Free will and addiction

A commentary in Addiction Research and Theory offers a 3rd way for debates about whether addicts have control over their drug use:

Our view is that the debate about free will in addiction, like the broader debate about free will in all human behavior, is unlikely to be won by either extreme view (Baumeister 2008). Self-control is an important form of what people understand as free will, and the capacity for self-control is real but limited-thus neither complete nor completely lacking. The traditional notion of willpower may be useful here, especially if one understands willpower as a kind of psychological energy that fluctuates as people use it up and then re-charge it (Baumeister et al. 1998; Vohs and Heatherton 2000). Free will is a partial, sometime thing.

There is certainly room to incorporate biological and genetic vulnerabilities in such a model. People may vary as to the reward power of drugs and alcohol: Some people get more pleasure than others from them. Social factors and personal experiences may also contribute to individual differences in such propensities. Thus, some people end up with stronger cravings than others.

Still, some freedom remains. The wine does not pour itself into a glass and thence down the alcoholic’s throat. The person thus makes a choice between competing impulses: indulging pleasure now versus abstaining for the sake of nonspecific but substantial delayed gains. Choosing the path of virtuous abstention depends on willpower, however. When willpower has been depleted (such as by other acts of self-control, or even by decision making in any context; see Vohs et al. 2008), their likelihood of choosing the immediate pleasure increases.

If a disease model for addiction is to be retained, we suggest abandoning the virus or germ models in favor of something more like Type II diabetes. One does not become infected with diabetes. Rather, a natural bodily vulnerability becomes exacerbated by experiences, many of which are based on personal choices. Many people will not become diabetics regardless of what they eat, but others will suffer diabetes to varying degrees as a function of diet and exercise. Moreover (and again unlike a virus), there is no definite boundary that separates the sick from the healthy. Diabetes, and by analogy addiction, is a continuum. Those who are constitutionally vulnerable move themselves along this continuum by virtue of the choices they make.

Such an approach might produce a more socially beneficial “mythology” of addiction. Our research findings have suggested that promoting disbelief in free will produces destructive, antisocial behaviors generally. We propose that similarly destructive effects are likely to come from depicting addiction as loss of free will. People who have made bad choices like to hear and to think that they did not really or freely make those choices. But catering to that view excuses their behavior and sometimes contributes to enabling them to continue making similar choices.

Instead, we advocate a view that biology is not destiny. Being born with a genetic receptivity to liking drugs or alcohol does not guarantee a life of addiction. It is perhaps a form of bad luck, but one that can be overcome with prudent though sometimes difficult choices. Difficult choices are difficult because they consume relatively large amounts of psychological energy. Depicting addiction in this way may encourage people to sustain belief in free will and to take responsibility for their own choices and actions. As our research findings suggest, such an attitude is likely to produce behaviors that are beneficial for both the individual and society.

I find this model useful and I think a lot of the field is already there.

However, the writers seem to neglect a couple of important aspects of their own framework.

If one is to frame addiction with a continuum of vulnerability, part of the continuum would be people who are doomed to become addicts regardless of their choices. Isn’t that the case with Type II diabetes? That some will never develop it, some may or may not depending on their activity levels and diet, while others with develop it regardless of their diet and activity levels. 

Also, within the context of their metaphor of psychological energy, there might be times when a person has none and times when a person has no internal or external resources to replenish this energy.

Their closing paragraph seems to slight both of these considerations. Acknowledging these considerations does disavow the role of choice. Even on the end of the continuum where a person’s biology and environment doom them to developing addiction, choices could influence the onset, course and severity. And, within the psychological energy metaphor, during periods of replenished energy a person may have the power to make choices that will protect or expend this energy in ways that preserve it (and initiate/maintain recovery) or diminish it (and lead to relapse).