Where Is the Line in Addiction Between Illness and Selfishness?
And how it relates to my compassion for frightened conspiracy theorists
I spent six damn years getting a PhD in health behavior research and am still as confused as ever about my position on addiction.
Granted, addiction wasn’t my area of focus so I claim zero professional expertise on the topic. However, behavior change and health management was central to my studies, so you’d think I’d have come out the other side of that education with more clarity on the issue.
Don’t get me wrong, I fully understand that some form of illness often underlies, and results from, addiction. We know that chronic drug use causes real changes in the brain. It’s also pretty clear that many individuals in the throes of drug use feel powerless to it and lack access to effective solutions (don’t get me started on how insufficiently we have treated this issue in the US from a policy perspective.. that’s a rant for another day).
But as the daughter of a long time drug addict, I’ve seen some horrible things addiction can lead a person to do.. to themselves, but also to those they’re meant to take care of. The shame and disappointment (I wish there were a stronger word for that) that come from having a parent like this makes me wonder what proportion of the issue I can attribute to real illness, and what proportion I can count him responsible for as a manifestation of selfish, lazy indulgence as the easy way out of dealing with life’s challenges.
Substance use disorder is a complex web of biological, psychological, social, cultural, familial, regulatory, and environmental factors, some of which are out of a person’s control. But also, (most) people have freedom of choice and agency in the matter. So how much of addiction can people really be held responsible for, and how much are they powerless to?
Of course, there is no clear or uniform answer. It’s a muddied gray area of overlapping and interacting factors that can’t (and perhaps shouldn’t) be disentangled. Even at the highest levels of research and legislation, this debate has and will continue to evolve as the search for truly effective treatments continues, and addicts themselves have widely varying perceptions of whether ‘disease’ is an appropriate or useful descriptor of the issue.
When it comes to other people, I’m not really concerned about the designation of “disease vs. personal responsibility.” Why? Because they haven’t hurt me or my family. But in the one case closest to home, I wonder about it often. Being on the receiving end of the second-hand consequences of addiction, it feels like a big, unreasonable ask to expect compassion and support after decades of lies and letdowns.
I suppose in the best of cases, individuals struggling with addiction would do as much as is within their genuine power to recover, given their circumstances and resources, and the systems and people around them would extend as much support as they can manage, without violating their personal boundaries to self-protect.
In my case however, whether it be self-protection or unfairly blaming a person with an illness, I still hold my father fully responsible for the life he lives and what it’s cost the rest of us. Long ago I exhausted my willingness to try to help, and so far, no amount of scientific evidence on the neuroscience of addiction has convinced me into a more compassionate view of his circumstances.
So what in the world does this have to do with my orientation toward conspiracy theorists and science deniers?
Over the last few years, as I’ve become more embedded in research myself, I’ve been increasingly frustrated by people who reject science and facts in favor of nonsense that often just reinforces their pre-existing feelings, fears, and biases. I’ve been utterly confused about how such a wide range of people could believe and commit to misinformation they saw on some unverified social media post despite a mass of reputable, unbiased, easily verifiable facts to the contrary. I view myself as a critical thinker, so it’s difficult to see so much information being consumed uncritically.
But then it occurred to me- in ignoring the complexity of addiction in my father and attributing it all to selfishness, I’ve been in some way doing what I’ve been so frustrated by in others- clinging to my emotion-based opinion on the matter, even while knowing intellectually there’s more to it than that.
The awareness that I’m guilty of that same tendency in some way, that I, too, would favor feelings over facts, has exposed a common vulnerability I share with those I previously thought were beyond the realms of reason and logic. Being honest with myself about this has awoken a bit more compassion in me toward those who buy into misinformation because of a deep, overwhelming fear or pain.
For example, what’s the root of vaccine hesitation or refusal for many parents? It’s fear for their children, stoked largely by inaccurate claims spread on social media. Why do some people believe SARS-CoV-2 is a hoax? Because that’s more comforting to believe than the reality that humanity is as vulnerable and unprepared as 2020 proved we were for natural phenomena like a novel virus.
Don’t get me wrong, I’m still just as concerned about the rapid spread of misinformation and the threat it poses to the health and safety of society. I still believe wholeheartedly that our feelings don’t justify uncritical media consumption and endorsement of harmful untruths.
But emotional biases are powerful, and I have more sensitivity for that now. So I’ll still continue to advocate for science and critical thinking, but with a greater softness toward the humans on the other side of some of these contentious issues. Because we’ve all got a lifetime of emotional baggage, and its impact on our search for truth is tough to contain.
