What is Addiction?

Sinnott‐Armstrong, Walter; Pickard, Hanna

doi:10.1093/oxfordhb/9780199579563.013.0050

Cited by 23 publications

(7 citation statements)

References 11 publications

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“…In this respect, they are well suited to address timely concerns about the ‘vindictiveness’ of attribution of responsibility in the context of substance misuse and substance dependence (Poland 2011). Arguably, the classical approaches fare better than recent attempts to sketch a secondary notion of responsibility, such as ‘responsibility without blame’ (Sinnott-Armstrong 2013). The reason for this is twofold.…”

Section: Discussionmentioning

confidence: 99%

Lessons from akrasia in substance misuse: a clinicophilosophical discussion

Radoilska

Fletcher

2016

BJPsych advances

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Substance misuse is an important public health problem as well as a major clinical challenge (Nuffield Council on Bioethics 2007). Arguably, these aspects are intimately related. In public discourse, substance misuse is routinely associated with increased burden on national health and social services, loss of productivity and the commission of often violent criminal offences. These uniformly negative connotations reinforce stigmatising attitudes towards substance misuse that might not only discourage people from seeking professional help in a timely fashion, but also stand in the way of successful recovery. In turn, relatively high relapse rates (Levy 2013) exacerbate the negative impact of substance misuse on public health. Philosophical work on the nature and scope of akrasia, or weakness of will (Arpaly 2000;Davidson 2001; Radoilska 2013a,b), offers a promising way of breaking out of this impasse by providing the conceptual resources required to challenge an implicit notion of control over one's actions that seems to be at root of the problem. This article focuses on variant models of akrasia, although it also acknowledges the potential role of other factors that could complement a holistic approach to a viable recovery plan. Substance misuse: three fictitious case vignettes Mr Miller: biological causationMr Robert Miller is a 65-year-old retired chief executive. His mother died at the age of 82 from 'old age'. His father died at the age of 58 from carcinoma of the oesophagus, having been a heavy drinker throughout his adult life. Mr Miller was an only child and described a happy and stable childhood despite his father's drinking. He excelled at school, enjoyed good peer relationships and obtained a first class honours degree at university. He married in his late 20s, had two children in his 30s and, in his mid-40s, became the chief executive of a national company. He was described by his family as a good husband and father, with a reputation for honesty, integrity and fairness. Throughout his working life he drank alcohol most days, attributing this to the stress of his job and frequent socialising. In his early 60s he developed a morning tremor of his hands, which he thought was due to anxiety. His wife and children became increasingly concerned about his drinking, especially as he was known on occasions to drink and drive. Under considerable family pressure he saw his general practitioner (GP) and was referred for cognitive-behavioural therapy (CBT) to treat anxiety, stress and depression. He attended these sessions regularly, but did not find them helpful and his drinking pattern did not change. Following a blood test to check thyroid function, his GP detected markedly deranged liver function and referred him to a consultant psychiatrist, who diagnosed moderate alcohol dependence. Mr Miller declined the offer of medication, believing that he was strong willed enough to reduce his drinking on his own, but he did accept two counselling sessions with a substance misuse liaison worker.Lessons from akrasia in ...

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Section: Discussionmentioning

confidence: 99%

Lessons from akrasia in substance misuse: a clinicophilosophical discussion

Radoilska

Fletcher

2016

BJPsych advances

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“…First, I am aware of no author that studies or writes about addiction, but that denies a role for desires. Whether it is thought that desires compel addicts [35][36], are non-compelling but disordered [37][38][39], are non-disordered but abnormally difficult to resist [40][41], are not different in kind from those occurring in cases of weakness of will [42][43], or are completely ordinary and resistible, making addiction condemnable [12,44], everyone agrees that desires have a role to play. Consider further the widely acknowledged role of the desire-and motivationproducing mesolimbic dopamine system in addiction [35-36, 40, 45-46].…”

Section: Addiction Involves Desires and Impaired Controlmentioning

confidence: 99%

“…It is worth pointing out that addiction researchers will often describe addiction or its various features in ways that suggest they have a dispositionalist account in mind. For instance, consider Hanna Pickard and Walter Sinnott-Armstrong's definition of 'addiction' as "a strong and habitual want that significantly reduces control and leads to significant harm" [41,861]. Their discussion of this strong and habitual want seems to reveal that it is a disposition they have in mind.…”

Section: A Disposition By Any Other Namementioning

confidence: 99%

Towards a dispositionalist (and unifying) account of addiction

Kelly

2022

Theor Med Bioeth

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Addiction theorists have often utilized the metaphor of the blind men and the elephant to illustrate the complex nature of addiction and the varied methodological approaches to studying it. A common purported upshot is skeptical in nature: due to these complexities, it is not possible to offer a unifying account of addiction. I think that this is a mistake. The elephant is real -there is a there there. Here, I defend a dispositionalist account of addiction as the systematic disposition to fail to control one's desires to engage in certain types of behaviors. I explain this position, defend the inclusion of desires and impaired control, and flesh out the notion of systematicity central to my account. I then try to show how my dispositionalist framework can unify the disparate, seemingly incompatible accounts of addiction (and their respective methodological approaches). I close with a brief plan to extend and implement my account.

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“…201ff. ; Murphy, 2017; see also Sinnott-Armstrong & Pickard, 2013, Griffiths, 2013. Despite the outward similarities in their defining behavior, it is crucial for the purposes of understanding and treating both groups to recognize that their brains work in fundamentally different ways.…”

Section: Philosophical Issues In the Addictionsmentioning

confidence: 99%