Awards
AAPP Karl Jaspers Award (2024)
Temple Graduate School Summer Research Grant (2024)
CHAT Advanced Graduate Research Fellowship (AY 2022-23)
APA Central Graduate Student Travel Stipend (2022)
Publications
The Contours of Agency in Addiction
(Philosophy, Psychiatry, & Psychology, forthcoming)
In their replies to “The Epistemic Prerequisites of Reliable Abstinence in Addiction”, Federico Burdman and Zoey Lavallee identify substantive considerations that call the plausibility of my Epistemic Prerequisites Model (EPM) into question. Burdman argues that how I talk about the ability to φ “reliably” is problematic, and that it makes more sense to focus on the scalarity of ability and self-control at the level of individual behaviors. I clarify the notion of reliability operative in EPM and argue that we ought to center how an addict’s control over individual behaviors varies with environmental factors, which has important implications for extended autonomy. Lavallee argues that my emphasis on automaticity overlooks important ways in which behavioral control is compromised in addiction, and whether they break the EPM framework. If the phenomena Lavallee indicates do in fact compromise behavioral control, they may be compatible with EPM; and if they are not, the model will require revision, but its core claims will remain intact.
The Epistemic Prerequisites of Reliable Abstinence in Addiction
(Philosophy, Psychiatry, & Psychology, forthcoming)
The distinction between first- and second-order ability in the philosophy of action enables new clarity in the discussion of behavioral control in addiction. Addiction involves automated patterns of thought and behavior that undermine the (first-order) ability to reliably abstain. However, addicts retain a second-order ability to reliably abstain if they remain able to learn the “epistemic prerequisites” of reliable abstinence, including addiction-specific metacognitive skills and cue-avoidance strategies. The second-order ability to reliably abstain depends to a significant extent on societal context and access to the right resources. This “Epistemic Prerequisite Model” supports the view that addiction is a compulsion, and suggests that moral responsibility in addiction depends on factors relating to both orders of ability.
Benzos (as) needed: research into as-needed and intermittent benzodiazepines for anxiety is required for comprehensive best prescribing practices
(Frontiers in Psychiatry, April 2025)
The medical and public health communities are divided around the use of benzodiazepine ("benzo") pharmacotherapy for anxiety disorders. Recent years have seen increased attention to benzo overprescription and its risks, leading to a pervasive emphasis on deprescribing. Some have resisted this trend, arguing that the balance of evidence supports the safety and efficacy of benzo pharmacotherapy for both short-term and long-term treatment of anxiety disorders. Given that rising rates of anxiety disorders and benzo misuse are both serious public health concerns, there is an urgent need for comprehensive evidence-based best practices for the prescription of benzos for anxiety. At present, however, major scientific gaps make it impossible to formulate such guidance. Most concerning is the lack of research into as-needed and intermittent prescription and use, which are both what benzos are best suited for, and likely, how they are most commonly administered. Further research into the safety and efficacy of both long-term daily and intermittent, as-needed benzo prescription and use are badly needed. But a roundly "anti-benzo" sentiment may be causing problematic underprescription of benzos, particularly when superior alternatives like cognitive-behavioral therapy are not widely available.
Torturous Withdrawal: Emotional Compulsion in Addiction
(European Journal of Philosophy, December 2024)
Withdrawal involves emotional pain that motivates much addictive behavior. In this paper, I argue that the emotional pain of withdrawal compels much addictive behavior. Researchers have noticed this possibility but it is widely underappreciated. Among philosophers, only Hanna Pickard has discussed emotional compulsion in addiction, and the emotional aspect of withdrawal has been almost completely neglected. Accounts of emotional compulsion in the philosophical literature (from Tappolet, Elster, and Furrow) probably do not capture how the distress of withdrawal compels, so I propose a more suitable account of “pathodoxastic” compulsion in addiction. On this account, the emotional pain of withdrawal compels when it undermines the ability to believe that one can continue to endure it, and therefore the ability to intend abstinence.
Does Addiction Cause Addictive Behavior?
(Philosophy, Psychiatry, & Psychology, March 2024)
Is addiction a behavioral pattern, or the underlying cause of a behavioral pattern? Both views are found in prominent accounts of addiction, but theorists generally do not notice that they are taking a controversial position, let alone justify it. A third possibility is that addiction consists in both addictive behavior and its causes, though this view is less obviously present in the literature. I argue that two important considerations favor the "cause view" over the "behavior" and "hybrid" views. The first is that we want to be able to explain addictive behavior with reference to addiction. The second is that addiction seems to persist long after addictive behavior has ceased. Only the cause view can easily accommodate both data points.
Mme de Staël's Philosophy of Imagination
(Cahiers staëliens, November 2023)
In De l’Allemagne, Mme de Staël develops a sophisticated philosophical psychology that centers not on reason, but imagination. She does this by bringing French Enlightenment philosophy, particularly Rousseau and Diderot, into dialogue with German thinkers, including Kant and Herder. For Mme de Staël, imagination transcends the epistemic limits of sensibility and reason by incorporating sentiment.
Select Works in Preparation
Does Addiction Excuse Carjacking?
Philosophical treatments of moral responsibility in addiction have been simplistic. Most philosophers who comment on the topic agree that addiction partially impairs self-control, and therefore partially reduces moral responsibility for addictive behavior. But some of the most other-harming addictive behaviors are completely under the agent’s control. What addicts have lost control over, first of all, is whether they will decide to engage in the behaviors to which they are addicted (consumption, use, or engagement). But they have not lost control over the instrumental reasoning processes and actions concerning means for achieving those “primary addictive behaviors.” A taxonomy of the harms of addiction is required. I identify three such harms: (a) harms that accrue to the addict themself through unsafe behavior; (b) unintended, other-harming omissions of obligatory acts, due to executive dysfunction; and (c) intended, other-harming actions aimed at procurement of drugs or other objects of addiction. Crucially, addicts do not intentionally harm others qua addicts, unless they live in a society in which other-harming behaviors are particularly salient as means for primary addictive behavior, under the condition of felt urgency. When many addicts are engaging in criminal activities like theft, mugging and carjacking, deeper societal factors are at play for which addicts cannot be singled out as responsible.
Drug-Seeking, Continuity of Care, and Epistemic Injustice (with Julia Alessandra Harzheim)
Several bioethicists have argued that medical providers should cultivate attitudes of trust and epistemic humility towards their patients, to protect them from epistemic injustice and associated harms (Rogers, 2002; Buchman, Ho and Goldberg, 2017; cf. Francis, 2010; Parker, 2019). This rationale has been extended to the provision of healthcare to addicts, who experience stigma and discrimination in healthcare with adverse effects on health outcomes (Reyre et al., 2013; Buchman and Ho, 2014). The fact that there are major obstacles to trusting patients with dependency or addiction is universally acknowledged. But there are few focused discussions of particular obstacles, or how to work towards trust when they are encountered. This paper focuses on the question of how providers ought to interpret one possible sign of drug dependence or addiction: drug-seeking behavior, and specifically the seeking of commonly misused habit-forming drugs like opioids, benzodiazepines, and amphetamines. It is understandable for a provider to become cautious or suspicious when a new patient comes to them seeking a commonly misused substance. But we argue that providers should try to take new patients’ reasons for drug seeking as good-faith testimony, and to utilize information gleaned from this testimony in clinical decision-making--particularly in the absence of complete medical records. Medical providers risk epistemic injustice and associated harms when they do not take seriously the testimony of new patients they know or assume to have dependency or addiction. Our view recommends patient-provider contracts (like “opioid contracts”) despite recent criticism (Collen, 2009; Buchman and Ho, 2014) and rejects the use of machine learning in the prediction of patient behavior (Funer and Solloch, 2023; Pozzi, 2023a, 2023b, 2023c, 2023d). It also illustrates how providers can work towards trusting relationships with patients, representing a concrete expression of epistemic humility that may be helpful for understanding epistemic humility more generally.