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Biology versus Choice: Is a simple explanation of addiction enough?

At the recent Addictions conference, held in D.C. and sponsored by Elsevier, a well known academic publishing house, I got myself into one of those long debates with a fellow addiction researcher. The question we were debating was whether addiction is primarily biological or if it is mostly a matter of personal choice. We ran through research evidence, the notion of stigma, and more, making us late for the afternoon session of talks – but it was worth it.

My take on it was that one can’t separate biology from choice, a point I have made over and over (see my choice Vs. control talk), and that ignoring the biology of addiction is therefore impossible. My opponent across the stage (or lunch table as it were) was Christopher Russell, a graduate student at the University of Strathclyde in the United Kingdom who is a bigger believer in the choice view of addiction, along with people like Dr. Bruce Alexander of Rat Park fame and Dr. Gene Heyman who wrote “Addiction is a disorder of choice.”

I like good debates and at as far as I understand it Christopher and I ended-up agreeing that as usual neither biology, nor choice, do a good enough job of explaining a complex disorder like substance abuse and addiction. I’ve been making that point for a while, so I’m pretty comfortable with the final conclusion – Biology, environment, and choice (cravings) all factor into addiction as I understand it. Without understanding the machinery and how genetics and behavior affect it, I think the rest of the discussion is moot, but it is pretty much as pointless without addressing environmental influences and the role of choice.

I liked debating with Christopher so much that we’re going to be bringing him on a writer on A3. He’ll help us keep on top of the most recent addiction research and news while bringing in another voice on the topic that I think will help move our discussion forward. So please help me welcome Christoper Russell from the U.K., and look ahead for his contribution as well as a likely ongoing debate about the importance of biology versus personal choice.

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