These are the days of “wicked” problems. Wicked problems are real-world problems that are difficult or impossible to solve, either because we lack essential knowledge to solve them, or because many people with different areas of expertise have irreconcilable opinions about the methods and presuppositions requisite to getting started, or because they are interwoven with other problems in complex ways, or because any theoretically plausible solution is economically (or otherwise practically) prohibited. Poverty, homelessness, education, sustainability, and addiction are all such problems.1
Philosophers have a particularly good skill set for working on these problems, since they are big-picture thinkers who study the sciences (for example) with an eye not just toward practicing them but toward understanding what their underlying values and assumptions are and how they interconnect. What is more, philosophers think about the methods and limits of the sciences, what makes an explanation a good one, and to what kinds of errors in thinking scientists might be vulnerable. But working on wicked problems means that philosophers will have to drag themselves from their offices, just as scientists will have to drag themselves from their labs, and work together in interdisciplinary settings. This will be no mean feat, as even within their disciplines scientists have difficulty working with one another (as do researchers in the humanities). Biochemical psychologists are as far from neuroscientific psychologists in assumptions and methods as both are from clinical psychologists and as psychologists are from chemists. A downside to the focus and precision that the sciences have managed in answering specific questions is that they have become so siloed that the relevance of one subdiscipline to another has become all but obscured. The same is true of many workers in the humanities: digital historians share few interests or methods with seventeenth-century Russian historians. In philosophy, the middle of the twentieth century gave rise to similar stark divisions. The division between two main approaches to doing philosophy cut so deeply that each side held the other in contempt, holding that those who practiced philosophy based on assumptions and methods other than their own weren’t doing philosophy at all. The questions asked seemed to be the same for the two camps, but what the questions meant—and the methods that were considered acceptable for answering them—were so disparate that the two conversations were incommunicable (one side would call this “radically untranslatable”). Naturalistic, analytic-style philosophy is the kind that is best suited to addressing wicked real-world problems.
In philosophy, both questions and methods change as circumstances outside of philosophy change. Gone are the days when disputes about the number of angels that can sit on the head of a pin occupy the discipline’s best thinkers. With global communications and economic relations becoming the norm, social and political philosophers are being sought in university hiring ads more than any other areas of specialization, although because technology continues to outrun thought about whether and how it ought to be used, ethics remains an area of significant activity. The history of philosophy, aesthetics, and epistemology are less active.
Methods change in philosophy as they do in the sciences; when one set no longer seems to offer promise and others might, at least some philosophers will take up the new ones, and to the extent that they are influential writers, the new methods take over. “Armchair” philosophy, once the paradigm of truth-seeking, bases its arguments on logical, or “modal,” relations, those that distinguish between the possible and impossible or the contingent and the necessary. These arguments feel secure because when they are formally correct they are valid—the truth of the conclusion follows absolutely from the truth of the premises. But because the truth of those premises also has to be established, unless one is willing to put one’s faith in philosophical castles built in the air, at some point there must be contact with the world. For this reason, armchair philosophy found itself stymied by the end of the twentieth century. Although there are still plenty of philosophers who espouse the method of a priori reasoning, it has largely given way in many areas of research to more empirically informed methods. Even if there is no empirical side to the philosophy itself (and there is such a thing as experimental philosophy, or “x-phi,” but it commands no significant part of the discipline’s time), philosophers are increasingly more engaged with other disciplines in, for example, social and political philosophy, ethics, philosophy of science, as well as in scientific metaphysics. For some questions, the armchair approach simply won’t work, and wicked problems are the paradigm of this kind of question.
Consider addiction, one example of a wicked problem. Like other wicked problems, the first difficulty we encounter in attempting to ameliorate it is that there is no definitive formulation of what addiction even is. The National Institute for Drug Addiction is very clear in its biologically based account that addiction is a “chronically relapsing disease” explainable in terms of the functioning of the chemistry of the brain’s reward system. This definition comes out of many years of neurochemistry and scanning studies. For others, however, such as Gene Heyman, a Harvard psychologist, addiction is a matter of consistently made choices to use a drug2—essentially, a kind of utility analysis. In support of this definition, four large and well-known epidemiological studies provide evidence that the choices of populations labeled “addicted” change as their circumstances change. Most drug addicts stop using by the time that they reach their mid-thirties, these studies show—not because they get medical treatment for a disease but rather because of ordinary adult responsibilities, incentives, cultural expectations, and the penalties associated with use.3 Yet others agree with Johann Hari, who argues both in his recent book Chasing the Scream and in his popular TED Talk that social isolation is the culprit; while still another group of researchers counts it as a type of learning disorder. And let us not forget the eighty-year-old, most popular of all definitions, the one provided by the religion-derived, God-based AA program and its descendants, which says that addiction is a spiritual disease (whatever on earth that can possibly mean). All these simple, singular definitions illustrate vividly by their own declarations what is wrong with them: they assume that addiction is the kind of thing that has a single assignable cause and that understanding what it is will provide us with the key to how to address it.
I do not mean to say here that each of these definitions is wrong or that I advocate another that I think is right. Instead, the point is that by the very nature of wicked problems, none of these definitions alone will do, although each has something important to offer (with the exception of the spiritual-disease account, which seems to have no way of being rendered coherent).4 Addiction certainly involves learning, particularly if we’re talking about Hebbian learning, the strengthening of synaptic connections between neurons, and other sources of brain plasticity; it is clearly associated with larger than usual amounts of dopamine in areas of the mesocorticolimbic system associated with seeking and reward and the changes in structure that follow from that. What is more, it is absolutely true that addiction is often very sensitive to social environment—one series of well-known studies showed that happy rats raised with their l
ittle rat friends in little rat playgrounds had virtually no taste for readily available morphine compared to rats raised in isolation in confining cages. Another large longitudinal study established that a huge contingent of returning Vietnam vets who had been addicted to heroin while in the war setting had no problem staying free of the drug once they returned from the jungle to their families and friends. The spiritual-disease definition, in contrast to these other definitions—since it is neither verifiable nor falsifiable by any conceivable evidence—remains a mere unscientific assertion. But even with the testable hypotheses, we can see that the claims made address only one aspect of the phenomenon of addiction; they make sense, but only within the framework of the assumptions and methods from within which they are derived do their respective declarations regarding the nature and causes of addiction make sense.
In order to begin to attack the wicked problem that addiction is, it will be necessary for biochemists, neuroscientists of several types, developmental psychologists, sociologists, epidemiologists, philosophers, and others to work together. Philosophers are no longer free to constrain the discussions concerning addiction to armchair analyses of compulsion, akrasia (weakness of will, more or less), decision theory, or unjustified beliefs. To be relevant to the discussion, we must take seriously the genetic, epigenetic, environmental, and resulting psychological effects on persons who fall into addictive behavior, as well as larger social circumstances such as poverty, education, and crime, which correlate with larger percentages of addiction in certain populations. These empirical data will need to be employed dynamically with conceptual issues if philosophers are to assist in the development of a consistent set of definitions of addiction that will make it possible to take action to address it. I say a “set of definitions” because as a wicked problem heed must be paid, even within the discipline of philosophy, to distinctions between addiction to opiates, which may well differ from addiction to cigarettes, as well as from addiction to gambling, food, and the like. This is in addition to addiction that arises in connection with other psychological disorders and/or social inequities and/or trauma. The addiction of a white, male Wall Street broker to cocaine may well have little in common with a poor uneducated Southern black woman’s addiction to meth.
That said, there are still things to do and ways to address the issue. Clearly, an adequate analysis of addiction, however complex, would presumably provide ideas regarding promising approaches to improving the lives of those harmed by it. The prevailing conceptions, however, so far don’t. With respect to the most popular notion of what addiction is, that derived from AA-based programs, we fail to see any such result. Although data from AA itself are virtually impossible to come by due to the feature of anonymity among its membership, AA-based treatment centers seem to have no more than a 5 to 10 percent success rate,5 which is about the same as the rate of “spontaneous remission” or no treatment at all. This shouldn’t surprise us, since history has pretty well demonstrated that appeal to God and/or religious structures to manage our medical and social problems generally has no positive impact and, in fact, has most often exacerbated them.6 The conception of addiction underlying as many as 95 percent of the residential treatment programs currently operating in the United States, that it is a spiritual disease, not only suggests no specific modes of treatment, but it also offers no answer to the question of whether the “spiritual treatment” has worked. The current strategy is to say that if a program of treatment is followed by an individual’s return to addictive behavior, it is because the individual in question didn’t follow the program. The patient/client is perfectly welcome to return to the residential facility for another round of “treatment” and to pay, or have his or her insurance pay, the usually considerable fee again. Far from providing reliable help for addiction, one might reasonably say that the unproven (untestable) practices employed by these facilities, together with their business model, and the tight bonds that the treatment industry has to the insurance industry, in fact contribute to the increasing size of the socially defined epidemic of addiction in the United States.
Focusing on the National Institute for Drug Abuse’s brain chemistry–based analysis of addiction promises more but still fails to offer a satisfactory means of mitigating problems associated with addiction. Treating individuals with certain chemical addictions with drugs such as Naltrexone, Soboxone, or Campril (to name a few) can be extremely helpful. Even more promising is the latest research on treating addiction issues with psychedelics of various sorts (LSD has in several studies been extremely successful in the treatment of tobacco addiction, while psilocybin has been studied for use on depression and MDMA in the treatment of trauma, both underlying factors in the lives of many individuals who seek treatment for addiction). But even these don’t address the social dimensions of addiction. One study, however, of the most violent inmates at the Richmond, Virginia, jail, showed that treatment of addiction symptoms, including providing counseling, education, employment preparation, and the like—in short, addressing the general social isolation that accompanies incarceration—reduced both recidivism and violence. Portugal may be the paragon of using social change to mitigate addiction issues. Perhaps here we see some attention to the choice element involved in addiction, because what Portugal has done is to change the circumstances, including the incentives and penalties associated with drug use. By decriminalizing drug use, and conceiving of it instead as a public-health issue, associated problems have been dramatically reduced. Overdoses from drugs have been reduced by 80 percent since 2001; HIV cases among drug users are down; and, contrary to expectations, both adult and adolescent past-month and past-year drug use has been lowered. Because resources formerly directed toward law enforcement have been redirected toward drug treatment, drug prevention, and harm reduction services—as well as toward social support services—Portugal has been able to effectively mitigate a number of a certain kind of addictive problems.
The point is that with addiction, as well as with many other wicked problems—the most pressing problems for our social world—the way forward for philosophy, as for many other disciplines, is to resist the urge to train our students to believe that one way of thinking, one set of assumptions and methodologies, is sufficient. Philosophy has long believed herself to be the queen of the sciences (this is a long-established gender assignment, and one to which the author is in this particular case not averse), subject to no other and qualified to dictate to others the nature and limits of their own enterprises. In one way, this is right: there is no doubt that philosophers are correct that their discipline overlooks and considers the questions essential to both the arts and the sciences. But if philosophy is to remain relevant in the ways that she claims to be, then philosophers are going to have to get up from their armchairs and become responsible to the world that they claim to lead by engaging with the sciences, learning what our best empirical scientists have to say, and using those results to push the frontier of human experience forward.
- I addressed some of these issues, as well as other complexities regarding addiction, in my 2016 book Addiction: A Philosophical Approach.
- Let us artificially simplify this problem even in this discussion of its wickedness by limiting our focu
s to drug addictions, even though the current edition of the Diagnostic and Statistical Manual (DSM), the standard diagnostic tool used by psychiatrists and psychologists, currently includes gambling disorder among the addictive ones.
- Gene Heyman, Addiction: A Disorder of Choice (Cambridge, MA: Harvard University Press, 2009).
- If one says that disease is a malfunction of something, for instance, as in kidney disease, then the spiritual disease seems to be without referent, because what is a spirit’s function, since it is not part of a larger system from which the very concept of function arises? If, on the other hand, we think of disease as corruption, that is rotting or falling into parts, how could that make sense for spirits, which are assumed philosophically to be essentially simple and incapable of natural disintegration, which is supposed to account for their immortality? If, finally, disease is thought to be infection by something external, as bodies are infected by bacteria and viruses, how could that happen for spirits, which are assumed to be nonphysical, so that the distinction of inside/outside is incoherent?
- Lance Dodes, The Sober Truth: Dubunking the Bad Science Behind 12-Step Programs and the Rehab Industry (Boston, MA: Beacon Press, 2014).
- For instance, think of the 30 Years’ War, Europe’s deadliest religious conflict: whether actually fought over the welfare of humanity or for economic reasons, it compounded the natural miseries of the seventeenth century many times over, creating a medical catastrophe unsurpassed in modern European history as well as famine and other interrelated sources of human suffering.