Peter R. Martin: Historical Vocabulary of Addiction
Louis C. Charland’s comments
I am writing to offer praise and a comment for reflection on Peter R. Martin’s remarks on the history of the term “addiction” in his Historical Vocabulary of Addiction (Martin 2016).
Martin’s brief historical comments on the origins of the medical meaning of “addiction” go well beyond what is common in contemporary state of the art medical discussions on the history of the term “addiction” (Maddux and Desmon 2000). This is to be commended. In particular, citing detailed examples, Martin skillfully draws our attention to the manner in which very early usages of the term begin to branch out from a more generic meaning of the term, to more specific usages that point directly to specific substances known for their neuropsychopharmacological properties. Addiction to alcohol is his first example.
Before making this point about early medical usages of the term, Martin commendably mentions an earlier generic use of the term “addiction,” which centers around “dedication, devotion to a thing or an activity” (Martin 2016). Yet he does not appear to mention an important feature of this generic use of the term, which might be of interest to medical practioners and scholars interested in addiction. This is that “addiction” in this prior generic sense of ‘devotion’ occurs with sometimes very different – even paradoxical – social evaluations of the practices with which it is identified.
Devotional addictions can occur when there are no substances with neuropsychopharmacological properties: for example, addictions to God, or to a person who is loved. These can develop into extreme forms (sometimes called “passions”), where agency and “agentive selfhood” are severely compromised and there are harms to self and/or others, even though the addiction itself is still viewed as a laudable social practice. Evidently, progressive “loss of selfhood” and “loss of control” in addiction are not new notions and are not limited to addictions directed at substances with neuropsychopharmacological properties.
There are a variety of examples like these in the history of addiction in the early modern period, which highlight the manner in which some addictions can be viewed as positive, even though they also lead to negative consequences, including physical harms, compromised agency and loss of self (Lemon 2018). The point is that addictive practices are subject to social evaluations that vary and their positive or negative character is not an objective feature of the practices themselves, but instead a result of social contextual factors. In sum:
The history of addiction in the early modern period teaches us that addiction is a paradoxical human phenomenon that offers rich possibilities for positive action and development, though these are inextricably bound and inseparable from risks that may lead to negative outcomes. This provides a helpful contrast to current discourse on addiction, which is often paralyzed with the oversimplifications imposed by the adoption of false dichotomies, especially the view that the term “addiction” refers to a phenomenon that is exclusively either good or bad (Charland 2020).
It is interesting that even practices such as excessive individual participation in community “health drinking” (to the point of complete inebriation) in the early modern era, which was clearly understood to sometimes lead to harmful compulsive drinking in the individual over time, was often excused and even lauded, despite its harmful consequences (Lemon 2018). The reason is that the addiction was socially appraised according to a higher ethical ideal of devotion to community bonding, where the health of the individual drinker is secondary.
Indeed, in these early uses of the term “addiction,” addictions apparently have a paradoxical feature built into them. Submitting or surrendering to a passion always carries an inherent risk of coming to a point where one loses oneself in an addiction, with all the negative consequences that may come with this. And yet this can still ultimately be declared a good thing! One could attempt to stipulate and redefine “addiction” in such a way that it carries no inherent risk of paradox of this sort. But that would arguably represent an impoverishment of the original meaning and conceptual dynamics of the term – and the human (all too human) realties it was developed to capture and contend with. The view that medical addictions to substances with neuropsychopharmacological properties are pathological should probably always be understood with this nuance in mind.
References:
Charland LC. A puzzling anomaly: Decision-Making Capacity and Research on Addiction. In: Iltis A, MacKay D, editors. Oxford Handbook of Research Ethics. Oxford: Oxford University Press; 2020
Lemon R. Addiction and Devotion in Early Modern England. Philadelphia: University of Pennsylvania Press; 2018
Maddux JF, Desmon DP. Addiction or dependence? Addiction 2000;95(5):661–5.
Martin P. Addiction. Historical Vocabulary of Addiction. inhn.org.ebooks. November 24, 2016.
May 27, 2021