“The opposite of addiction, I have learned, is not sobriety but choice.” –Never Enough: The Neuroscience and Experience of Addiction – Judith Grisel

This isn’t really about television — only tangentially. It’s actually about perspectives on addiction. Watching the tv show Lost just provided a pop-culture window into how it’s depicted.

Years after it ended, I binged on all six seasons Lost, which isn’t something of which I watched so much as one episode during its original run. I don’t know why I chose now—perhaps it was because someone referenced it, and I didn’t know the reference. Perhaps because it seems like a blind spot in my encyclopedic knowledge of television. Most of the world is in lockdown, and it’s as good a time as any to indulge.

On the subject of indulgence and, by extension, addiction (clearly I indulge in my television addiction no matter how many times I claim I won’t), the thing that stuck with me from my Lost immersion was the character John Locke’s insistence that addiction is about choice. Right after reading Judith Grisel’s Never Enough: The Neuroscience and Experience of Addiction, in which Grisel states that the opposite of addiction is not sobriety but choice, I watched Locke give another character, Charlie Pace, a heroin addict, the opportunity to make the conscious choice about whether to use or not. Simple but powerful. It’s always about choosing to do or not.

Yes, choice. The true freedom.

“I understand firsthand the despair that grows as drugs come to make our choices for us, deciding whom we will be with and what we will do. This gloomy cell of repetition occupied by every addict, despite variation in periodicity, strips us of our most precious commodity, the freedom to choose. This is why I’m not against drugs or drug use, but am so thoroughly opposed to addiction: it strips us of our precious freedom. And this is also why it makes no more sense to cure addiction by imposing permanent or semipermanent limits on our range of choices than it does to teach compassion through corporal punishment. How could one give rise to the other? Just as children need autonomy in little doses in order to learn restraint, people in recovery obviously can’t be entrusted with ourselves all at once. But given social support, a range of attractive alternatives, and perhaps short-term medical interventions, we can learn to choose life—despite its obvious imperfections—over death. Ultimately, this freedom is the antidote to addiction. When I occasionally hear sober people say that using is no longer an option, I cringe. It is precisely an option. That’s exactly the point. So, what might be an ideal cure?”

I didn’t expect Lost to offer parallels to books on addiction, but it’s interesting to see depictions of addiction on television. Most of them don’t theorize about sobriety versus choice, most don’t look compassionately at the addict’s plight, and we as a society so, as Grisel writes, demonize and pity addicts… especially so when it’s seen as a moral failing and usually the use of “hardcore” drugs, like opioids.

But what always strikes me, given the damage it does, is that we fail to recognize alcohol as a hardcore drug. Its legality and ubiquity – and the expectation that drinking will accompany every occasion (everything from mourning to exuberant celebration) – has entirely skewed the perception of its danger.

“Social convention is pickled in the intoxicating juice of alcohol. In 1839, an English traveler named Frederick Marryat noted in his diary that American practice was “if you meet, you drink; if you part, you drink; if you make acquaintance, you drink; if you close a bargain, you drink; they quarrel in their drink, and they make it up with a drink. They drink, because it is hot; they drink, because it is cold.””

This is one of the most powerful parts of Grisel’s book – that she takes alcohol and the cultural imperative that it be an integral part of our lives – to task.

“I am also particularly curious about the general practice of celebrating peak experiences with a sedative. I understand that it is easy to be overwhelmed by strong emotions, and I appreciate the desire to evade stark reality, but still, it seems odd that we drink and use to permit or enhance strong feelings as well as to mute them.”

“Alcohol is a neurological sledgehammer. By acting throughout the brain to influence a multitude of targets, the drug affects virtually all aspects of neural functioning. One or two drinks help to blur the edges, and a reduction in anxiety promotes relaxation. But with a few more drinks, a person loses inhibitions as cortical monitoring is shut down and subcortical, “emotional” regions are freed from normal constraints. As one approaches the legal limit for alcohol in the blood, behavior is sedated, and speech and coordination are impaired. Still more drinking and the person might lose consciousness. These effects are what justify alcohol’s classification as a sedative-hypnotic.”

“Alcohol has been such a huge part of our culture since we had culture that it can be nearly impossible to see the ways we all participate in the unsustainable epidemic of alcoholism. So we walk a fine line, glancing up at the scope of the battlefield, looking in the mirror at the ways we contribute, but mostly walking with our eyes cast down, perhaps as my colleague felt meeting me in the hallway after my successful dissertation defense.”

“This seems funny, because it obviously isn’t creating the occasion, but rather the excuse to use an occasion for drinking. These businesses are well aware of psychological learning principles as they work to associate contexts with alcohol, noting that “insights have enabled us to create and position products for specific moments of consumption: enjoying a game or music event with friends, shifting toward a more relaxed mood after work, celebrating at a party or sharing a meal.” Along similar lines, in 2014 the British Beer Alliance, a consortium of major British brewers, invested £10 million in the marketing campaign “There’s a Beer for That,” aiming to showcase “the variety of beer available in the UK and how these different styles fit perfectly a wide range of occasions.””

“What might we do differently? As a start, we might work to ensure more spaces where not drinking isn’t just tolerated but acceptable. In addition to offering more beverage options, we could convey this acceptance by really seeing and hearing each other, putting the “social” back into the drinking. Practicing this, we might notice that at least some of those we meet will be better sated by friendship than by booze.”

Alcohol may be the “socially acceptable” addiction, and probably the most common, which is why it’s so perplexing.

“…thought-provoking paradox. If alcohol and other drug addictions were rare events, unlikely except for a few tragic cases, it would be one thing. But in the face of superabundant examples proximal, ubiquitous, and concrete, as well as our own family wounds concerning the stuff, our deep collective denial is strange. The manic insistence on ignoring the obvious is reminiscent of cigarette commercials I grew up watching. The juxtaposition of youthful athleticism with a nicotine habit seemed as odd to me as a child as the insistence today that alcohol somehow makes everything sexier and livelier. I still remember one commercial in particular that showed a group of gorgeously tanned young adults whitewater rafting down a rugged canyon as they promoted a popular menthol brand. Really? Smoking while rafting? This incongruity is thoroughly pervasive. We always kick off the annual meeting of the Research Society on Alcoholism, where I recently received my twenty-five-year membership pin, with a reception. Free drink tickets—two per person, just right for the social drinker—are offered to everyone, and the drug flows freely (because you can pay cash when your tickets run out).”