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Scientists don't have a way to quantify willpower to tell people how much willpower they need to overcome addictions without any kind of medical help
Medicine Beginning to Recognize Addiction as a Disease of the BrainFifty-two year old Jacques Harvey (a pseudonym) has spent most of the last five years living in a tent in a grassy field behind a church in Austin, Texas. Once a successful nuclear power technician in California, Harvey's world began to unravel when, he believes, an alien, robot-like presence levitated into his apartment and abducted his wife. Terrified of returning to the site of his "abduction," Harvey began drifting across the country, never spending a night indoors, even in the worst weather, dealing with his fear by always sleeping outside.
At first Harvey's friends were more than happy to offer him a place to stay, but he was only able to extinguish his terror with alcohol. He became ashamed of his behavior when he was drunk. As an atonement and walked from the San Francisco Bay Area to his native Texas to leave his shame—and the extraterrestrials.
When Harvey lives outdoors, he is sober. Harvey does not ask for money, but offers to wash windows of stopped cars at an intersection near an on-ramp to an interstate highway. After a man in a similar mental state froze to death in 2010, people in his neighborhood often stop to bring him food and blankets or ice, depending on the weather. Harvey receives no institutional services. Every month or so, a kindly neighbor offers to take him to the Veterans Administration Hospital for psychiatric help, but Harvey always declines.
Fifty-three year-old Randy Jansen (again, a pseudonym) was struck by a car while crossing an intersection in late 2009. Suffering 22 broken bones and undergoing seven surgeries, Jansen was released from an Austin, Texas hospital only to confirm that the reason he had not seen his wife or son was that they had left to find work in New Jersey. Previously diagnosed as an alcoholic and suffering bipolar disorder, Jansen dealt with his problems by assuming the lifestyle of the classic drunk in the gutter.
Even worse, Jansen found another street person's stash of Vicodin (hydrocodone), enough to keep himself on pain medication. When the Vicodin ran out, Jansen developed the very common "explosive" diarrhea associated with withdrawal, right in the middle of a busy street, and was run over a second time.
For Jansen, however, getting run over a second time was an enormous stroke of luck. He was sent to a psychiatric facility and offered a relatively new medication called Suboxone. Also known by its chemical name buprenorphine, this medication acts on the same receptors in the brain that respond to hydrocodone, oxycodone, heroin, and opium-derived drugs. Coming off Suboxone also causes withdrawal symptoms, but they are much less severe than those associated with withdrawal from other drugs like it.
The US government places tight regulation on the use of Suboxone. Only psychiatrists who do group therapy are allowed to prescribe the drug at all, and only recently have they been allowed to treat up to 100 patients at a time. (The previous limitation on the number of patients any one doctor could treat with the drug was 10.) Randy Jansen, however, chanced to be examined by a psychiatrist who had room on his roster to treat him, and after six months of treatment from a half-way house, Jansen overcame his addictions to both alcohol and Vicodin and got a job working for a dry cleaner. But could he have overcome addiction just by willpower? Can't we all?
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