From Don Zimmerman, British Columbia:

....In the past, I have discussed the relation between a deterministic point of view and treatment for addiction with my wife Doreen, who worked in the addiction field back in Ontario in the 1980’s and early 1990’s.

Here is a notion that might possibly be worth exploring. It occurs to me that acceptance of a naturalistic orientation is pertinent not only to the point of view of treatment providers, but also to the point of view of the addict. I mean: Many people who experiment with drugs and end up becoming addicted begin with a non-scientific, free-will orientation throughout their lives and reason, "I am a free agent. I have choice. I will never become addicted. I can stop whenever I choose," and so on. At the same time, they have a perception of their own uniqueness—that is, they tell themselves something like "I am special. I deserve more than my share of good things and have always had my way. I am not weak-willed like some people. I am immune from all these statistics about drug addiction. It will never happen to me," and so on. And then they are surprised to find themselves unable to escape from the scientifically lawful progression of events leading inevitably to addiction.

A scientific education and adoption of a naturalistic point of view might help people realize that freedom and uniqueness are illusory and do not confer exemption from statistical probabilities. Then, they would be more inclined to say to themselves, "If I experiment with drugs, I, like everyone else, will be governed by scientific principles that make it highly probable that things will keep getting worse," and so on. Having this realization, maybe the individual would be less likely to take the "first step" toward addiction.

So much for my rambling. Maybe this has all been said before. But I emphatically agree that a naturalistic point of view is beneficial in regard to this (and many other) social problems.

I have recently drafted an essay I intend to submit for publication that may fit well with your thinking. The focus is on the relationship of prevention and treatment within the disease model where recreational use (read acute phase of use) is addressable with prevention and treatment, but that once the disease process attains chronicity then a chronic disease model takes over and treatment/maintenance becomes the best model management. This thinking is based in part on the research reported in the September 1997 issue of Science, and on the Institute of Medicine publication on Dispelling the the Myths of Addiction. The underlying premise in the research reported in these sources is that continued use leads to structural changes in the brain, and that once these changes occur a chronic disease state exists. The thesis of my paper is that prevention efforts and early onset treatment effort are where the emphasis should be place with regard to resources. The logic (following your premise) is that the only effective time to intervene is when free will is still operating, i.e., before a chronic condition is established.

"Thus, for instance, in the human body, ...when irregular events follow from any particular cause, the philosopher and physician are not surprised at the matter, nor are ever tempted to deny, in general, the necessity and uniformity of those principles by which the animal economy is conducted. They know that a human body is a mighty complicated machine: That many secret powers lurk in it, which are altogether beyond our comprehension: That to us it must often appear very uncertain in its operations: And that therefore the irregular events...can be no proof that the laws of nature are not observed with the greatest regularity in its internal operations and government. The philosopher, if he be consistent, must apply the same reasoning to the actions and volitions of intelligent agents..."

I think scientists sometimes assume that our own discipline is characterized by steady progress, in contrast to philosophy which goes in circles, never making definite progress. However, philosophy has succeeded in organizing puzzlement once and for all about many things, one of which is free will. ("Organizing puzzlement" doesn’t mean giving an absolutely final answer, but scientific answers are not absolutely final either.) Probably not a single contemporary philosopher accepts the "standard model" as described in your article, and most would not acknowledge any contradiction or opposition between free will and determinism. Free will indeed requires determinism, because the absence of determinism is randomness, which is not compatible with free will.

From Reed Richter, Chapel Hill, NC

Naturally, I have my own take on the free will issue (as does every professional philosopher). I think our ordinary common sense notion of "free will" is vague and probably inconsistent with causal determinism (CD) as you claim. But as you recognize, what is important is not whether we have "free will," rather it is whether or not we can make sense of "moral responsibility and choice" given that the world is for all practical purposes determined. You correctly point out that even if CD is true, praise and blame (rewards and sanctions) are appropriate "just to the extent that [an agent has] the capacity to anticipate and be influenced by them." Our system of morality has a pragmatic utility in shaping behavior that we value.

Thus far I agree, but I’m not sure that it establishes the conclusions that you want: viz., … We can no longer justify the claim that rewards and sanctions are "deserved" (as opposed to being pragmatically useful or justified.) and … There is no good reason to stigmatize an addict’s behavior after the addiction has taken hold.

There are a couple of issues you need to address in order to satisfy my doubts.

1. You don’t address the issue that there is a big difference between addiction and (say) Alzheimer’s. Addicts can and often do take responsibility for their condition and get clean. The Alzheimer’s patient literally have no control over their condition. I can understand that from the point of view of the rehabilitation therapist, HIS continuing to stigmatize the addict is counterproductive. But that doesn’t mean that there is no pragmatic value for the rest of us to continue to stigmatize. For example, perhaps the recognition that society as a whole continues to express moral disapproval of the addict is a motivating background factor in therapy. You obviously are in a better position to address this issue than I.

2. What is your position on the behavior of a serial killer like Ted Bundy? Can we not justifiably be disgusted with his behavior both before and after he became a committed killer? Can’t this disgust play a useful role in discouraging other potential killers, and also in shaping society’s response to serial killing in general. Maybe societal stigma is the main force motivating society to deal with addiction. Even legalization may be seen as a result of stigmatization if it is seen a means to lower addiction rates and minimize its effects.

3. It may be pragmatically useful to pursue a strategy of "deserved" blame and punishment. We know from game theory that in many common situations (e.g., iterated prisoner dilemmas) a tit for tat strategy leads to the most beneficial outcome. In past contexts it is plausible to suppose that it was a useful (Darwinian) strategy for a family or individual to seek revenge and strike back if injured. The family (or individual) reputation would then be a useful deterrent. If this strategy has survival value it is reasonable to suppose that humans who have a proclivity to value revenge for its own sake will be selected for. Hard-wiring this preference or value is a lot more efficient than relying on some reasoned calculation of the consequences; i.e. human groups that were thus hard-wired in general would do better. I am not being original here. This issue is much discussed cf. Passions within Reason. Obviously there are circumstances where this proclivity for revenge leads to annihilation ; e.g. the Mideast, Ireland, the Hatfields and McCoys, etc.. In such cases survival depends on reason overruling passion. Nevertheless, even in our society pursuing revenge may be useful to some significant degree, e.g. don’t mess with litigious people. The law becomes another means of retaliation. The point is that desiring punishment as a means of revenge may have some substantial pragmatic utility. Thus it is not in the least bit clear that causal determinism undermines the reasonableness of viewing justice as deserved punishment.

TC replied:

Re 1:  Ongoing social disapproval of addiction is obviously going to continue, and should. The question is, how is disapproval of addiction expressed in social policy? If it’s by the punitive withdrawing of the supports necessary for recovery, then it’s counterproductive. If it’s expressed by attacking the root, structural causes of addiction (e.g., employment, education), as well as in public health warnings about cigarettes, booze, and drugs, then it’s productive. Shunning and otherwise punishing addicts and other deviants comes quite naturally to all of us, so there’s little danger that it will soon disappear as an inducement to stay clean. The problem, though, is that it often doesn’t work particularly well, given the strong incentives arising out of impoverished living conditions (both economic and cultural) to use substances.

Re 2:  We can’t help but be disgusted with serial killers, both before and after they kill, and that motivates us to deter and restrain, but should also motivate us to create conditions which reduce the likelihood of serial killers being produced again. But we don’t focus on the last option since many suppose people can simply rise above their circumstances, and thus don't need our help.

Re 3:  I don’t doubt that the retributive impulse has been hard wired into us, for "good" evolutionary reasons, so the notion that someone deserves to suffer for having themselves incurred suffering has had pragmatic value in ensuring survival. But getting rid of the metaphysical confusion about the causally disconnected self that has originative free will might help mitigate the excesses of tit-for-tat revenge so characteristic of human conflict. A naturalized notion of desert, as part of a naturalized understanding of morality, might help to keep punitive sanctions at a merely useful, not horrific, level, and encourage attention to those factors that give rise to aggression in the first place. Once we have good alternatives to punishment, then the pragmatic value of desiring retribution will diminish, and will count less as a justification for imposing it.