Pubdate: Sun, 02 Jul 2017 Source: Boston Globe (MA) Copyright: 2017 Globe Newspaper Company Contact: http://services.bostonglobe.com/news/opeds/letter.aspx?id=6340 Website: http://bostonglobe.com/ Details: http://www.mapinc.org/media/52 Author: Kaila Kuban PUSHING POWER OF CHOICE MAKES THOSE STRUGGLING WITH ADDICTION INTO MONSTERS I cringe to think about some parent whose child is struggling with opioid addiction reading "Stop calling addiction a brain disease," and running to the mall to buy "gift cards or movie tickets" as incentives for their child to "choose" not to use. I cringe to think about the specialists who have worked so long to change our cultural thinking around addiction sighing as these outmoded ideas about addiction-as-a-choice are given prime media play. And I cringe to think of those who have been blessed not to have the specter of addiction touch their families reading this and thinking, "See, it's not a disease." The medicalization of addiction has its problems, but like many things previously thought to be moral failings - for example, gender dysphoria and depression - the move to a medical model allows crucial things, such as insurance coverage, research funding, and subsidies for treatment centers. Sally Satel and Scott O. Lilienfeld are correct that addiction is not just biological. Like almost everything, including many cancers, there is a complex interplay of nature and nurture. But nurture cannot be confused with choice. The authors collapse the complex webs of people's lives into a question of motivation where addiction "can be altered when the user confronts foreseeable consequences." Right - if only we made the consequences of opioid addiction harsher! We are dealing with substances that so alter one's thinking that a person can watch a loved one overdose, or have an addicted partner kill their own child, and still want the drug. Arguing for the power of choice in the face of these realities is to create a monster - for who else would keep using after seeing these consequences? And once we see those struggling with addiction as less than human, we are liberated from having to try to help. Just think of all the tax money we can save. Kaila Kuban West Roxbury - --- MAP posted-by: Matt