Is Addiction a Disease or a Choice? Gene Heyman Interview

Addiction is a choice: faculty insight with Gene Heyman

Psychology lecturer Gene Heyman discusses his controversial book Addiction: A Disorder of Choice with interviewer Jenny Attiyeh of ThoughtCast.

Understanding addiction

Gene Heyman, a lecturer on psychology at the Harvard Medical School and Extension School instructor, wrote a controversial book, Addiction: A Disorder of Choice. The book has influenced how many psychologists perceive and treat addiction.

Heyman uses the same definition of addiction as the American Psychiatric Association: “The persistence of drug use despite aversive consequences.” Heyman believes in the choice model of addiction, which flies in the face of the disease model.

Heyman points out that some psychiatric disorders can be influenced by outsides, such as concern over legal consequences and respect from children and parents. Other disorders, like schizophrenia, can't be influenced by opinions of others. The schizophrenic may know that by hallucinating they will embarrass their children, but they will continue to hallucinate. When looking at drug addicts, one of the main things that stopped addicts from using was the concern over what their parents and children thought of them. There were costs and benefits to their addiction.

One of the reasons Heyman says he wrote Addiction: A Disorder of Choice is to let the public know that most addicts quit and it is not the chronic relapse disease it is portrayed to be. Of all psychiatric disorders, it has the highest remission rate.

When researching Addiction: A Disorder of Choice, Heyman looked at every study he could comparing people who quit drugs to those who did not. The most common factor in the people who did not quit was the presence of an additional disorder, whether it was medical or psychiatric. Heyman believes coexisting disorders keep some addicts from seeking treatment.

In planning for treatment and setting policy, Heyman says it is important to truly understand addiction. He maintains that treatment for addiction does not need to based on a medical model.

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