title: Addiction: choice or compulsion?
abstract: Normative thinking about addiction has traditionally been divided between, on the one hand, a medical model which sees addiction as a disease characterized by compulsive and relapsing drug use over which the addict has little or no control and, on the other, a moral model which sees addiction as a choice characterized by voluntary behavior under the control of the addict. Proponents of the former appeal to evidence showing that regular consumption of drugs causes persistent changes in the brain structures and functions known to be involved in the motivation of behavior. On this evidence, it is often concluded that becoming addicted involves a transition from voluntary, chosen drug use to non-voluntary compulsive drug use. Against this view, proponents of the moral model provide ample evidence that addictive drug use involves voluntary chosen behavior. In this article we argue that although they are right about something, both views are mistaken. We present a third model that neither rules out the view of addictive drug use as compulsive, nor that it involves voluntary chosen behavior.
authors: Centre for the Study of Professions, Oslo and Akershus University College of Applied Sciences , Oslo , Norway.
authors: Edmund
authors: E
authors: Henden
authors: Hans Olav
authors: HO
authors: Melberg
authors: Ole Jørgen
authors: OJ
authors: Røgeberg
keywords: addiction; choice; compulsion; irresistible desires; rationality
references: Oxf Ser Soc Cogn Soc Neurosci. 2009;2009:509-533
references: 25309963
references: PLoS One. 2007 Aug 01;2(8):e698
references: 17668074
references: Philos Rev. 1978 Apr;87(2):225-40
references: 11661829
references: Philos Psychiatr Psychol. 2010 Mar 1;17(1):1-22
references: 24659901
references: Behav Brain Sci. 2008 Aug;31(4):415-37; discussion 437-87
references: 18662461
references: Psychol Bull. 1991 Jul;110(1):86-108
references: 1891520
references: AJOB Neurosci. 2012 Apr 18;3(2):40-49
references: 22724074
references: Science. 1997 Oct 3;278(5335):45-7
references: 9311924
references: Am J Psychiatry. 1971 Nov;128(5):541-6
references: 5114367
references: Philos Trans R Soc Lond B Biol Sci. 2008 Oct 12;363(1507):3137-46
references: 18640920
references: Bioethics. 2006 Feb;20(1):16-20
references: 16680878
references: Brain Res Brain Res Rev. 1998 Dec;28(3):309-69
references: 9858756
references: Psychol Rev. 1990 Apr;97(2):147-68
references: 2186423
references: Am J Bioeth. 2007 Jan;7(1):8-11
references: 17366151
references: Curr Opin Neurobiol. 2013 Aug;23(4):581-7
references: 23428657
references: Am Econ Rev. ;94(5):1558-90
references: 29068191
references: Brain Res Brain Res Rev. 1993 Sep-Dec;18(3):247-91
references: 8401595
references: Am J Bioeth. 2002 Spring;2(2):37-47
references: 12189075
references: Bioethics. 2006 Feb;20(1):1-15
references: 16680876