Consumer Illnesses and Maladies

Consumer Illnesses and Addiction

One of the main problems in the scholarship of consumer illnesses lies in the issue of defining addiction in the first place. In a strictly biological definition, addiction refers only to psychoactive substances (such as drugs, alcohol, and tobacco) that produce chemical alterations in the brain. However, even those studying addiction at the cellular and genetic level agree that psychological, social, and cultural factors play a role in drug, alcohol, and gambling addictions. What is uncertain is the degree to which these factors are responsible for triggering or leading to an individual's addiction to a particular substance. Current research has yet to pinpoint the nature of addiction or resolve the extent to which addiction can be identified with brain dysfunctions, as evidenced in the title of a volume on the most recent addiction research, What Is Addiction? (Ross et al. 2010). Many psychiatrists have eschewed the term addiction altogether in favor of dependence; and substance dependence is the phrase used in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), as opposed to addiction.

A philosophical issue with the notion of addiction is the question of the extent to which addicts can or cannot control their behavior, or the question of free will versus compulsion. Scholars from a variety of disciplines note that most people diagnosed as addicts break their dependence on their own, without any sort of assistance. This suggests that addicts can exercise a measure of control over their behavior, albeit with difficulty. However, scholars also note that unless the individual's underlying emotional and psychological issues (usually anxiety and/or depression) are resolved, he or she will likely relapse. Gene M. Heyman attempts to apply the same psychological principles used in everyday decisions to addiction; in other words, he views addiction as an inherent outcome of choice. He argues that because hard drugs—particularly cocaine and heroin—bind directly to receptor sites in the brain, the intoxication effect undermines the appeal of other options to the point that addicts adopt a local frame of reference that prioritizes immediate gratification over consideration of long-term well-being. In concluding that drug addiction is a matter of chemical reactions in the brain that reorient consumers to an immediate frame of reference that is blind to negative consequences, Heyman suggests that treatment should decrease the reward value of the drug and increase the reward value of abstinence, thereby repackaging “global bookkeeping” (long-term evaluation of aggregated choices) to appear as immediate benefits.

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