This post is a bit different from what I’ve been doing with Recovery Writing so far. Instead of offering a writing exercise for personal recovery, I’m presenting a bit of my own writing about addiction. This post is a bit of a manifesto, or the start of one, and it’s a longer read than I’ve uploaded before. “The Case Against Addiction” is something that’s been working its way through my synapses for years and has finally found some language—a call to reimagine human compulsions beyond the limits of “disease.” I’ll be curious to hear what you all think.
Making Addiction Real
The word “addiction” refers to a wide group of compulsive behaviors that have a detrimental effect on the lives of people engaged in them. If someone says “I have an addiction,” they might drink alcohol compulsively, spend money compulsively, watch pornography compulsively, fall in and out of love compulsively, use heroin compulsively, eat food compulsively, or do any of a large number of other behaviors compulsively.
However, not all compulsive behaviors are thought of as addictions. For example, the kind of repetitive and counting behaviors associated with obsessive compulsive disorder are not generally understood as addictions. Likewise, there are a number of uncontrolled tics known as “bad habits”—like biting nails or restless fidgeting—that don’t qualify. To be an addiction, a behavior has to be a chronic, compulsive, and ultimately detrimental overindulgence in some form of pleasure.
The reason that the term “addiction” includes pleasurable compulsive behaviors and excludes all others has to do with its history. Addiction was born as a reassessment of the pleasure-giving but undesirable activity of excessive drinking that was, before the 19th century, viewed as a moral failing. Drunkards were weak-willed individuals—sinners—who indulged too much in drink and deserved public shaming in this life, hellfire in the next. The same view was also held of people who engaged in other forms of compulsive pleasure-seeking, like fornicators, spendthrifts, laudanum drinkers, and gluttons.
The reassessment of these behaviors began in 1805 with the publication of Benjamin Rush’s Inquiry into the Effects of Ardent Spirits upon the Human Body and Mind. Rush (who signed the Declaration of Independence and fought in the American Revolution) argued that, instead of being a sin which the drunkard willfully participates in, alcoholism was a disease caused by the action of alcohol on the drinker.
By the end of the 20th century—which saw the rise of Alcoholics Anonymous and the spread of the Twelve-Step recovery movement—Rush’s ideas about alcoholism had morphed and grown in American consciousness until they came to include all manner of pleasure-seeking compulsions under the umbrella term “addiction.” Addiction, as disease, is now the dominant understanding of these compulsive behaviors in the United States, effectively displacing (but not extinguishing) the older, “moral view” of the same compulsions.
When humans change the way they think about something, they also change their behaviors related to that thing. They create new institutions, pass new laws, build new buildings, invent new devices, adopt new habits and values, form new relationships, take on new identities—in short, they transform their personal, social, and material realities in ways that accord with the new way of thinking. I refer to this process of recreating the world in the image of an idea with the phrase “making real.”
Addiction is made real through the activity of people who believe in it. This activity gives a tangible, material reality to addiction in the form of legal documents, insurance claim paperwork, treatment cell blocks in prisons, mutual aid society meeting spaces, popular media depictions of addiction and recovery, pharmaceutical treatments, expensive rehab centers and detox facilities, publications of national medical organizations, and all of the many other physical things that humans produce in order to address, affirm, control, and comment upon addiction as a disease.
Humans who believe in addiction also act in ways that give the “disease” a social reality, which takes the form of things like interactions between treatment center clients and staff, arrests made by DEA agents, negotiations among lobbyists and politicians, the interviews of reporters documenting things like the “opioid epidemic,” camaraderie among fellow addicts in Twelve-Step fellowships, public advocacy efforts by pro-addiction-as-disease social movements, and the relationships between self-identified addicts and their therapists, social workers, religious authorities, lawyers, and family members.
This social reality translates into a highly personal reality when individuals absorbed in compulsive pleasure-seeking come to view themselves as addicts. Taking on addiction as an identify, such people adopt a new self-image, interpret their life histories in new ways, exhibit new behaviors, engage in new relationships, and perform intimate acts like journaling, prayer, confessional speech, and self-storytelling in ways that are shaped by their internalized and personalized version of the idea called “addiction.”
As addiction is given personal, social, and material substance, it also adds itself to reality as we humans understand it. “The real”—by which I mean the ways in which we collectively experience and understand our existence—takes on new qualities when an idea like addiction is made into a normal, commonsense feature of our world. Simply put, when addiction is made real, reality comes to include addiction. And so, the phrase “making real” also refers to the way in which ideas like addiction are not only made real by human action but also contribute to the structure of shared human experience.
We now live in a reality where there are millions of self-identified addicts, a massive addiction treatment industry, multiple mutual aid societies for various types of addicts, laws about addiction and addiction treatment, pills that claim to treat addiction, countless tell-all autobiographies and self-help books, official recognition of addiction as a disease from the American Medical Association, and many, many other products from the process of making addiction real.
This process has established addiction as a durable and self-perpetuating feature of our reality which transcends the entire collective of humans who are convinced that addiction is a disease. In fact, if every addict and every addiction-is-a-disease-believing individual were suddenly removed from the Earth (and assuming there were some humans left willing to run things), we would still have people who fall into self-destructive patterns of compulsive pleasure-seeking. We would also have all the same laws on the books, all the same treatment centers and detoxes, and all the same mutual aid societies. We would have an entire legal, social, and material infrastructure built to apprehend and process compulsive pleasure-seekers as addicts. The first time an inebriate or an opium eater showed up in drug court—or confessed their behavior to a doctor or therapist—the wheels of this infrastructure would begin to turn again, eventually reproducing all the same the social relations and individual identities that we now associate with addiction.
All this does not mean that compulsive pleasure-seeking has no reality independent of “addiction.” Both addiction and its predecessor, “sin,” are ideas that built themselves into our world on the back of human compulsion, which existed prior to them both. For this reason, when I speak of “addiction,” I am not talking about the underlying behaviors that addiction appropriates to make itself real. Instead, I am talking about the idea “addiction is a disease” plus all the work we do to give this idea life.
Together, this idea and this work constitute a construct of collective imagination, something that builds itself into our world through our collective process of imagining and enacting it as a lived reality. This places addiction in a class of things like “money,” “democracy,” “salvation,” and “human rights”—imaginal entities that exert a tremendous influence over human experience and behavior. All such entities are made real by the humans under their influence in ways that become self-sustaining, normalized, and common sense. As a result, addiction has grown into a durable part of our world in ways we can’t fully control. We are, to repurpose a phrase, powerless over addiction. It is an idea that has made itself difficult to unthink.
We Are All Addicted
In the ways I’ve described so far, addiction is just like any other construct of collective imagination. It arises through humans and makes itself real through us, but it isn’t under the conscious control of any specific person or group. Just like we do with other imaginal entities like “justice” and “art” and “manhood” (and so on), we do a lot of work to make addiction real, even though we are not always entirely aware of this labor or why we are doing it.
But addiction may also be unique among these entities in the service it provides to the American psyche, which is one of displacement, repression, and scapegoating. The United States as a whole is caught in a dangerous pattern of compulsive overconsumption, while Americans largely remain in a denial about our collective behavior and its emerging consequences. One expression of this denial is the projection of our faults onto addicts, a minoritized group of citizens who do individually what we are all doing as a nation—consuming to the point of self-extinction. By isolating addiction as a “disease” that exists only within the bodies of addicts, we can collectively ignore all the ways in which the very same dynamics appear in the normal, “non-addictive” activities of daily life in the US. Like filling our tanks with gas.
When the second President Bush stood before Congress and declared that “America is addicted to oil,” he was not far from the truth. Reportedly no stranger to compulsive pleasure-seeking himself, Bush was perhaps well positioned to see the dynamics of his own relationship to pleasurable substances reflected in America’s energy dependence and related foreign policy. The irony that it should be George W who made this observation—he was, at the same time, overseeing a massive project of regime change and oil asset seizure in Iraq which had already resulted in the deaths of millions of Iraqis—was likely lost on the president, most famous for his gaffes and airheadedness. Nevertheless, he had somehow stumbled on to a critical insight, that the US (like many other nations) depends on oil in precisely the same way that dope fiends depend on dope. Specifically, our relationship with oil is self-destructive, persists in spite of negative consequences, and grows more severe over time. Also, and just like any “addiction,” we put a great deal of effort into denying the facts of our oil dependency, even though they are plain for all to see.
But oil dependency is only one aspect of our “disease,” which is to consume all resources in excess of what our planet can endure. Each year humans gobble up more materials than the Earth can regenerate in a year’s time, and each year we hit the point of overconsumption earlier. Economists sometimes refer to our always-accelerating overconsumption as “consumerism,” a term they use to praise this behavior, thinking of it as the driving force of the US economy. This “spin” on the facts allows us to go on believing that filling our air with pollutants, our oceans with trash, and our bodies with microplastics are all perfectly normal, rational—or in any case unavoidable—things to do.
As a rule, an active addict never consciously attempts to make addiction real in their own lives. Instead, they work very hard at the project of making other ideas real—ideas like “I can stop anytime I want,” “I’m not hurting anyone but myself,” and “I’m only having a good time.” Each of these ideas seeks to interpret the underlying compulsive pleasure-seeking behavior in a way that makes it reasonable, harmless, even justified. But, as the compulsion progresses and its consequences grow more severe, none of these ideas can fully account for the facts of the addict’s behavior. “I’m only having a good time” doesn’t hold up for long when your life is defined by losses—loss of money, employment, relationships, housing, health, sanity, freedom.
In exactly the same way, we Americans are collectively avoiding the project of making “oil addiction” real. Instead, we are working overtime on a set of already threadbare ideas—“consumerism,” “profit,” “economic growth,” “free enterprise,” “luxury,” “middle class lifestyle,” and so on—ideas for which the real-making process requires massive expenditures of energy and natural resources. Just as the alcoholic attempts to realize a fantasy of control while steadily drinking himself to death, we grasp at these fantasies of comfort and power while the Earth sheds biomass and temperatures climb.
And this brings me back to the service that “addiction” provides to the American psyche. Every time we point to a fentanyl user twitching on a street corner and say “there is an addict,” we effectively say to ourselves “but not us. We are not like him.” Statements like that are dangerous acts of denial. They allow us to go on with our potentially world-ending levels of “ordinary” consumption and pretend that we are doing nothing wrong, when the fact is that our collective “disease” is far more dangerous than the one affecting the man on the corner. After all, he is only killing himself.
But placing “his” overconsumption in opposition to “ours” also misses the point. In every way that matters, they are exactly the same thing—manifestations of the same underlying process. In order to even have a chance at recovery, we will have to admit that we are just as “addicted” as he is.
Overconsumption, Big and Small
Compulsive pleasure-seeking is an adaptive response on the part of certain individuals to an environment of collective overconsumption. While this type of individual behavior can arise in many contexts, it is endemic in situations where overconsumption dominates. Such environments create a great deal of stress for individuals, who become alienated and socially dislocated within them. This stress results from the many ways in which the process of collective overconsumption repurposes and rearranges all the particulars of human life—including our desires and values—in order to meet its own needs. In this way, compulsive pleasure-seeking is nothing more than the realization of overconsumption in the lives of individuals.
Just as individuals who adopt the identity of “addict” are internalizing a project of collective imagination, so do the same individuals internalize the dynamics of a self-destructive culture when they become compulsively fixated on a specific source of pleasure. Such fixation provides above all else a relief from the distress created by living in a human-made reality that is dramatically out of sync with the rest of life on this planet. In seeking relief this way, the addict enters a personal trajectory that mirrors our common fate—ever increasing consumption along with ever greater consequences.
By virtue of internalizing and personalizing our collective overconsumption, the compulsive pleasure-seeker provides society the service of acting out our shared dysfunction for all to see. In this way, the drunkard stumbling through the streets acts exactly like a canary in a coal mine. His progressively less recognizable song and painful death are meant to warn of an invisible danger that threatens to kill us all. But, instead of heeding the warning, we walk past his cage, telling ourselves that the bird is defective, and go on swinging our axes into the earth.
None of this absolves individual overconsumers of personal responsibility for their particular state of affairs or for the harm they cause others as they act out their “addictions.” In fact, through the interpersonal pain and chaos they create, overdrinkers, overdruggers, oversexers, overspenders, overeaters, and so on are all perpetuating the very conditions for others that led to their own compulsions. Even if collective overconsumption were to end immediately today, we would still have several generations worth of trauma and self-destructive personal habits to work out. We would also still have—lurking in the way we each carry our maladaptations to collective “disease”—the potential for some group of us to set off the process of collective overconsumption all over again.
Individual compulsion remains a real problem, and it is often by making a full account of their actions and attempting to amend the harm they have caused that chronic pleasure-seekers find lasting sobriety. However, without a collective recovery—meaning a shared reality in which we work together to end collective overconsumption and undo its damage—individuals in personal recovery end up readapting themselves to the demands of a diseased culture. In the process, they increase their participation in collective overconsumption—by getting a job, driving to work, buying nice things with their money—leading, eventually, to a situation that is both deeply unfulfilling and painfully reminiscent of the conditions which led to their self-destructive behaviors in the first place. In most cases, such efforts at recovery result in either relapse or the development of new personal compulsions to cope with the trauma of living a perfectly ordinary life in a deeply troubled world.
And here we arrive at the greatest failing of “addiction” for the compulsive individual. By defining itself as a disease, addiction has been able to ward off much of the harm caused by the moral model of compulsive pleasure-seeking. Where sin responded to compulsion with punishments and shame, the disease model responds with treatment and care. But addiction also locates the problem of overconsumption within individual bodies without ever connecting the dots between personal and collective dysregulation. In working to make addiction real through our legal system, treatment industry, and mutual-aid societies, we ensure that individual compulsives internalize the source of their affliction rather than locate it in the space between themselves—with all their pain, trauma, and desires—and a culture of destructive overconsumption. This means self-identified addicts have no context in which to understand their condition and are even actively discouraged from thinking of their compulsions as anything other than an inscrutable personal failing, probably encoded somewhere in their genes. Without context, addicts cannot imagine a solution to their struggle that looks like anything other than an unwitting reassimilation to and reproduction of the underlying problem.
Failures of recovery are failures of imagination, specifically of our collective imagination and its wayward project of diseasing “addicts.” To be clear, there is no individual solution to collective overconsumption. We cannot recycle or rehab our way out. We are going to need to stop making addiction real—it is only another form of denial—and begin a project of collective recovery.
Interesting perspective that I don’t wholly agree with nor disagree with. You make interesting points that we’re all addicts in the current framing of addiction—when really it’s often just coping with a fucked up world. I believe the disease definition came about due to insurance coverages in health care. ACA deepened that perception—that BTW as a person in recovery from my various compulsions—I do not believe in. You don’t “catch” addiction. You earn it through repeated behaviors.
Thought provoking read.
Whew, James, seriously, you've fully pulled back the veil in this amazingly deep dive into the "collective unconscious". Reading this is the first time I've been able to wrap my mind around the false narratives alive and thriving in our culture and beyond. I believe this is because your essay speaks from the heart, into the heart whilst the ego sits it out, unable to push back the truth. I suggest this essay be offered into the History of Addiction Studies or sent to the higher-up of all systems who work in so-called "Addiction Treatment". A brilliant expose of the underpinning of how modern society desires and will resort to killing to live a life of non-responsibility and a pleasure seeking existence without ever recognizing the consequences now knocking at the door of every heart here in the USA and elsewhere in the God forsaken world.