I shot heroin and cocaine while attending Columbia in the 1980s, sometimes injecting many times a day and leaving scars that are still visible. I kept using, even after I was suspended from school, after I overdosed and even after I was arrested for dealing, despite knowing that this could reduce my chances of staying out of prison.
My parents were devastated: They couldn't understand what had happened to their "gifted" child who had always excelled academically. They kept hoping I would just somehow stop, even though every time I tried to quit, I relapsed within months.
There are, speaking broadly, two schools of thought on addiction: The first was that my brain had been chemically "hijacked" by drugs, leaving me no control over a chronic, progressive disease. The second was simply that I was a selfish criminal, with little regard for others, as much of the public still seems to believe. (When it's our own loved ones who become addicted, we tend to favor the first explanation; when it's someone else's, we favor the second.)
We are long overdue for a new perspective — both because our understanding of the neuroscience underlying addiction has changed and because so many existing treatments simply don't work.