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May 24, 2011 / Lukasz Cerazy

Choosing to Become an Addict

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The inspiration for writing this article comes from a very interesting and heated debate I had with a medical doctor and a close relative of an addict. We were talking about mechanisms that determine outcomes for people that end up in addictions of harmful substances and had quite different views on the matter. We all agreed that being an addict of any kind of substance is harmful to ones health and environment in the medium to long run. Firstly, it degenerates vital organs and affects the mind. Secondly, there are social costs, or negative externalities, associated with an addiction, which society has to bear. These come in the form of higher costs for national health, increased crime, broken families and funding of various help-organisations to give a few examples. The point where we seemed to disagree the most was surrounding the scenario of choosing between ones family vs. alcohol or drugs. Why take drugs or drink alcohol at all, if it is common knowledge that these substances are harmful? In the debate I was met with the argument that the addicted person should have enough power or self-control to know that he or she was doing something wrong and be capable of giving up their bad habits. I disagree with this view and think that it is a simplification, because I believe that individuals can reach such a point where they react to their addiction and therefore do not actively choose to abandon their families. That point is when the best option the addict sees is to pursue their abuse, which I also think is what best describes an addict. This might seem counterintuitive so let me elaborate on why I believe so.

Economics can offer very valuable explanations as to how individuals make decisions in various situations. One of the key concepts that can be applied is known as discounting. This concept is easy to understand when applied to an economic example: Discounting is a function of bringing future transactions to a net present value. This can also be expressed as the difference between present transactions compared to future ones. Most people prefer current consumption to future consumption because they want to achieve the benefits now rather than at a later point in time. The discount rate expresses what it would take to compensate an individual for putting their consumption forward in time. With a discount rate of 10% per annum, one would have to pay 10£ of every 100£ to compensate an individual for waiting one year to spend their income. The public sector uses a 3,5% rate on projects running up to 30 years, so 10% might seem high. However, many factors determine how heavily individuals discount the future. Your sex and culture will have a significant influence on how much focus you put on the present compared with the future. For individuals who are prone to addictions the time-line is skewed very heavily towards the present, requiring huge compensations for them not to engage in taking drugs or drinking alcohol. This means that despite the well-known fact that drinking, smoking and having unprotected sex is potentially lethal, individuals will still engage in these activities as long as they see a greater benefit from doing so now compared to any risks associated with their health in the future. Furthermore, the fact that the disadvantages are expressed or appear later in time, individuals will often place too much emphasis on the short run.

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The second very useful concept is what economists call Rational Choice Theory. The framework assumes that individuals are acting in their own best self-interest and describes how they engage in a cost-benefit analysis whenever they are presented with a choice. This is a simple framework where all the benefits are pooled on one side and held up against all the disadvantages on the other side. A situation when someone uses addictive substances is therefore expressed as follows: advantages > disadvantages. An important distinction is that the theory is not concerned with any of the motives behind the decision but rather with the balancing of costs versus benefits. The word rational in this case relates to the optimisation of personal utility and does not relate to making choices with a clear conscience or sane state of mind. The theory therefore fails to address issues like ethicality, moral or empathy; however, it gives us a good understanding as to why the addict simply does not stop their abuse.

In the initial stages of taking drugs or drinking alcohol the costs are not large and do not outweigh the benefits one might get from engaging in these activities. The benefits could be expressed as the utility an individual receives from being in a social context or from seeking an escape from ones everyday life. However with time, as the appetite of the body for the addictive substance grows, the costs rise dramatically. This means that the choice no long is associated with getting a short-term benefit, but rather avoiding the very large costs of not letting into the desire. This leads me to conclude that even though an addict knows that he or she might be doing something that is harmful to themselves they will continue doing so until the costs outweigh the benefits, which can be very difficult, especially if their abuse is associated with a depression, psychosis or other types of difficult circumstances. This means that despite the actions of the addict pursuing their abuse, which may lead to other areas of their lives being seriously neglected because of the ever growing costs, they will continue to do so as long as there is a net benefit. This is a very important distinction, because their choice is not concerned with prioritising between two different options, but rather between carrying out the intake or not.

This theory is of course not perfect and has its weaknesses because it does make assumptions about the amount of information available. The addict is limited by what he or she views as a benefit and perhaps lacks a better understanding of the consequences of going down a road of heavy drinking or drug use. However, I am still not lead to believe that the choice is as simple as being a good parent versus giving into an addiction.

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3 Comments

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  1. Marcin C. / May 27 2011 22:50

    Quite a nice argumentation but I must disagree with you. IMHO, an addiction is not a choice, an addict is not able to use for himself rational tools as “discounting” theory or “rational choice” theory or any other one. Even the highest moral arguments have a very limited impact on an addict’s behaviour. At the advanced stage of an addcition simply no rational or moral relations have any key impact on the an addict’s decision to drink or not to drink. To drink or not to drink is not a question. It becomes a necessity of body and mind even if completely destructive and unpleasent for everybody including an addcit at the moment of drinking/taking drugs etc. Irrespective of the cognition of an addict or an objective perspective even if there are no short term benefits at all, an addcit will continue his addiction for any price, which is ompletely irrational if we still want to be close to economic definitions… Why some very advanced addcits are winners in the war with themselves? That is a mystery, another irrational decision as a reaction to an extreme situation which made a revolutionary impulse in an addict’s mind. You can call it a mystery or a miracle… one can not control them.. hopefully economy has nothing to to with miracles in this drama..

  2. maggieannthoeni / May 31 2011 08:35

    Thank you for a thoughtful post (as are other post you offer, so thank you for a thoughtful blog site!)

    Your review of conditions leading to, and/or supporting on-going addictions touch on most of the factors. As you say, personal emotional history context contributes to how addiction may begin, and also complicates getting clear of addiction. Some of your remarks on ‘immediate’ vs ‘distant’ rewards reminded me of Ruby Payne’s “Framework for Understanding Poverty”. She identifies a similar behavior in ‘economic planning’ of people in deep, especially trans-generational, poverty. Choices are made, in part, to seek distraction from, relief from, current and chronic stress and discomfort. A new gadget or entertainment expenditure offers momentary escape – saving the money instead, if ‘discretionary spending’ is restricted almost to zero by real income, can ‘feel like’ denial of human longing for ‘a break from struggle’. There is an underlying ‘discouragement’, a type of hopelessness.

    So – thinking too of Marcin’s remarks (previous comment) – I’m afraid economic realities do play some role, for some cases, of ‘recovery from addiction’ – or for potential likelihood of recovery. Not in every case, of course. Perhaps a key concept is “felt support” – a supportive human community surely must always be involved in recovery. Perhaps ‘economic structures and policies’ are also experienced as a ‘felt support’ (or not).

    My studies and experiences are centered in psychology as ‘key to human potential’. I so very appreciate your coming from the field of economics. “All of it” is, of course, inter-woven!

    Maggie

  3. Lukasz Cerazy / Jun 3 2011 10:18

    Dear Marcin and Maggie – thank you both for sharing your thoughts.

    I think that an addict does make decision about taking a drung or drinking alcohol. Economics, being a social science, offers ways of explaining decision-making because these are not made completely randomly – even in a state of heavy intoxication. It is, of course, difficult to construct models that completely explain decision-making which we have to be aware of.

    It sounds like I would do well to look up Ruby Payne 😉

    Lukasz

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