The conventional concept of addiction this book confronts—the one accepted not only by the media and popular audiences, but by researchers whose work does little to support it—derives more from magic than from science. The core of this concept is that an entire set of feelings and behaviors is the unique result of one biological process. No other scientific formulation attributes a complex human phenomenon to the nature of a particular stimulus: statements such as "He ate all the ice cream because it was so good" or "She watches so much television because it's fun" are understood to call for a greater understanding of the actors' motivations (except, ironically, as these activities are now considered analogous to narcotic addiction). Even reductionist theories of mental illness such as of depression and schizophrenia (Peele 1981b) seek to account for a general state of mind, not specific behavior. Only compulsive consumption of narcotics and alcohol—conceived of as addictions (and now, other addictions that are seen to operate in the same way)—is believed to be the result of a spell that no effort of will can break.

Addiction is defined by tolerance, withdrawal, and craving. We recognize addiction by a person's heightened and habituated need for a substance; by the intense suffering that results from discontinuation of its use; and by the person's willingness to sacrifice all (to the point of self-destructiveness) for drug taking. The inadequacy of the conventional concept lies not in the identification of these signs of addiction—they do occur—but in the processes that are imagined to account for them. Tolerance, withdrawal, and craving are thought to be properties of particular drugs, and sufficient use of these substances is believed to give the organism no choice but to behave in these stereotypical ways. This process is thought to be inexorable, universal, and irreversible and to be independent of individual, group, cultural, or situational variation; it is even thought to be essentially the same for animals and for human beings, whether infant or adult.

Observers of addictive behavior and scientists studying it in the laboratory or in natural settings have uniformly noted that this pure model of addiction does not exist in reality, and that the behavior of people said to be addicted is far more variable than conventional notions allow. Yet unexamined, disabling residues of this inaccurate concept are present even in the work of those who have most astutely exposed the inadequacy of conventional models for describing addictive behavior. Such residues include the persistent view that complex behaviors like craving and withdrawal are straightforward physiological reactions to drugs or are biological processes even when they appear with nondrug involvements. Although these beliefs have been shown to be unfounded in the context in which they first arose—that of heroin use and heroin addiction—they have been rearranged into new notions such as drug dependence, or used as the basis for conditioning models that assume that drugs produce invariant physiological responses in humans.

It is the burden of this book to show that exclusively biological concepts of addiction (or drug dependence) are ad hoc and superfluous and that addictive behavior is no different from all other human feeling and action in being subject to social and cognitive influences. To establish how such factors affect the dynamics of addiction is the ultimate purpose of this analysis. In this reformulation, addiction is seen not to depend on the effects of specific drugs. Moreover, it is not limited to drug use at all. Rather, addiction is best understood as an individual's adjustment, albeit a self-defeating one, to his or her environment. It represents an habitual style of coping, albeit one that the individual is capable of modifying with changing psychological and life circumstances.

While in some cases addiction achieves a devastating pathological extremity, it actually represents a continuum of feeling and behavior more than it does a distinct disease state. Neither traumatic drug withdrawal nor a person's craving for a drug is exclusively determined by physiology. Rather, the experience both of a felt need (or craving) for and of withdrawal from an object or involvement engages a person's expectations, values, and self-concept, as well as the person's sense of alternative opportunities for gratification. These complications are introduced not out of disillusionment with the notion of addiction but out of respect for its potential power and utility. Suitably broadened and strengthened, the concept of addiction provides a powerful description of human behavior, one that opens up important opportunities for understanding not only drug abuse, but compulsive and self-destructive behaviors of all kinds. This book proposes such a comprehensive concept and demonstrates its application to drugs, alcohol, and other contexts of addictive behavior.

Since narcotic addiction has been, for better or worse, our primary model for understanding other addictions, the analysis of prevailing ideas about addiction and their shortcomings involves us in the history of narcotics, particularly in the United States in the last hundred years. This history shows that styles of opiate use and our very conception of opiate addiction are historically and culturally determined. Data revealing regular nonaddictive narcotic use have consistently complicated the effort to define addiction, as have revelations of the addictive use of nonnarcotic drugs. Alcohol is one drug whose equivocal relationship to prevailing conceptions of addiction has confused the study of substance abuse for well over a century. Because the United States has had a different—though no less destructive and disturbing—experience with alcohol than it has had with opiates, this cultural experience is analyzed separately in chapter 2. This emphasis notwithstanding, alcohol is understood in this book to be addictive in exactly the same sense that heroin and other powerful drug and nondrug experiences are.

Cultural and historical variations in ideas about drugs and addiction are examples of the range of factors that influence people's reactions to drugs and susceptibility to addiction. These and other salient nonpharmacological factors are outlined and discussed in this chapter. Taken together, they offer a strong prod to reconceive of addiction as being more than a physiological response to drug use. Drug theorists, psychologists, pharmacologists, and others have been attempting such reconceptualizations for some time; yet their efforts remain curiously bound to past, disproven ideas. The resilience of these wrongheaded ideas is discussed in an effort to understand their persistence in the face of disconfirming information. Some of the factors that explain their persistence are popular prejudices, deficiencies in research strategies, and issues of the legality and illegality of various substances. At the bottom, however, our inability to conceive of addiction realistically is tied to our reluctance to formulate scientific concepts about behavior that include subjective perceptions, cultural and individual values, and notions of self-control and other personality-based differences (Peele 1983e). This chapter shows that any concept of addiction that bypasses these factors is fundamentally inadequate.