Abstract
Addiction, the Concept of Disorder, and Pathways to Harm: Comment on Levy
Highlights
Levy (2013) argues that “addiction is not a brain disease,” an important claim because, contrary to common wisdom, believing that mental disorders are brain diseases apparently increases stigma (Angermeyer and Matschinger, 2005; Schomerus et al, 2012)
Levy presupposes the harmful dysfunction (HD) analysis of disorder (Wakefield, 1992a,b, 1999a,b, 2006): “[A] n individual suffers from a disorder only if they experience a biological dysfunction and that dysfunction is harmful, where the judgment of harm is made by reference to social norms of flourishing” (Levy, p. 11)
He accepts that addicted individuals have substance-induced brain dysfunctions, and that when their dysfunctions cause harm, such individuals are addictively disordered. (Note that throughout this commentary, consistent with HD and standard psychiatric usage, I use “disorder” as a generic term for medical pathology, inclusive of Levy’s term “disease.”)
Summary
Levy (2013) argues that “addiction is not a brain disease,” an important claim because, contrary to common wisdom, believing that mental disorders are brain diseases apparently increases stigma (Angermeyer and Matschinger, 2005; Schomerus et al, 2012). He accepts that addicted individuals have substance-induced brain dysfunctions, and that when their dysfunctions cause harm (e.g., suffering, impairment of agency), such individuals are addictively disordered.
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