One of the main frustrations of dealing with addiction is that it involves such irrational behaviors. For example, why would anyone who nearly died from a previous overdose continue to use drugs like heroin or fentanyl? The irrationality of addiction allows society to paint addicts as deranged antisocial people hellbent on the selfish pursuit of one’s own pleasure at the expense of their families, their health and their society. This is why there is so much moralizing and stigma around addiction.

However, none of us are rational all the time. The source of our irrationality isn’t a lack of intellect or an inability to think rationally. It’s simply that our rationality is sometimes overridden by our emotionality. It is the familiar struggle of “head” versus “heart.” 

Many people demonize addicts but all of us knowingly make decisions that may not be in our own interest. For example, eating foods we know aren’t good for us, spending money unwisely, putting off seeking medical attention for something potentially serious, etc. Decisions, big and small, involve emotions. Which car to buy, whether or not to get married or have kids, whether or not to eat that chocolate cake, etc. Rarely if ever are these decisions based on purely logical calculations. Difficult decisions are usually difficult precisely because they involve pitting our hearts against our minds, balancing what we want against what logic tells us.

I believe addiction is impossible to understand without considering emotional elements. Our behaviors are driven by both logic and emotions. Emotions play key roles in the development of addiction, the maintenance of addiction, and also the process of bringing addiction under control. In the final three chapters of the book, I propose a framework based on emotions that seeks to explain addiction as an emotional phenomenon. I propose that harnessing emotions is essential for effective treatment of addiction.