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The Thirteenth StepAddiction in the Age of Brain Science$
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Markus Heilig

Print publication date: 2015

Print ISBN-13: 9780231172363

Published to Columbia Scholarship Online: November 2015

DOI: 10.7312/columbia/9780231172363.001.0001

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An Entity in its Own Right

An Entity in its Own Right

(p.18) 3 An Entity in its Own Right
The Thirteenth Step

Markus Heilig

Columbia University Press

This chapter asks: Is there really any important difference between people who develop a destructive relationship with a drug and those who do not? Is there a line, however bright, the crossing of which signifies it an important transition and justifies distinguishing those who have crossed it from those who have not? Or is all substance use in principle equal, and harmful in varying degrees that depend only on the amounts used and the social, economic, or medical circumstances of the individual? It is argued that whether there is a difference between people who develop a destructive relationship with a drug and those who do not needs to be determined by clinical utility. If there are certain characteristics that tend to occur together in people with particular treatment needs, or in whom similar mechanisms are at play that could be targeted by current or future treatments, then it is practical to have a specifically labeled category (or group of categories) for those people.

Keywords:   addictive disorder, addiction, addictive behavior, substance use

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