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If an individual is fat but wants to be thin, it is not a genetic disease. If someone is stupid, but wants to be smart, it is not a genetic disease. If a drunk is a drunk, but doesn’t want to be a drunk anymore, it is not a genetic disease. Addiction is a decision.

This is arguably the most powerful statement in the book and may be considered the central message. James has just been told that his grandfather was an alcoholic and is essentially being given an out—it is not his fault he became an alcoholic and drug addict, he simply has a genetic predisposition. James rejects this idea completely and says that he chose to drink. His problems are his fault and his fault alone. To recover, he must decide to stop drinking. This is a grand dismissal in a culture of blame. Of course, it’s also an oversimplification. Intelligence levels, metabolism, and the like are governed by some biological factors. But the message still comes through, and it is quite optimistic. James believes that people can change themselves and are capable of much more than they realize. But the first requirement is total acceptance of responsibility.

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