Over the next few weeks I want to address a fascinating and important topic, that of the nature of addiction. We've all known addicts; some of us are or have been addicts; addiction is terrible and frightening.
But just what is addiction? What makes some substances and activities addictive, but others merely rewarding?
In our culture, the concept of addiction is very confused. We seem simultaneously to embrace two contradictory conceptions of what addiction is.
On the one hand, we think of it as a kind of bad behavior that deserves punishment.
On the other hand, we think of it as a disease, and so as calling for treatment and compassion.
But how can it be both? How crazy is that? Do we lock up heart patients? Do we give disability payments to crack addicts?
Our confusion as a culture is institutionalized at the national level. The Drug Enforcement Agency is a branch of the Justice Department with multi-billion dollar budget and a mandate to target drug users with the full might of the law.
The National Institute on Drug Abuse is a different, smaller agency — an arm of the National Institutes of Health — that is devoted to pursuing the problem of drugs and addiction as a medical phenomenon.
I hope, over the next few weeks, to see if we can gain some clarity over this daunting and puzzling phenomenon.