Addiction, the Concept of Disorder, and Pathways to Harm: Comment on Levy

Abstract

Comments on an article by N. Levy (see record 2013-16774-001). Levy argues that addiction is not a brain disease which is an important claim because, contrary to common wisdom, believing that mental disorders are brain diseases apparently increases stigma. Levy presupposes the harmful dysfunction (HD) analysis of disorder. Levy interprets the HD analysis as requiring that, to be a disorder, a dysfunction must not only cause harm but cause harm in almost any accessible environment (AAE). Levy observes that addicts sometimes abstain successfully or obtain safe, reliable drug access, suffering no harm. Thus, addictive disorder is not identifiable with brain dysfunction. To defend the AAE, Levy cites dyslexia, a presumed brain dysfunction impairing reading ability. Levy is not arguing that dyslexia is not a disorder today, rather, he is arguing that, as the AAE predicts, if there existed a costless way to alter the environment and eliminate dyslexia’s harm today, then, as in pre-literate times, dyslexia would not be a disorder today, either. Without the AAE, addictive disorders might be brain diseases even if brain dysfunctions only sometimes cause harm. (PsycINFO Database Record (c) 2016 APA, all rights reserved)