Failure of guilt, misguided free will, and the potential benefits of legitimate disapproval: the case for stigmatizing addiction

Abstract

Calls to destigmatize addiction have been widely circulated. Removing or reducing society’s disapproval appeals to addicted people for obvious reasons: It removes one of the penalties for their destructive behavior. Many addicted people would prefer to continue indulging in their illicit pleasures while enjoying the respect and sympathy of society, rather than being condemned as selfish, weak-willed individuals who put their own short-term pleasures ahead of the well-being of family, self, and society (Davies, Citation1997; Peele, Citation1998). Regarding addicted people as unfortunate victims of disease is a much more sympathetic perspective, not least because it absolves them of responsibility. The case for destigmatization has been bolstered by arguments that addicted people have no control over their actions, that the addictive indulgences just happen to them without their consent and indeed possibly against their will. This view is popular among not only among addicted people, but also among paid treatment providers (Russell et al. Citation2011), but it is highly debatable at best (see below). In contrast, Vanyukov (Citation2023) makes a compelling case against destigmatizing addictive behavior. He says that there is an important place for legitimate disapproval, that is, for society to express its negative value judgment about addiction. Indeed, such disapproval may help motivate addicted people to conquer their addictions. Apart from some quibbles, we are sympathetic to Vanyukov’s analysis. Both society and individual addicted people could potentially benefit from a reinstatement of society’s overt disapproval of problematic substance use and addiction. We begin by summarizing Vanyukov’s argument, then proceed to elucidate issues of free will and decision making among addicted people. Then we suggest ways that legitimate disapproval (Vanyukov’s term) could be beneficial to society—including to the addicted people themselves. Vanyukov seems to accept the broad view that any stigma is inherently bad, or at least that modern society views stigma as unfair and inappropriate. Vanyukov says that the very term ‘stigma’ implies that society is unjustified in condemning addiction. We think this is inaccurate. Who would advocate removing the stigma of racism, so that overt racists would be tolerated sympathetically? The same goes for the stigmas associated with perpetrators of child abuse, sexual harassment, and rape. It is certainly true that societies vary as to which traits and actions they stigmatize. There is increasing sense that stigmas formerly associated with being born out of wedlock (‘bastards’) and homosexuality were unfair. The unfairness was precisely because the individuals were essentially not responsible for the conditions that brought the stigma. (After all, no child can prevent itself from being born out of wedlock!) The presumptive legitimacy of stigmatizing racism underscores Vanyukov’s point: Society’s disapproval is a potent means for changing behavior toward the better (as society understands what is better). Therefore, it is at least worth considering whether that disapproval can profitably be employed to improve public health and safety by combating destructive patterns of drug use and, indeed, addiction.