Addiction Narratives: Background Assumptions and Policy Implications

The predominant narratives of addiction—Disease and Choice narratives—frame addiction as a personal problem to be addressed by controlling an individual’s behavior. By analyzing the epistemic function of narratives of addiction, this paper shows that these narratives construct a story about the nature of addiction by assuming simplistic views about human agency, leading to drug policies that narrowly focus on individual behavior. Assumptions embedded within narratives must be made transparent so that the partial, perspectival, and situated nature of the knowledge that narratives convey is made evident and can be evaluated. As a result of their over-simplistic assumptions about human agency, Disease and Choice narratives neglect a significant factor in addiction: the social context which informs and sets limits on the reasons and values that enter into decision-making. This paper argues for the adoption of Social Constraint narratives, which would require policy agendas to focus on the social contexts that make drug use so appealing. As a result, agencies dealing with drug policy would need to collaborate with other agencies focusing on relevant social issues in order to create structural change, thus affecting the social environment and not merely the individual.