The history of the treatment of alcohol and other drug problems is often assumed to be a straightforward story of progress—moralism, neglect, and brutality were displaced by scientific knowledge, medical activism, and professional civility; a view that the addict exercised free will in choosing to use drugs was succeeded by an understanding of how a "disease" or "disorder" could overrule the capacity to choose.

This assumption is historically incorrect. First, it neglects the coexistence and mutual influence of views emphasizing free will or social or biological determinism. While one view may have enjoyed greater influence at a given time, its competitors have never been vanquished. No generation has any more solved the puzzle of addiction than it has resolved the related enigmas of the relationship between mind and body, choice and compulsion. Second, it is...