Addiction and personal responsibility

BBC 2 last night aired a programme on addiction entitled Am I Normal, presented by clinical psychologist Tanya Byron. The documentary itself did not arrive at any startling conclusions, finding that addiction could be attributed to a combination of biological, psychological and social factors. What it did expose however, was the tendency to use the description ‘addiction’ as a means to absolve people of personal responsibility for a whole range of excessive, compulsive and damaging behaviours.

I have no particular medical knowledge and I would be reluctant to dismiss a gamut of research adduced to support the theory that behaviours as well as substances can be addictive. I am in no position to dispute these findings, which amount to brain scans proving that people seek to replicate experiences which release endorphins (if I have understood correctly), but there are various social implications which arise if we decide to take this broader approach to the definition of addiction.

In particular it is important that medicalising behaviour which damages either the subject or those around them, does not equate to suggesting that the subject has no control over the exhibition of this behaviour. There should be no suggestion of removing or diminishing the personal responsibility these 'addicts' are asked to assume for their own actions, on the basis of their alleged addictions. Most addiction experts have in my understanding moved away from the approach that addicts are predetermined and helpless victims of a disease. I believe it is now acknowledged that there is still an element of choice, albeit limited in chronic cases, incumbent even in alcoholism or drug addiction. As a society, we should certainly not be in the business of absolving of responsibility, those who claim to be addicted to behaviours where no physical dependency is possible. Of course psychological addiction is a real and powerful phenomenon , but if, when addicts drink alcohol, smoke cigarettes or inject heroin, free will is still at work, how much more so is this the case when people are ‘addicted’ to chocolate, computer games or pornography?

If research is being carried out in order to understand the human brain more completely, then such work must surely be valuable. If that research finds that certain compulsive behaviours share characteristics with more established addictions, then we have discovered something important about the causes of such compulsions. However one twenty year old computer game enthusiast last night ascribed violence he had inflicted upon his parents (when they removed his computer due to excessive game-playing), to his ‘addiction’ and the therapy he was receiving seemed to facilitate this logic. Here we run into difficulties and encounter thinking which would have legal consequences and ramifications for our publicly funded health service.