Pleasure Gone Awry? A New Conceptualization of Chronic Pain and Addiction

Abstract

I examine what happens in the brain when patients experience chronic pain and when subjects are addicted to alcohol. We can find important parallels between these two cases, and these parallels can perhaps point us toward new ways of treating (or at least understanding) both issues. Interestingly, we can understand both cases as our pleasure system gone awry. In brief, I argue that chronic pain and alcohol addiction both stem from a dysregulation in our brain’s reward structure. This dysregulation in what should be our pleasure circuitry pushes individuals to behave in ways counterproductive to their needs and to feel unpleasant things. In other words, there is likely both something quite right and perhaps quite wrong about how some philosophers are thinking about pain as an evaluative state. I shall be arguing that pain is both hedonic and evaluative, though perhaps not in the ways they are imagining.