As a rule of thumb, book authors who put "Ph.D." in their bylines have personal axes to grind. Schaler certainly has his, often going on tangents; but Addiction Is a Choice also makes a very good case against the popular pseudo-medical view of addiction as a disease. It's necessary to take some of the tangential tirades about the author's Internet experiences and the actions of specific organizations lightly to get at the core, but it's worthwhile.
It's popularly held that many things -- drugs, TV, computers, and people -- have the power to take away people's free will with respect to their use, and to compel people to keep using them. In a common form of this view, these objects even exercise cognitive control, compelling the victims to deny that they are addicted. In a "Life of Brian"-like twist, addicts can be recognized because they deny that they are addicted, but accepting the charges of addiction doesn't get them off the hook either.
Schaler shows the incoherence of the idea that drug addiction is a disease. He notes the contradiction in the view that addicts have their volition diminished by the substances they take, yet that they carry out complex plans to ensure continued access to their drugs. He points out that this view absolves people of responsibility for their own actions, including good actions as well as bad ones.
If smokers' physical addiction to nicotine causes them to smoke, one might just as easily argue rapists' bodies cause them to commit rape, murderers' bodies cause them to commit murder, child abusers' bodies cause them to abuse. What kind of world would we live in if those theories were upheld by the courts? If we attribute responsibility for the harm people do to themselves to physiological processes, don't we, to apply the rule of law justly, then have to remove people's responsibility for the harm they cause to others?People do quit their harmful addictions, he notes, when they have sufficient motivation to (such as imminent danger of death). If drugs caused involuntary consumption, then the rate of "remission" should be independent of motivating factors; physical conditions don't go away just because they're particularly life-threatening.
Unfortunately, this book pursues more tangents than its short length can support. For example, Schaler devotes a chapter to his charges that a number of people prominently associated with Moderation Management received a murder confession from one of its members and failed to act on it; this action was reprehensible if Schaler's facts are correct, but their actions are irrelevant to the issues which the book addresses. An idea may be endorsed by people who take contemptible actions, but that does not prove that the idea is wrong.
While the book is a mixed bag, its central message is an important one, and is not heard often enough. Perhaps Schaler's work will inspire others to similarly challenge the pop-medical view of addiction.
This review last revised on March 3, 2002
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