Should There Be Such a Thing as Addict Pride?

By Maia Szalavitz 07/18/12

People with autism embraced the idea of "neurodiversity" to celebrate their condition as a positive identity, not a disease and disability. Should addicts do the same?

Animal scientist Temple Grandin photo via

Autistic advocates coined the term “neurodiversity” to express the idea that there are many types of brain wiring—and that different doesn’t mean worse and may sometimes means better. While autism itself is associated with disability, these activists argue that disability alone isn’t what defines the condition and appropriate accommodation can often allow autistic talent to flourish.

For example, autistic trailblazers like animal scientist Temple Grandin contend that the intensity, fascination with systems, obsessiveness and tolerance for repetition that characterize her condition are also pretty much a recipe for success in engineering, mathematics and computer science. "Neurodiversity may be every bit as crucial for the human race as biodiversity is for life in general. Who can say what form of wiring will prove best at any given moment? Cybernetics and computer culture, for example, may even favor a somewhat autistic cast of mind," Harvey Blume wrote in 1998 in Atlantic magazine about the then-burgeoning movement. Since then, it has become a cliché to note the abundance of autistic traits in the people at the top of those fields.

The notion of neurodiversity needs to be incorporated into our thinking about drug policy and treatment.

While the neurodiversity cause has been embraced by people with a wide variety of brain differences—from bipolar disorder to schizophrenia to ADHD—addiction advocates are only beginning to pick it up. British harm-reduction pioneer Peter McDermott was, by most accounts, the first to argue that addicts should be considered as a type of neurodiverse population and respected appropriately, in a presentation to the British Advisory Council on the misuse of drugs. I wrote about the idea in an article earlier this year; since then, ex-addict and neuroscientist Marc Lewis also weighed in.

And indeed, a similar thread—not without controversy—seems to connect addiction to creativity and openness to experience in the same way that systematic thinking has been linked to autistic traits. Still, by understanding the parallels between both the potential abilities and the potential disabilities associated with these conditions, people concerned with addiction could learn a great deal. The notion of neurodiversity needs to be incorporated into our thinking about drug policy and treatment.

Some similarities are striking. For one, both autistic people and people with addictions tend to have unusual sensitivities, often experiencing sounds as too loud, lights as too bright or situations and emotions as too intense. Both try to address these problems in ways that seem inappropriate or even antisocial to the mainstream. Autistic people may withdraw into themselves, rock, self-mutilate and perform other strange and repetitive behaviors. Meanwhile, parents and teachers often relentlessly focus on taming their behaviors rather than addressing their underlying distress.

Addicted people, of course, often use drugs to cope with a world they find overwhelming. At least half have underlying conditions like depression, ADHD, schizophrenia or bipolar disorder, which, like autism, are linked not only to vulnerabilities but also to strengths. If the drugs we use to self-medicate are illegal, however, our behavior—not our distress—is what gets targeted.

Autistic and addicted people also share another commonality: both are stigmatized and often seen as self-involved and without empathy. In fact, in both cases, their pain may sometimes result from an excess of other-focused emotion that is so intense it provokes attempts at self-soothing and escape, rather than attempts to connect and help. That looks selfish and even uncaring from the outside—but rather than a lack of concern, the problem can also be an excess of it and a difficulty with modulating responses. (Of course, this is not always what’s going on: there’s an incredible diversity among both people with addiction and autistic people. Like other humans, both can sometimes be indifferent or actually cold.)

Yet even as we may celebrate such differences associated with addiction as creativity and sensitivity, we should also do everything we can to mitigate differences that are themselves purely disabling. Although neurodiversity advocates often say they don’t want a “cure” for autism, they’re not opposing efforts to relieve suffering; rather they want reduced disability without devaluing difference.

Indeed, the main opposition to the idea of neurodiversity has come from some parents of severely autistic children, who see the condition itself as nothing but a disaster and believe that wiping it off the face of the earth would be an unquestionable good. There is a similar longstanding debate in the deaf community related to cochlear implants. Some deaf people oppose the use of these devices because they fear that it will destroy the flourishing sign language culture they share, while others, again, see nothing wrong with wanting to eliminate the disability. The question of what most enriches the self and the world is complicated.

All in all, however, what’s notable about these parallels is that the solution to relieving disability in both autism and addiction is to understand the underlying issues rather than focus on the “problem” behaviors. Recognizing that brain wiring differences create diverse needs—and may also be accompanied by particular gifts—is crucial.
Rather than curing or punishing them, we can provide addicts what they need to function in a world not built for brains like theirs.
By doing this, with addiction, we can move away from the misguided idea that drugs are the source of the problem—and instead look at what makes about 10% to 15% of users susceptible to engaging in compulsive use. We can also get beyond the notion that vulnerability to addiction is simply a deficit and start to examine the contributions addicted people can make if we focus on their abilities, not just the harms associated with active drug use in a world that condemns it.

Rather than aiming to “cure” addictive behavior or punish people in order to try to end drug problems, we can seek to understand them and provide what addicts need to function comfortably in a world that isn’t built for brains like theirs. And just as autistic behavior should not be seen as problematic when it is helping people function and not hurting others, the same should be true with addictive actions.

In practice, this could mean anything from supporting involvement in 12-step programs to recognizing that antidepressants and other psychiatric drugs as well as maintenance with methadone, buprenorphine, or even heroin may be the best way to allow some neurodiverse brains to function. It would also mean letting go of emphasizing what is “normal” and “appropriate” and focusing instead on what best allows people to work and love and causes the least harm.

Instead of pitting abstinence against harm reduction, the neurodiversity approach recognizes that every brain is different and that what works for me may not be what works for you. The focus on abilities rather than disabilities also rejects the idea that having an addiction should be shameful and instead allows recovery—or even progress toward recovery—to be celebrated.

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Maia Szalavitz is an author and journalist working at the intersection of brain, culture and behavior.  She has reported for Time magazine online, and is the co-author, with Bruce Perry, of Born for Love: Why Empathy Is Essential—and Endangered, and author of Help at Any Cost: How the Troubled-Teen Industry Cons Parents and Hurts Kids. You can find her on Linkedin and  Twitter.