ADDICTIONS ARE ABOUT BEHAVIOUR, NOT DISEASE

When it comes to thinking about addiction, opinions converge. Having bought
into the addiction industry's mantra, so-called social progressives and
conservatives alike share the same ideological hangover from the Prohibition
era, with a twist of AA sadism: all are religious about abstinence, and all
accept as Bible from Sinai the wisdom of coercing addicts into treatment
regimens.

But perhaps the greatest error made in the attempt at humane formulations
about addiction is to cast as a disease what is essentially a problem of
behaviour.

The dangers of gathering more and more behaviours under the disease label is
not something pharmacology moguls, politicians or health-care professionals
ruminate about, despite the ramifications for a society already committed to
morality-lite and diminished personal responsibility.

In his book Diseasing of America, addiction researcher Stanton Peele breaks
with this tradition. Disease conceptions of misbehaviour are bad science and
morally and intellectually sloppy, argues Peele.

''Once we treat alcoholism and addiction as diseases, we cannot rule out
that anything people do but shouldn't is a disease, from crime to excessive
sexuality to procrastination.''

While the application of the medical disease model to addictions was
developed to ''remove the stigma from these behaviours,'' there is no
genetic marker for alcoholism or drug addiction. Still, the misconception
that these behaviours are linked to a genetic vulnerability is aired
repeatedly by the media in the absence of evidence.

The rationale for using the disease model to describe addiction even though
it is intellectually dishonest is that medical treatment is effective.

Yet another deception. An overview of controlled studies indicates that
''treated patients do not fare better than untreated people with the same
problems.''

Of note is a 4,500-subject U.S. epidemiological study conducted in 1996 by
the National Longitudinal Alcohol Epidemiological Survey.

Treated alcoholics, it was found, were more heavily alcohol-dependent on
average than untreated alcoholics. Clearly a behavioural problem cannot be
remedied by medical intervention. Addicts are cured when they decide to give
up the habit.

The disease conception of addiction acts to isolate the noxious behaviour
from the person. Thus when we claim that drugs, much like the flu, ''get a
hold'' of you, we conveniently deflect from that which mediates behaviour:
personality, values, character or lack thereof. Once someone becomes
involved with drugs, we explain everything they do by saying it was due to
the drugs, forgetting, in the process of this circular argument, that the
source of the addiction is the person and not the drug. An honest look at
drug use means we cannot separate it from the person.

Heroin addicts are thus highly disposed to having social problems even
before they become addicted; and truancy and smoking behaviour serve as good
predictors of future drug use.

With the disease label as a protective rampart, addicts have taken to
comparing their ''disease'' with having, let's say, diabetes or cancer. How
opting to shoot up for the first time, then doing it again, then stealing
cash to get some, even breaking and entering -- mimic the organic disease
process in cancer or diabetes, is unclear.

As Peele explains, addictive disorders are known only by the behaviours they
describe. In the absence of the ongoing behaviour there is no way of telling
whether the person is, or will be, addicted.

''By claiming that alcoholics are alcoholics even if they haven't drunk for
15 years, alcoholism is made to seem less tied to drinking behaviour and
more like cancer,'' but ''a person does not get over cancer by stopping a .
. . behaviour'' . . . while ''the sole and essential indicator of successful
remission of alcoholism is that a person ceases to drink.''

It is unfortunate that the various preventive programs school kids are
exposed to are delivered by equivocating addicts-cum- activists who
conveniently convey that ''it'' can happen to anyone, that kids have little
control and that once diagnosed as an addict, always an addict.

This sets in motion, where there is already some drug use, a self-defeating
cycle of abstinence and relapse, not to mention an overall rise in
drug-related involvement.

Most youngsters outgrow their occasional binges and turn into responsible
adults. For doing what they do as a rite of passage, teens and college
students do not deserve to be labelled diseased.

What they do need is to be held accountable for their behaviour. Failure to
hold the person who strays responsible for his actions means that you cannot
credit the person who doesn't. That's the logic of diminished
responsibilities all round.

For the rest, the lingering paranoia of the temperance and prohibition era,
which has culminated in AA disease dogma, should be consigned to the
historical dustbin.