Addiction and Moralization: the Role of the Underlying Model of Addiction

Abstract

Addiction appears to be a deeply moralized concept. To understand the entwinement of addiction and morality, we briefly discuss the disease model and its alternatives in order to address the following questions: Is the disease model the only path towards a ‘de-moralized’ discourse of addiction? While it is tempting to think that medical language surrounding addiction provides liberation from the moralized language, evidence suggests that this is not necessarily the case. On the other hand non-disease models of addiction may seem to resuscitate problematic forms of the moralization of addiction, including, invoking blame, shame, and the wholesale rejection of addicts as people who have deep character flaws, while ignoring the complex biological and social context of addiction. This is also not necessarily the case. We argue that a deficit in reasons responsiveness as basis for attribution of moral responsibility can be realized by multiple different causes, disease being one, but it also seems likely that alternative accounts of addiction as developed by Flanagan, Lewis, and Levy, may also involve mechanisms, psychological, social, and neurobiological that can diminish reasons responsiveness. It thus seems to us that nondisease models of addiction do not necessarily involve moralization. Hence, a non-stigmatizing approach to recovery can be realized in ways that are consistent with both the disease model and alternative models of addiction.

Is cleanliness next to abstinence? The effect of cleanliness priming on attitudes towards harm reduction strategies for people with substance use disorders

“…Our results did provide support for a link between health‐conscious messages and moral judgements, an issue that pervades long‐standing debates on whether drug addiction is a brain disease or a learned behaviour, the culpability of the individual, and thus the moral responsibilities of society to treat them (Frank & Nagel, 2017; Grifell & Hart, 2018; Leshner, 1997; Levy, 2013). Proponents of the disease model argue it reduces moral stigma and facilitates treatments focused on symptom management; opponents counter that it ignores social causes and more effective treatments that are curative.…”

“…Proponents of the disease model argue it reduces moral stigma and facilitates treatments focused on symptom management; opponents counter that it ignores social causes and more effective treatments that are curative. Evidence suggests healthcare providers and the public share biases against some “unhealthy” individuals (e.g., those who are obese, mentally ill, or abuse substances), and those moral judgements can be resistant to medical education (Frank & Nagel, 2017). This study demonstrated that, by focusing on the efficacy of specific treatment options, such as HRS, negative attitudes towards people with SUDs can be reduced.…”

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