I argue that addiction is not a chronic, relapsing, neurobiological disease characterized by compulsive use of drugs or alcohol. Large-scale national survey data demonstrate that rates of substance dependence peak in adolescence and early adulthood and then decline steeply; addicts tend to “mature out” in their late twenties or early thirties. The exceptions are addicts who suffer from additional psychiatric disorders. I hypothesize that this difference in patterns of use and relapse between the general and psychiatric populations can be explained (...) by the purpose served by drugs and alcohol for patients. Drugs and alcohol alleviate the severe psychological distress typically experienced by patients with comorbid psychiatric disorders and associated problems. On this hypothesis, consumption is a chosen means to ends that are rational to desire: Use is not compulsive. The upshot of this explanation is that the orthodox view of addiction as a chronic, relapsing neurobiological disease is misguided. I delineate five folk psychological factors that together explain addiction as purposive action: strong and habitual desire; willpower; motivation; functional role; and decision and resolve. I conclude by drawing lessons for research and effective treatment. (shrink)

Felt necessity, or the phenomenon of experiencing some person or object as a felt need, plays important roles in structuring human agency. Philosophical treatments of the relationship between agency and felt necessity have tended to focus on appetitive needs and necessities arising from a particular type of care. I argue that we have much to gain by considering a third underexplored variety of felt necessity that I call “attachment necessity.” Attachment necessity has its own distinct parts to play in structuring (...) agency, and like its more familiar relatives, it can also illuminate important aspects of addiction and love. (shrink)

There is a debate about the nature of addiction, whether it is a result of brain damage, brain dysfunction, or normal brain changes that result from habit acquisition, and about whether it is a disease. I argue that the debate about whether addiction is a disease is much ado about nothing, since all parties agree it is “unquestionably destructive.” Furthermore, the term ‘addiction’ has disappeared from recent DSM’s in favor of a spectrum of ‘abuse’ disorders. This may be a good (...) thing indicating more nuance in typing the heterogeneous phenomena we used to call ‘addiction’. (shrink)

After describing the disorder of psychopathy, I examine the theories and the evidence concerning the psychopaths’ deficient moral capacities. I first examine whether or not psychopaths can pass tests of moral knowledge. Most of the evidence suggests that they can. If there is a lack of moral understanding, then it has to be due to an incapacity that affects not their declarative knowledge of moral norms, but their deeper understanding of them. I then examine two suggestions: it is their deficient (...) practical reason or their stunted emotions that are at fault. The evidence supports both explanations. I conclude with an overview of the debate concerning whether they are morally or legally responsible for their actions. (shrink)

Mental disorder (earlier entitled “illness” or “disease”) is ascribed to deviations from normal thoughts, reasoning, feelings, attitudes, and actions that are considered socially or personally dysfunctional and apt for treatment. Schizophrenia, depression, and bipolar disorder are core examples. The concept of mental disorder plays a role in many domains, including medicine, social sciences such as psychology and anthropology, and the humanities, including literature and philosophy. Philosophical discussions are the primary focus of the present entry, which differs from the entry on (...) Philosophy of Psychiatry in noting several different approaches—not only those of the philosophy of science and mind, but also those arising from phenomenology and social theory. -/- Mental disorder is a widely contested concept and there are longstanding debates on whether disorders are biological or social in nature. Even uncontroversial disorders, such as those listed above, were not always regarded as disorders in the past (Porter 2002). Moreover, the status of mental disorder has frequently indicated ethical, as much as other deficiency (Irwin 2013). Such reminders direct our attention to contemporary medical psychiatry’s sometimes uncompromisingly neurobiological, and avowedly value-free “medical model”, with its incumbent analogies and assumptions, and to the general question of how the taxa of psychiatric classifications are to be viewed as objects of natural science. This model has received intensive philosophical scrutiny, including arguments that deny these conditions are deficiencies at all. Along with issues arising from cognitive psychology and the neurosciences, such foundational matters make up much of the following entry. Because of their focus on issues central to the philosophy of mind and ethics (e.g., the mind-body problem, moral responsibility, agency and identity), analyses of mental disorder have extensive implications for those fields. As clinical phenomena, they also reflect an inescapable, everyday, social reality, giving theoretical inquiries additionally urgent practical, moral, and legal implications. (shrink)

The image of craving as a desire of unimaginable and irresistible force is poised to solve the puzzle of addiction: persistent drug use despite severe negative consequences. But the image is flawed. Drawing on science, philosophy, and first‐person testimony, I argue against irresistibility and develop a more nuanced, heterogeneous account of craving for drugs. Craving comes in three varieties, each corresponding to a kind of answer to the question why people crave drugs: cue‐induced, goal‐focused, and attachment‐based. This in turn grounds (...) an approach to addressing addiction that is humane and heterogeneous, moving beyond strategies that are fundamentally controlling. (shrink)

D’Angelo and Tamburrini invited readers to consider doping in sport as a health issue and dopers as potential addicts who need therapy rather than offenders who need punishing. The issue of addiction in sport is important and very much under researched. In this essay I explore the extent to which addiction can be justifiably used as an excuse for offending behaviour. The favoured argument is that addicts experience a craving or compulsion to use over which they have no control. I (...) argue that there is insufficient evidence that addicts experience such compulsion. Although it seems science is unravelling some of the mysteries of addiction, it has not provided sufficient evidence that addictive consumption amounts to compulsive use. Nevertheless, it is clear that addicts do have difficulty with controlling their use and such difficulties ought to be considered in any judgements about moral responsibility. This does not mean that rules or laws including anti-doping legislation should be altered because not all.. (shrink)

Addiction and certain varieties of interpersonal attachment share strikingly similar psycho-behavioral structures. Neuroscientists, psychologists, and philosophers have often adduced such similarities between addiction and attachment to argue that many typical cases of romantic love represent addictions to one’s partner and thus might be appropriate candidates for medical treatment. In this paper, I argue for the relatively neglected thesis that some paradigmatic cases of addiction are aptly characterized as emotional attachments to their objects. This has implications for how we should understand (...) the nature of addiction and for the ethics of attachment more broadly. (shrink)

Charland's article suggests that we need to think more about whether decision-making capacity is impaired in severe addiction, working from the idea that drug dealers rely on this understanding of addiction to draw in their clients. Charland argues that it is possible to make a choice without being in control (to make decisions without having decision-making capacity). I argue in support of Charland's ideas by examining the reasons supporting a medical model of addiction and its importance. (For Charland's article and (...) the full set of commentaries, please see the Research Gate link). (shrink)

ABSTRACT This paper uses abduction to propose a theory of addictive desire that is based on a dual dysfunction in learning and motivation. The theory is termed the Coherent Dual Theory of Addictive Desire (CDT) because it proposes that a dual dysfunction lies at the heart of addictive desire. This paper first lays out CDT in psychological terms. It then focuses on how CDT coheres with both the neurobiology and phenomenology of addictive desire, granting the theory empirical support and more (...) explanatory power. The paper concludes by addressing an objection from opponent process theory. The result is a theory of addictive desire that contains multiple abductive virtues: It is simple, general, testable, and coherent on the levels of neurobiology, psychology, and phenomenology. (shrink)

Recreational drug use, whether publicly acknowledged or privately hidden, has long been a common activity within human societies. Though this comes with serious hazards, it also produces benefits, which often go unrecognized. Given the current prohibitory policies, it is important to consider whether such use ought to be restricted. I will do just that, focusing on whether recreational drug use can be part of a reasonable conception of the good life, as well as whether restrictions constitute an infringement on freedom. (...) I will argue that, in moderation, recreational drug use constitutes a positive good for a large group of people, and that criminalization places an unfair burden upon these people, which breaches the liberal principle of neutrality. (shrink)