There is little evidence that any disease has the capacity to impose specific integrated behavioural strings in the place of previous ones. However, it may be the case that, in response to the conditions created by a disease, people will voluntarily adopt various strategies to cope with it; and that in a probabilistic sense, some strategies are more useful, and hence more likely, than others. However, these are purposeful and voluntary adaptations to conditions created by the disease, and their inclusion alongside other symptoms creates important dilemmas. Is it reasonable to conceive of the practise of injecting insulin as a symptom of diabetes? If so, where was this symptom before the discovery of insulin therapy? However we resolve this problem, it is clear that, even if we classify such things as symptoms, there is a clear difference in the way the word is being used when (a) we describe something such as high temperature, shortage of breath, or a skin rash, as a symptom, and (b) we talk about going into a pub and buying a pint of beer as a symptom. Whatever we mean by the word 'voluntary' (i.e. whether we take it to imply a metaphysical exercise of the power of 'free will', or a particular mode of cerebellar functioning) it is clear that going into a pub is voluntary in a sense that having a high temperature is not. For these reasons, the inclusion of acts of drug- or alcohol-directed appetitive behavior as parts of the disease symptomatology, alongside involuntary bodily changes, lumps together two sets of phenomena which require different levels of explanation. (Davies 1997, 143)
Davies, John B. 1997. The myth of addiction. 2nd ed. Amsterdam: Harwood Academic.
Davies, John B. 1997. The myth of addiction. 2nd ed. Amsterdam: Harwood Academic.