Saibiayi Alimu
University of Macau
Whether addiction is a pathology remains a controversial topic within the philosophy of medicine. Some debates focus on whether alcoholism should be regarded as a disease or as a brain disease (Fingerette, 1988; Segal, 2013; Heather, 2013; Heyman, 2009; Levy, 2013; Lewis, 2017; Pickard, 2022). Recently, the concept of behavioral addiction has garnered increasing attention (Grant et al, 2010). Some philosophers discuss the relation between eating disorder and addiction (Foddy and Savulescu, 2010; Foddy, 2011; Charland, 2013; Szmukler, 2013; Dolcini, 2025). The inclusion of gambling disorder in the fifth edition of DSM invites further consideration of whether behavioral addictions are genuine pathological conditions.
In this paper, I examine the reasons for and against viewing addiction as a pathology. I consider whether addiction satisfies two of the most important criteria for inclusion, dysfunction as a descriptive notion and harmfulness as an evaluative element (Boorse, 1977, 1997; Cooper, 2005). I examine the issue from the perspective of both strong and minimal models of medical model. Strong disease model commits to specific causal hypotheses in terms of abnormalities in underlying neurobiological systems, which are responsible for the observed patterns of signs and symptoms. Minimal model characterizes disease at the personal level, by appeal to characteristic courses of signs and symptoms.
I argue that addiction plausibly qualifies as a harmful condition, encompassing both substance and behavioral addictions, consider drug addicts and gambling addicts exhibit similar emotion dysregulation, myopic decision making and denial. Similarly, the harmful consequences include societal dimensions—such as the neglect of family responsibilities—and personal consequences, including financial loss and psychological distress. I suggest that in cases of behavioral addiction, the claim that addiction involves brain dysfunction is more contestable. Especially, with the absence of a concrete substance, it is difficult to identify the source of addiction attribution. Further, I respond to the potential objection that reducing the gambling addiction to the activation of similar neurocircuits as the case of substance addiction.
Chair: Edoardo Fazzini
Time: 05 September, 11:20 – 11:50
Location: SR 1.005
SOPhiA 2026 