bioethics.global
Addiction · read in full · 5 of 13
The book (PDF)

Section 5

Four positions

Four positions. The test is a fifth.

The debate today has gathered around four positions. The structure places itself among them, not only against the old swing between disease and weakness.

Harm reduction

Reduce the harm the use spills onto others. Clean needles. Supervised consumption sites. Naloxone to reverse overdose. Possession decriminalised, at amounts the structure reads as appropriate. Without making abstinence the goal.

What it gets right. Condemnation narrows the corridor further. The person is owed a floor, at whatever state of use they are in now. The book calls it the dignity-floor: the minimum every person is held at, whatever else is being calculated. And the larger structure’s responsibility reaches the conditions under which the use happens.

Where it stops short: it treats the widening of the corridor as separate from the use that keeps running. The structure agrees with the immediate help, and reads further. To widen the corridor again, three things need attention. The mind’s recalibration. The underlying history. And the writing of new records that hold. Harm reduction alone does not produce these.

Harm reduction is the floor. The structure requires the levels above it too.

Criminalisation

Punish. The larger structure treats the use as a breach of law. A fine. Prison. It depends on the substance and the place.

What it gets right. Use sometimes spills into the shared room at real cost. And above the line, the larger structure has the authority to respond.

Where it falls short: it collapses the response into punishment. The structure reads the crossing of the line and applies the correction hierarchy from the chapter on law. The least intervention for the most stability. The response is set by what actually makes things stable again. Not by what institutions have always defaulted to.

Criminalisation that does not restabilise is parasitic contraction at the scale of institutions. The structure refuses it as such, whatever the law says.

Medicalisation

Treat. The use is a medical condition. The clinic addresses it with medicine, therapy and social help.

What it gets right. The changes the use makes are real. Medical help, at the level where the mind recalibrates, is legitimate. And the person is owed the dignity-floor through the medical care the larger structure supplies.

Where it falls short: it reduces the person’s authority to the medical frame. Your authority over your own mind includes whether you take up medical help at all. Which forms you take up. And how your own commitments stand toward the medical care.

Medical help is part of the correction. Your authority is not reducible to the medical frame.

Personal responsibility

The answer is the person’s own commitment. Seeing that the corridor has narrowed. Committing to the work of recovery. Keeping attention on the history underneath.

What it gets right. Your capacity to choose is real. Your commitments are facts. And recovery without your own authority is not recovery in any sense the structure endorses.

Where it falls short: it treats the commitment as enough. The narrowed corridor is a condition the commitment works inside. The medicine chapter’s level one is sleep, food, a stable home, people around you. Without the larger structure supplying the dignity-floor there, the person’s commitment is being asked to work in conditions the structure itself should supply.

A fifth

Four positions. Four readings of what addiction is and what the response requires. The structure gives a fifth.

The corridor narrowed faster than alternatives could be widened. Sovereign below the line. The correction hierarchy above it. A correction that brings together three things: lowering the noise floor, writing new records that hold, and attention to the history underneath.

The structure takes the strongest version of what each position gets right, and places it in the four conditions.

Source. Ø Applications, Chapter 7 — Cognitive Sovereignty and Addiction. The book in full: the420code.org/Applications.pdf. The short edition: the420code.org/models/applications/07-cognitive-sovereignty-and-addiction/. The film, The noise floor: the420code.org/films/applications/. Its kill switches: APP-7.1 to APP-7.5.