The addiction paradox

Actor Philip Seymour Hoffman’s February death from a drug overdose triggered media reports blaming the terrible disease of addiction for claiming another life. But calling addiction a “disease” may be misguided, according to an alternative view with some scientific basis. Most people who are addicted to cigarette smoking, alcohol or other drugs manage to quit, usually on their own, after experiencing major attitude adjustments. Although relapses occur, successes ultimately outnumber fatalities. People can permanently walk away from addiction.

Evidence that addiction is a solvable coping problem rather than a chronic, recurring disease seems like encouraging news. But it’s highly controversial. Neuroscientists and many clinicians regard drug addictions as brain illnesses best vanquished with the help of medications that fight cravings and withdrawal. From this perspective, drug-induced brain changes increase a person’s thirst for artificial highs