On the Grounds for Calling Addiction a Disease

In this paper, I look into the debate about the status of addiction as a disease. Although addiction is widely regarded as a disease, several authors have put forward reasons for agnosticism or skepticism about the appropriateness of the disease label. Any attempt to address this issue directly is complicated by its relationship to several other contentious issues, both on the side of theories of addiction and on the side of theories of disease. My primary aim in this paper is to identify the major points of contention. My secondary aim is to offer a limited defense of the disease view. The crux of the debate is whether addiction is aptly pictured as the result of psychological dysfunction. The main hurdle for the psychological dysfunction claim is that we currently lack a relatively unified account of the behavioral trait that most strongly suggests dysfunctional processes: the loss of expectable ability to control behavior. I argue that there is a sense in which the dysfunction claim may be warranted even in the absence of a unified causal account. However, this requires assumptions that are to some extent controversial, most notably, the impaired control view of addiction and the acceptability of dysfunction-talk based on personal- level behavioral traits.