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pcvarmint · 2016-08-09 · Original thread
There needs to be a distinction made between addiction and dependence, neither of which necessarily implies the other.

Dependence is when your body depends on a substance (generated internally or externally), and suffers withdrawal when it's missing.

Addiction is any repetitive self-reinforcing behavior.

Whether an addiction is "good or bad" is a value judgment which is very dependent on sociocultural and legal context.

Going to work every day to a job you love, can be considered a "good addiction". Same for a "runner's high".

Addiction occurs when the behavior is self-reinforcing and other behaviors of the same or less cost cannot produce the same relative reward that the addictive behavior does. The reward can be decreased pain, distraction from stress, euphoria, or other conditions which subjectively feel better than the status quo. Usually this means there's a stressful situation or lack of pleasure in the status quo. Addiction can be viewed as a rational economic decision based on limited information or time preference, with benefits and costs which are totally subjective to the addict. The benefits and costs do not need to appear to be rational to an outside observer, who has different subjective values and time preferences. [5]

The AA model of complete abstinence and submitting to a higher power is bad for several reasons: It can trigger painful or life-threatening withdrawal symptoms; it denies the person the power to control their addiction, causing learned helplessness; and it does not allow the person to learn to moderate their own addiction.

People behave rationally towards satisfying their addiction, such as by taking complex steps to buy drugs, and they rationally avoid law enforcement and/or medical intervention which prevents them from satisfying their addiction. Their behavior may not be legal, wise, moral or safe, but it is rational towards their immediately perceived needs. They are not hostage to a "disease" which makes them behave uncontrollably, like a seizure does. A disease does not involuntarily make one correctly drive a car down a complicated route to satisfy an addiction. Addiction is a choice. [0] [1] [2]

To say "addiction is a choice" does not imply any moral failing of the addict. In societies where addiction is not tolerated and is viewed as a moral failing, this can either help or hurt the addict, depending on their temperament and situation.

Conversely, saying "addiction is a disease, and not a choice" does not help a person gain control of their addiction, and it delivers an underhanded moral judgment against them, similar to calling someone a sinner but praying for them.

In some societies, ingesting psychotropic substances like coca tea is common, even among children, and does not generate social stigma. There's also not an expectation of intoxication, which decreases the somatic effect it has on the person, and lowers its addictive potential. Zinberg called this "Set and Setting" [3].

In societies where certain behaviors are severely punished, there can be a higher rate of addiction, because of the "forbidden fruit" syndrome, and because the addictive behavior is one of only a few ways out of an seemingly oppressive situation, giving the person a temporary feeling of self-control.

The disease model of AA is unscientific. It presupposes a biological disease, without any demonstrable etiology or mechanism.

When addiction researchers describe changes in body chemistry, MRI scans, etc., they are rarely controlled experiments, so it is uncertain whether the observed changes are due to: 1) random variation among the population, 2) a preexisting condition which increased the chances of the addictive behavior, 3) a symptom of the addictive behavior itself, 4) the effects of (sometimes involuntary) medical treatment post-addiction, or 5) the stress of simply being tested. [4]

Addiction is a learned behavior which provides a temporary subjective reward over not doing the behavior. There is no disease or involuntary lack of control over the behavior. The reward is extremely subjective, and depends on the biology of the person, their social/psychological state, the effects of the behavior on the person's biochemistry, and the social/legal consequences of others learning about their addiction. Everyone will value the multitudes of factors differently. But they always make the final decision of whether to continue the addictive behavior or not.

[0] https://www.amazon.com/dp/081269404X

[1] http://www.psychiatrictimes.com/addiction/addiction-choice

[2] http://www.macleans.ca/society/health/addiction-new-research...

[3] http://www.psychedelic-library.org/zinberg.htm

[4] http://www.thecleanslate.org/myths/addiction-is-not-a-brain-...

Edit: Added:

[5] https://www.wiso.uni-hamburg.de/fileadmin/bwl/rechtderwirtsc...

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