Addicted to Addictions

'We have become a society addicted to addictions' declared Nosher as we walked towards his allotment shed one fine afternoon. We had been hoeing our respective strawberry patches, and it was time to relax on our old deckchairs and enjoy the sunshine.
'Do you mean obsessed with addictions?' I inquired. I was glad to accept the proffered wine glass, as Nosher's opening gambit implied the need for reflection.
'It depends on how you define addiction' Nosher replied as he poured us each a glass of his excellent parsnip wine. 'Now that addictions of all sorts have been medicalised, any behaviour that a person feels strongly compelled to repeat, but feels powerless to resist the urge to do so, seems to be called an addiction.'
'Is this about the addiction-therapy business, or the human condition of the addicts themselves?' I asked, already feeling things were getting a little complicated.
'In a way it's about it all' said Nosher 'but primarily it's about the fact that any person who feels compelled to repeat behaviour that is self-destructive can now claim to be a victim of forces outside their control, and medical science and the addiction-therapy business colludes in this by teaching them that they have a physical and/or pyschological problem, whereas the main issue is that they made wrong choices that they don't like the consequences of, yet don't appear to have the moral resources to accept responsibility for what they've done, to learn from their mistakes and change their behaviour. It's easier to blame society and/or their physiology, and/or their emotional problems.'
We sat for a few moments enjoying the sunshine and gazing upon our freshly-weeded strawberry patches.
'Have you been reading medical textbooks again, Nosher?' I inquired.
'Amongst other things' he replied 'but mainly I keep my eyes open and look around. And what I see is as society addicted to addictions.'
'So you don't believe that addiction is a genuine disease?' I said. Nosher looked around as if consulting his surroundings for inspiration.
'Medically speaking' he said after a pause 'disease and illness are characterised in terms of disturbance of function, which presupposes that whatever constitutes normal function is well understood.'
'So are you saying that addiction isn't well understood?'
'Addiction appears to be a complex process involving a number of complex factors, and disturbance of normal function is only one, and sometimes a very minor, aspect of the whole scenario.'
'So you're saying that it isn't a disease?'
'Not in the sense that hepatitis or cholera are diseases' Nosher explained. 'In addiction any disturbance of physiological function appears to arise as a result of addictive behaviour, not as the cause of it.'
'So to call addiction a disease or illness is misleading?'
'Exactly!' there was a hint of triumphalism in Nosher's voice 'addiction appears to have much more to do with individuals desiring a pleasurable release from an otherwise empty or bothersome life, and they then cling to this source of release even when it is destroying their lives, instead of finding a more constructive solution to their problems.'
We heard a Green woodpecker laughing in the trees over on the edge of our little allotment. It seemed to be laughing at us. Then a question occurred to me.
'So the medical approach to treating addictions, and the addiction therapy business, which is very well funded by the State, has a vested interest in convincing people they're ill and require expert treatment, thus locking them into a cycle of dependency?'
'That's exactly what I'm saying' Nosher confirmed. 'Addiction would better be seen as a failure of an individual's capacity to manage their own self-valuing, as a failure of moral resources in society, and dealt with by teaching children how to value themselves and how to maintain a healthy positive evaluation of themselves through constructive and productive means.'
This reminded me of something I'd read recently.
'It's interesting that only the most troublesome cases of addiction are ever treated by the experts' I said 'because the vast majority of people who confess to having an addiction at one time or another spontaneously resolve the problem themselves.'
'Which means' Nosher added 'that addiction isn't a true disease, because it can be overcome if individuals have the moral capacity to take responsibility for their lives, and the courage to face up to the problems they've caused. It may be uncomfortable, but discomfort has not yet been categorised as a medical condition so far as I know.'
This remark was accompanied by another outbreak of laughter from the Green woodpecker up in the trees. This time I was sure it was laughing at us.
'But surely some cases of severe addiction do require expert help?' I said 'especially in cases of alcohol or drug withdrawal?'
'That's not at issue' Nosher replied 'the issue here is the extent to which addiction should be seen primarily as a problem of individual self-valuing and moral adequacy, so that as a society we insist that addicts acknowledge and accept what they really are: morally inadequate individuals who refuse to take responsibility for responding constructively to their circumstances. Only when they accept that can they take the first steps towards changing their moral outlook on life so that in the future they don't feel driven to seek solace or excitement in self-destructive habits.'
At this the Green woodpecker flew off, laughing insanely to itself, as if the very prospect of moral reform was a ridiculous fantasy.
'Somehow I can't see this idea catching on' I said 'primarily because it requires that society itself is reformed - in other words our social and cultural values would have to incorporate the idea of moral reform. At present the very notion of morality induces large swathes of the morally inadequate (at all levels of society) to smirk with derision at the very idea of creating a better society with better people in it.'
'Sad, but true' was Nosher's response.
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