Mimesis Law
27 January 2022

Mark Lewis and the Dangers of Redefining Addiction

Important: Addiction is a very serious topic and shouldn’t be taken lightly. This article will be touching on some sensitive and controversial topics so if you or a loved one is struggling with addiction, there is a website that can help find rehab near you so be sure to check it out.

In Sunday’s Washington Post, Marianne Szegedy-Maszak analyzes the findings of neuroscientist Marc Lewis in his book, The Biology of Desire. As noted in the column, Lewis makes the controversial assertion that addiction is not an actual medical illness, but a choice. Although the column is scientific in nature, it is interesting to note how Lewis’ findings are very similar to the way rank and file prosecutors typically view drug addiction and recovery.

Szegedy-Maszak points out that Lewis is not some type of arch-conservative politician trying to make a name for himself by blasting the “rise of a highly profitable industry for addiction services.”

Lewis speaks not just from the Mount Olympus of academic science – he’s a neuroscientist and professor of developmental psychology now in the Netherlands and previously at the University of Toronto – but as a former addict.

Despite these credentials, it is clear that Lewis takes a very negative view of the “Disease Model” of addiction, which stands for the proposition that “willpower [is] not enough to control the habit.” Lewis’ views are contrary to those of the American Medical Association and they also seem to negate the potential impact that recovery based probations can have on drug-addicted offenders.

Over the past few decades, the criminal justice system has slowly but surely become more and more amenable to the idea of treating addicts rather than incarcerating them. This is due to the fact that the public has a better comprehension of the struggles of being an addict and how they need the Best Drug Rehab centers to be able to overcome the addiction. The idea that such treatment is not only unnecessary but counterproductive, should have defense lawyers and doctors screaming in unison.

Defense attorneys have long relied on the idea of their clients “getting help” for a drug or alcohol problem as a way to lessen the length and severity of punishment. No one said dealing with addiction was easy, but it is not impossible to try and get life back on track. With there being facilities like Portland inpatient treatment centers, for example, the idea of trying to beat addiction may come sooner than some may think. It’s all about improving health and overall wellbeing.

The red-handed client who is expecting to be found guilty of a serious crime often finds this to be a good time in his or her life to seek treatment for addiction. It is a very common scenario for the defense attorney to explain to the prosecutor how his or her client has “hit rock bottom” with these pending criminal charges and that a stint in rehab should be just the thing to turn the client’s life around. If they are looking for rehab they may want to visit this website to learn more.

Prosecutors used to roll their eyes at these “rehab as salvation” monologues, but now they are more inclined to be indignant if the defense attorney fails to offer rehab as a solution. This isn’t because prosecutors have miraculously evolved into a more compassionate group of believers in addiction recovery – it’s just that rehabilitation for offenders has become such a boilerplate portion of plea negotiation. Although a prosecutor may be more than willing to agree that a defendant seeking drug or alcohol rehabilitation is an acceptable reason to offer probation rather than incarceration, it is rarely because the prosecutor has a genuine belief that the defendant is truly going to change his or her life for the better. Addiction recovery treatment has just become a very tangible part of the criminal justice machine, and — as noted by Dr. Lewis — also a very profitable one.

Lewis’ views mirror those typically held by prosecutors. Although prosecutors have learned to pay adequate lip service to the importance of a defendant “getting help,” the majority would agree with Lewis’s argument that addiction should not be described as a disease. As noted by Szegedy-Maszak:

The alternative, he asserts, is to call addiction what it is: a really bad habit caused by a constellation of variables and a brain that is receptive to compulsively reinforcing really bad habits. Most important, the habit is possible to break, not by becoming a ‘patient’ getting medical attention in order to ‘recover’ but by becoming a responsible adult with a solid vision of the future who has at last decided to break a destructive habit.

Prosecutors are typically appreciative of those defendants who take personal responsibility for their actions. However, blaming drug addiction rarely rises to that particular level of personal accountability.

But, in fact, addicts can and do stop. And according to Marc Lewis in ‘The Biology of Desire,’ this reveals a basic problem with the medicalization of addiction. ‘People choose to stop when they have suffered more than enough,’ he writes. ‘And when circumstances lend a hand. And when the possibility of self control becomes as attractive – more attractive – than any other possibility, including temporary relief.’

Under Lewis’s description, it would seem that prison time would be just as effective in helping cure addiction as medical intervention. Quite frankly, most prosecutors would be just fine with prison over a medically supervised intervention in most instances. That’s not to say that prosecutors across the board are consistently advocating prison for small drug offenses. However, for those types of cases that are directly tied to drug addiction – for instance, the drug addict who burglarizes a home for drug money – prosecutors would much rather see the defendant in prison than on probation with rehab.

To be clear, Lewis is not advocating that addicts be sent to prison – Szegedy-Maszak does not address the legal ramifications for Lewis’s beliefs. In fact, Lewis seems to advocate that addicts should just be left to their own devices until they find some sort of incentive to break their bad habit. As a person who quit smoking only after having the pleasure of going through chemotherapy, I can’t say that Lewis’s position is totally without merit. However, Szegedy-Maszak is correct to take Lewis to task for “playing down the staggering social costs of addiction.”

When Lewis advocates against addiction being treated as a medical condition, he is making the argument that treatment is counterproductive. Although the crux of his argument seems to be against pharmaceutical treatment for addiction, he throws the baby out with the bathwater when he denies addiction is a true illness. Illnesses, by definition, can be helped by health care professionals, including psychiatrists and psychologists who guide therapy sessions for addicts.

If, as Lewis argues, there is no illness to be treated, what other options exist for dealing with the addict who becomes a criminal defendant? Beyond the obvious, of course.

Main image via Flickr/Jeff Djevdet

6 Comments on this post.

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  • Ken Womble
    25 August 2015 at 10:13 am - Reply

    The implementation of treatment as an alternative to incarceration often misses the mark. In my career, the majority of clients that I have had take a plea to a treatment program have been people caught selling drugs. The dealers are the ones facing enough jail time to make a treatment alternative a worthwhile option, while the addicts are given a choice between 12 months of treatment or 30 days jail. Once the dealer is in treatment, he will often get sanctioned for positive drug tests … for weed.
    Not to say I haven’t witnessed tremendous individual successes in treatment court, but at least in Brooklyn, the programs often start at a minimum of a one year mandate. When it is either one year plus of treatment or 20-30 days jail, the addict almost always chooses the quicker out.

    • shg
      25 August 2015 at 11:32 am - Reply

      This is a very touchy subject, as it’s had some very useful effects for clients, and yet I’ve heard over and over from clients who actually want to clean up that drug treatment is a cesspool of incompetence, bullshit and, worst of all, drugs. They keep calling, complaining that the people who are supposed to be rehabbing them are dealing instead, and there’s more drugs inside rehab than on the street.

      But if rehab gets them out sooner, then, well.

      • Anon
        26 August 2015 at 5:29 pm - Reply

        Forgive me not using my name or e-mail, for obvious reasons, but I speak from years of personal experience. Scott is absolutely right that the rehab system is chock full of sheer incompetence and bullshit – but there are also plenty of excellent doctors who can legitimately help. Lewis isn’t totally wrong, but he also isn’t right. Terrible choices and bad habits are what start an addiction, but even if those habits are broken and your life cleaned up – you are still left with a physical addiction that in some cases, can literally kill you. Problem is, rehab can treat the clinical addiction, but it can’t fix the choices and habits that started it, and will ultimately lead to relapse if they aren’t addressed.

        Addiction can never be fixed with forced rehab and it can’t be fixed with prison. No matter how much the courts want to fix our drug problems and no matter how hard they try, they are utterly impotent – the only person who can fix an addiction is the addict.

        Ordering an addict into rehab does nothing but feed into the incompetence and bullshit of the rehab system. This is evident by the fact that the near universal experience with the inpatient rehab system is ineptitude and bullshit, but the outpatient experience is infinitely better (not to mention the remission rates between the two). The primary difference between them is that in general, people are court-ordered or forced into the former but attend the latter of their own free choice.

        Addicts either get their shit together and get medical or mental help (if needed) or they die an addict. The courts and rehab facilities don’t get to choose which.

        • shg
          26 August 2015 at 5:57 pm - Reply

          Your comment was approved despite your anonymity, but your choice of phony emails is not appreciated.

  • Murray Newman
    25 August 2015 at 12:16 pm - Reply

    I completely agree. It isn’t that Lewis is wrong. Rehab has become one hell of an industry, but it has become almost synonymous as an alternate punishment outlet. Judges feel good about saying that they tried to get some help as they were dispensing merciful justice, but they use a cookie cutter approach. It is completely silly to send a dealer to rehab. It is also silly to require an interlock device on a DWI defendant’s vehicle when the intoxicating substance isn’t alcohol.

    But they do it anyway.

    My concern with Lewis’s position is that he speaks in terms of absolutes. According to Obi-Wan Kenobi, only a Sith does that.

    • shg
      25 August 2015 at 12:51 pm - Reply

      It is also silly to require an interlock device on a DWI defendant’s vehicle when the intoxicating substance isn’t alcohol.

      Not if you’re in the business of making, selling, installing and repairing interlock devices.