ABSTRACT

The core paradox of addiction is a persistent tendency of the addict to choose what she believes she doesn’t want. Addiction is sometimes characterized by other attributes, such as dependence on a substance, withdrawal (sickness on quitting), a preoccupation that squeezes out “normal” activities, or tolerance (a progressive insensitivity to the relevant reward), but none of the first three is necessary for the core paradox (witness gambling, cocaine dependence, and smoking, respectively), and the last is not specific: There is probably no rewarding activity that does not habituate with repetition. Activities with one or more of the other attributes may properly be called addictions, of course—dependency without awareness, or even “willing addictions” despite a knowledge of negative consequences (Flanagan 2016; Pickard & Ahmed 2016); but these do not entail the puzzling feature of choosing what one consciously doesn’t want. The nub of the problem is this apparent paradox of choice. For centuries it has remained a scientific puzzle and a moral/legal quandary. The problem has become more urgent for two reasons: not, perhaps, because the human susceptibility to addiction has increased, but because (1) it endures while other causes of premature death and disability have dropped away, and (2) human craft has developed addictive activities faster than it has developed protections against them. There was a great acceleration when the growth of trade permitted worldwide sharing of opium, coca, tobacco and other natural substances, another when new techniques extracted or synthesized concentrated ingredients from them (Crocq 2007), and, arguably, a current expansion into fast-paying interactive patterns that do not depend on substances—video games, internet gambling, internet porn, and absorption in the internet itself.