Driven by data; ridden with liberty.
During a Newsnight discussion with actor Matthew Perry and Baroness Meacher, Mail on Sunday columnist Peter Hitchens argued that addiction is a “complete fantasy” because “humans have free will”. Hitchens’ later article, Matthew Perry and the Addiction Fiction, reveals this stance is highly dependent on fallacious reasoning.
When discussing reports of Perry’s ‘battling addiction’, Hitchens describes this as “a prejudiced phrase which assumes that ‘addiction’ exists, and that he has no free will, and so must wrestle for the rest of his days with some mighty overpowering force.” It is a false dichotomy to suggest an addict has no free will. Firstly, many medical conditions are characterised by involuntary actions, such as incontinence and Tourette’s syndrome. Incontinence does not abolish free will. Human will is constrained by our frailties: unconstrained will is a matter for creator gods. Secondly, even if the drug use is wholly voluntary, that does not make addiction an “excuse”, as Hitchens suggests, nor does it extinguish addiction as a meaningful concept. The American Society of Addiction Medicine defines addiction as:
Addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social and spiritual manifestations. This is reflected in an individual pathologically pursuing reward and/or relief by substance use and other behaviours.
Thus, an addiction discourages cessation with physical and psychological pain. Hitchens points out Theodore Dalrymple’s book Junk Medicine. Dalrymple worked as a prison doctor, and is the pen-name of Anthony Daniels, who wrote in the New Statesman that:
Addiction is a real physiological phenomenon, of course, and there are addictions to drugs from which withdrawal can actually be dangerous: alcohol is the one that springs to mind.
Dalrymple believes the effects of heroin withdrawal have been exaggerated, arguing it is no worse than having the flu. Turning to alcohol, the observed symptoms of alcohol withdrawal can include shaking and hallucinations. Hallucinations may be an atypical withdrawal symptom, but are by no means a cinematic invention. By partially highlighting Dalrymple’s work over other doctors – their observations are dismissed as merely “opinion” – and failing to mention Dalrymple’s other statements, Hitchens commits the cherry-picking fallacy. Moreover, if, as Hitchens claims, addiction was not real, then there would be no withdrawal symptoms. This is the stolen concept fallacy: the belief that withdrawal symptoms are real but overestimated necessarily includes the belief that such symptoms exist.
During the television discussion, Hitchens argued that addiction’s non-existence was demonstrated by a lack of “an objective diagnosis”. Medical conditions can present with strange symptoms; supposedly ‘core’ symptoms may be absent. Clinical diagnoses are made without performing any tests. Mental illnesses are diagnosed by behavioural observations and psychological examination. Hitchens’ argument misunderstands the procedure of medical diagnosis. Hitchens then states that deference to doctors should be avoided, as they are “often horribly wrong and are very vulnerable to fashion”. Furthermore:
Doctors also don’t want to miss a chance to keep a patient by prescribing a pill or a spell in a costly clinic. Their opinion is no substitute for thought.
This is an appeal to motive: owning a medical doctorate does not affect the validity of the proposition that addiction exists. Also, neither does Matthew Perry, an addict, being unable to describe what addiction is imply its non-existence – that is an argument from fallacies.
Hitchens’ arguments – addiction currently lacks a medical test; withdrawal symptoms are overstated; a large bureaucracy rests upon tapering drug use – do not prove that addiction is a “complete fantasy”. That is simply a non sequitur. Addiction is a real physiological condition, though its effects may be misunderstood.
Amendment (01/01/2014 13:14): As Christopher Snowdon has pointed out, Dalrymple is the pen-name of Anthony Daniels, not Anthony Eden. I apologise for this error.