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mitechka comments on Wanting to Want - Less Wrong
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I suspect we're doing some extrapolation here in order to distinguish these cases. I expect that if Mimi knew more about herself and the world, and thought more clearly, she would still want to not want heroin; while I expect that if Larry knew more about himself and the world, and thought more clearly, he would be likely to reject the system of belief that causes him to think homosexuality immoral.
Alternatively, after sobering up, Mimi might decide that experiencing heroine high makes her life so much more fulfilling, that the much shortened life expectancy of a heroine addict doesn't seems to be a fair price to pay for it.
As usual it is all up to personal definition of utility.