Addiction, compulsion, and weakness of the will

Henden, Edmund

doi:10.1093/acprof:oso/9780198727224.003.0007

Cited by 4 publications

(6 citation statements)

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“…We find ourselves in broad agreement with Lewis's description of addiction as a complex human problem in need of multiple levels of analysis, that neither rules out choice and experience nor impaired control and compulsivity, and which importantly involves brain changes that stabilize into deeply entrenched habits that are difficult to extinguish [1][2][3]. In this commentary we focus on his claim that the view of addiction emerging from this description, rules out a disease-based conception of addiction.…”

supporting

confidence: 63%

“…2 Without norms of one kind or another there would consequently be no way to talk about diseases, including brain diseases. 3 Now, presumably Lewis does not want to deny the existence of brain diseases (e.g., that Alzheimer's disease, schizophrenia or stroke are brain diseases). What he denies, as we understand it, is a certain interpretation of the norms assumed by his opponents to show that addiction is a brain disease, namely the interpretation according to which it is a brain disease because the underlying brain changes by deviating from norms of neural function and standard neural architecture (presumably norms which are intrinsic to the brain and can be specified in purely neuronal terms) constitute some neural abnormality.…”

Section: Normativity and The Brainmentioning

confidence: 99%

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What Is Wrong with the Brains of Addicts?

Henden

Gjelsvik

2016

Neuroethics

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In his target article and recent interesting book about addiction and the brain, Marc Lewis claims that the prevalent medical view of addiction as a brain disease or a disorder, is mistaken. In this commentary we critically examine his arguments for this claim. We find these arguments to rest on some problematical and largely undefended assumptions about notions of disease, disorder and the demarcation between them and good health. Even if addiction does seem to differ from some typical brain diseases, we believe contrary to Lewis, that there are still good reasons to maintain its classification as a mental or behavioral disorder.

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supporting

confidence: 63%

Section: Normativity and The Brainmentioning

confidence: 99%

What Is Wrong with the Brains of Addicts?

Henden

Gjelsvik

2016

Neuroethics

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“…The ecological, posthumanist perspective refrains from imposing this hierarchy, instead viewing the individual as an arrangement of equally voluble, intermittently dominant volitional states. Henden's (2016) dual process theory could be expanded, therefore, in a posthumanist approach, to recognise the co-occurrence of potentially multiple processes of volition driven by multiple competing and interacting sets of priorities, produced interactively within the individual by the wider ecology in which they are situated.…”

Section: Dissociated Volitionmentioning

confidence: 99%

“There’s No Sense to It”: A Posthumanist Ethnography of Agency in Methamphetamine Recovery

Selvey

Maher²,

Fitzgerald

2021

Contemporary Drug Problems

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The orthodox construction of agency within addiction recovery discourse is built upon a fault line between two conflicting principles: that people who use drugs in harmful ways cannot control their behavior, but that they can also regain that control through intentional effort. The conceptual confusion inherent in this framework can harm people using drugs by producing inadequate accounts of commonly invoked aspects of recovery such as “triggers,” “self-control,” and “addictive behavior.” This ethnographic study involved qualitative interviews and observations with nine people over 6 months as they engaged in recovery from harmful methamphetamine use, to explore their experiences of agency, and how these experiences could be shaped by the discourse of volition/compulsion. Thematic analysis was conducted using a posthumanist theoretical framework. We found “relapse triggers” to be diffuse aspects of particular environments rather than specific stimuli, able to provoke what would normally be considered conscious, intentional behavior rather than only autonomic or “mindless” processes. Participants also described their identities as internally divided and multiple, with drug related behaviors separated from their true selves. Finally, agency was experienced as emergent and distributed rather than as a particular resource located within individuals. Attending to these complex experiences of agency can help resolve the tension between loss of control and personal responsibility for people who use drugs, by renegotiating the historically imposed categorical distinction between volitional and compelled actions, and the cultural constructions of “addictive” versus “normal” behavior.

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“…Distance was fitted as the sum of four Gaussian distributions and the mean of the lowest distribution was set as the threshold for IBS-homologous recurrence (see Fig S1). For the IBD analysis, PED and MAP file formats were created from using VCFtools and the proportion of the genome IBD between pairs of samples was calculated using isoRelate R package (41). Genetic distance was calculated using estimated mean map unit size from P. chabaudi chabaudi of 13.7 kb/cM (42).…”

Section: Methodsmentioning

confidence: 99%

High proportion of genome-wide homology and increased basal pvcrt levels in Plasmodium vivax late recurrences: a chloroquine therapeutic efficacy study

Rovira-Vallbona

Hong

Kattenberg

et al. 2021

Preprint

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Chloroquine (CQ) is the first-line treatment for Plasmodium vivax malaria in most endemic countries. Monitoring P.vivax CQ resistance (CQR) is critical but remains challenged by the difficulty to distinguish real treatment failure from reinfection or liver relapse. Therapeutic efficacy of CQ against uncomplicated P.vivax malaria was evaluated in Gia Lai province, Vietnam. Sixty-seven patients were enrolled and followed-up for 42 days using microscopy and (RT)qPCR. Adequate clinical and parasitological response (ACPR) was 100% (66/66) on Day 28, but 75.4% (49/65) on Day 42. Eighteen recurrences (27.7%) were detected with a median time-to-recurrence of 42 days (IQR 35, 42) and blood CQ concentration <100ng/ml. Parasite genotyping by microsatellites, SNP-barcoding and whole-genome sequencing (WGS) identified a majority of homologous recurrences, with 80% (8/10) showing >98% identity-by-descent to paired Day 0 samples. Primary infections leading to recurrence occurred in younger individuals (median age for ACPR=25 years [IQR 20, 28]; recurrences=18 [16, 21]; p=0.002), had a longer parasite clearance time (PCT for ACPR=47.5h [IQR 36.2, 59.8]; recurrences=54.2h [48.4, 62.0]; p=0.035) and higher pvcrt gene expression (median relative expression ratio for ACPR=0.09 [IQR 0.05, 0.22]; recurrences=0.20 [0.15, 0.56]; p=0.002), but there was no difference in ex vivo CQ sensitivity. This study shows that CQ remained largely efficacious to treat P.vivax in Gia Lai, i.e. recurrences occurred late (>Day 28) and in the presence of low blood CQ concentrations. However, the combination of WGS and gene expression analysis (pvcrt) with clinical data (PCT) allowed to identify potential emergence of low-grade CQR that should be closely monitored.

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Addiction, compulsion, and weakness of the will

Cited by 4 publications

References 0 publications

What Is Wrong with the Brains of Addicts?

What Is Wrong with the Brains of Addicts?

“There’s No Sense to It”: A Posthumanist Ethnography of Agency in Methamphetamine Recovery

High proportion of genome-wide homology and increased basal pvcrt levels in Plasmodium vivax late recurrences: a chloroquine therapeutic efficacy study

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