This article was published in Scientific American’s former blog network and reflects the views of the author, not necessarily those of Scientific American
This post is part of a collaborative narrative series composed of my writing and Chris Arnade's photos exploring issues of addiction, poverty, prostitution and urban anthropology in Hunts Point, Bronx. For more on the series, look here.
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The aim of this paper is to describe a conceptual framework of questions which an adequate theory of drug addiction must attempt to answer. First, a satisfactory definition of addiction is sought and it is concluded that it is best defined by repeated failures to refrain from drug use despite prior resolutions to do so. This definition is consistent with views of addiction that see decision-making, ambivalence and conflict as central features of the addict's behaviour and experience. On this basis, a three-level framework of required explanation is set out, consisting of (1) the level of neuroadaptation, (2) the level of desire for drugs and (3) the level of 'akrasia' or failures of resolve. The crucial argument is made that explanatory concepts used at the 'lower' levels in this framework can never be held to be sufficient as explanations at higher levels, i.e. the postulation of additional determinants is always required at Levels 2 and 3. In particular, it is a failure to address problems at the highest level in the framework that marks the inadequacy of most existing theories of addiction. The paper concludes by considering the relevance of the ideas presented to the concept of 'compulsive drug use' and concludes that this concept is no longer useful in the explanation of addiction.¹
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Each of the following is a different person, a different moment in addiction, a different part of the story. They are conversations and emails and phone calls. They are what is pure.
Dust to Dirt: Hunts Point, Bronx. Courtesy of Chris Arnade.
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"I'm clean. I mean, I relapsed yesterday, but I'm pretty much clean. I can get off of it. Pass me that stem?"
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"I need another 15 cents for a bag. You got 15 cents? C'mon, I really need it."
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"Gone from “Park ave, to Park bench”…literally…coming up on 20 years in recovery. Slept on the streets of the Lower East Side, Sold on street corners…hardest job I ever had…LOL….and yes I can laugh at it because I Survived."
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"Since I got here, I feel used to it. I know it's where I belong. But ever since I got here I feel worse than I did before."
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"There was a time when i thought my life was over and i suffered for the last 12 or 13 years of my active addiction. I lived in places like the wards island shelter, port of authority bus terminal, other reach out shelters, under the cross bronx expressway in a cardboard box, etc. I was just waiting to die. I overdosed 4 or 5 times down at hunts point, was brought out of it with narcan by EMTs and turned around and went right back down the street to cop again."
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"She needs to panhandle so she'll have something to take in detox when they don't give her enough."
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"I love what I do. I do it because it gives me the attention that I need. And the drugs. The drugs, drugs, drugs, drugs, drugs."
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"I was kissing her and it tasted all charcoaly. Not like good pork charcoal, like the burnt, broken, jagged crack pipe kind."
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"I'm a person who's lost right now but trying to find my way out. Heroin's an excuse."
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"I'm an outsider. I don't have friends. I think a lot of myself: there are certain things I do and don't do. Addiction makes you do things you don't want to do. The only way I can prostitute is to drink and to do cocaine. How can you pretend to love and have sex otherwise?"
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"I found a homeless shelter..that has a very long program for addicts..My grandma agreed to pay the small fee. I am scared but I would rather be there than on the streets prostituting or living with random men, staying sick and wasted. I pray that I can recover, because all I want is to someday be happy, to be with my kids again."
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"You're fine now. I promised her half of this bag because she paid for half. You can get half of the next. Go back to sleep and I promise I'll get you straight."
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"My dream is to take this as a stepping stone. At the end of the day I'm always coming back here. This is what I know."
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"We're not bad people. I'm just playing the card I'm dealt."
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More Hunts Point Addiction Writing
Chris Arnade's Photos and his Facebook feed