Squaring the Circle: Addiction, Disease and Learning

The history of ideas about addiction often comes down to a history of debates over the use and meaning of language (Levine et al. Journal of Studies on Alcohol 15:493–506, 1978). Nowhere is this more clear than in the interminable “Is addiction a ‘disease’?” debate. In Marc Lewis’ excellent Biology of Desire and in his paper that centers this issue, there is far more agreement between his work and mine than there is disagreement on the “disease” question. Here, however, I make a case for greater compatibility between the “disease” view and learning models of addiction than Lewis does, because I think the nuance is worth exploring. Indeed, if addiction science and ethics paid more attention to nuance in general, the whole field would be far better off.