Tuesday, April 9, 2013

The Fix: How Addiction is Invading Our Lives and Taking Over Your World by Damian Thompson

Rating: 3/5

The cover of this book contains no author credentials, no "by the author of", and no author's blurbs. If it weren't for the lovely design on the front, it would have all the ear-marks of being questionable. However, according to Wikipedia, Damian Thompson is a journalist with a Ph.D. in the sociology of religion. Does this make him as qualified to talk about addiction as, say, a neurologist or an evolutionary psychologist or an addictions expert? Probably not. However, Thompson has some personal experience with addiction, and most of the book is written from a sociological perspective. 

Thompson is convinced the "disease model" of addiction is incorrect, but his arguments against it are weak, in my opinion. It depends on how you define "disease", which he doesn't explicitly do. However, it seems as though Thompson believes to qualify for the term "disease", an illness must be a) scientifically identifiable  b) have only involuntary symptoms; and c) be incurable. This seems too narrow to me, but these are the points on which his arguments rest. 

Addiction cannot be specifically found or tested for in the organic body. Thompson argues that this means it's not a disease. But in the history of science, many diseases failed this test until the technology arose to detect them, or the pathology was discovered. I would be curious to know if Thompson doesn't believe that things like Fibromyalgia and ME/CFS are real diseases either, since they lack this qualification. But it's painfully obvious to me--literally-- that my chronic illness is a real disease, even though the doctors can't locate the source of it in my body. 

Thompson also believes that because addictive behaviour is "voluntary", it can't be a symptom of a real disease. But people who have struggled with addiction know that succumbing to cravings doesn't exactly feel like an act of free will. There must be some intermediate between voluntary and involuntary to cover addictive behaviour. Is depression a disease? Because the symptoms of depression consist of voluntary action (or inaction) too. 

Finally, for the author to call something a disease, it apparently has to be incurable. This seems ridiculous to me, but this was one of his arguments: Alcoholics Anonymous says that alcoholism is an incurable disease, and the only treatment is a 12-step program and total abstinence. But some people recover from alcoholism without this treatment. Therefore, it's not a disease. This is the argument Thompson makes. But his conclusion doesn't follow from his premise. The logical conclusion is that alcoholism isn't incurable, and that AA isn't the only treatment. Not all diseases are incurable - talk to people who have no traces left of cancer in their bodies. 

Thompson even admits that the disease model has its uses, and that it's really a semantic argument anyway. So why make a big deal about it? He fears the drawbacks if people buy into the disease model wholeheartedly. Personally I think buying anything wholeheartedly is going to have drawbacks, and on principle, everything in the universe should be approached with a critical eye. But I suppose there are people who don't do this, and that Thompson is making a point about the dangers of totally accepting the disease model to the exclusion of other ideas. Fair enough, but you can make this point without relying on unconvincing arguments to prove addiction isn't a disease. 

Personally, I don't know if it is a disease or isn't, and I'm not sure this categorizing is actually important in a practical sense. Thompson's point is that addictive behaviour exists on a spectrum, and is becoming more and more normalized in our society. He sees it as a problem of neurochemistry (on which he gives a basic primer) and availability -if a particular thing is not widely available and affordable, there is no widespread addiction to it. But addictive behaviour is easily transferable, and companies are specifically designing more products to be as addictive as possible.

The majority of this book covers the current state of addiction (mostly in Western society). There are lengthy chapters on alcohol, drugs, and porn, but the section on food is disappointingly short. Gambling, gaming, and shopping are also briefly discussed. Aside from a few details, I didn't learn much that I didn't already know, and Thompson offers little in the way of solutions. 

If this is your first foray into the subject of addiction, this is an interesting and easy-to-read book. But there isn't much new information here for anyone who has already read a book or two about it. The Fix definitely isn't self-help, so if you are suffering from addiction yourself, you won't get much assistance here, aside from the knowledge that you are definitely not alone.

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