G. writes: “I am currently an addiction psychiatrist and that means 100% of the people I see have one or more serious addictions. While I operate from the neurobiological perspective with regard to addiction, phenotypic plasticity is operative. I would estimate that 40% of the population is at risk for addiction if exposed to a matching intoxicant. Availability of drugs as seen in the current opioid epidemic is always a significant factor. It is hard to ignore the cultural biases that lead to this exposure. It seems to be part of the American culture that people expose themselves to drugs and alcohol at an early age. In Middle School and High School as well as college there is peer pressure. People who abstain from intoxicants are viewed as being square or possibly closet prohibitionists. The former President of Mexico Vincente Fox suggested the entire reason for the War on Drugs was “America’s insatiable appetite for drugs.” I think that he was right. I think that an important public health strategy would be to intervene at the “philosophy for living stage” that currently seems based on hedonism before the significant neurobiological effects from the intoxicants takes over. Is there any advice that Stoics may have to offer in this situation? I guess I see the problem as a lack of a reasonable plan for living at the bare minimum when it comes to excessive drug and alcohol consumption. There is not much of a window between that and a full blown addiction.”
This is a very difficult question, as a lot of factors enter into addiction, from social and psychological ones to possibly genetic contributions. I will try to stick to a Stoic perspective, without pretending to provide a general solution to the problem of addictive behavior.
To begin with, let us separate two components of the issue, as outlined by G. himself: the societal environment vs what individuals can do.
As far as the first is concerned, right, I would agree that the fact that we broadly do not teach our kids about virtue and how to develop a meaningful path in life is a serious problem, and possibly a significant contributor to the high levels of addiction we see in American society. I don’t think it is by chance that the US in particular suffers from this plague, being one of the most consumerist societies on the planet. While I don’t expect any dramatic societal change in that direction — especially given the current political climate — I support efforts to teach Stoicism or other virtuous philosophies of life (Buddhism, for instance) to young people. For instance, I am at the moment exploring the possibility of co-writing a graphic novel-type book for kids that introduces them to the basics of Stoicism by exploring a series of problems that potential readers may experience, including bullying and the sort of peer pressure toward drugs and alcohol that G. is talking about. I’m not sure when it has gone out of fashion to teach sound principles to the next generation, both at home and at school, but it seems way past the time to reverse the trend.
The second issue, that of individual choices insofar as adults are concerned, can itself be split into two components: on the one hand, people who have not engaged in potentially addictive behaviors but are at risk of doing so; on the other hand, those who are already addicts to substance abuse, gambling, or other destructive behaviors and are trying to get out of them.
I would wager that embracing Stoicism is a very good preventive measure for people in the first category. While Stoics have no objection to the enjoyment of a variety of pleasures (they are preferred indifferents), they do object to any pleasure that takes over and begin to own us. Here, for instance, is Diogenes Laertius on alcohol:
“[The Stoics] will take wine, but not get drunk.” (Lives of the Eminent Philosophers, VIII)
Even the pleasure of everyday food is an occasion to practice the Stoic virtue of temperance, according to Musonius Rufus:
“The more often we are tempted by gastronomic pleasure, the greater the danger it presents. And, indeed, at each meal, there is not one chance for making a mistake, but several.” (Lectures XVIII.B4)
About mode dangerous pleasures, modern Stoic Bill Irvine says:
“There are some pleasures, the Stoics would argue, from which we should always abstain. In particular, we should abstain from those pleasures that can capture us in a single encounter. This would include the pleasure to be derived from certain drugs: Had crystal meth existed in the ancient world, the Stoics would doubtless have counseled against its use.” (A Guide to the Good Life, p. 114)
So I would say that someone at risk of becoming addicted to something, but who is considering Stoicism as a philosophy of life, or has already began her training as a prokoptousa, is equipping herself with good tools to resist temptation, especially if her practice is supported by a local, or even an online, community of Stoics.
The situation of people who is already addicted is far more difficult, of course. That person may be first and foremost in need of medical attention, and if so, then she should seek it immediately. But as my colleague Lou Marinoff, author of the bestselling Plato, not Prozac! reminds us, do take medications (the Prozac of the title) if you need to, in order to bring your brain back to a sufficient degree of stability and be able again to think straight — the Stoics would say that you need to restore your “ruling faculty,” as Marcus called it. But the medications aren’t going to do the thinking for you, they simply allow you to regain some degree of agency so that you can think and make decisions. At that level, embracing Stoicism, studying it and practicing it, are good ways to manage whatever problem, not just addiction.
Incidentally, on the topic of Stoicism and mental health in general, I recommend this excellent article by Zachary Augustine, entitled “Dis-ease (Mental Health),” published over at the Modern Stoicism site.
I’d like to bring up one additional point. We are all familiar with the famous Serenity Prayer, used nowadays at meetings of Alcoholics Anonymous:
God, grant me the serenity to accept the things I cannot change,
Courage to change the things I can,
And wisdom to know the difference.
In preparation for my forthcoming book, I have done some research on it, given its strong Stoic connotations. I found that the prayer in its modern form is attributed to Reinhold Niebuhr, an American theologian who used it in his sermons as early as 1934. The same sentiment is detectable, however, across centuries and cultures. Solomon ibn Gabirol, an eleventh-century Jewish philosopher, expressed it this way: “And they said: At the head of all understanding is realizing what is and what cannot be, and the consoling of what is not in our power to change.” Shantideva, an eighth-century Buddhist scholar, similarly wrote: “If there’s a remedy when trouble strikes / What reason is there for dejection? / And if there is no help for it / What use is there in being glum?”
Yet there is an even more ancient version: “Make the best use of what is in your power, and take the rest as it happens. Some things are up to us and some things are not up to us. Our opinions are up to us, and our impulses, desires, aversions — in short, whatever is our own doing. Our bodies are not up to us, nor are our possessions, our reputations, or our public offices, or, that is, whatever is not our own doing.” That one, of course, is found in Epictetus’ Enchiridion, right at the beginning. It is not just a guide to dealing with the sort of problem that Alcoholics Anonymous focuses on, it is a guide for life more generally, and — just to come back full circle to my first suggestion — ought to be taught to our kids.