, we take comfort in believing that those who continue to use drugs despite these negative consequences really don't want to be doing so, but cannot control his/her behavior because they are the victims of a medical affliction, a disease. This is unfortunately not the case. 

An Alternative Theory of Addiction:

There may be many reasons that some people continue to use drugs despite hardship; and - aside from their desire to use drugs - I contend that such reasoning is typically rooted in a) misplacement of personal priorities and b) disarray of personal motivation (both of which are dictated by one's own values and judgement, and both of which I elucidate further on). 

Our personal priorities and personal motivation are in many ways one in the same. They are mutually complementary. Our priorities influence our motivation, while our motivation influences our actions (actions which, to state the obvious, reflect our priorities and motivation).

(1) Disarray of personal priority

Our priorities are the elements in our lives which we value most; 

Our priorities may include things which we rely upon for happiness, health & well being, love & affection, or a sense of purpose. Other priorities may be those people, activities or things in which we have a large investment or for which we hold a large degree of responsibilty (such as holding a job or parenting) - whether or not we personally derive any satisfaction from prioritizing such things.

Being irrational, imperfect, and largely emotionally driven creatures, it is common for us to misplace our own priorities, due to poor judgement & emotionalization of our choices. Some passionate teenage relationships could be a classic illustration of misprioritization; and a perfect conceptual analogue to a drug problem such as "addiction":

Jack loves Jill and Jill loves Jack. They have been together for three years. They are mutually dependent on each other emotionally and intimately. These lovers are addicted to a relationship, in every sense of the word. They devote all their time to each other, spending every waking moment together while neglecting school, work, family, friends, and their own independent well being. Were they to spend time apart, Jack and Jill would suffer symptoms of withdrawal, with characteristive depression, anhedonia, lethargy, amotivation, etc. Despite failing grades, strained friendships, and write-ups at work due to excessive absenteeism, Jack and Jill continue spending all their time together, while neglecting other pursuits. They have both prioritized their excess togetherness to an extent exceeding other vital priorities such as work, school, and their own health. To top it off, Jack has began beating Jill, causing her frequent injuries. None the less, Jill is reliant on Jack, and prioritizes their mutual love more than she prioritizes her health. Whether Jill's misprioritization in this case is a matter of emotional investment, irrationality, low self esteem or simply a death wish; Jill may or may not have considered for herself, and for the onlooker, is up for debate.

(2) Disarray of personal motivation

When harm to oneself or others is insufficient to deter one from their continued patterns of destructive drug use. 

When ones motivation to continue taking drugs outweighs ones motivation to cut down on use or stop taking drugs altogether.

Our judgement determines our personal priorities and motivation...

In the midst of addictive drug use, our personal choices in these circumstances may include; continuing our current behavior, abstaining from drugs, or moderating our use by making changes to our lifestyle. Our own values and judgement are a major determinant in what choices we make in this case. 

Poor judgement can lead the addict to misplace his own priorities, leading to a lack of motivation to change his behavior - and in fact, positive motivation to do the opposite - when it may be important in maintaining his well being, or the well being of others.

Commonly, misguided judgement leads to a misplaced set of priorities and motivation which, when acted upon, intersects with one's relationship with their environment and bystanders in a way which harms others. Poor judgement could be a matter of simple incompetence, or it could be a case of conscious disregard for "better" judgement - indicating a moral failing. In any case, poor judgement is the final factor leading to the harmful behavior which we attribute to addiction.

"Very well", one might say, "but what about the biological component of addiction? Isn't this how we know addiction is a disease in the first place?" - More on that in my next piece.

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