Responsibility without Blame for Addiction

Abstract

Drug use and drug addiction are severely stigmatised around the world. Marc Lewis does not frame his learning model of addiction as a choice model out of concern that to do so further encourages stigma and blame. Yet the evidence in support of a choice model is increasingly strong as well as consonant with core elements of his learning model. I offer a responsibility without blame framework that derives from reflection on forms of clinical practice that support change and recovery in patients who cause harm to themselves and others. This framework can be used to interrogate our own attitudes and responses, so that we can better see how to acknowledge the truth about choice and agency in addiction, while avoiding stigma and blame, and instead maintaining care and compassion alongside a commitment to working for social justice and good.

Psychosomatic subjects and the agencies of addiction

“…Pickard,45 for example, offers the enticing possibility of holding addicts responsible for overcoming their addictions but not blaming them for their addictions. But this turns out to be a distinction not between addicts’ responsible free agency (which it is the work of therapy to empower) and the agency of their addictions (which might be suppressed and blamed for anticipated relapses).…”

“…Detached blame is retained as both a basis for demanding behavioural change and for negatively sanctioning problematic behaviour. We must renounce only affectively infused spite in response to what Pickard45 calls the addict’s ‘disorder of choice’. Conspicuously missing from her account are (1) a warrant for the claim that addicts are emancipated rather than merely domesticated by the changes ‘therapeutically’ imposed on them through negative sanctioning, and (2) a warrant for viewing addicted choices as somehow ‘disordered’ rather than just blameworthy—that is, a warrant for therapy over criminal corrections or civil retribution.…”

“…But it does nonetheless seek to appear dispassionate in its dispensation of justice. Or in Pickard’s45 language, to favour ‘detached’ over ‘affective’ blame, just deserts over lynch mobs.…”

If You Can't Change What You Believe, You Don't Believe It

“…14 I am not supposing that the fact that someone is blameworthy entails that it is appropriate for others to censure that person. See Adams (1985: 21-24), Pickard (2011Pickard ( , 2013Pickard ( , 2014Pickard ( , 2017, and Rosen (2004).…”

The Routledge Handbook of Philosophy and Science of Addiction, HannaPickard & Serge H.Ahmed (Eds), London and New York: Routledge, 2019, ISBN 978–1–138‐90928‐1 (hbk), ISBN 978–1–315‐68919‐7 (ebk).

“…It is the latter collaboration that provides the editors of this Routledge Handbook which could be seen as a sort of culmination of the recent intersection of philosophy and science in addiction studies. Previously, Pickard had authored several enlightening analyses of some of the concepts central to addiction , while Ahmed had argued for the introduction of ‘choice’ in animal models of addiction . A partnership between these two was always likely to be fruitful and so, indeed, it has proved.…”