Today, an interesting article about whether addicts have free will.
Here’s a piece that’s interesting for its take on a still contentious philosophical issue. Do humans have free will? Intuitively virtually everyone would agree that we do. People “make decisions” all the time, as if they could have decided otherwise. Yet most modern philosophers will explain that, in some fundamental sense, free will is an illusion. I will not attempt to summarize their arguments. See Sam Harris, Jerry Coyne, Daniel Dennett. Some, like Dennett, will allow that we may as well *think* we have free will, because that’s how our minds have developed to function, via evolution. Otherwise you might sit there catatonic, unable to move. The biggest issue with understanding that free will is an illusion is the problem of personal responsibility, especially in criminal matters. And attorneys have used such defenses, about the “criminally insane,” in the past.
So this article suggests that similar thinking might affect what to do about addiction. There seem to be plenty of people who are addicted to drugs or alcohol who would *like* to quit. Why can’t they? Why can’t their free will let them make a decision to stop? What is it that’s overriding their ability to make such decisions…?
Now let’s read the article.
NY Times, Maia Szalavitz, 24 Apr 2023: This Is What Neuroscientists and Philosophers Understand About Addiction
The writer has first-hand experience with these matters. She opens:
When I was arrested and charged with possession with intent to sell cocaine in 1986, I was addicted to both coke and heroin. Although I was facing a 15 years-to-life sentence, the first thing I did after my parents bailed me out and held a family meeting was to find and secretly inject some prescription opioids that I knew the police hadn’t confiscated. …
Was my brain hijacked by drugs — or was I willfully choosing to risk it all for a few hours of selfish pleasure? What makes people continue taking drugs like street fentanyl, which put them at daily risk of death?
These questions are at the heart of drug policy and the way we view and treat addiction. But simplistic answers have stymied efforts to ameliorate drug use disorders and reduce stigma.
Her examples illustrate that people can manage their addictions, to a point.
Claims that people with addiction are unable to control themselves are belied by basic facts. Few of us inject drugs in front of the police, which means that most are capable of delaying use. Addicted people often make complicated plans over days and months to obtain drugs and hide use from others, again indicating purposeful activity. Those given the option will use clean needles. Moreover, small rewards for drug-free urine tests — used in a treatment called contingency management — are quite successful at helping people quit, which couldn’t be possible if addiction obliterated choice.
However, those who contend that substance use disorder is just a series of self-centered decisions face conflicting evidence, too. The most obvious is the persistence of addiction despite dire losses like being cut off by family members or friends, getting fired, becoming homeless, contracting infectious diseases or being repeatedly incarcerated.
I am reminded of the 1945 film The Lost Weekend, which I saw years and years ago.
Then she tries to hone in on what researchers have discovered. I can’t quote the entire article, so I’ll try to choose some choice bits. The key seems to be that drug use affects the mind’s assessment of near-term vs long-term risks and benefits.
During addiction, people also tend to prioritize short-term rewards over long-term gains, which means that they postpone the pain associated with quitting, often indefinitely. This idea, which is known as “delay discounting” further helps explain why people with chaotic childhoods and precarious incomes are at higher risk: When a better future seems unlikely, it is rational to get whatever joy you can in the present.
The writer notes that a majority of addicts have had traumatic childhoods or various kinds of mental illness, or even are autistic to some degree.
Another key point:
Most people who try drugs don’t get addicted, even to opioids or methamphetamine, which suggests that factors other than simply being exposed to a drug can contribute to addiction. The majority of people who do get hooked have other psychiatric disorders, traumatic childhoods or both — only 7 percent report no history of mental illness. Nearly 75 percent of women with heroin addiction were sexually abused as children — and most people with any type of addiction have suffered at least one and often many forms of childhood trauma. This data implies that genetic and environmental vulnerabilities influence risk.
The writer describes her own experience with cocaine.
So what are the researchers’ conclusions? Here’s the free will angle:
But if addicted people are making choices that are harmful to themselves or others, shouldn’t they be held responsible for their behavior? Hanna Pickard, distinguished professor of philosophy and bioethics at Johns Hopkins University, calls for a framework she labels “responsibility without blame.” In this view, addicted people do have some control over their decisions. However, that doesn’t mean they deserve blame or that shaming and punishing them will improve matters.
And then some solutions, by re-framing the problem.
Instead, providing people with both the skills and the resources they need to change, and compassionately holding them accountable as they learn to make different choices, can promote recovery. (This approach is a therapeutic one, not aimed at adjudicating addiction-related crimes, although the idea could potentially be extended into the legal realm.)
Research finds that framing addictive behavior as an involuntary brain disease reduces the tendency to blame people for it. But this perspective does not necessarily alleviate stigma or the desire to punish. This is probably because viewing individuals as having no autonomy dehumanizes them and makes others want to lock them up in an attempt to protect society.
And this is the problem with denying free will.
The article concludes:
To recover, people with addiction need both new skills and an environment that provides better alternatives. This doesn’t mean rewarding people for bad behavior. Instead, we must recognize that compulsive drug use is far more often a response to a life where meaning and comfort appear out of reach than it is a selfish quest for excess pleasure.
These are complex issues which, of course, conservatives tend to over-simplify. Good, bad; addicts bad; lock them up.
The deep issue of free will is not quite addressed in this piece.
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Personal angle: I have never taken any drugs of any sort that anyone would call addictive. Not even marijuana. Two reasons, perhaps: I was repelled by my parents’ cigarette smoking, while I grew up. While I still lived at home through high school and even college, commuting from the Valley to UCLA, I kept my bedroom door closed against the stench of cigarette smoke throughout the house. Thus my disinclination to smoking anything. Second reason: I was a bit of a square, without many friends in high school or college, and so never had opportunities to be tempted into trying any kind of drugs.
This is analogous to my comments about how I was a slow-starter sexually, and therefore missed the AIDS crisis, and survived that era by not becoming infected, while so many others of my generation did, and died.
On the other hand, I do drink alcohol somewhat more than is recommended, ever since the 1990s (when I was in my late 30s and early 40s), when I discovered martinis and (via Charles Brown) single malt scotches, though I’ve cut back substantially since my heart procedures two and three years ago. Still, I can’t quite quit. Why is that? Don’t I have the free will to decide that I’ll be better off just quitting entirely? There’s something else going on about free will than the simple-minded idea that every person is ‘free’ to make decisions, including those that would benefit their future health.
