Since the dawn of the internet, pornography has effectively become ubiquitous, pervasive, and increasingly normalised. Study findings show remarkable similarities in how the brain reacts to pornography, and other known addictive substances, and indicate that consuming pornography is comparable to consuming other known addictive substances. Moreover, two of the biggest risk factors for addiction are the substance’s availability and its easy accessibility, particularly in the case of younger persons. To date, pornography addiction has been conceptualised as a (...) behavioural addiction. However, the body of research data on pornography addiction does not provide conclusive support for behavioural addiction. The aim of this thesis is to put forward the idea that pornography can, and should, be conceptualised as an addictive substance, and, that when pornography is consumed, an addictive substance is consumed. In order to support this claim, there are many factors that must be addressed. I first clarify what pornography entails by exploring how it is conceptualised, what pornography ‘does’, and what it means to be a pornography consumer. Secondly, I examine the conceptualisations of substances, substance consumption and addiction, respectively, as well as the subsequent difference between substance and behavioural addiction. Thirdly, I give an inclusive overview of pornography addiction by not only examining the most recent perspectives of researchers, but also of pornography consumers. I conclude by suggesting how we should go about conceptualising pornography addiction, and then propose how the set of diagnostic criteria for pornography use disorder should be formulated for a future iteration of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders. I argue that, given the abundance of academic research on substance addiction, compared to the scarcity of research on behavioural addiction, conceptualising pornography as an addictive substance is more likely to create a sense of urgency for the future research of pornography addiction than would be the case if it is considered a potential behavioural addiction. Furthermore, I argue that the classification of pornography as an addictive substance, and the inclusion of pornography use disorder in a future iteration of the DSM, will raise awareness of the potential adverse effects of pornography consumption and, therefore, the harmful consequences of pornography use disorder. (shrink)

Background: Recent literature on addiction and judgments about the characteristics of agents has focused on the implications of adopting a ‘brain disease’ versus ‘moral weakness’ model of addiction. Typically, such judgments have to do with what capacities an agent has (e.g., the ability to abstain from substance use). Much less work, however, has been conducted on the relationship between addiction and judgments about an agent’s identity, including whether or to what extent an individual is seen as (...) the same person after becoming addicted. Methods: We conducted a series of vignette-based experiments (total N = 3,620) to assess lay attitudes concerning addiction and identity persistence, systematically manipulating key characteristics of agents and their drug of addiction. Conclusions: In Study 1, we found that US participants judged an agent who became addicted to drugs as being closer to ‘a completely different person’ than ‘completely the same person’ as the agent who existed prior to the addiction. In Studies 2-6, we investigated the intuitive basis for this result, finding that lay judgments of altered identity as a consequence of drug use and addiction are driven primarily by perceived negative changes in the moral character of drug users, who are seen as having deviated from their good true selves. (shrink)

The global rise of addictions in the modern world is alarming. What the discipline of modern Western psychology fails to recognize is the connection between the loss of a sense of the sacred and the rise in addiction and mental illness. Due to the spiritual desolation prevalent in the present day and its traumatizing effects, the human search for wholeness and healing is all too often diverted into destructive and dysfunctional behaviors. It is only a spiritual approach to the (...) science of the soul that allows psychology to restore the categories of Spirit, soul, and body, along with their corresponding degrees of reality. This paper examines the root causes of addiction in order to better understand the collective search for wholeness and healing. The framework employed for this study is the perennial psychology—an application of the universal wisdom found in humanity’s spiritual patrimony to the proper understanding of this burgeoning crisis. The objective of the study is to propose a more integrative approach to assessment, diagnosis, and treatment of addiction. (shrink)

Ontologies are being developed throughout the biomedical sciences to address standardization, integration, classification and reasoning needs against the background of an increasingly data-driven research paradigm. In particular, ontologies facilitate the translation of basic research into benefits for the patient by making research results more discoverable and by facilitating knowledge transfer across disciplinary boundaries. Addressing and adequately treating mental illness is one of our most pressing public health challenges. Primary research across multiple disciplines such as psychology, psychiatry, biology, neuroscience and pharmacology (...) needs to be integrated in order to promote a more comprehensive understanding of underlying processes and mechanisms, and this need for integration only becomes more pressing with our increase in understanding of differences among individuals and populations at the molecular level concerning susceptibility to specific illnesses. Substance addiction is a particularly relevant public health challenge in the developed world, affecting a substantial percentage of the population, often co-morbid with other illnesses such as mood disorders. Currently, however, there is no straightforward automated method to combine data of relevance to the study of substance addiction across multiple disciplines and populations. In this contribution, we describe a framework of interlinked, interoperable bio-ontologies for the annotation of primary research data relating to substance addiction, and discuss how this framework enables easy integration of results across disciplinary boundaries. We describe entities and relationships relevant for the description of addiction within the Mental Functioning Ontology, Chemical Entities of Biological Interest Ontology, Protein Ontology, Gene Ontology and the Neuroscience Information Framework ontologies. (shrink)

Research in the philosophy of addiction commonly explores how agency is impacted in addiction by focusing on moments of apparent loss of control over addictive behavior and seeking to explain how such moments result from the effects of psychoactive substance use on cognition and volition. Recently, Glackin et al. (2021) have suggested that agency in addiction can be helpfully analyzed using the concept of affordances. They argue that addicted agents experience addiction-related affordances, such as action (...) possibilities relating to drugs, drug paraphernalia, and drug-related activities, as aberrantly salient motivations for action. Building on this approach, we present a novel two-tiered affordance model of addiction. In doing so, we suggest that what is significant about the addicted person’s world is not simply what affordances are experienced as salient, but also the way in which the addicted person’s world is shaped by a dominant concern. It is not only that addiction-related affordances become more prominent as addiction progresses but that one’s plurality of concerns become monopolized by and funneled through addiction. Our model endorses Glackin et al.’s idea that addiction-related affordances become aberrantly salient, while proposing why they become and remain so. This way of viewing agency in addiction also brings to light important implications for recovery and treatment. For, if an addicted person adopts a new, even “socially approved”, dominant concern, there is a risk that the shape of addiction is preserved, even though the content changes, leaving an individual at the risk of addiction substitution or relapse. (shrink)

Currently there is such a cornucopia of conflicting theories in the field of addiction studies that it has become exceedingly difficult for treatment providers, therapists, and policymakers to integrate this vast field of knowledge into effective treatment. Since such a chaotic overabundance of treatment theories, styles, and definitions cloud the field of addictionology, many therapists claim their field is in need of a paradigm shift. In the last 20 years an integrative and compound model has emerged known as the (...) biopsychosocial model, but without a solid and comprehensive meta-framework, syncretistic confusion can result when therapists pick and choose techniques without direction or an overall rationale. To address this problem, Guy du Plessis applies integral theory as a conceptual framework for understanding addiction, as well as a meta-therapeutic framework for therapists. The integral foundation of addiction outlined in this book provides researchers, academics, treatment providers, policy makers, and therapists with a conceptual architectonic of addiction and its treatment that is integrative, inclusive, and practical. An Integral Foundation for Addiction Treatment belongs on the shelf of every addiction treatment therapist, and anyone else who is impacted or influenced by the topic. (shrink)

Progress in addiction science is hampered by disagreements and ambiguity around its core construct: addiction. Addiction Ontology (AddictO) offers a path to a solution of the kind that has addressed similar problems in other areas of science: a set of clearly and uniquely defined entities to which terms such as ‘addiction’, addictive disorder’ and ‘substance dependence ’can be applied for ease of reference while recognizing that it is the construct definitions and their unique IDs that (...) are central, not the terms. (shrink)

Anorexia nervosa is an eating disorder characterized by very restrictive eating or dieting leading to weight loss, a fear of weight gain, and a distorted body image. Several physiological mechanisms and behaviors that maintain and worsen symptoms of anorexia have addictive qualities that parallel that of substance use disorder. Similarities between anorexia nervosa and substance use disorder are explored, including other relevant diagnoses and phenomenons like reward deficiency syndrome. Related mechanisms and behaviors associated with anorexia and substance (...) use disorder include compulsion, the detrimental continuation of maladaptive behaviors, impaired control, and disorder-related changes in neurology. Conceptualizing anorexia nervosa as an addiction could assist in creating effective treatments for this disorder. (shrink)

Self-narrative is often, perhaps primarily, a tool of self- constitution, not of truth representation. We explore this theme with reference to our own recent qualitative interviews of substance-dependent agents. Narrative self- constitution, the process of realizing a valued narrative projection of oneself, depends on one’s narrative tracking truth to a certain extent. Therefore, insofar as narratives are successfully realized, they have a claim to being true, although a certain amount of self-deception typically comes along for the ride. We suggest (...) that, because agents typically value certain outcomes more highly than truth for truth’s sake, it makes sense to narrate in ways that aren’t strictly true if that helps ensure highly valued outcomes do come true. Walker (2012) outlines three ways of defending the truth of past-directed narratives, but the role of future-directed narratives in realizing highly valued truths provides her a fourth way. (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 article proposes and outlines an integrally informed 12 Step-based therapy that is adapted for treating addicted populations. Integrated Recovery Therapy (IRT) as a therapeutic orientation is an Integral Methodological Pluralism to therapy for treating addiction. Its two main features are paradigmatic and meta-paradigmatic. The paradigmatic aspect refers to the recognition, compilation and implementation of various methodologies in a comprehensive and inclusive manner. The meta-paradigmatic aspect refers to IRT’s capacity to weave together, relate and integrate the various paradigmatic (...) practices. IRT is a meta-therapy derived from the Integrated Recovery Model, which is a comprehensive, balanced, multi-phased and multi-disciplinary clinical model designed for in-patient addiction treatment. As with the Integrated Recovery Model, IRT’s philosophy is derived from an integration of the 12-step abstinence-based philosophy, mindfulness, positive psychology, and Integral theory. It is suggested here that the application of IRT as a meta-therapy provides a truly comprehensive and integrated therapeutic orientation for therapists who treat addicted populations. -/- Keywords: Integrated Recovery Therapy, Integrated Recovery model; 12 Steps; mindfulness; Integral theory; positive psycholog. (shrink)

In this essay I explore the notion of philosophy as a way of life as a recovery pathway for individuals in addiction recovery. My hypothesis is that philosophy as a way of life can be a compelling, and legitimate recovery pathway for individuals in addiction recovery, as one of many recovery pathways. I will focus on logic-based therapy applied in the context of addiction recovery. The aim of presenting a case study is to show how a client (...) receiving LBT is provided with techniques and a worldview that can contribute to a philosophically oriented recovery program. In the case study the client was advised to apply the moral philosophy of Friedrich Nietzsche as an uplifting philosophical framework to counteract his unproductive worldview and fallacious thinking. Considering that there is an ostensibly low efficacy rate for the treatment of addiction, articulating the value of philosophy as a way of life as a recovery pathway provides a conceptual and methodological framework for the development of novel philosophically-based addiction treatment and recovery-oriented programs—thus expanding the treatment and recovery options available for those seeking recovery from addiction. (shrink)

In my presentation I argue for the utility of a philosophical counseling method, called logic-based therapy (LBT), in the treatment of addicted populations. In the context of addiction treatment LBT could be also classified as a philosophical psychotherapy. Philosophical psychotherapy can be understood as an umbrella term for interventions designed to treat mental health disorders, with theoretical foundations that are philosophical. Philosophical psychotherapy would be distinct from philosophical counseling, as the latter does not directly treat mental health disorders. I (...) suggest that LBT has utility beyond philosophical counseling and is a viable intervention in the treatment of certain mental health disorders, like substance use disorders. I provide a brief overview of LBT and then discuss a LBT case study with a client suffering diagnosed with a substance use disorder. In the case study the client was advised to apply the moral philosophy of Friedrich Nietzsche as an uplifting philosophical framework to counteract his unproductive worldview and fallacious thinking. Considering that there is an ostensibly low efficacy rate for the treatment of addiction, articulating the value of philosophical psychotherapies in the context of addiction treatment can assist in the development of novel philosophically-based addiction treatment and recovery-oriented programs––thus expanding the treatment and recovery options available for those seeking recovery from addiction. (shrink)

It is largely unethical to sentence individuals who are addicted to drugs to prison. While substance use can be a crime, it must be treated differently from other crimes because addiction is a psychiatric disorder. Prisons are penal institutions. Legitimate goals of penal sanctions include retribution, deterrence, rehabilitation, and incapacitation.[i] Most of these goals do not speak to those with substance use disorder, and incarceration may be counterproductive given the wide availability of drugs and feeble rehabilitation efforts (...) in prison. Further, it may be the case that substance use disorder impairs an addict’s autonomy, calling into question his criminal culpability. Our understanding of substance use disorder has evolved and our prison sentencing practices must do the same. This paper will first provide background on substance use disorder as a psychiatric disorder. Then, the need to focus on rehabilitating rather than punishing those with substance use disorder who commit crimes will be explored. Finally, this paper will address whether an individual with substance use disorder can be considered culpable for any crime—regardless of severity—and whether that individual’s autonomy is impaired due to his addiction. I conclude that culpability should depend on whether the serious crime would have occurred in the absence of the drug addiction. In most cases, it is unethical to sentence an individual with substance use disorder to prison where other options such as home confinement are available. (shrink)

This article outlines an integrally informed model for addictionon treatment and recover that is being pioneered and developed at Tabankulu Secondary Addiction Recovery Center in Cape Town, South Africa. Tabankulu is the world’s first inpatient Addictionon treatment center to implement an integrally informed treatment model. The Integrated Recovery model is a comprehensive, balanced, multi-phased, and multi-disciplinary approach to the treatment of and recovery from addiction. Its philosophy is derived from integrang a 12 Step abstinence-based methodology, mindfulness-based interventions, positive (...) psychology, and Integral Theory. The case is made that addictionon treatment facilities, therapists working with this population, and recovering addicts will become more proficient, effective, and consequently have higher success rates by becoming integrally informed. (shrink)

In this paper, I present and criticize several historical arguments in favour of prohibition and criminalization of illicit psychoactive substances. I consider several versions of Charles Brent’s argument from drug harms and an argument from addiction based on Kantian view on autonomy. My criticism will mainly rely on empirical evidence on drugs, drug use, and addiction. I think that in light of this evidence, all of the arguments lose their cogency or can be refuted altogether. Moreover, the evidence (...) reveals an inconsistency in the international drug law framework. In conclusion, I therefore provide a general argument challenging the legitimacy of the existing distinction between licit and illicit drugs based on the inconsistency. (shrink)

According to a number of influential views in penal theory, 1 one of the primary goals of the criminal justice system is to rehabilitate offenders. Rehabilitativemeasures are commonly included as a part of a criminal sentence. For example, in some jurisdictions judges may order violent offenders to attend anger management classes or to undergo cognitive behavioural therapy as a part of their sentences. In a limited number of cases, neurointerventions — interventions that exert a direct biological effect on the brain (...) — have been used as aids to rehabilitation, typically being imposed as part of criminal sentences, separate treatment orders, or conditions of parole. Examples of such interventions include medications intended to attenuate addictive desires in substance-abusing offenders and agents intended to suppress libido in sex offenders.This chapter reviews some of the ethical issues raised by the use of neurointerventions as aids to rehabilitation. (shrink)

Can we identify potential long-term consequences of digitalisation on public health? Environmental studies, metabolic research, and state of the art research in neurobiology point towards the reduced amount of natural day and sunlight exposure of the developing child, as a consequence of increasingly long hours spent indoors online, as the single unifying source of a whole set of health risks identified worldwide, as is made clear in this review of currently available literature. Over exposure to digital environments, from abuse to (...) addiction, now concerns even the youngest (ages 0 to 2) and triggers, as argued on the basis of clear examples herein, a chain of interdependent negative and potentially long-term metabolic changes. This leads to a deregulation of the serotonin and dopamine neurotransmitter pathways in the developing brain, currently associated with online activity abuse and/or internet addiction, and akin to that found in severe substance abuse syndromes. A general functional working model is proposed under the light of evidence brought to the forefront in this review. (shrink)

Attaining Nirvana Using the Universal Formula: Eliminating Imbalances in the Body, Emotions, Mind, and Spirituality -/- By Angelito Malicse -/- Introduction -/- Nirvana, the state of ultimate peace and liberation, can only be attained by eliminating all imbalances in the body, emotions, mind, and spirituality. My universal formula, which follows the law of balance in nature, the law of karma as a systemic principle, and feedback mechanisms, provides an exact path to achieving this state. -/- Imbalances in human life arise (...) due to physical illnesses, negative emotions, irrational thinking, and spiritual confusion. These imbalances cause suffering, preventing people from achieving inner peace. By applying my universal formula, one can correct these defects and align with the natural laws that govern life, leading to a harmonious existence and the attainment of Nirvana. -/- This essay will provide real-world examples of how imbalances arise in each aspect of human existence and how applying my universal formula eliminates them. It will also highlight the importance of medicine, positive emotions, deep faith in God or Divine Essence, and how they contribute to balance and enlightenment. -/- 1. The Role of the Body in Creating Imbalance and the Solution -/- Example of Physical Imbalance: Chronic Illness Due to an Unhealthy Lifestyle -/- Scenario: A person consumes excessive processed foods, avoids exercise, and does not get enough sleep. Over time, they develop obesity, diabetes, and heart disease. These physical imbalances create suffering by limiting mobility, causing chronic pain, and shortening lifespan. -/- Solution Using the Universal Formula: -/- Follow the Universal Law of Balance in Nature: The body requires proper nutrition, movement, and rest to function optimally. A balanced diet, regular exercise, and sufficient sleep restore equilibrium. -/- Apply the Law of Karma as a Systemic Principle: The body operates as a biological system, and like any system, it must be free of defects to function correctly. Eliminating unhealthy habits and seeking medical care corrects these defects, restoring proper function. -/- Use Feedback Mechanisms for Self-Correction: Pain, fatigue, and illness are signals from the body indicating an imbalance. Instead of ignoring these warnings, one should adjust lifestyle choices, preventing further suffering. -/- Example of Physical Imbalance: Addiction (Alcoholism, Drug Use, Smoking) -/- Scenario: A person suffers from alcohol addiction, which damages their liver, distorts their judgment, and causes conflict in relationships. -/- Solution Using the Universal Formula: -/- Follow the Universal Law of Balance in Nature: The human body cannot function well when it is poisoned by harmful substances. Eliminating alcohol and drugs and replacing them with healthy habits restores physical and mental balance. -/- Apply the Law of Karma as a Systemic Principle: Addiction is a defect in the nervous system—it alters brain chemistry, leading to dependency. Medical treatment, rehabilitation, and psychological support correct this defect, helping the person regain control. -/- Use Feedback Mechanisms for Self-Correction: Withdrawal symptoms, declining health, and damaged relationships are signals of imbalance. Recognizing these signs motivates change, leading to recovery. -/- The Importance of Medicine -/- Medicine plays a crucial role in restoring physical balance. When the body suffers from illness, medical intervention corrects internal imbalances. However, medicine must be combined with lifestyle changes and emotional stability for long-term health. -/- 2. The Role of Emotions in Creating Imbalance and the Solution -/- Example of Emotional Imbalance: Uncontrolled Anger and Hatred -/- Scenario: A man is always angry at his coworkers, leading to stress, conflicts, and isolation. -/- Solution Using the Universal Formula: -/- Follow the Universal Law of Balance in Nature: Anger disrupts inner peace and must be regulated through emotional awareness and self-discipline. -/- Apply the Law of Karma as a Systemic Principle: Uncontrolled anger is a defect in the emotional system. Practicing patience, forgiveness, and communication corrects this defect, leading to healthier interactions. -/- Use Feedback Mechanisms for Self-Correction: Frequent stress, tension, and failed relationships indicate emotional imbalance. Recognizing these effects motivates change toward emotional stability. -/- The Importance of Positive Emotions in Human Relationships -/- Positive emotions such as love, compassion, and gratitude create harmony in relationships. Expressing kindness and understanding balances social interactions, reducing conflicts and strengthening bonds. This balance is necessary for personal peace and the path to Nirvana. -/- 3. The Role of Spirituality in Creating Imbalance and the Solution -/- Causes of Spiritual Imbalance -/- Spiritual imbalances occur when a person lacks connection, purpose, or faith. The main causes include: -/- 1. Materialism and Excessive Focus on the Physical World – Prioritizing wealth, power, or pleasure over inner peace and wisdom leads to dissatisfaction. -/- 2. Religious Dogma and Fear-Based Beliefs – When spirituality is based on fear, guilt, or rigid doctrines, it creates psychological distress rather than enlightenment. -/- 3. Loss of Faith or Meaning in Life – When people lose trust in God, Divine Essence, or Higher Purpose, they experience emptiness and existential suffering. -/- 4. Isolation and Lack of Spiritual Practice – A lack of meditation, prayer, or reflection disconnects people from inner wisdom. -/- Example of Spiritual Imbalance: Loss of Faith and Meaning -/- Scenario: A person feels lost, purposeless, and disconnected from life. -/- Solution Using the Universal Formula: -/- Follow the Universal Law of Balance in Nature: The soul craves connection to something greater. Engaging in spiritual practices like prayer, meditation, or service restores spiritual balance. -/- Apply the Law of Karma as a Systemic Principle: A loss of faith is a defect in the spiritual system. Deepening one’s connection to God, Divine Essence, or Higher Guidance corrects this defect, bringing fulfillment. -/- Use Feedback Mechanisms for Self-Correction: Depression and existential dread indicate spiritual emptiness. Seeking meaning through faith and selfless service restores harmony. -/- The Importance of Deep Faith in God or Divine Essence -/- Faith provides inner stability, helping people endure suffering and maintain hope and resilience. A deep connection with the Divine or Universal Truth aligns human existence with higher wisdom, guiding one toward Nirvana. -/- Conclusion -/- Attaining Nirvana requires eliminating imbalances in the body, emotions, mind, and spirituality. My universal formula provides the exact method to restore balance by aligning with natural laws, correcting systemic defects, and using feedback mechanisms for self-correction. -/- By embracing health, positive emotions, wisdom, and spiritual faith, one can transcend suffering and achieve ultimate peace. This is the path to Nirvana—the state of complete harmony with the universe. -/- . (shrink)

Sikh Gurus' spiritual wisdom is universal. It is applicable to all, regardless of caste, creed, color, gender, age, and religion. But it is sad to note that a large numbers of Sikh children are not motivated enough to follow Sikh values. Many young people are addicted to alcohol, drugs, substance abuse and social media due to prevalent societal fashion or peer pressure. Unfortunately, Sikhs are ignoring this facet of their community life. However, there is no shortage of available opportunities (...) that can help Sikh youth to avoid this awful situation. The only condition is that we must reorient our outlook and actions. Let us have a look at the available options. (shrink)

Impairment of self-control is often said to be a defining feature of addiction. Yet many addicts display what appears to be a considerable amount of control over their drug-oriented actions. Not only are their actions clearly intentional and frequently carried out in a conscious and deliberate manner, there is evidence that many addicts are responsive to a wide range of ordinary incentives and counter-incentives. Moreover, addicts have a wide variety of reasons for using drugs, reasons which often seem to (...) go a long way towards explaining their drug-oriented behavior. Many use drugs, for example, to cope with stressful or traumatic experiences. In this article I argue that some standard philosophical explanations of addicts’ impairment of self-control are inadequate, and propose an alternative. (shrink)

In this paper, we contend that the psychology of addiction is similar to the psychology of ordinary, non-addictive temptation in important respects, and explore the ways in which these parallels can illuminate both addiction and ordinary action. The incentive salience account of addiction proposed by Robinson and Berridge (1993; 2001; 2008) entails that addictive desires are not in their nature different from many of the desires had by non-addicts; what is different is rather the way that addictive (...) desires are acquired, which in turn affects their strength. We examine these “incentive salience” desires, both in addicts and non-addicts, contrasting them with more cognitive desires. On this account, the self-control challenge faced by addicted agents is not different in kind from that faced by non-addicted agents – though the two may, of course, differ greatly in degree of difficulty. We explore a general model of self-control for both the addict and the non-addict, stressing that self-control may be employed at three different stages, and examining the ways in which it might be strengthened. This helps elucidate a general model of intentional action. (shrink)

In what sense is a person addicted to drugs or alcohol incompetent, and so a legitimate object of coercive treatment? The standard tests for competence do not pick out the capacity that is lost in addiction: the capacity to properly regulate consumption. This paper is an attempt to sketch a justificatory framework for understanding the conditions under which addicted persons may be treated against their will. These conditions rarely obtain, for they apply only when addiction is extremely severe (...) and great harm threatens. It will be argued also that to widen the measures currently in place in some jurisdictions, though philosophically well-motivated, would require very strong evidence of a set of conditions disposing a person to an addictive future. It is doubtful that any such currently available evidence is strong enough to justify coercive treatment. Nevertheless, coercive treatment of addiction is already a reality, with the potential for more, and so some discussion will be presented regarding the extraordinary safeguards necessary to prevent misapplication of such treatment policies. (shrink)

An important philosophical issue in the study of addiction is what difference the fact that a person is addicted makes to attributions of autonomy (and responsibility) to their drug-oriented behavior. In spite of accumulating evidence suggesting the role of emotional dysregulation in understanding addiction, it has received surprisingly little attention in the debate about this issue. I claim that, as a result, an important aspect of the autonomy impairment of many addicted individuals has been largely overlooked. A widely (...) shared assumption in the philosophical literature is that for addiction to impair a person’s autonomy it has to make them (in some sense) take drugs against their will. So-called “willing addicts” are therefore usually seen as exempted from the autonomy impairment believed to characterize “unwilling addicts”, the latter being those who ‘truly want’ to stop using drugs but find their attempts repeatedly derailed by failures of self-control. In this article, I argue that the association between addiction and emotional dysregulation shows why this assumption is false. Emotional dysregulation is not only consistent with the possibility that many addicts take drugs ‘willingly’, it supports the hypothesis that they use drugs because they truly want to. The article proposes an explanation for why emotional dysregulation should nevertheless be seen as an aspect of their loss of control and an important reason why they have impaired autonomy. I end by exploring some implications of this account for addict’s decision-making capacity when they are prescribed the drugs to which they are addicted. -/- . (shrink)

Normative thinking about addiction has traditionally been divided between, on the one hand, a medical model which sees addiction as a disease characterized by compulsive and relapsing drug use over which the addict has little or no control and, on the other, a moral model which sees addiction as a choice characterized by voluntary behaviour under the control of the addict. Proponents of the former appeal to evidence showing that regular consumption of drugs causes persistent changes in (...) the brain structures and functions known to be involved in the motivation of behavior. On this evidence, it is often concluded that becoming addicted involves a transition from voluntary, chosen drug use to non-voluntary compulsive drug use. Against this view, proponents of the moral model provide ample evidence that addictive drug use involves voluntary chosen behaviour. In this paper we argue that although they are right about something, both views are mistaken. We present a third model that neither rules out the view of addictive drug use as compulsive, nor that it involves voluntary chosen behavior. -/- . (shrink)

Does addiction to heroin undermine the voluntariness of heroin addicts' consent to take part in research which involves giving them free and legal heroin? This question has been raised in connection with research into the effectiveness of heroin prescription as a way of treating dependent heroin users. Participants in such research are required to give their informed consent to take part. Louis C. Charland has argued that we should not presume that heroin addicts are competent to do this since (...) heroin addiction by nature involves a loss of ability to resist the desire for heroin. In this article, I argue that Charland is right that we should not presume that heroin addicts are competent to consent, but not for the reason he thinks. In fact, as Charland's critics correctly point out, there is plenty of evidence showing that heroin addicts can resist their desire for heroin. These critics are wrong, however, to conclude from this that we should presume that heroin addicts are competent to give their voluntary consent. There are, I shall argue, other conditions associated with heroin addiction that might constrain heroin addicts' choice in ways likely to undermine the voluntariness of their consent. In order to see this, we need to move beyond the focus on the addicts' desires for heroin and instead consider the wider social and psychological circumstances of heroin addiction, as well as the effects these circumstances may have on the addicts' beliefs about the nature of their options. (shrink)

Mental conflict not always amounts to weakness of will. Irresistible motives not always speak of addiction. This book proposes an integrated account of what singles out these phenomena: addiction and weakness of will are both forms of secondary akrasia. By integrating these two phenomena into a classical conception of akrasia as poor resolution of an unnecessary conflict – valuing without intending while intending without valuing – the book makes an original contribution to central issues in moral psychology and (...) philosophy of action, including the relationship between responsibility and intentional agency, and the nature and scope of moral appraisal. In particular, the proposed integrated account is grounded in a general theory of responsibility and a related model of action as actualisation bringing together insights from both volitional and non-volitional conceptions, such as the intuition that it is unfair to hold a person responsible for things that are not up to her and the parity of actions and attitudes as legitimate objects of moral appraisal. Furthermore, the actualisation model supports a distinctive version of the Guise of the Good thesis which links valuing and intending in terms of success in action and explains why akratic actions and their offspring – addiction and weakness of will – are necessarily less than successful yet fully responsible. (shrink)

This paper tries to show that the naturalistic view of addiction is mired in contradictions that stem from reducing the addict to a weak-willed subject who loses control over his or her body. From a phenomenological perspective, addiction reveals itself to be a habit which eventually becomes harmful, but has its primary sources in the embodied needs of a worldly subject. The aim of this paper is to uncover the dimensions of the lived addiction that are neglected (...) in the contemporary naturalistic discourse: the lived-body and the worldly context of the addict. Firstly, we try to do justice to the variety of addictions by underlying that their new and surprising forms are determined by the intersubjective tissue wherein the subject operates. Secondly, the loss of control in addiction, how the subject deals with the tendency to satisfy a need, is experienced as powerlessness, as expressed in the accounts of ecstasy addicts regarding altered states of mind. The last section of this paper will argue that this sense of powerlessness cannot be equated with a weakness of the will because a strong, forceful will engenders the same vertigo of being prey to strange powers. The embodied aspect of addiction and the spontaneous, bodily need it saturates will clarify further this claim. (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)

Addicts are often portrayed as compelled by their addiction and thus as a paradigm of unfree action and mitigated blame. This chapter argues that our best scientific theories of addiction reveal that, psychologically, addicts are not categorically different from non-addicts. There is no pairing of contemporary accounts of addiction and of prominent theories of moral responsibility that can justify our intuitions about the mitigation of addicts but not non-addicts. Two conclusions are advanced. First, we should either treat (...) addicts as we normally treat non-addicts (as fully culpable) or embrace the skeptical conclusion that everyone is less responsible than we thought—perhaps not responsible at all. Second, we should be doubtful that theorizing about responsibility will be advanced by focusing on particular kinds of psychopathologies. (shrink)

How should addictive behavior be explained? In terms of neurobiological illness and compulsion, or as a choice made freely, even rationally, in the face of harmful social or psychological circumstances? Some of the disagreement between proponents of the prevailing medical models and choice models in the science of addiction centres on the notion of “loss of control” as a normative characterization of addiction. In this article I examine two of the standard interpretations of loss of control in (...) class='Hi'>addiction, one according to which addicts have lost free will, the other according to which their will is weak. I argue that both interpretations are mistaken and propose therefore an alternative based on a dual-process approach. This alternative neither rules out a capacity in addicts to rationally choose to engage in drug-oriented behavior, nor the possibility that addictive behavior can be compulsive and depend upon harmful changes in their brains caused by the regular use of drugs. (shrink)

I show that Pickard’s argument against the irresistibility of addiction fails because her proposed dilemma, according to which either drug-seeking does not count as action or addiction is resistible, is flawed; and that is the case whether or not one endorses Pickard’s controversial definition of action. Briefly, we can easily imagine cases in which drug-seeking meets Pickard’s conditions for agency without thereby implying that the addiction was not irresistible, as when the drug addict may take more than (...) one route to go meet her dealer. (shrink)

Supposing that addicts choose to act as they do, rather than being compelled to behave in particular ways, what explains the choices that they make? Hannah Pickard has recently pointed out that we can go a long way to answering this question if we can make sense of why addicts value the ends they pursue. She argues that addiction is a social identity that gives purpose and structure to life and that the choices that addicts make are valuable to (...) them as ways of sustaining this social identity. But if addicts freely make choices towards ends that they perceive as valuable in terms of a social identity to which they contribute, and therefore if addiction involves the deployment of quite considerable agential apparatus, how are we to hold on to the natural assumption that addictions are disempowering? In this paper I present an answer to this question. Drawing on the resources of the phenomenological tradition, I argue that some social identities give purpose and structure to life in a way that inhibits, rather than enables, the exercise of a capacity that is central to our form of life. I elaborate the hypothesis that paradigmatic cases of addiction involve this sort of disempowering social identity. (shrink)

It is common to think of addiction as involving behavior which in some sense is ?out of control.? But does this mean addictive actions occur because of compulsion or because of ordinary weakness of will? Many philosophers argue that addictive actions occur because of weakness of will, since there is plenty of evidence suggesting that they are not caused by irresistible desires. In fact, addicts seem, in general, to perform these actions freely in the sense of having the ability (...) to refrain from doing so. In this paper I argue, first, that it is not the addiction-as-compulsion view that is mistaken, but rather the view that irresistible desires are a defining feature of compulsion. Second, drawing on some results in addiction neuroscience, I construct and defend a new analysis of compulsivity that distinguishes addictive from weak-willed actions in a way that is consistent with the view that addictive actions are performed freely. (shrink)

In addiction, apparently causally significant phenomena occur at a huge number of levels; addiction is affected by biomedical, neurological, pharmacological, clinical, social, and politico-legal factors, among many others. In such a complex, multifaceted field of inquiry, it seems very unlikely that all the many layers of explanation will prove amenable to any simple or straightforward, reductive analysis; if we are to unify the many different sciences of addiction while respecting their causal autonomy, then, what we are likely (...) to need is an integrative framework. In this paper, we propose the theory of “Externalist” or “4E” – for extended, embodied, embedded, and enactive – cognition, which focuses on the empirical and conceptual centrality of the wider extra-neural environment to cognitive and mental processes, as a candidate for such a framework. We begin in Section 2 by outlining how such a perspective might apply to psychiatry more generally, before turning to some of the ways it can illuminate addiction in particular: Section 3 points to a way of dissolving the classic dichotomy between the “choice model” and “disease model” in the addiction literature; Section 4 shows how 4E concepts can clarify the interplay between the addict’s brain and her environment; and Section 5 considers how these insights help to explain the success of some recovery strategies, and may help to inform the development of new ones. (shrink)

This paper argues that the crucial feature of the drug-related desires experienced by addicted agents is not that they ‘push’ the agent with a force she cannot oppose, but that they are not easily undermined by things that normally have the ability to undermine desires —in other words, that they are extraordinarily recalcitrant. As a result, the disposition to experience these desires is very persistent over the long-term, manifesting itself in particular episodes of wanting to use drugs that recur with (...) great frequency. Both the persistence and the recurrence of these desires, it is argued, contribute to a diminished ability to respond to relevant reasons that speak against drug use. (shrink)

Addicts sometimes engage in such spectacularly self-destructive behavior that they seem to act under compulsion. I briefly review the claim that addiction is not compulsive at all. I then consider recent accounts of addiction by Holton and Schroeder, which characterize addiction in terms of abnormally strong motivations. However, this account can only explain the apparent compulsivity of addiction if we assume—contrary to what we know about addicts—that the desires are so strong as to be irresistible. I (...) then consider accounts that invoke the phenomenon of “ego depletion,” according to which a person can resist temptation for a while, but not indefinitely. Implicit in this account is the assumption that addiction-related desires persist long enough to deplete the addict’s willpower. The balance of the paper argues that the persistence of the desire to consume drugs is a significant form of dysfunction in its own right, and that it makes an important and independent contribution to the compulsivity of addiction. I argue that addiction involves dysfunction in a mechanism that normally prevents a person from being tempted to do something that would invite disaster. (shrink)

In an earlier article in this journal I argued that the question of whether heroin addicts can give voluntary consent to take part in research which involves giving them a choice of free heroin does not – in contrast with a common assumption in the bioethics literature – depend exclusively on whether or not they possess the capacity to resist their desire for heroin. In some cases, circumstances and beliefs might undermine the voluntariness of the choices a person makes even (...) if they do possess a capacity for self-control. Based on what I took to be a plausible definition of voluntariness, I argued that the circumstances and beliefs typical of many vulnerable heroin addicts are such that we have good reasons to suspect they cannot give voluntary consent to take part in such research, even assuming their desire for heroin is not irresistible. In a recent article in this journal, Uusitalo and Broers object to this on the grounds that I misdescribe heroin addicts' options set, that the definition of voluntariness on which I rely is unrealistic and too demanding, and, more generally, that my view of heroin addiction is flawed. I think their arguments derive from a misunderstanding of the view I expressed in my article. In what follows I hope therefore to clarify my position. (shrink)

Previous discussions of addiction have often focused on the question of whether addiction is a disease. This discussion distinguishes that question – the disease question – from the question of whether addiction is a disability. I argue that, however one answers the disease question, and indeed on almost any credible account of addiction, addiction is a disability. I then consider the implications of this view, or why it matters that addiction is a disability. The (...) disease model of addiction has led many to see addiction as primarily a medical problem, and to make medical treatment of the addicted person the first priority in addressing addiction. Once addiction is viewed as a disability, different concerns are foregrounded. The problem of addiction resides not only in the addicted person, but also in the social environment in which the addicted person finds herself. The fundamental ethical question about addiction is not how addicted persons can be treated or otherwise changed, but how a just society can make reasonable accommodations for addicted persons. (shrink)

This paper argues that the crucial feature of the drug-related desires experienced by addicted agents is not that they ‘push’ the agent with a force she cannot oppose, but that they are not easily undermined by things that normally have the ability to undermine desires —in other words, that they are extraordinarily recalcitrant. As a result, the disposition to experience these desires is very persistent over the long-term, manifesting itself in particular episodes of wanting to use drugs that recur with (...) great frequency. Both the persistence and the recurrence of these desires, it is argued, contribute to a diminished ability to respond to relevant reasons that speak against drug use. (shrink)

In this chapter we focus on the structure of close personal relations and diagnose how these relationships are disrupted by addiction. We draw upon Peter Strawson’s landmark paper ‘Freedom and Resentment’ (2008, first published 1962) to argue that loved ones of those with addiction veer between, (1) reactive attitudes of blame and resentment generated by disappointed expectations of goodwill and reciprocity, and (2) the detached objective stance from which the addicted person is seen as less blameworthy but also (...) as less fit for ordinary interpersonal relationships. We examine how these responses, in turn, shape the addicted person’s view of themselves, their character and their capacities, and provide a negative narrative trajectory that impedes recovery. We close with a consideration of how these effects might be mitigated by adopting less demanding variations of the participant stance. (shrink)

I consider cases of multifetal pregnancy in which one fetus with a fatal birth defect poses a risk to the survival of another healthy fetus to show that the substance view anti-abortion position leads to a contradiction. In cases of complicated multifetal pregnancy, if intervention by selective abortion to terminate the defective fetus is not performed, both fetuses will die due to the conditions created by the defective fetus’s fatal birth defect. Because abortion is wrong on the anti-abortion position, (...) and a moderate anti-abortion position cannot make an exception for selective abortion in cases of complicated multifetal pregnancy if it operates on the substance view, choosing selective abortion must be wrong, so one must let both fetuses die. However, the substance view anti-abortion position must take letting both fetuses die to be wrong, otherwise it will undermine itself as an anti-abortion position. Further, the substance view provides grounds for why letting fetuses die would be wrong anyway. Thus, the substance view anti-abortion position must take both having an abortion and not having an abortion to be wrong, which is a contradiction. Therefore, cases of complicated multifetal pregnancy show that the substance view anti-abortion position is false. (shrink)

The addiction literature is fraught with conceptual confusions, stalled debates, and an unfortunate lack of clear and careful attempts to delineate the phenomenon of addiction in a way that might lead to consensus. My dissertation has two overarching aims, one metaphysical and one practical. -/- The first aim is to defend an account of addiction as the systematic disposition to fail to control one’s desires to engage in certain types of behaviors. I defend the inclusion of desires (...) and impaired control in the definition, and I flesh out the notion of systematicity central to my dispositionalist framework. I engage the so-called ‘disease vs. choice’ debate, criticizing its presupposition that we are dealing here with a dichotomy and arguing that the movement towards a middle ground is the right track to take. I explain how the dispositionalist account can capture this middle ground and how it serves to expand upon existing views, in particular by filling in the metaphysical details. -/- The second aim is to show how the account I defend can help to unify the extant views and disciplinary perspectives in the literature. Both the dispositionalist aspect of my framework and the methodology adopted (applied ontology and systematic metaphysics) can move the literature towards both substantive and methodological unification. This will help to clear up conceptual confusions, resolve (or sometimes dissolve) apparently intractable disputes, situate different research perspectives with respect to each other, facilitate interdisciplinary dialogue, and help to frame important questions about addiction. Finally, I offer the beginnings of an ontology of addiction, which will provide a terminologically well-structured guide to the addiction literature in a way that will facilitate more effective and efficient communication and data management across disciplines. (shrink)

It is often assumed that, except perhaps in a few rare cases, people with addiction can be aptly held responsible for having acquired the condition. In this chapter, I consider the argument that supports this view and draw attention to a number of challenges that can be raised against it. Assuming that early decisions to use drugs were made in possession of normal-range psychological capacities, I consider the key question of whether drug users who later became addicted should have (...) known that addiction was a likely outcome of their decisions to use drugs in a way that makes them blameworthy for their lack of foresight. I focus on three different points of contention surrounding this claim: how likely the outcome to be predicted was, how tolerable risk should be weighed against the expected value of decisions to use, and how reliable the relevant predictive abilities of the average person are. Once we consider in some detail what would have to be true in order for someone to be aptly held responsible for becoming addicted, the prospects for making a convincing case to that effect look, I argue, somewhat more uncertain than they might at first appear. (shrink)

This paper is a study of Brentano’s ontology, and more specifically of his theory of substance and accident as put forward toward the end of his life in the materials collected together as the Kategorienlehre or Theory of Categories. Here Brentano presents an auditious (re-)interpretation of Aristotle’s theory of substance and accidence. We show that on the view Brentano initially defends, it is space which serves as the single substance upon which all other entities depend as accidents. (...) In an appendix, however, Brentano puts forward an even more radical suggestion, inspired by the physics of Kelvin. According to this final view, space itself is an accident of a deeper substance: the present time. (shrink)

In this paper, I consider particular attempts by E. J. Lowe and Michael Gorman at providing an independence criterion of substancehood and argue that the stipulative exclusion of non-particulars and proper parts (or constituents) from such accounts raises difficult issues for their proponents. The results of the present discussion seem to indicate that, at least for the case of composite entities, a unity criterion of substancehood might have at least as much, and perhaps more, to offer than an independence criterion (...) and therefore ought to be explored further by neo-Aristotelians in search of a defensible notion of substancehood. I indicated briefly how such a unity criterion might be used by neo-Aristotelians to support the inclusion of hylomorphic compounds in the category of substance, given the traditional role of form as the principle of unity within the compound. (shrink)

In my initial critique of the substance view, I raised reductio-style objections to the substance view's conclusion that the standard human fetus has the same intrinsic value and moral standing as the standard adult human being, among others. In this follow-up critique, I raise objections to some of the premises invoked in support of this conclusion. I begin by briefly presenting the substance view as well as its defense. (For a more thorough presentation, see the first part (...) of my critique.) I then raise objections to three claims involved in the substance view's defense: the claim that the standard human fetus's intrinsic value and moral standing is a function of its potentiality; the claim that the standard human fetus's intrinsic value and moral standing is a function of its essential properties; and the claim that it is the possession of the basic potential for rational moral agency that best accounts for the wrongness of killing the standard human fetus, among others. (shrink)

This inaugural lecture, delivered on 17 November 2021 at the University of Neuchâtel, addresses the question: Are material objects analyzable into more basic constituents and, if so, what are they? It might appear that this question is more appropriately settled by empirical means as utilized in the natural sciences. For example, we learn from physics and chemistry that water is composed of H2O-molecules and that hydrogen and oxygen atoms themselves are composed of smaller parts, such as protons, which are in (...) turn composed of yet smaller parts, such as quarks, and so on. While the question at the center of this lecture might thus appear to fall more appropriately into the empirical domain of natural science, I argue that metaphysics in fact has an important role to play in determining how best to answer the question before us. More concretely, I propose that the Aristotelian doctrine of hylomorphism, when appropriately interpreted, provides the best metaphysical answer to the question of whether and how material objects are analyzable into more basic constituents. Hylomorphism holds that those entities to which this doctrine applies are, in some sense, compounds of matter (“hylē”) and form (“morphē” or “eidos”). Thus, the title of this lecture, “Form, Matter, Substance”, refers to the claim that lies at the center of the doctrine of hylomorphism, as applied to the domain of material objects, namely that sensible substances are the result of combining matter and form in the right sort of way; or, for short, “form + matter = substance”. I begin in Section II by providing some historical background which brings out Aristotle’s motivations for proposing the doctrine of hylomorphism in the context of his analysis of change. Section III turns to some of the main features of the contemporary hylomorphic theory I have defended especially in Koslicki (2008) and Koslicki (2018). Section IV discusses some challenging questions concerning artifacts which arise for both hylomorphic and other approaches to the metaphysics of concrete particular objects. Section V concludes by summarizing why, as contemporary metaphysicians, we should prefer a hylomorphic theory over its competitors as an analysis of concrete particular objects that is compatible with our current scientific understanding of the world. (shrink)