How a society views individuals who engage in addictive behaviors has an important influence on addiction and recovery from addiction. If addiction is seen as a moral failing, it will be condemned. If seen as a deficit in knowledge, it will be educated. If the addiction is viewed as an acceptable aberration, it will be tolerated. If the addiction is considered illegal, it will be prosecuted. If viewed as an illness, it will be treated. Social policies mirror these different views with strategies ranging from prohibition and criminalization to hospitalization and mandated treatment.
The United States has used an economic view of supply and demand with which to frame its policies. However, supply reduction has coexisted uneasily with demand reduction, and interdiction with treatment. For many policymakers addiction is viewed predominantly as a legal problem, and so interdiction and zero tolerance are considered the appropriate policies. Increasingly, then, the major responsibility for managing addictive behaviors and addicted individuals is given to the police, the courts, and the legal system. At the same time, there are a number of illness-oriented policymakers who see addictions as social epidemics or chronic medical or psychological conditions. They, along with the treatment community, promote policies to provide interventions to assist the individual addict and reduce the harm from addictions on society.
There are serious shortcomings in current perspectives and the efforts at interdiction, prevention, criminalization, and treatment that they support. Interdiction and elimination of the supply feeding addictive behaviors appear impossible as long as the demand from current and new consumers remains high. Attitudes about legal and illegal addictions vary significantly, causing confusion in messages and approaches to addiction and recovery. Punishment has become closely linked to treatment, mixing external pressure with internal motivation that often increases attendance at treatment programs but makes personal recovery more challenging. Attempts to reduce harm for addicted individuals are often banned because they are seen as supporting addictions. Inconsistencies in attitudes and approaches toward addictions abound. The reality is that it is difficult to balance concern for the individual who becomes addicted and the welfare of the society and its other citizens. Many in the political, legal, prevention, and treatment systems believe that new approaches are needed.