Addiction – neither compulsion nor free choice

A Northumbria University academic whose research had a major impact on NHS health policies around alcohol consumption has just published a new book on addiction.

Nick Heather, an Emeritus Professor of Alcohol and Other Drug Studies in Northumbria University’s Department of Psychology, has co-edited Addiction & Choice, which considers how addicts make choices about their behaviour.

Professor Heather is one of the UK’s leading experts on alcohol, drug studies and addictive disorders, having published more than 500 works on addiction and other topics.

Thanks partly to his research, the National Institute for Health and Care Excellence recommended that NHS professionals routinely carry out alcohol screening and give advice and help on cutting down drinking where necessary. As a result, GPs and nurses now ask patients how much alcohol they consume in a week as a standard part of health checks and medical appointments.

Addiction & Choice takes philosophical, psychological, legal and neuroscience perspectives to encourage a rethinking of the relationship between addiction and choice and how the consequences of addiction can be better alleviated. In particular, it argues that it is unhelpful to see addiction as involving either no choice whatever (i.e., as ‘compulsion’) or as a completely free choice just like any other. The truth lies between these extremes and addiction is therefore a disorder of choice in which addicts have difficulty, often great difficulty, in changing their behaviour.

Professor Heather explained: “Addiction is best viewed as a ‘disorder of choice’ in which – despite strenuous efforts – the individual’s choices are inconsistent over time. The addict tries and resolves time and time again to quit or radically modify their behaviour, but repeatedly fails.

“Answering the question of why people repeatedly behave in ways they know are bad for them is the central problem in the study of addiction. It’s therefore important for us to explore the implications of the middle ground between ‘free choice’ and ‘no choice’. 

 “Our book contains reflection, discussion and research by very clever and distinguished people on the implications of seeing addiction in this way, together with the possibilities it offers for a better public understanding of addiction and how to prevent and treat it.”

Professor Heather’s research into alcohol consumption and its subsequent inclusion in NHS health policy was highlighted in the 2014 Research Excellence Framework – an assessment of the quality of research undertaken in all UK universities – as being an outstanding example of research with an impact on society.

Alongside his academic experience, Professor Heather also worked as a consultant clinical psychologist with the Newcastle, North Tyneside and Northumberland Mental Health NHS Trust.

Addiction & Choice: Rethinking the Relationship, edited by Professor Nick Heather and Professor Gabriel Segal, is published by Oxford University Press and is available to purchase now. It is also due to be published online at www.oxfordscholarship.com towards the end of November.