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Addiction, Poverty and the Myth of Willpower

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Which one of two ways you talk about addiction is more telling about your life philosophy than it is about addiction itself.

On Sunday, Philip Seymour Hoffman was found dead in his New York City apartment. While his fans mourn the loss of a great actor, coverage has turned to the particulars of how he died. The cause of his death was allegedly a drug overdose; outlets have graphically reported that he was found with a needle still sticking in his arm.

When any high-profile addict dies, the barrage of articles, tweets and TV interviews invariably centers on his or her addiction. It did recently for Cory Monteith, for Whitney Houston and it will for Philip Seymour Hoffman too.

And, there will be two threads of discussion. The first will focus on what it means to be an addict. How the disease grips your brain. How the mentally ill or unstable will often self-medicate with drugs and alcohol to lessen or dull their pain. How the science behind addiction is documented. How addiction is considered a disease and is often genetic.

The second kind of discussion from the talking heads? There will be no compassion, only blame. They will say addicts are selfish. They are lazy. They lack willpower. That if they really want to, they have the ability to turn their lives around. Sound familiar?

The discourse surrounding addicts and their culpability in their addiction is remarkably similar to the discourse surrounding the poor and their culpability in their poverty.

Believing an addict is to blame for their addiction is a fundamentally conservative philosophy.

If you're lucky, the poor and the addicted are both outside your comfortable, everyday life. They are the ultimate "other." It is easy to look down on them. To believe they made bad choices that resulted in their situation. We like to believe that we could never be them. But the reality is, as the saying goes, "there but for the grace of God, go any of us."

It only takes one accident, one debilitating disease or losing your job to begin the slippery slope toward drowning in debt, losing your savings and winding up destitute. Desperate. Even homeless. Or, you could have the misfortune to simply be born into a poor family. Growing up in a food-insecure house with little emotional or financial support makes pursuing higher education (often necessary for overcoming poverty) incredibly difficult.

The systematic racial and economic injustices in our country contribute to a pervasive culture of inequality. While some people are able to change their circumstances, many are not. And that does not mean they didn't try hard enough. It doesn't mean they had a moral failing. It merely means that they didn't overcome the tremendous odds stacked against them.

And could you become an addict? Have you ever had one or three drinks too many? Have you taken more Vicodin than you needed after recovering from a surgery? Smoked a cigarette at a party? If not, that's great, but like poverty, addiction can also be a slippery slope. No single factor can determine whether or not someone trying drugs, alcohol or cigarettes will become addicted to them. It's a mixture of biology, environmental factors, developmental stage, social environment and even gender and ethnicity.

Why don't people quit before they become addicted? According to the National Institute on Drug Abuse, "When drug abuse takes over, a person's ability to exert self control can become seriously impaired. Brain imaging studies from drug-addicted individuals show physical changes in areas of the brain that are critical to judgment, decision-making, learning and memory, and behavior control. Scientists believe that these changes alter the way the brain works, and may help explain the compulsive and destructive behaviors of addiction."

Put bluntly: taking drugs damages a person's brain. If your brain is damaged, you cannot will yourself to change your behavior.

Believing that overcoming poverty or addiction is as simple as willpower or "wanting it enough" aligns with the conservative view that you are in charge of your destiny. It's the American myth - that if you try hard enough, you can overcome anything -- abuse, poverty, hardship, addiction, anything. It's a grand notion to be sure, but the flip side to that argument is that you are solely responsible if you don't succeed in life. That success is only due to your personal accomplishment and failure is due to no one's fault but your own.

Bill O'Reilly happened to be making the talk show rounds to promote his latest book when Whitney Houston died. He told Matt Lauer on The Today Show, "I don't believe that anyone is a slave to addiction ... I believe it is a disease, it's a mental disease. But you have free will, and you can get through the disease, as millions of people have chosen to do it ... You don't have free will when you have lung cancer. You do have free will when you're a crack addict."

No, addiction isn't cancer. You know what else isn't cancer? Schizophrenia. Bipolar disorder. Depression. Mental diseases, like addiction, are stigmatized because people who don't have experience with them don't understand them. They can't see a physical manifestation of depression so it must not be real. If it's all in someone's head, it can't be quantified or qualified. If someone doesn't see you as sick, how can they know you actually are?

But, again according to the National Institute on Drug Abuse, the very definition of addiction is about disease. "Addiction is defined as a chronic, relapsing brain disease that is characterized by compulsive drug seeking and use, despite harmful consequences. It is considered a brain disease because drugs change the brain -- they change its structure and how it works. These brain changes can be long lasting, and can lead to the harmful behaviors seen in people who abuse drugs."

Many people have said they don't feel sorry for Philip Seymour Hoffman. That his death wasn't a tragedy as much as it was "senseless" or "stupid" or even "inevitable." That he and he alone are to blame for his death. That he was willfully complicit in his suicide. I don't believe that.

Some people can overcome poverty or addiction or both. But some people can't. And that is due to a wide variety of ways our society and our brains are fundamentally structured. And that, like losing someone to addiction, is a tragedy.