Vivek Kumar of The Jackson Laboratory argues that addiction should be viewed as a disease, much like diabetes or hypertension (“Maine Voices: The key to addressing the addiction epidemic begins with science,” Feb. 2).

He argues that this disease is the result of genetic and environmental factors (such as cultural or social norms) over which people have no control. The implication he draws is that those with an addiction should be provided with access to treatment, rather than treating it as a moral failure.

There is, however, another side of the issue. Without denying the genetic or environmental factors, one can acknowledge that some people quit drug use when it becomes too costly, a result entirely at odds with the disease model.

For example, based on a concept from my doctoral thesis (http://tinyurl.com/je6rkal), my colleague Gene Heyman has pointed out (http://tinyurl.com/zkmuqs5) that “research shows that addiction has the highest remission rate of any psychiatric disorder, that most addicts quit drugs without professional help and that the correlates of quitting are those that attend most decisions, such as financial and familial concerns.”

Kumar’s approach (which he equates with science) implies that an individual is entirely at the mercy of factors beyond his or her control, while Heyman’s approach (based on laboratory findings) implies that taking an active role (such as changing one’s situation) might have some effect.

Accepting the latter premise would mean that an addict might escape his or her problem, even if access to treatment were less than ideal.


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