I'm writing a paper tonight for my psych class on the prompt "Is addiction a choice?" Sadly, by "write a paper", I mean I'm reading two essays in a book we were provided with and then writing <3 pages of response. It's a bit pathetic ... half our grade depends on three essays written this way. Not much for critical thought.
What's irritating, though, is the quality of the essays we're provided with. In theory, these were published papers written by well-known psychological researchers. Yet they tend to make really basic errors - ad hominem attacks, argument by analogy, dismissing the opposition's arguments without citing any evidence. The essay by Schaler I'm reading right now is arguing that the disease model of addiction is flawed. (NB: I'm not taking a position on that - poor arguments annoy me whether I agree with the conclusion or not.) Now, that's certainly an argument that could be made on rational grounds, but Schaler is taking the position that addiction is not a disease by arguing that diseases have certain characteristics that diseases don't. I'll quote a few of the more annoying statements from the section arguing that it's not a physical disease (he covers mental disease later - never mind that that is a somewhat blurry line).
"Sometimes a routine physical examination reveals signs of disease when no symptoms are reported ... the disease is said to be 'asymptomatic'." He goes on to argue that addiction could never be diagnosed without symptoms, sort of missing the idea that we have diagnostic tools today that we didn't have in the past, and will continue to increase our diagnostic tools. We knew that there were physical risk factors for, say, heart disease, even before we could test for the genetic markers for high cholesterol. He also misses the idea that some diseases are asymptomatic until environmental factors come into play.
"True, such conditions as migraine and epilepsy are diagnosed primarily on the basis of symptoms. But, in general, it is not standard medical practice to diagnose diseases on the basis of symptoms alone." Yes, but there are exceptions, as Schaler just indicated ... what is it that keeps addiction from potentially being one of them?
"We continually hear that addiction is a disease just like diabetes ... [but] the analogy cannot be turned around. It would be awkward to tell a person with diabetes that his condition was 'just like addiction' and inaccurate too: when a person with diabetes is deprived of insulin he will suffer and in severe cases may even die. When a heavy drinker or drug user is deprived of alcohol or other drugs his physical health most often improves." I think this parallel is invalid to begin with, as it suggests that treatments for different diseases are somehow comparable. If you're going to make it, though, wouldn't it make more sense to compare addiction to an allergy, or celiac disease, or Crohn's/IBD, or some kinds of migraines (ooh, he did before!)? For many of those, removing the environmental trigger can reduce symptoms to a manageable level, or even eliminate them entirely.
For that matter, Schaler seems to switch between definitions as it suits him - is 'addiction' the effects of a given drug on the body (cirrhosis of the liver)? Is it susceptibility to dependence? Is it the behavior associated with obtaining and administering drugs?
Gah. I guess the takeaway from this rant here is "don't make comparisons to stuff you don't understand, because it makes you look like a jackass".
What's irritating, though, is the quality of the essays we're provided with. In theory, these were published papers written by well-known psychological researchers. Yet they tend to make really basic errors - ad hominem attacks, argument by analogy, dismissing the opposition's arguments without citing any evidence. The essay by Schaler I'm reading right now is arguing that the disease model of addiction is flawed. (NB: I'm not taking a position on that - poor arguments annoy me whether I agree with the conclusion or not.) Now, that's certainly an argument that could be made on rational grounds, but Schaler is taking the position that addiction is not a disease by arguing that diseases have certain characteristics that diseases don't. I'll quote a few of the more annoying statements from the section arguing that it's not a physical disease (he covers mental disease later - never mind that that is a somewhat blurry line).
"Sometimes a routine physical examination reveals signs of disease when no symptoms are reported ... the disease is said to be 'asymptomatic'." He goes on to argue that addiction could never be diagnosed without symptoms, sort of missing the idea that we have diagnostic tools today that we didn't have in the past, and will continue to increase our diagnostic tools. We knew that there were physical risk factors for, say, heart disease, even before we could test for the genetic markers for high cholesterol. He also misses the idea that some diseases are asymptomatic until environmental factors come into play.
"True, such conditions as migraine and epilepsy are diagnosed primarily on the basis of symptoms. But, in general, it is not standard medical practice to diagnose diseases on the basis of symptoms alone." Yes, but there are exceptions, as Schaler just indicated ... what is it that keeps addiction from potentially being one of them?
"We continually hear that addiction is a disease just like diabetes ... [but] the analogy cannot be turned around. It would be awkward to tell a person with diabetes that his condition was 'just like addiction' and inaccurate too: when a person with diabetes is deprived of insulin he will suffer and in severe cases may even die. When a heavy drinker or drug user is deprived of alcohol or other drugs his physical health most often improves." I think this parallel is invalid to begin with, as it suggests that treatments for different diseases are somehow comparable. If you're going to make it, though, wouldn't it make more sense to compare addiction to an allergy, or celiac disease, or Crohn's/IBD, or some kinds of migraines (ooh, he did before!)? For many of those, removing the environmental trigger can reduce symptoms to a manageable level, or even eliminate them entirely.
For that matter, Schaler seems to switch between definitions as it suits him - is 'addiction' the effects of a given drug on the body (cirrhosis of the liver)? Is it susceptibility to dependence? Is it the behavior associated with obtaining and administering drugs?
Gah. I guess the takeaway from this rant here is "don't make comparisons to stuff you don't understand, because it makes you look like a jackass".
posted by ismith at 10:03 PM
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