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• Christopher Caldwell - Addicts have made a choice 

We have a justice system that treats drug use as a malevolent act of will (to be punished) and a medical profession that treats it as an unfortunate disease (to be cured). Who is right? In a magnificent new book, Addiction: A Disorder of Choice , Gene M. Heyman, a lecturer in psychology at Harvard Medical School, argues that it is not his fellow medical professionals.

Addiction is voluntary. The idea that addiction is a “chronic, relapsing brain disease” may be well-meaning but it is false. “Everyone,” Mr Heyman writes, “including those who are called addicts, stops using drugs when the costs of continuing become too great.” We need to make clear, though, what Mr Heyman means by “voluntary”. He does not deny that addiction is an enormous problem that can wreck a life, or several. If you drive drunk or embezzle money to pay for your coke habit when you ought to be studying, the consequences can be permanent and devastating.

But addiction is not the kind of problem that most people think it is. It is not so very far from setting interest rates, devising depreciation schedules and other economic problems of “intertemporal choice”. It involves weighing the value of a current good (intoxication) against the value of various future ones that are shrouded in uncertainty. . . .

The centrepiece of the disease theory of addiction is philosophical, not scientific. It is that nothing that produces sub-optimal outcomes as consistently as addiction does can be freely chosen. “No one chooses to be an addict,” as the saying goes. Mr Heyman shows that this is wrong – or at least that this is the wrong way of getting at the problem.

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