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Addicted by Choice?

James Q. Wilson's a review, in the latest Claremont Review of Books, of the provocative book, Addiction: A Dissorder of Choice, is now online.  A sample:

But if attitudes and sanctions affect drug use, how can we explain the familiar claims that people in drug treatment programs are rarely if ever cured and that "once an addict, always an addict"? The explanation is easy: these claims are not true.

Heyman draws on three major national surveys to show the falsity of the argument that addiction is a disease. The Epidemiological Catchment Area Study (ECA), done in the early 1980s, surveyed 19,000 people. Among those who had become dependent on drugs by age 24, more than half later reported not a single drug-related symptom. By age 37, roughly 75% reported no drug symptom.

The National Comorbidity Survey (NCS), done in the early 1990s and again in the early 2000s, came to the same conclusion: 74% of the people who had been addicts were now in remission. As with the ECA, the recovery rate was much higher than in the case of psychiatric disorders. The National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), done in the early 2000s with more than 43,000 subjects, came to pretty much the same conclusion.

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British commentator Theodore Dalrymple made a similar point owing to his time spent as a doctor in the British prison system. His basic question was if it was merely an addiction then why were drugs like heroin and cocaine a permanent growth industry in the UK? Also, his experience confirmed to him that even though he was called Dr. No by inmates because he refused to satisfy their cravings with small doses, most of the inmates seemed to recover from their addictions over time in prison.

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