This chapter explores the complex question whether addiction constitutes a disease. You will learn to distinguish “addiction-proper” from dysfunctional decision-making and understand a characteristic trajectory from initial experimentation to full-blown addiction. The chapter defines “addiction-proper” as a disease where the brain’s reward system hijacks neurocognition, leading to dysfunctional decision-making exacerbated by environmental interactions, ultimately compromising an organism’s viability. It adopts a negative theory of health, asserting that health is the absence of disease and that a healthy organism lives a life proper to it. You will also learn why the authors argue against positive theories of health, considering them theories of well-being rather than health. The chapter proposes that addiction-proper is a disease and potentially a natural kind, or a family of natural kinds. It further examines the concept of disease, the naturalism versus constructivism debate, and the medical model of mental disorder, particularly the strong version aligning with the view of addiction as a disease. This chapter examines whether addiction constitutes a disease. We begin by distinguishing “addiction-proper” (following Ross et al. 2008) from dysfunctional decision-making. We propose a characteristic trajectory from initial experimentation with habit-forming phenomena to full-blown addiction, where dysfunctional decision-making is a hallmark, but not every individual on this trajectory is diseased. We define addiction-proper as a disease where the brain’s reward system hijacks a person’s neurocognition, leading to dysfunctional decision-making that is exacerbated by environmental interactions. This neurocognitive hijack results in a failure of the whole system to maintain the organism’s overall viability. We adopt a negative theory of health, asserting that health is the absence of disease, and that a healthy organism, free from dysfunction, lives a life proper to it. We argue against positive theories of health, contending they are merely theories of well-being, which is distinct from health, even if mental health and well-being are related. We propose that addiction-proper is a disease and at least a candidate for being a natural kind, or maybe a closely related family of natural kinds. While dysfunctional decision-making is not a natural kind, it can be characterized in ways that support inductive inferences. The chapter further explores the concept of disease, naturalism versus constructivism, and the medical model of mental disorder, particularly the strong version which aligns with our view of addiction as a disease.

Is Addiction a Disease?

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发表日期：

2026年

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Angé Weinrabe,
Dominic Murphy

摘要

This chapter explores the complex question whether addiction constitutes a disease. You will learn to distinguish “addiction-proper” from dysfunctional decision-making and understand a characteristic trajectory from initial experimentation to full-blown addiction. The chapter defines “addiction-proper” as a disease where the brain’s reward system hijacks neurocognition, leading to dysfunctional decision-making exacerbated by environmental interactions, ultimately compromising an organism’s viability. It adopts a negative theory of health, asserting that health is the absence of disease and that a healthy organism lives a life proper to it. You will also learn why the authors argue against positive theories of health, considering them theories of well-being rather than health. The chapter proposes that addiction-proper is a disease and potentially a natural kind, or a family of natural kinds. It further examines the concept of disease, the naturalism versus constructivism debate, and the medical model of mental disorder, particularly the strong version aligning with the view of addiction as a disease. This chapter examines whether addiction constitutes a disease. We begin by distinguishing “addiction-proper” (following Ross et al. 2008) from dysfunctional decision-making. We propose a characteristic trajectory from initial experimentation with habit-forming phenomena to full-blown addiction, where dysfunctional decision-making is a hallmark, but not every individual on this trajectory is diseased. We define addiction-proper as a disease where the brain’s reward system hijacks a person’s neurocognition, leading to dysfunctional decision-making that is exacerbated by environmental interactions. This neurocognitive hijack results in a failure of the whole system to maintain the organism’s overall viability. We adopt a negative theory of health, asserting that health is the absence of disease, and that a healthy organism, free from dysfunction, lives a life proper to it. We argue against positive theories of health, contending they are merely theories of well-being, which is distinct from health, even if mental health and well-being are related. We propose that addiction-proper is a disease and at least a candidate for being a natural kind, or maybe a closely related family of natural kinds. While dysfunctional decision-making is not a natural kind, it can be characterized in ways that support inductive inferences. The chapter further explores the concept of disease, naturalism versus constructivism, and the medical model of mental disorder, particularly the strong version which aligns with our view of addiction as a disease.