Welcome to the new book's network. Welcome to new books in psychology. I'm Jeff Adler speaking today, John T. Meyer. John is a psychotherapist at the Cambridge Therapy Center. Today, we are discussing John's new book, The Disabled Will, A Theory of Addiction, published by Rutledge Press in April, 2024. In his book, John puts forth a novel vision of addiction as a fundamentally political or problem that requires political solutions. This vision sees addiction not as a cognitive defect, but rather as a disability of the will that requires proper accommodations. John, thanks for joining me today. Pleasure, Jeff. Thanks for having me. Awesome. So, in many ways, this book is a response, is a reconceptualization of how we speak about addiction. So, to make sure our audience on a level playing field, how would you describe the current addiction landscape in which this book is responding? Yeah, so it's a nice way of framing the question. So, as your listeners, a lot of people know, there's a lot of debates about what addiction is, what I think about addiction, in the sort of philosophical and psychological landscape that I'm speaking to, one debate is whether addiction is disease or not. So, there's a way of understanding addiction as a disease that's very influential in psychiatry, but also influential among a lot of people, you know, in recoveries from addiction. So, there's like a broad-based support for thinking of addiction as a disease, and then a lot of philosophers are psychologists that actually addictions kind of unlike a disease in many ways. It seems to be responsive to reasons and incentives in a way that diseases aren't. So, there's this debate, is addiction a disease or not? So, I guess the initial motivation for the book was kind of addressing this question, or kind of offering a different framing of addiction, which doesn't focus on the question of whether it's a disease or not it focuses on a slightly different question of whether it's a disability. So, okay, before we get to the disability about this, I want to unpack something that you are very careful about your book, and I find it extremely helpful, which is this argument that the idea that addiction is a disease is both descriptively false, like it doesn't hold up to scrutiny, and it's not, I think, it's not going to be called a useful myth, like in practice, it doesn't work well. So, can you unpack both those claims? Definitely, yeah. So, on the descriptive claim, so there's a bunch of data. So, Jean Heyman has a great book on this called Addiction of Disorder of Choice, which kind of summarizes a lot of data. But it looks like people kind of, what I'm going to age out of addiction, so people will meet the criteria for substance use disorder in their 20s and 30s. They get into their 30s and 40s, and they get mortgages, make it kids, they reduce their use and no longer meet the criteria for substance use disorder. So, a very common pattern, not everyone, but a lot of people meet that pattern. And that's very much unlike a disease except diabetes doesn't work like that. Alzheimer's disease doesn't work like that. People don't spontaneously, on their own, quote unquote, get better. So, it doesn't have the sort of pattern of a disease. And then there's sort of micro level things that you offer people gift cards for refraining from their substance of choice for a week for two weeks. And people respond to these sort of incentives quite powerfully. So, there's a lot of data suggesting people, even with allegedly overpowering addictions like cocaine addiction, can refrain from using cocaine for a significant period of time in response to relatively small cash incentives or what you or I might call reasonably small cash incentives. So, all this has pointed to this different picture of addiction on which it's a more rational choice rather than a disease. And I myself don't really endorse that view of addiction, but a lot of people have argued that this data should move us away from addiction as disease to addiction more as a rational choice. So, the second part of your question. Yeah, so you might say, so there are a bunch of ways to respond in this one way that's very powerful to me, because my book, I mean, in general, my approach is to give a lot of deference to the, to the opinion of people who themselves have addictions. And that in a way has a final say, and I take seriously the fact that the disease model has a lot of currency in recovery communities and for a lot of people. It's a very important narrative of how to understand their own recovery. So I say, well, maybe disease, it's kind of a useful fiction or useful myth, even if it's not literally true according to some psychologist definition, still it's a way of framing addiction. That's helpful for a lot of people and we should retain it. And that the argument there is a bit more indirect, but I think I'm also not sympathetic. I think ultimately we should reject that as well. Conceiving addiction as disease often has stigmatized in the facts. And it's not in general the best way of framing it, especially once we have an alternative story, like the one I offer in the book, but that sort of moves us to the, to the question, to the positive view of addiction. So I'm reluctant to embrace it as even as a, as a, as a idealization or as a myth about addiction. Okay. That helps. So before we move into the positive view, I did actually want to, one interesting thing is that, and you just sort of touched upon it in your answer there, which is, to a naive person, there seems to be something charitable about the disease view, at least compared to a view that's just like addicts just behave in bad behavior. It's just sort of like, I think what you call it morally, like reprehensible behavior. So can you sort of go back a little farther and say how the disease you emerged and, you know, why it still might be a little more sympathetic to the addict than the view that came for it, but why you still see it as sort of stigmatizing. Yeah, awesome. Yeah. Yeah. It's a great point. So, and my general view of addiction is one on which I guess like the arc of moral progress bends slowly, but then there's justice or like, I think we're, like, I think we're very, very slowly improving our understanding of addiction over like decades and centuries. And so quite right. The disease model, I think, is objectionable in the ways I've just outlined. However, it's much better than what it's replaced. So, so, so what it's replaced seems to be, and it's tough to find people who really hold this, this view like in the, in the literature, even in the older literature, at least to my knowledge, but there's this view on which addiction is in some sense a moral failing. So addiction is bad behavior in some sense of bad. This revelatory of a bad character that people who have bad character, they engage in sort of viseful actions like stealing like adultery, but also like the excessive use of alcohol tobacco and narcotics. So it's the vice and how should it be treated well device and it should be treated by moral approbation. And when it leads to crime, it should be treated with punishment. So this is the legal or moral view of addiction. And the disease model emerged in the 20th century as a sort of improvement on this view or rejection of this view on being like, no, that's the wrong way of thinking about it addiction. We should not be treating addiction as a moral failing to be treated in the courts. Rather, it's a sort of medical failure medical issue to be treated in hospitals and clinics, and we should not be so focused on blaming people with addictions, but rather with helping them. And I think that's great. I also do not wish to blame people with with addictions and in that sense, I think the disease model is a step forward. In many, many ways, it was like a transitional phase, I think in our understanding of addictions, how I would see it so lots of good, much better than what replaced, despite the, the concerns about the, about it that I've raised. Okay, cool. I think that brings us all up to speed, then now let's bring us to this current, this current moment, how do we to use your term, how do we bring the moral arc of progress in the topic of addiction. Even farther, let's let's, in broad strokes, what are you, what's your endorsement, what do you think we should actually see addiction. Yeah, and so, so, so one way of thinking is it is kind of in a wayside stepping this debate like not saying it is or isn't a disease, although maybe we'll essentially circle around to that. So, but rather, well, what, what is addiction like what category does it fall into just if you're coming at this naively. So there's this view in the law, I mean, in the US it's been in the law since the passage of the Americans with disabilities act and a lot of other countries treat addiction this way in the law, as a, as a disability. So addiction is treated in a lot of US law and a lot of international law as a disability, once a disability we'll get into that but at first approximation blindness and deafness or core examples of disabilities. So the thought of the book is the initial thought of the book is we shouldn't at first pass at least think of addiction as a disease or brain disease like Alzheimer's disease as people often do. Well, rather we should think of it as a disability, like blindness or deafness and crucially in this will come out more as we talk about the positive view to have a disability is not to be bad in some way or to be defective in some way disability. I think I follow a lot of disability activists here. It's just a neutral difference, you know, being blind or being deaf. It's just to be embodied in a different sort of way into experience the world in a different sort of way away that's often discriminated against, but it's in of itself neutral. So thinking of addiction as disability moves us to that's much more neutral descriptive conception of what addiction of what addiction is. I want to make sure that we return to your point earlier about who you went from the courts to the to the medical facilities, but right now before we get there, because I think that's a very, very useful way to track this whole thing. But let's just first make sure we unpack this kind of view of addiction. So, okay, so it's a disability. What is it a disability of. So yes, so that's, so I think the big picture thing is addiction is a disability and that's the way the book is saying we should take that view seriously and think about its implications and the implications are quite broad. And then within that. So there's a more kind of philosophical question that you raised or what kind of addiction, what kind of disability is it it's not in the case of blindness, we have some rough sense of what the disability is. What is in the case of addiction. So, so my view is that addiction is basically a disability of the will. I think of following the philosopher Michael Bradman is like a faculty, we all have for forming plans and making choices and sticking to our plans over the long term. So this is something we human beings and maybe other animals do. And in people with addictions that faculty works somewhat differently, especially with regard to their plans with regard to certain substances or activities. So addiction is in the first place, a disability of the will, the will works a bit differently in people with addiction, it's not worse, but differently. Okay. And so to kind of continue along with this analogy from addiction to be more like blindness or deafness, as opposed to in the case of disabilities, as opposed to Alzheimer's diabetes, as the case of diseases. So again, sort of like the naive reader from a moral standpoint, I like where we're going, but one, you know, question that came up for me personally is for example. But doesn't anecdotally, doesn't it feel a little different in that we associate people can be more vulnerable for addiction, for example, when they've experienced great recent hardship in life. And so, you know, to my knowledge, blindness and deafness aren't like that as much they aren't sensitive to like very events in the environment as much so how can we like sort of unpack that potential contrast, or is that just not a real contrast. No, it is, it is very much a real contrast. I mean, I don't know about the about the recent hardship data, but I've been in like people who've experienced a sort of what are called adverse childhood childhood experiences kind of trauma and other things, or do seem to be more prone to addictions, which is, which is not doesn't seem to be the case in blindness or deafness. So I don't, so this might well be so. I mean, in general, I think I, I, I want to share with distinguished the kind of causal history of addiction, how we ought to treat addiction. So I think addiction does seem to have a causal history that's more bound up with adverse life experiences, maybe, than, than blindness and deafness are although, of course, tons and tons of people have addictions without having any. I mean, everyone has some adverse life experiences, but without having what clinics call adverse and conversely a lot of people go the other way so I think the etiology of addiction. It's kind of poorly understood. But I think even granting that it doesn't impact the claim that addictions disability I think I think addiction is a disability in the ways I described, and we should just say, well, some, some addictions have this more complicated. So some disabilities have this more complicated etiology, but they should still nonetheless be treated, both like in the law and clinically as disability. So that's how I would respond to these sort of considerations. Cool. That, that makes sense. Then with that in mind, let's kind of unpack what implications are. And yeah, I would like to sort of, if we can tie it back, but you said how in the moral failing view of addiction. Addictions matter of the courts, then in the kind of disease you, it was a matter of medical facilities. And so what institutions job is it? And yeah, and just say more about that. Yeah, I really like that framing in a way we go back to the courts. I mean, that's, that's the big picture thing is like, we begin in the services, there's a super, you know, broad sketch, but I, but I like this way frame in it. We begin as we're in the criminal courts, where people are punished for their wrongdoing and offer excuses and all this thing when does the criminal courts. We move from, so that's the, I guess, pre 20th century, although in many, it's still, it's still the case in many places in the world and in the United States. People are still treated this way, but that's how it used to be for everyone. We moved then to the hospitals, so from the criminal courts to the hospitals, which is kind of the hospitals in the clinics or the home of the disease model. So, so we move as a word in the dictionary back into the civil courts. So, to the civil courts and the legislatures. So people with so again thinking about again drawing a lot on disability so. Blindness kind of off you, I don't know the history as well, but blindness has a similar narrative where back and pre history I think maybe used to physical disabilities were seen as moral failings I think we, we all now see that view is sort of morally different, but I think some ancient civilizations used to have it. And then blindness was a sort of medical thing to be treated by, to be treated by doctors and of course doctors have a role there. But now we think blind people are just citizens, and they have certain rights. They have, they have certain needs that are maybe different from those of people who are not blind and so we have laws to enforce their rights. They have political organizations to represent them. And they both as we all do. And it's sort of an issue of, you know, basically you up. It happens in the legislatures and then when the legislators fail we have the civil courts and other legal mechanisms to enforce the rights of blind people. So I think of addiction and much the same way moving from the hospitals back to the courts now the civil courts primarily and legislature so, so stating and enforcing the rights of people with addictions. That's how I think of the, of the, as it were the movements of that narrative. It's that time of the year your vacation is coming up. You can already hear the beach waves, feel the warm breeze, relax and think about work. You really, really wanted all to work out while you're away. Monday.com gives you and the team that piece of mind. When all work is on one platform and everyone's in sync, things just flow wherever you are. Tap the banner to go to Monday.com. Okay. And how, okay, so that's sort of the onus of responsibilities on how let's go now. If let's say for an addict. How does this help someone? How is this a better form of treatment. Yeah. Yeah, so there's, so it's, so I think it's a very much open question so the, so let me say a couple things so the, the point of the book is, is to say, is to offer a kind of big, you know, a broad view of what addiction is that's not. That's sort of an alternative to the disease model and one that's well grounded. I think in the law, as well as in philosophy. And so a couple questions are kind of what is it, what does it, as you quite went out, what does it do for people with addictions. I think there are a couple questions here. One, like, what does the clinical work look like if we take the disability model actually what does treatment look like. Should it look different. I mean, I think there's some concrete ways in which it looks quite different so involuntary. Treatment which is practice in Massachusetts under section 35 looks a lot less sympathetic on this sort of picture so so big picture things about treatment like we should be much, much more reluctant about treatments that infringe on the rights of people. Can I ask you to, can I ask you to impact with those hours for people, I myself don't know. Yeah, yeah, and this is a Massachusetts specific thing it happens in other states but Massachusetts is one of the few states where you can, and it doesn't happen that often to be honest but it does happen where people can be involuntarily committed, you know, due to the concerns of their family and friends to treatment. For so in most states, as you can do that only for suicide risk and things like that in Massachusetts and a few other states you can do that for addiction treatment very controversial sort of policy. And so I mean, the big picture like is this view, I mean, is very reluctant to endorse anything like that that the addicted people are people with with rights which maybe we should have acknowledged even if we don't accept my view, but the view sort of hammers in the home that addicted people are people with rights that should be infringed only in very rare circumstances and so it's very unsympathetic to sort of involuntary treatment things like that. It's very sympathetic to making things available that are useful so this is so e cigarettes and vaping is one example that are sometimes banned in some places because of somewhat, you know, you know, concerns about about health hazards. But this view is very sympathetic to giving people access to all the all the things that they might want in order to manage say a nicotine addiction. So it's very, very sympathetic with kind of respecting people's rights and giving people's access to the tools they need. And then that I think it's, it's quite open and like what actually addiction treatment looks like under disability model. Maybe it looks a lot like what we already have. Maybe it looks radically different I think it's yet to be explored and it's yet to be explored also I mean, a big thing about this view is like how do we dictate people themselves feel about this view. I mean, I think the view is in a way answerable to people with addictions and as I say in the book, if people with addictions, consider this book, this view carefully I don't care for this we don't like this. This does not represent who we are. Then I say so much the worst for the view. So the view is really offered in the first place to be what the actions be like does this seem right to you. And, and hopefully does. But if it doesn't I think that's a serious objection to the view so the view is ultimately beholden to the judgments of people with the actions themselves. Yeah. No, no, it's okay. No, it's okay. It's fine. I was going to, I was going to actually ask like, whether it's in your practice talking to people have you actually like presented this book or theory or ideas to people who suffer from addictions and what has that kind of has the reception then. Yeah, so mixed I'd say, I'd say to solidly mixed. I mean, it's tough because I think people have like the word disability maybe doesn't have the best like a lot of people have, I guess, negative associations with that word. And so when you say, and that's maybe coming from a place of ableism or coming from other places and so it's tough to get like a neutral evaluation of you. And so I find my my rough experiences when I describe the view in one sentence people are like, I don't know, I don't know about that. But when I get when I give them a couple paragraphs or the book. If they read the book then they're they're more sympathetic. So I think people, people, you know, it depends how deeply the views described but I guess we don't know yet as I say the conclusion you know I myself have a history of alcohol abuse disorder alcohol addiction. And I, I like the view, I like the view, but I'm just one, I'm just one person. I do think my view matters but I think it's, it's not dispositive and so, and so when one wants a critical NASA people. But some people do some people don't so I think it's, I think the jury's out I'd say. Okay, fair. Well, let's now. Let's then kind of get into the nitty gritty I wanted to kind of explore a few, I found very interesting points you made throughout it. One thing. Specifically, you know, I will, I will be, I will know myself is that I am one to really binge like kind of like self help person development content. And I must say I've actually pretty sympathetic to the idea that in a way you should object to which is that things like perfectionism. Things like excessive exercise. Things that are in not just normal but relatively high doses can be considered healthy can be to use your word in the book. Ballerized in the case of perfectionism, you very much say like that's not what you're talking about here that is not addiction so I just found it very interesting so can you unpack this claim of like how this kind of term you hear a lot of how like perfectionism is just a form of addiction extra over exercise a form of addiction how that doesn't quite jive with your theory of addiction. Yeah, definitely so, so I guess the background view and this is picking up on the earlier question of what kind of addiction is it. I mean, the background view is we have these wheels. So we have these wheels to kind of transcend sort of calculation of particular outcomes we have make certain choices we have certain tendency some of us are really stubborn some of us are really relaxed. There's a great diversity in the human will which is kind of a thing. And, and I think some of these forms of, of William or as I say, valorized I think certainly through, you know, you know, certain forms of, you know, perfectionism as you say, other sort of quirky tendencies of the will or what one might see as quirky tendencies get get valorized and that's that's one that I'm in favor of valorizing certain people's tendencies. So where does addiction come from, like what is addiction above and beyond that addiction about people with addiction or subject to systematic deep seated discrimination and exploitation of a degree that's like qualitative, I don't know, just a shocking degree, especially to the degree to which people are out loud about it. So, you know, you'll ask people, would you allow your child to marry someone of an opposite race, and they'll, and a lot of people now will say, yes, not everyone, and the actual numbers probably lower because people can rely on these sorts of surveys. But, but people are now a bit more open minded about it than they were say 50 years ago. Would you allow your child to marry someone with an addiction history, the numbers are incredibly, are incredibly low people are still openly discriminatory against people with, with addictions. Would you rent a room to someone with addiction history, people are still incredibly low numbers. There's like widespread and sort of, and it's sort of like socially still okay to stay in the way that it's not as much at least in, in some context with race. Or gender that people are openly discriminatory of addiction so what is addiction it's a mix of a certain tendency of the will, and a certain pattern of discrimination and exploitation. So, going back to your examples, what I think most of those things you're describing are things that are kind of tendencies the will and from a psychological point of view kind of structurally analogous to the mechanisms of addiction, but are not subject to the same kind of discrimination and that's why people will ask me is workaholism and addiction. And I think people do, you know, have, have real tendencies towards work that are, that are structurally, you know, analogous to things that people have addiction. What makes workaholism not an addiction is that it's not subject to the same forces of discrimination and exploitation. Indeed, often at least in certain contexts, the opposite. I see so, so addiction is to have these, I'll use the term in the book, I think volitional differences to have some kind of somewhat particular quirks of your will or volitional system, plus to be the object of stigma. It's those two things together that equals kind of addiction, your view. Is that correct? Precisely. Yeah, precisely. Okay, that, that I think that helps a lot. So, one thing that, so then just to unpack that, let's imagine a world where we have really overcome these stigmas. You know, we're very far from that to your point, I imagine, but like, in, in that kind of world, how are we speaking about to not rely on the word again, people who have volitional differences that results in them kind of taking excessive, you know, alcohol, drug use, like, how would we talk about that in this kind of hypothetical society or world. Yeah, and so, you know, it's hard to say because it's hard to say what what these kind of actuals how to think about it. We have a kind of a slight picture of this. I mean, on this view. So, exploitation, I guess it's really distinctive to addiction. I think all, all differences are all, all sort of minority differences are a lot of them are subject to discrimination, but exploitation, especially connected with diction. So we've created these products, if you think of the case of tobacco. So cigarettes, which are like designed as a machine for exploiting addiction and people will smoke, you know, one happy day and it's, you know, just the right size and just the right price. So tobacco addiction used to be less subject to these sorts of things so tobacco addiction in the 18th century obviously was a thing, but it was not as systematically exploited. So maybe, I don't know the literature on this so maybe the health outcomes were not quite as as profound. It's hard to know because a lot of other things really not. Right. But gambling and addiction is another one I talk about a lot gambling addiction now seems to be one where it's like, you know, I think people did lose fortunes in 18th century gambling, but the ease with which one can do that in the 21st century, especially with gambling apps. It's like unprecedented in human history. So, as a, as a, as a first pass question, what would this like, look like without discrimination exploitation well, one can look, you know, a few hundred, a few hundred years back, where we didn't have quite the same technology as an exploitation. And it would look maybe a little more like that. What would it look like without the discrimination that's that's harder to say that's kind of always been with us and feels intractable at least sometimes. So, but at first approximation that's what it might look like, but, but it's hard to say how to know how to think about these conversations. It's actually a great transition to, and then of course I wanted to ask actually so I'm glad you took my counterfactual in front of there, which is, this was a nuanced discussion, which was, how does this. So, how does it look like, how does it look like it looks like a little bit of an investigation as a volitional disability disability or disability of the will. How does that cash out in terms of prohibition versus legalization and I just, I sort of give my, why this is interesting to me is that I feel like, you know, since my days in college and people are sort of like, experimenting, it was, there's always the talk of how, you know, Portugal had legalized all their drugs and how is that good or bad and how much are we focused on helping from addiction versus how much are we in mass trying to prevent addiction from starting so, how does this whole theory cash out in this whole legalization versus prohibition questions. Yeah, and as you say, so it's a, it's a, it's a difficult, it's a difficult and subtle question. And so here's my, so I think, I come from a place of wanting, you know, people giving people lots of options and especially people with addiction so I gave the example vaping earlier there's debates in the US and other countries about whether vaping and e-cigarettes should be legal course, of course they should like these are such a, these are such a great accommodation for people so I like offering people what I call accommodations kind of borrowing on the literature on the broader literature and disability. And also very much against criminal penalties I think people, people who, at least people who use substances should not be criminalized criminally penalized or put in jails and so I accept decriminalization in some sense of that term that term gets used in different ways but but I'm very sympathetic with it, but, but I do think that certain technologies as I say have grown up that are kind of especially designed to exploit the tendencies of people with addictions in the book I call them anti accommodations. So an accommodation is something like a wheelchair ramp or curb cuts that kind of makes life easier for people with disabilities and for everyone else to be honest, these accommodations tend to be good things for everyone. And, and I'm all in favor of those obviously and I'm all in favor of making making say vapes except more accessible, but I think they're also anti accommodations there. I think gambling apps are very clear example where, you know, 20 years ago if you wanted to gamble it indeed if you wanted to gamble your savings you could do it you could go to Las Vegas or you could, you could somehow manage to do it. Now it's much easier one can do it, you know, in a few minutes. And that's an anti accommodation that's that is a device that makes life much much harder for people with gambling addictions and it does so not for the heck of it. But in order to exploit those people for profits of generally large corporations. I think you're another example, hard alcohol, which we're so used to now we're only used to like, you know, 80 proof alcohol be in a standard way of social with each other. But it's that's like a recently designed anti accommodation in the last couple hundred years, these like highly refined alcohols. So, I am, I'm in favor of finding some way, at least, as long as certain conditions are not a pro of prohibiting these things, generally probably the manufacturer and sale them so I'm, I'm comfortable with criminal penalties on people who manufacture and sell these items if needed, rather than people who use them, but I get it so it's a so, and it's to protect the rights of the minority. I think when people say, advocate probate for him in cigarettes, for example, they point out that public health benefits would be better, and they probably would. That's not the argument here, the argument is to protect the rights of a class of people, the subclass of people, people with, with addictions or addictive tendencies. All of us should forsake certain things so alcohol again is a great example. I think for most people having the martini occasionally is a nice thing. But when we think about prohibiting the sale of like spirits, the manufacturer and sale of spirits, that's would be case of a majority giving up certain privileges in order to protect the rights of a minority. So that's the structure of the arguments, not because it would be a public health benefit, although it probably would, but because it would protect the rights of a minority. Against exploitation and discrimination. So that's, that's, that's the general shape of the view. I see. So it really is what you're trying to optimize for here is helping these people who have a disability that makes them vulnerable to these kinds of substances. Yeah, and I think even, yeah, optimizing, it's right. So optimization is the language of kind of benefit, and this is, this is the language of rights. I think there are people. Yeah, yeah, but it's an important, it's a nice distinction. So it's like, yeah, I think there are certain people who have certain rights. And even if it would be great for all of us, even if maybe if unbalanced, it would be better if we could have an occasional martini. Still the nature of these rights prohibitions is there, they're not concerned with like overall wellbeing, at least not primarily. They're concerned with certain people having certain rights and, and those rights need to be enforced. So that's the structure of the argument. Yeah, it's a funny it's so, so then it's, it's, it's the right of someone to live in an environment where they don't have to be subject to these forms of expectations, the key term here. That's what kind of makes it work. I see. So it's a form of expectation. Okay, that, that makes sense. I, then I would just ask like, are you sort of bring this up in passing? Like, are things like, I don't know, video game addiction or those going to be sort of case by case sort of like, you know, social media addiction is talked a lot. Is that going to be sort of like more of a not hard and fast, be gliders prohibit view, but a more nuanced discussion. Yeah, they are case by case. Those two cases seem to be quite, I mean, video game addiction, I think the, the case is getting quite strong for treating that as a, as some form of addiction. I mean, the, the, the exploitation there. Is there the, the really negative life outcomes are there. So I'm not, I mean, I think this is, I think we have a lot of addictions that are more like cigarettes, for example, which are still everywhere. Like there were a lot of us that were low hanging fruit before we got to before we got to video game addiction, but I think there's a strong case there for treating that as an addiction and maybe making policy implications. Social media addiction is a really tough one. I guess I'm not sure what to think about it. I mean, because it's one of these where most people, I don't know, I don't know if it's 50% but I bet it's 50% at least a lot of people use social media or certainly certainly if you brought them into phone use to phone addiction. So it doesn't seem to be discriminated against in the same way or there is, there is certainly the element of exploitation, certainly. So I'm not quite sure where social media is or phones fit on the spectrum or what sort of policy implications. This has been video games, I think there's a strong case we're putting them on the side of on the side of cigarettes and alcohol and things like that. Okay, that makes sense. Yeah, that makes sense. Those are, we're still sort of getting the data right? Yeah, yeah, I think these are all so these are also new and like we're still like, the nice thing about this, the slowness and the moral arc. I mean, it is very interesting to think about video games and phones and things like this, but like we're still working on like tobacco and alcohol, which has been around for a while. And so we're still figuring out the proper policy treatment of these so, so, so yeah, we're still figuring out the games and phones as well. We'd have to give one more specific example. So we've covered this sort of like, yeah, the more complicated cases of like video games and phones. We've covered the classic cases of tobacco alcohol and gambling. What about, you know, things like that are legal, but there's, I mean, I don't know the data on this, but whether it's like heroin or cocaine, I mean, anecdotally speaking, or not individually. When here's the news, there's a lot of problems like you hear about the opioid crisis all the time so what about those things that are legal, but are still pernicious like what's the right way to handle those things. Within this framework of giving rights to people who suffer from this addiction disability. Yeah, I can speak to opiates which is a case I know slightly better so it's so I think the general view is first of all, protect is offering people with with opioid use disorders, the accommodations that they need for example, and so we have these accommodations for opioid use disorders we have medications like suboxone which are still stigmatized in certain places but are incredibly effective in the treatment of opiates disorders and so obviously this view is, you know, it's up to the people with themselves whether they want to avail them with also this accommodation, but this view is strongly in favor of making these widely available. And then in the case of opiates we also have what we have in the case of cigarettes in tobacco which is these highly refined exploitative technologies indeed we're seeing in other countries with fentanyl and indeed the opiates, you know the opiate crisis I think is in a way as people as journalists have documented and a fact of these technologies like OxyContin which are maybe we're technologies that were designed for a good purpose for them but then we're kind of like turned to it to a much darker purpose and had really profound negative effects. So I think the opiate crisis is like support for this view of seeing like addiction has driven by discrimination and exploitation to support making accommodations like suboxone as freely available as possible, and restricting anti combinations on the supply side rather than on the demand side, like fentanyl and stuff like this, whether one could get some things in between, you know, if people use moch opium in some, in some way that was less harmful than this now I don't know what to think about those cases, but the view is very clear on how we should think of it's very pro making suboxone widely available and very pro, very against fentanyl in favor of strong prohibitions on the manufacturing sale of fentanyl and things like that which we already have been forcing those even more strongly. I see that's good so I see so having this kind of like, yeah, this preserving the rights of people from predictions minimize exploitation does provide us a good way to think about all these kind of tricky issues that you're about that's, that's okay, I want to ask this is, I'm kind of straight far from I've got to be very interested so for all the readers, not all these questions are covered the book so I wanted to ask. So I asked earlier about how have addicts themselves responded to this. One thing I'm, you know, it hasn't happened in my own life really but one thing I'm very conscious of is that family members of addicts. It's really, it's very hard like these. So, how have, have you talked to anyone who is not at themselves but has been deeply effective whether it's a child of an addict the spouse of an addict whatever might be, how have they responded to this kind of discussion. I have, I have talked to people in this has and this questions come up and I think it's a, I think it's a really important question I mean, so, and the book and the book doesn't really doesn't really address it I mean so I mean, we know that. People with people who are loving either family or romantic relationship with people with victims face a distinct stat of challenges and they're great organizations. They're devoted towards people so notably, notably alanon, which would, which some Westerners might be familiar with which is a kind of a 12 step program kind of a sister program to alcohol autonomous, but the members of alanon are people who have a loved one in their lives. With an addiction or with an alcohol addiction in the case of alanon. So, so there's it. So, there's a distinct set of issues that people with victims face. And people said, how does this view look. I mean, I think the response that I've gotten to people who've raised this or people who haven't sell us and having a loved one with with an addiction. It's kind of a bit like what I was describing earlier with people with addictions which is when I give them one sentence they're like, I don't really buy that. And when I put a couple paragraphs and they're like, Oh, okay, maybe I can get there. Get my head around it. But I mean, it's, but, but, but one would want a more developed answer I think it's, it's one of the many areas in which I think the kind of the view on this article in the book the details could be a whole framework could be more, more fully developed. Because it seems to be people with in relationship with people addiction seem to be subject to a certain sort of harm or a certain, certain sort of stress. The many people with people who have loved ones who have physical disabilities don't have the analysis experience it seems specific to the case of addiction. So what is it about addiction that gives rise to these particular experiences and how does the disability view speak to it it's really, it's, it feels to me a really important question. That's kind of, that's kind of left open for the book by the book so it's something people other people have asked me and it seems really important and something I'd like to, I'd like to think more about. Well, I do it's her future book. Yeah, well, this has been great I want to say because it's very, you know, humane book. Any final messages you want to give for audience. No, no final messages. Well, final messages is, is yeah, thank you this has been such a helpful has been such a helpful interview I really, I'm really, especially for people with a history of addiction being in their, in their families or in their own lives. I want to reiterate something I've already said which is really this is sort of this is a proposal. It's not books are often presented as here's my book and here's my argument here why it's true which is, you know, there, there's social pressures to do this. This book is not quite offered in that spirit it's offered as a hypothesis to be verified by people themselves so if you're someone with eviction or or loved one with addiction. Have a look at the spoken if and think if it's true and if it's not, and you don't think it's true, please let me know why not that would be great, but kind of make up your own mind on it and I'll be interested to hear what people think of because this is ultimately offered to people with exceptions as a proposal that they might accept but they also might not accept so I welcome feedback table and with that note of humility john thank you so much. [MUSIC] [MUSIC PLAYING]
John T. Maier's The Disabled Will: A Theory of Addiction (Routledge Press, 2024) defends a comprehensive new vision of what addiction is and how people with addictions should be treated. The author argues that, in addition to physical and intellectual disabilities, there are volitional disabilities - disabilities of the will - and that addiction is best understood as a species of volitional disability. This theory serves to illuminate long-standing philosophical and psychological perplexities about addiction and addictive motivation. It articulates a normative framework within which to understand prohibition, harm reduction, and other strategies that aim to address addiction. The argument of this book is that these should ultimately be evaluated in terms of reasonable accommodations for addicted people and that the priority of addiction policy should be the provision of such accommodations. What makes this book distinctive is that it understands addiction as a fundamentally political problem, an understanding that is suggested by standard legal approaches to addiction, but which has not received a sustained defense in the previous philosophical or psychological literature. This text marks a significant advance in the theory of addiction, one which should reshape our understanding of addiction policy and its proper aims.
Jeff Adler is an ex-linguist and occasional contributor to New Books Network!
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