Mala Szalavitz

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Thanks to the excellent 3 Quarks Daily for pointing me to Mala Szalavitz’s Substance.com essay, “Most People With Addiction Simply Grow Out Of It.” Hopelessly addicted is a phrase we’re all familiar with, but it’s an extreme outlier, not the rule, as most people kick after a few years. We likely believe addiction is terminal because we conjure the most extreme and dramatic examples to represent it; call it the Availability Heuristic of heroin and the like. Unfortunately, that misunderstanding influences laws and treatment. An excerpt:

“Why do so many people still see addiction as hopeless? One reason is a phenomenon known as ‘the clinician’s error,’ which could also be known as the ‘journalist’s error’ because it is so frequently replicated in reporting on drugs. That is, journalists and rehabs tend to see the extremes: Given the expensive and often harsh nature of treatment, if you can quit on your own you probably will. And it will be hard for journalists or treatment providers to find you.

Similarly, if your only knowledge of alcohol came from working in an ER on Saturday nights, you might start thinking that prohibition is a good idea. All you would see are overdoses, DTs, or car crash, rape or assault victims. You wouldn’t be aware of the patients whose alcohol use wasn’t causing problems. And so, although the overwhelming majority of alcohol users drink responsibly, your ‘clinical’ picture of what the drug does would be distorted by the source of your sample of drinkers.

Treatment providers get a similarly skewed view of addicts: The people who keep coming back aren’t typical—they’re simply the ones who need the most help. Basing your concept of addiction only on people who chronically relapse creates an overly pessimistic picture.

This is one of many reasons why I prefer to see addiction as a learning or developmental disorder, rather than taking the classical disease view.”

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