The Myth of Normal 182

Two things to note right away: First, my definition omits disease—which is not to say that it must exclude it. As I articulated in chapter 6, most illnesses are best understood as complex processes manifesting a person’s entire life, rather than discrete “things” in themselves. In the end, as with many conditions, calling addiction a disease may capture relevant aspects of it without coming close to explaining the phenomenon, let alone granting us a workable pathway to healing it at its source. Second, this definition is not restricted to drugs. The same drive that often devotes itself to substances can activate any number of behaviors, from compulsive sexual roving to pornography; from inveterate shopping to the internet (both of which habits I know well); from gaming to gambling; from any sort of binge eating or drinking to purging; from work to extreme sports; from relentless exercising to compulsive relationship-seeking; from psychedelics to meditation. The issue is never the external target but one’s internal relationship to it. Are you craving and partaking of something that affords you temporary relief or pleasure, inviting or incurring negative consequences but not giving it up? Welcome to the meeting. Free coffee in the back. If you’ve seen me speak on this topic, whether in person or on YouTube, you’ll probably know what I’m about to ask next. I usually pause here to invite a show of hands: “Who, by the definition just given, is now or ever has been addicted?” No matter the audience size, virtually no one’s hand ever stays lowered—except, I like to jest, for the occasional liar’s. That is how downright normal addictions are in our culture today. I invite you, fearless reader, to put yourself to the same test, with or without the hand-raising. Of course, not all addictions are created equal, except in the broadest of broad strokes. My HIV- and hepatitis-C-ridden patients in the Downtown Eastside surely stand apart from most of us in the degrees of suffering that hurled them into their habits, in the extent to which their dependencies dominate their lives, and, too, in the dire consequences their habits visit upon them. This is to say nothing about the diminished inner or outer resources available to them, often for socioeconomic and racialized reasons not of their