Addiction and autonomy: Why emotional dysregulation in addiction impairs autonomy and why it matters

Abstract

An important philosophical issue in the study of addiction is what difference the fact that a person is addicted makes to attributions of autonomy (and responsibility) to their drug-oriented behavior. In spite of accumulating evidence suggesting the role of emotional dysregulation in understanding addiction, it has received surprisingly little attention in the debate about this issue. I claim that, as a result, an important aspect of the autonomy impairment of many addicted individuals has been largely overlooked. A widely shared assumption in the philosophical literature is that for addiction to impair a person’s autonomy it has to make them (in some sense) take drugs against their will. So-called “willing addicts” are therefore usually seen as exempted from the autonomy impairment believed to characterize “unwilling addicts,” the latter being those who “truly want” to stop using drugs but find their attempts repeatedly derailed by failures of self-control. In this article, I argue that the association between addiction and emotional dysregulation shows why this assumption is false. Emotional dysregulation is not only consistent with the possibility that many addicts take drugs “willingly,” it supports the hypothesis that they use drugs because they truly want to. The article proposes an explanation for why emotional dysregulation should nevertheless be seen as an aspect of their loss of control and an important reason why they have impaired autonomy. I end by exploring some implications of this account for addict’s decision-making capacity when they are prescribed the drugs to which they are addicted.

Two Problems About Moral Responsibility in The Context of Addiction

“…To set the stage for the argument I present in the following sections, consider two ways of arguing for the addiction excuse that fail on these grounds. 3 Related claims have been defended by Matthews and Kennett (2019), Kennett, Vincent, and Snoek (2015), Levy (2011), McConnell (2022, Pickard (2017), T. Schroeder and Arpaly (2013), Sinnott-Armstrong (2013), Wallace (1999), Yaffe (2011), Watson (1999), andHenden (2023). David Brink (2021, ch.…”

Addiction studies

“…The potential participants need to be able to make meaningful decisions and they need to make them voluntarily. It is still discussed whether addiction in itself is something that prevents this kind of consent (Charland 2002;Henden 2023;Uusitalo and Broers 2015). The research participants and their voluntariness may also face further challenges with the context; the studies may recruit participants in treatment centres, prisons, or other places where participating in the study may affect how they are treated in those facilities.…”