Addiction Unmasked: A Psychiatrist Debunks the Top 5 Myths

Elias Dakwar shares 5 big ideas from The Captive Imagination: Addiction, Reality, and Our Search for Meaning

What is addiction? Is it a disease? A moral failing? A spiritual crisis? Addiction has many faces, and is shrouded in misunderstanding. Here to puncture the many myths that surround the disorder is Elias Dakwar, author of the new book The Captive Imagination: Addiction, Reality, and Our Search for Meaning. Elias is a psychiatrist and an Associate Professor of Psychiatry at Columbia University. Here he is to share 5 of his big ideas.

Myth 1: Drugs are the problem.

Drugs are as dangerous as fire—and also just as helpful when approached thoughtfully. Yet psychoactive substances are generally regarded with suspicion. One reason is that they are believed to have what scientists call abuse liability, a property inherent to the drug that compels misuse or addiction. Abuse liability is thought to result from drugs acting, to a greater or lesser degree, on certain brain circuits and modifying them over time, rendering the brain more vulnerable to problematic and compulsive use. Social policy to combat addiction has, therefore, focused on cutting off access to certain drugs, primarily through criminalizing them.

It is highly problematic to focus on the harm of drugs to the exclusion of a more balanced perspective. This is like regarding fire as possessing, say, “forest-fire liability,” and criminalizing it because it is inherently dangerous. There are also real-world consequences to this perspective, beginning with the direct harms that have resulted from the war on drugs, such as mass incarceration and black-market adulteration of substances.