Sanity of Addiction: Contemplative and Humanistic Reflections on the Surgeon General's Report on Drugs

The Surgeon General's Report on Alcohol, Drugs, and Health authoritatively situated addiction as a brain disease and called for increased research into its underlying neurobiological mechanisms. While the Surgeon General's Report makes strides toward destigmatizing addiction and rightfully rejecting addiction-as-moral-weakness, it adopts addiction-as-disease as another oversimplified conceptualization of a complex human experience. Inspired by Eastern philosophy, we argue that addiction is a sane, protective response to suffering. We highlight evidence suggesting that so-called addictive substances are not powerful culprits that compel persons to action, as framed in the Report. Rather, we discuss addiction as a dysfunctional relationship with substances, developed out of sane attempts to escape the inevitable and universal truth of our own suffering. The compulsive use of a substance is the struggle of trying to escape pain, blame, shame, and loss. Rather than a choice between false dichotomies, then, addiction is normalized as part of the spectrum of human experience, enabled but not determined by either biology or so-called addictive substances. Viewing addiction as a process of the human experience, the therapeutic relationship remains the greatest practice tool at our disposal. We provide a clinical vignette to illustrate the application of humanistic and contemplative principles in addictions counseling.

Automated summary

The article argues that addiction is a rational, protective response to suffering and different from the conventional concept of disease. It emphasizes that compulsive substance use is an attempt to escape personal suffering, rather than being driven by the substances themselves.