Addiction and Self-Control

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This article sums up some of the ideas in the above book: Addiction and Self-Control. Perspectives from Philosophy, Psychology, and Neuroscience. It’s edited by Neil Levy and from the Oxford Series in Neuroscience, Law, and Philosophy. The Oxford University Press (OUP) is the world’s leading university press with the widest global presence.

Addiction and Self-Control is a close collaboration among prominent philosophers and scientists who interpret evidence and how it relates to agency, control, and responsibility of people addicted to alcohol and other drugs, like alcohol. Yes, alcohol is a drug.

They shed light on the factors that underlie addiction to try to understand how much control an addict has, how they reflect their beliefs or will, and to what extent they are accountable for their actions. Everyone who contributed to this publication agreed that using the best science available would be necessary to understand the issues they were exploring.

Neil Levy begins by diving into the complexities of addiction and self-control. It contends that a lack of self-control is a distinguishing feature of addiction. It might be difficult for addicts to make decisions that are consistent with their best judgments. From a variety of disciplinary perspectives, such as philosophy, psychology, and neuroscience, this conflict is discussed. Levy thinks about how paradoxical addiction is. Addicts say they sometimes feel out of control. On the other hand, theories of addiction frequently talk about deliberate activities. Concerns concerning the moral ramifications of calling someone an addict are also raised in the text. Is their lack of self-control a mitigating element or do they bear full responsibility for their actions?

The paradoxical nature of addiction.

On one hand, addicts report a feeling of lost control. On the other, theories often discuss addiction in terms of voluntary actions. The text also raises questions about the ethical implications of labelling someone as an addict. Are they fully responsible for their actions, or does the impairment of self-control serve as a mitigating factor?

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Importantly, they delve into the neuroscientific aspects of addiction. It discusses how brain functions might correlate with an addict’s impaired judgment and reduced self-control.

As well as the capacity of addicts to respond to ordinary incentives, presenting it as a topic of debate among scholars. While some argue that demonstrating responsiveness to one form of incentive indicates a general capacity to respond to others, critics like Walton and Nasrallah question this assumption.

The text also scrutinizes the role of therapeutic communities in influencing an addict’s behaviour. These environments can sometimes help addicts demonstrate control, raising questions about the nature of their self-control impairments.

In essence, the section wrestles with the idea of whether an addict’s response to a specific stimulus can be generalized to other situations. This debate has significant implications for treatment and policy-making in the sphere of addiction.

Then they focus on the concept of “Money as MacGuffin.” The author, Ainslie, has previously developed a model of will, which he revisits here. This model posits that efficient intertemporal bargaining—or making choices that consider future consequences—requires predictable decision-making.

One striking point is the paradoxical relationship between will and freedom. Ainslie contends that the very mechanism that rewards predictable choices may also be the one that grants the will its freedom.

They introduce the notion of hyperbolic discounting, a phenomenon where people value immediate rewards more highly than future gains. This is particularly relevant for understanding the irrationality often associated with addictive behaviour.

They continue the discussion on the role of risk and decision-making in addiction. The text delves into the concept of “Lady Luck,” suggesting that risky behaviours can sometimes refresh appetite. In other words, the thrill of the gamble can be an essential factor in addictive behaviours.

Interestingly, it points out that the perception of risk often requires intermittent loss. This is key to understanding why certain activities, such as gambling or even extreme sports, can become addictive. The text suggests that the value of “appetite” in these risky activities cannot usually be weighed directly against instrumental goals, making it a complex issue to dissect.

The authors raise thought-provoking questions about the nature of addiction, especially when considered from the angle of risk-taking and reward.

Picoeconomics of Gambling Addiction.

This part brings the discussion closer to the neuroscientific realm. It talks about the striatal circuit in the brain, which becomes conditioned to associate with unpredictable personal-scale rewards—such as the outcomes of gambling.

This is a continuation of Ainslie’s ideas, further discussing how people become habituated to rewards they know how to obtain reliably. This neural mechanism can explain why addicts are motivated to engage in behaviors like gambling, despite the risks involved.

Essentially, they combine the psychological and neuroscientific aspects to give a more nuanced understanding of addiction, especially in the context of gambling.

Team Reasoning, Framing, and Self-Control

This part explores the concept of the prisoner’s dilemma in the context of addiction and self-control. The text uses pollution as an example, where “defecting” refers to polluting and “cooperating” means refraining from it.

The discussion introduces the idea of “externality,” emphasising that each person’s actions have repercussions on others that aren’t reflected in the individual’s own rewards or penalties. This concept is fundamental for understanding collective behaviours and their impact on self-control.

They suggest that our decision-making isn’t solely individualistic. Instead, it can be influenced by the broader context and the actions of others, adding another layer of complexity to the issue of addiction and self-control.

Then continue the discussion with a focus on our connection to our future selves. The text brings up Bartels’ research, which explores whether there’s a correlation between how connected people feel to their future selves and their “discount rate”—the tendency to opt for smaller, immediate rewards over larger, delayed ones.

Interestingly, Bartels found that individuals who felt more connected to their future selves were more likely to delay gratification. This psychological angle offers a fresh lens to view the intricacies of self-control and addiction, suggesting that our perception of time and self could be pivotal factors.

This section adds a temporal dimension to the understanding of self-control, linking it to our sense of continuity with our future selves.

Phenomenal Authority

Examines the effectiveness of programs like Alcoholics Anonymous (A.A.). The text indicates that the success of A.A. isn’t solely dependent on the individual characteristics of its members. Rather, engaging in the A.A. programs themselves correlates with sobriety.

This section challenges the notion that the success of such programs relies solely on the individual. Instead, it suggests that the structure and activities within A.A. contribute to its effectiveness. This perspective adds nuance to our understanding of self-control and addiction, emphasising the role of external frameworks in facilitating change.

They discuss how A.A. portrays alcoholism as both a disease and an illness, considering the alcoholic as sick and in need of help.

This points out a significant epistemological disconnect. While A.A. starts with the premise that alcoholism is a disease, this viewpoint isn’t universally shared or supported by all evidence.

This raises questions about the validity of framing addiction solely as an illness and considers the implications of this framing for both the addict and those affected by their addiction.

This scrutinizes the philosophical underpinnings of A.A.’s approach, adding another layer of complexity to the discussion on addiction and self-control.

They question whether A.A.’s methodology, which relies heavily on the phenomenology of early members and spiritual transformation, is empirically valid.

They admit that alcoholics in A.A. sometimes manage to quit drinking but question whether this is due to the program’s official stances or other factors.

The text challenges us to consider the validity and effectiveness of traditional frameworks like A.A. in treating addiction, particularly when their foundational principles may not be empirically supported.

NOTE: In 2020 the Cochrane review proved that there is empirical data that shows AA’s effectiveness.

Varieties of Valuation in the Normal and Addicted Brain

Dives deep into the neuroscientific underpinnings of addiction. It discusses three primary mechanisms—goal-directed, habitual, and Pavlovian—that guide action selection under normal circumstances.

The text suggests that biased competition between these systems can lead to irrational behavioural patterns focused on short-term gains. This aligns with common observations about addictive behaviour, where short-term gratification often trumps long-term well-being.

This section brings a more scientific rigour to the discourse, emphasising that addiction isn’t just a failure of will or moral shortcoming but involves complex interplays within the brain.

This part delves into the ethical and policy implications of the neuroscience behind addiction.

Although the text steers clear of fully addressing the moral responsibility of addicts, it does argue that understanding neuroscience can be beneficial for implementing drug policy. This suggests a move toward a more compassionate and scientifically informed approach to dealing with addiction, rather than relying solely on punitive measures.

In essence, it advocates for an interdisciplinary approach to addiction, incorporating insights from neuroscience to inform legal and policy decisions.

They include references to studies that explore dopamine’s role in addiction and the neurobiology of behaviour.

Are Addicts Responsible?

Delves into the ethical aspects of addiction. It explores the notion of “reasons-responsiveness” to understand whether addicts have control over their actions.

The text posits that if an addict’s desire is too strong to resist, either in any circumstance or in their current situation, then they may not be fully responsible for their actions. This opens up a complex ethical debate on the moral responsibility of addicts, suggesting that the ability to control oneself is not always straightforward and can be influenced by various factors.

This challenges traditional notions of culpability and agency in the context of addiction.

They cite specific scenarios to illustrate the complexities surrounding the issue of responsibility in addiction. For instance, it introduces the concept of the “transfer principle,” a guideline to assess responsibility based on the consequences of one’s actions.

They introduce hypothetical cases to discuss the nuances of moral responsibility. It argues that while addicts might be responsible for the initial act that led them to addiction, their subsequent actions might be more difficult to categorize neatly under traditional ethical frameworks.

In the ethical landscape of addiction, we need to reconsider how we assign blame or responsibility.

Just Say No?

Takes a closer look at what happens when individuals lose control and act contrary to their intentions. The text explores various factors that could lead to such failures, including lapses in attention, impulse control, and deliberative capacity.

The text argues that a range of factors, both internal and external, can interfere with successful intentional action. It highlights that discussions about loss of self-control in addiction often focus on internal factors, but external influences shouldn’t be discounted.

In a nutshell, the section posits that the reasons for loss of control in addiction are multilayered and not solely confined to individual failings.

It posits that sometimes, the circumstances of one’s life can make it extremely difficult, if not impossible, to succeed at certain activities, including overcoming addiction.

The text suggests that the external conditions, such as social or personal circumstances, can make a flourishing life a remote possibility for some. It raises the question of how much control one actually has when faced with such challenges.

This adds another layer of complexity to the discourse, emphasising that individual choices are often influenced by a broader context that might not be within one’s control.

Addiction in Context

Questions the very notion that addicts have no control over their actions. The text delves into the effectiveness of clinical interventions that aim to enhance agency as a route to recovery.

They argue that if addicts truly had no control, then treatments focusing on increasing their agency would be puzzling, if not downright ineffective. This challenges the idea that addicts are utterly helpless and have no control over their addictive behaviour.

This opens up an avenue for debate, questioning the notion that addicts lack agency, and emphasise the role of clinical interventions that focus on enhancing individual control.

Are there nuanced capacities that addicts might have? It distinguishes between the power to refrain from using drugs on a particular occasion and the skills needed to manage psychological distress in the long term.

The text suggests that clinical interventions aim to provide these missing skills, allowing addicts to make different choices that align with their long-term well-being. This adds another layer to the understanding of self-control, emphasising that the ability to refrain from drug use in the moment does not necessarily translate into the skills needed for long-term recovery.

Are Addicts Akratic?

Akrasia is a term often used to describe a state where one acts against their better judgment.

The text suggests that to understand addiction, one must consider the complicated interplay between various systems like desire, choice, and intentional actions. It underscores the complex relations between these aspects, which are often oversimplified in the discourse on addiction.

This asks whether addicts truly act against their better judgment or if the situation is more nuanced. To answer this question we need to focus on the neuroscience behind dopamine signalling.

The authors caution against simplifying the dopamine signal as solely representing a difference in value. Instead, it suggests that dopamine signals might represent a difference in something less well-defined, like “likability.” This adds a level of neuroscientific complexity to the idea of akrasia in addiction.

Acting against one’s better judgment in addiction might be more neurologically complicated than previously thought.

The “Can’t-Be-Expected” factor diminishes or eliminates the addict’s power to comply with normal expectations, and another that implies severe burdens for compliance. This dichotomy offers a nuanced understanding of the constraints faced by addicts, making it difficult to neatly categorize them under traditional ethical frameworks.

Addiction and Blameworthiness

Discusses the role of dopamine in the context of learning and decision-making. It examines how dopamine release can be triggered by specific cues and actions, like the appearance of food.

This raises questions about the implications of dopamine-driven learning mechanisms for blameworthiness. It suggests that if dopamine release reinforces certain behaviours, then the issue of assigning blame becomes even more complex, as the addict’s actions might be heavily influenced by these neurochemical processes.

Turns out that habits and desires are distinct; one can act out of habit without necessarily having a desire to perform that action.

This allows a more nuanced understanding of addiction by differentiating between actions driven by habit and those driven by active desires. It suggests that not all actions in addiction are driven by an overwhelming desire to consume a substance; some might be mere habits, complicating the issue of blameworthiness.

Addiction Between Compulsion and Choice

Explores the boundaries of control in addiction. It acknowledges that while the mesolimbic dopamine system plays a central role in addiction, its workings aren’t under direct conscious control.

However, they also emphasise that not being able to control the dopamine system doesn’t necessarily mean that addicts lack all forms of control. This highlights the complex interplay between neurological processes and individual agency, suggesting that addiction lies in a grey area between compulsion and choice.

Research and experimental data involving rats describe how rats conditioned to associate a noise with sugar were far more likely to press a lever when given amphetamines.

The section uses this experimental data to illustrate how external substances can magnify habitual behaviours. It suggests that while addicts may not be entirely without choice, their actions are heavily influenced by substances that alter neurological functioning, making it difficult to draw a clear line between compulsion and choice.

Discusses the role of cravings and how they differ from intentions. While desires can be conflicting and serve as inputs to deliberation, intentions are the results of that deliberation, leading directly to actions.

The text suggests that cravings can be so powerful they overshadow other considerations, complicating the addict’s decision-making process. This section reinforces the idea that addiction lies in a complex space between compulsion and choice, where powerful cravings can significantly influence an individual’s actions.

There’s a great index listing various philosophical and neuroscientific topics, theories, and references found throughout the book, Addiction and Self-Control. It serves as a navigational tool, helping readers quickly locate specific information on subjects like dynamic choice theory, neural mechanisms, and cognition.

 

 

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