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How Much Does “Choice” Play a Role in Addiction?

If you could choose between alcohol or your drug of choice and a good-enough reason to refuse them, which would you choose? Many Columbia University studies performed by neuroscientist Carl Hart suggest that addicts can, in fact, choose sobriety — when the second option is appealing enough to avoid using. Learn more about choice and addiction here, and consider the choices you make and the benefits you earn every day when you decide to stay sober. Knowing What Is Better — Intuitively Hart, who runs a laboratory at Columbia University, has extensively studied the effects better choices can make in the mind of willing substance abusers. A recent profile in The Atlantic examined Hart’s discoveries concerning methamphetamine and cocaine addicts, and the choices they would make when presented with drugs or cash. Although common practice treats many addicts as victims of uncontrollable urges, Hart’s research suggests that conscious choice plays a larger role than previously suspected. The addicts, who did not demonstrate an interest in quitting and who were confined to a hospital for the duration of the 2-week study, decided every day between either methamphetamine or crack cocaine. Hart first offered each participant a sample dose of drugs; later on the same day, he gave them a choice between the same amount of drugs, $5 cash or a $5 store voucher. Mostly, the addicts chose the cash or the voucher over the drugs — except when a higher dose was offered, at which point the addicts chose the drugs. But then, something interesting happened. Your Money or Your Life When Hart upped the reward to $20, the addicts chose the money every time. Addiction science, which has long espoused the notion that addiction “hijacks” the addict into making bad choices, must now confront Hart’s findings, which conclude that even addicts in late stage addiction can choose to protect themselves against further abuse by making healthier choices. For many recovering addicts who make the choice between getting high and sustaining sobriety every day, this practice of “self-binding” means staying busy instead of staying bored, direct-depositing paychecks, and clipping ATM cards in half to avoid easy access to cash. In calmer moments, a user who is not suffering from withdrawal or cravings will make a better, safer choice every time — provided there is a better, safer choice available. The point? Addicts, when presented with a viable and appealing option, chose to go drug-free when they were not under the negative influences of withdrawal or cravings. (Photo via)

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