Overview
With addiction, the debate around attributability centers on whether chronic substance use as a disease impairs judgment enough for addictive behaviors to no longer be attributable to someone’s core character, comparable to a brain injury or dementia. Most with a substance use disorder genuinely want to quit and live a sober life, but they struggle with cravings and withdrawals intensely enough that they also struggle to align their behaviors and intentions. A few may not have any desire to quit or have any regard for the consequences of using, even if it affects others or could lead to their own death.
Those with an addiction are also generally able to articulate their reasoning for using which satisfies the answerability pillar of moral responsibility. However, we can also see that cravings and withdrawals can operate as strong forms of pressure, similar to how someone who feels like they’re starving or dying of thirst might commit acts of violence in order to get food and water. They can answer questions about their justification for the actions, and they might be able to do so without being hypocritical; “I only wanted to use it one last time before quitting” might be a flawed idea, but it can seem quite logical under the pressure of cravings that feel intolerable.