Abstract
Addiction appears to be a deeply moralized concept. To understand the entwinement of addiction and morality, we briefly discuss the disease model and its alternatives in order to address the following questions: Is the disease model the only path towards a ‘de-moralized’ discourse of addiction? While it is tempting to think that medical language surrounding addiction provides liberation from the moralized language, evidence suggests that this is not necessarily the case. On the other hand non-disease models of addiction may seem to resuscitate problematic forms of the moralization of addiction, including, invoking blame, shame, and the wholesale rejection of addicts as people who have deep character flaws, while ignoring the complex biological and social context of addiction. This is also not necessarily the case. We argue that a deficit in reasons responsiveness as basis for attribution of moral responsibility can be realized by multiple different causes, disease being one, but it also seems likely that alternative accounts of addiction as developed by Flanagan, Lewis, and Levy, may also involve mechanisms, psychological, social, and neurobiological that can diminish reasons responsiveness. It thus seems to us that nondisease models of addiction do not necessarily involve moralization. Hence, a non-stigmatizing approach to recovery can be realized in ways that are consistent with both the disease model and alternative models of addiction.
Highlights
Changing Models of AddictionDespite the rich debate on a proper understanding of addiction, much of the oftentimes heated scholarly debate in numerous fields centers on whether addiction is a disease, i.e. a pathological compulsion the concerned cannot resist, or whether it is a matter of choice, i.e. a matter of willpower and self-control
The disease model of addiction taken broadly characterizes addiction as Bsevere, chronic stage of substance-use disorder, in which there is a substantial loss of self-control, as indicated by compulsive drug taking despite the desire to stop taking the drugB [1; p. 364]
Instead of arguing whether addicted persons can make volitional choices or are out of control, and whether they are to be held responsible for their addiction and/or for their actions, in this article, we would like to focus on a different set of questions: We would like to shed light on the relation between addiction and moralization
Summary
Despite the rich debate on a proper understanding of addiction, much of the oftentimes heated scholarly debate in numerous fields (medicine, psychology, philosophy) centers on whether addiction is a disease, i.e. a pathological compulsion the concerned cannot resist, or whether it is a matter of choice, i.e. a matter of willpower and self-control. The disease model of addiction taken broadly characterizes addiction as Bsevere, chronic stage of substance-use disorder, in which there is a substantial loss of self-control, as indicated by compulsive drug taking despite the desire to stop taking the drugB [1; p. A chronic, relapsing brain disease that is characterized by compulsive drug seeking and use, despite harmful consequences. Marc Lewis, in his The Biology of Desire [8] as well as in this volume [5] demonstrates how one can conceive of addiction as related to significant brain changes and at the same time understand how addiction is Bmotivated repetition that gives rise to deep learning^ [5] This allows for attributing self-control and the capacity to learn otherwise to those who previously learned addictive habits.
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