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Addiction and Responsibility

Addiction and Responsibility

Jeffrey Poland
George Graham
Copyright Date: 2011
Published by: MIT Press
Pages: 320
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  • Book Info
    Addiction and Responsibility
    Book Description:

    Addictive behavior threatens not just the addict's happiness and health but also the welfare and well-being of others. It represents a loss of self-control and a variety of other cognitive impairments and behavioral deficits. An addict may say, "I couldn't help myself." But questions arise: are we responsible for our addictions? And what responsibilities do others have to help us? This volume offers a range of perspectives on addiction and responsibility and how the two are bound together. Distinguished contributors -- from theorists to clinicians, from neuroscientists and psychologists to philosophers and legal scholars -- discuss these questions in essays using a variety of conceptual and investigative tools. Some contributors offer models of addiction-related phenomena, including theories of incentive sensitization, ego-depletion, and pathological affect; others address such traditional philosophical questions as free will and agency, mind-body, and other minds. Two essays, written by scholars who were themselves addicts, attempt to integrate first-person phenomenological accounts with the third-person perspective of the sciences. Contributors distinguish among moral responsibility, legal responsibility, and the ethical responsibility of clinicians and researchers. Taken together, the essays offer a forceful argument that we cannot fully understand addiction if we do not also understand responsibility.

    eISBN: 978-0-262-29563-5
    Subjects: Philosophy, Psychology

Table of Contents

  1. Front Matter
    (pp. i-vi)
  2. Table of Contents
    (pp. vii-viii)
  3. Series Foreword
    (pp. ix-x)

    The Philosophical Psychopathology series publishes interdisciplinary work that is broadly concerned with psychopathology and that has significance for conceptual, methodological, scientific, ethical, and social issues related to contemporary mental health practices, as well as for more traditional philosophical issues such as the nature of mind, rationality, agency, and responsibility. In providing a philosophical examination of the forms, limits, and lessons of mental disorder as well as its study and treatment, the broader goal is to foster an interdisciplinary community focusing on issues in mental health and illness.

    The present volume brings together scholars from a wide range of disciplines to...

  4. Preface
    (pp. xi-xii)
  5. 1 Introduction: The Makings of a Responsible Addict
    (pp. 1-20)
    Jeffrey Poland and George Graham

    A person drinks a glass of wine. Suppose this is an instance of recreational behavior. It is a minor part of dinner in a fancy restaurant with family and friends. If someone gave the person a good reason for not drinking that glass of wine, such as that it would interfere with her ability to drive home, the person would refrain.

    Suppose a person sitting at a table next to the wine drinker is consuming a fifth glass of scotch within an hour. Suppose that because of this behavior, heavy drinking, which he engages in imprudently and often, he has...

  6. 2 Drug Addiction as Incentive Sensitization
    (pp. 21-54)
    Kent C. Berridge and Terry E. Robinson

    In this chapter we present a brief overview of the incentive-sensitization theory of addiction. This description is excerpted from our previous articles on the topic (Robinson & Berridge, 1993, 2003, 2008). We then offer a few additional comments on related issues that we hope might be relevant to philosophical analyses, some excerpted from essays on the concept of incentive salience for philosophers and psychologists (Berridge, 2009; Berridge & Aldridge, 2008).

    At some time in their lives most people try a potentially addictive drug—for example, alcohol. However, few become addicts. Even relatively few people who try “hard drugs,” such as cocaine or...

  7. 3 Free Will as Recursive Self-Prediction: Does a Deterministic Mechanism Reduce Responsibility?
    (pp. 55-88)
    George Ainslie

    Advances in brain imaging have revealed more and more about the physical basis of motivated behavior, making the age-old dispute about free will and moral responsibility increasingly salient. Science seems to be delineating chains of causality for feelings, choices, and even beliefs; but if all mental life is strictly caused by prior events, and those by still earlier events in a chain extending back before birth, how can individuals be held responsible for their actions? Most people feel that they originate their actions (Nadelhoffer, Morris, Nahmias, & Turner, 2005) and will readily give opinions about whether particular circumstances make an action...

  8. 4 Addiction, Responsibility, and Ego Depletion
    (pp. 89-112)
    Neil Levy

    Are addicts responsible for their drug-related behavior, that is, for the range of activities in which they must engage in order to procure, prepare, and consume their drug? In this chapter, I argue that the answer is no, at least with regard to much of this behavior and including some of the actions that are least easily excused in rival models. In defending the view that addictive behavior is not responsible behavior, I defend a view that is very popular, especially with the scientific community. But the account of addiction I offer will differ markedly from the account offered by...

  9. 5 Lowering the Bar for Addicts
    (pp. 113-138)
    Gideon Yaffe

    In public discussions of addiction and responsibility, it is common to find both those who are sympathetic to addicts who act badly and those who are not, holding, often merely tacitly, that addict responsibility is all or nothing. “It’s a disease!” one side says, suggesting that we can hold the addict no more responsible for wrongdoing than we can the person with laryngitis who keeps quiet when speech is called for. “No, it’s a matter of personal responsibility!” claims the other side, suggesting that wrongdoing by addicts is only cosmetically different, if even that, from wrongdoing by nonaddicts. What both...

  10. 6 Decision-Making Capacity and Responsibility in Addiction
    (pp. 139-158)
    Louis C. Charland

    It is perilous to generalize about the scope and nature of responsibility in addiction. Personal and social circumstances of addiction vary widely, as do the effects of various addictive substances and the manner in which they are metabolized in the individual. The nature, duration, and severity of addiction are also relevant variables that are often ignored. Admittedly, most addictive drugs have reasonably well-demarcated profiles of action, which permits some degree of extrapolation on the level of prognosis, pathology, and treatment. Nonetheless, despite these and other advances in our understanding of addiction, it is still impossible to reliably predict who will...

  11. 7 Addiction and Criminal Responsibility
    (pp. 159-200)
    Stephen J. Morse

    Let us begin with a tale of a genuine addict, Mr. Leroy Powell, whose criminal responsibility was addressed in a famous Supreme Court case, Powell v. Texas (1968) (all citations are from the case). Although some of the language used is outdated, the description of Powell’s condition is consistent with how an alcohol addict’s clinical problem would be described today.

    In December of 1966 in Austin, Texas, Powell was arrested, charged, and convicted of public intoxication. His defense counsel had argued that because Mr. Powell was afflicted with “the disease of chronic alcoholism … his appearance in public [while drunk]...

  12. 8 Grounding for Understanding Self-Injury as Addiction or (Bad) Habit
    (pp. 201-224)
    Nancy Nyquist Potter

    There is no doubt that the addiction construct has been seized upon and utilized in popular culture as well as in theology and medicine. The identification of addictive behaviors and full-blown addictions with lack of moderation and too much pleasure seeking has resulted in a proliferation of defined addictions ranging from garden-variety alcoholism and marijuana dependence to gambling, sex, love, shopping, and reading addictions, using the Internet, and role-playing games. It seems that almost anything done to excess and felt to be necessary to manage stress can be conceptualized as an addiction. Although many researchers distinguish between substance addiction and...

  13. 9 Contingency Management Treatments of Drug and Alcohol Use Disorders
    (pp. 225-246)
    Nancy M. Petry, Sheila M. Alessi and Carla J. Rash

    Colloquially, a substance use disorder is considered to be use of a substance that is “out of control.” Persons suffering from drug and alcohol use disorders report a multitude of adverse consequences stemming from their substance use, ranging from employment to legal, family, and health problems. Individuals with substance use disorders often experience intense guilt and regret regarding their use of substances, and many express extreme desire to abstain. Nevertheless, when they encounter the substance itself or a “trigger” for its use, they relapse—time and time again.

    Twelve-step fellowships such as Alcoholic’s Anonymous have popularized one conceptualization of substance...

  14. 10 Addiction, Paradox, and the Good I Would
    (pp. 247-268)
    Richard Garrett

    To paraphrase Shakespeare, Addictions come, not as single spies, but as whole battalions (Hamlet, act 4, scene 5). I can truthfully say that I am a food addict, but it is also true that my addictions came in clusters or battalions and not as single spies. Immanuel Kant said that it was David Hume who awakened him from his “dogmatic slumbers.” But in my case, it was an awareness of my food addiction and my struggles with it that awakened me from my own dogmatic slumbers. An interesting fact about addictions is that they are, in many respects, unique to...

  15. 11 What Is It Like to Be an Addict?
    (pp. 269-292)
    Owen Flanagan

    They say that people fear public speaking more than death. The origin of this chapter involved surviving death barely, and living to speak about matters that I wish I didn’t know about, specifically about what it is like to be an addict. There was nothing in my autobiography, certainly not in the story of my formative years, say the first 18 years of my life, that would have foretold that my future, 40 years later, would involve my giving a talk with this title, “What Is it Like to Be an Addict?” to a distinguished professional society, the “Society for...

  16. About the Authors
    (pp. 293-296)
  17. Index
    (pp. 297-306)