In The News

American University Weekly, Nov 9, 1999
(http://garamond.univpubs.american.edu/weeklypast/110999/story_4.html)

Addiction is a choice: or not?

By SHAUNNA BENNETT

Radio talk shows, magazines, chat rooms, and cable stations have been alive with talk of it in recent years. Addictions: chocolate, an abusive lover, tobacco, pornography, the Internet, alcohol-you name it, someone's talking about it.

But what if addiction doesn't exist? What if behaviors that wreak havoc on individuals and their families are nothing more than ethical choices? That is the thesis of Jeffrey Schaler, School of Public Affairs, in his new book, Addiction is a Choice.

Schaler's theories clearly challenge the popular belief that alcoholism, and other addictions--which he calls choices--should be classified as diseases. Schaler uses the nineteenth-century pathological definition called nosology that asserts, "there must be an identifiable alteration in bodily tissue, a change in the cells of the body," to qualify as a disease. And since none are found in the bodies of heavy drinkers and drug users, "this justifies the view that addiction is not a physical disease," his book asserts. The effects of such habits, such as cirrhosis of the liver that might be found in the corpse of an alcoholic, is a separate issue, he claims.

His book calls for a distinction between the common conviction that addiction is an act that individuals are physically unable to stop, and his definition of addiction as merely a "commitment, dedication, devotion, inclination, bent, or attachment."

Values lie at the heart of Schaler's beliefs about what society calls addiction. His book likens alcohol and heroin abuse to choices like whether one enjoys music, walks in the country, or the practice of religion. "Once we recognize that addiction cannot be classified as a literal disease, its nature as an ethical choice becomes clearer," his book alleges.

The cure to giving up an addiction, or making a change in behavior, most often stems from an individual's moment of truth, according to Schaler. "They made a decision." They give up their addictions when they decide that they no longer want the consequences of them, he says.

With his emphasis on personal choice, it might seem inconsistent that Schaler has a private practice in Silver Spring, Md., where he works with individuals, some of whom have drug and alcohol problems. But a closer look suggests it is not. While Schaler values choice, seeing it as empowering to each individual, he acknowledges that factors forced upon them by circumstance, not choice, often affect their ability to make the choices they want to make.

An "addiction is reflective of an underlying problem," he asserts. He lists such problems as low self esteem, being criticized and not praised, abusive relationships, and homes without much love or affection.

Because he believes the real problem, not the drug or alcohol abuse, needs to be addressed, he disagrees with programs like Alcoholics Anonymous (AA) and other approaches that follow what he calls "the disease model," of treatment, claiming they do not work. Both he and his book point to studies that support his view. He alleges that the medical establishment has an economic stake in perpetuating the status quo and says some people avoid personal responsibility and want to be taken care of, explaining why the current model isn't jettisoned.

"The price of freedom is being responsible," he asserts, adding, "It is a myth you can be free and not be responsible." He has helped to establish three major secular, free, self-help groups that are alternatives to AA and other "disease-model" approaches.

As he swims against the tide of popular culture and the nation's health care community, Schaler is no stranger to controversy. Last week, the Philadelphia City Paper ran a story about the failure of Chestnut Hill College to renew his teaching contract after complaints were made about some of his theories on addiction and AA.

At AU, where he has been an adjunct professor since 1990, his views also have been criticized at times. A furor erupted in 1995 when Schaler's letter calling mental illness, including schizophrenia, depression, and addiction, "fake diseases for which fake medicine is given" was printed in the Washington Post. A spate of letters assailing Schaler's views, some by AU alumni, soon hit the Post.

This semester Schaler is teaching Alcohol, Drugs and Society. Of today's AU students' reactions to his addiction theories, Schaler said those who are most resistant at the start of the semester, see his view by the end of the semester. "I think the students are fantastic at AU," he says, adding that he appreciates that colleagues here have been protective of his academic freedom.

In addition to his private practice, Schaler is a frequent radio and television commentator on addiction. He is a consultant on legal matters and served on the Montgomery County (Maryland) Drug Abuse Advisory council from 1982-1988. He also teaches at Johns Hopkins University, Peabody Conservatory of Music in Baltimore, Montgomery College in Rockville, and at George Mason University's Institute for Humane Studies.