What Would You Do Alone in a Cage with Nothing but Cocaine?: A Philosophy of Addiction

Hanna Pickard

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Princeton University Press

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What Would You Do Alone in a Cage with Nothing but Cocaine?

A Philosophy of Addiction

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Language: English

Published/Copyright: 2026

About this book

A revolutionary new paradigm for understanding addiction

Why do people with addiction use drugs self-destructively? Why don’t they quit out of self-concern? Why does the rat in the experiment, alone in a cage, press the lever again and again for cocaine—to the point of death? In this pathbreaking book, Hanna Pickard proposes a new paradigm for understanding the puzzle of addiction. For too long, our thinking has been hostage to a false dichotomy: either addiction is a brain disease, or it is a moral failing. Pickard argues that it is neither, and that both models stifle addiction research and fail people who need help.

Drawing on her expertise as an academic philosopher and her clinical work in a therapeutic community, Pickard explores the meaning of drugs for people with addiction and the diverse factors that keep them using despite the costs. People use drugs to cope with suffering—but also to self-harm, or even to die. Some identify as “addicts," while others are in denial or struggle with cravings and self-control. Social, cultural, and economic circumstances are crucial to explaining addiction—but brain pathology may also matter. By integrating addiction science with philosophy, clinical practice, and the psychology and voices of people with addiction themselves, Pickard shows why there is no one-size-fits-all theory or ethics of addiction. The result is a heterogeneous and humanistic paradigm for understanding and treating addiction, and a fresh way of thinking about responsibility, blame, and relationships with people who use drugs.

Reviews

"This book isn’t the usual book about addiction. . . . nobody seems to be able to agree on what addiction even is, or what domain of knowledge its study belongs to. Who better than a philosopher to kick the tyres of our uninterrogated intuitions and received ideas?"---Sam Leith --- "Anyone confronting addiction would do well to read Hanna Pickard’s new book, which should change how ordinary people and clinicians think about it. One important insight is that often a cure for addiction depends on the addict finding a new identity, other than that of being an addict. This is a book by a philosopher, based on experience in a therapeutic setting, that has the actual potential to save lives."---Brian Leiter, Leiter Reports --- "Pickard convincingly shows that while the diseased brain model aimed to destigmatize addiction, it has largely failed to do so while amplifying some addicts’ pessimism about recovery. Addiction researchers and clinicians will be enlightened." --- "[This book] has changed my understanding of my habits—and maybe it will change yours, too."---Jacob Rosenberg, Mother Jones --- "A brilliant and compelling contribution...that has the potential to reframe the public’s understanding of drug use and addiction. . . . It is a text rooted in radical compassion that supports autonomy, promotes responsibility without blame, and highlights the various factors that can cause and maintain an individual’s substance use over time."---Cassandra L. Boness, Science

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Frontmatter
i

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Contents
vii

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Note to Readers
ix

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Map of the Book
xi

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Introduction
1

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Part I. Explicating addiction
21

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Part II. Shifting the paradigm
75

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Part III. Solving the puzzle
123

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Part IV. Ethics and relationships
211

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Conclusion
270

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List of Acronyms
275

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Acknowledgments
277

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Notes
281

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Bibliography
301

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Index
331

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Publishing information

Pages and Images/Illustrations in book

eBook published on:

January 6, 2026

eBook ISBN:

9780691253558

Pages and Images/Illustrations in book

https://doi.org/10.1515/9780691253558

eBook ISBN: 9780691253558

Keywords for this book

Drugs; Addiction; Blame; Relationships; Brain disease; Addict; Cognitive; Psychological; Puzzle; Cravings; Conception; Denial; Pathology; Alcohol; Explication; Cocaine; Circumstances; Treatment; Consequence; Emotions; Clinical; Philosopher; Evident; Rats; Substance; Responsibility blame; Goal; Severe costs; Evident severe; Paradigm; Judgment; Mindset; Hurt; Abstinence; Profoundly; Attitudes; Intention; Animal; Heroin; Stance; Lever; Capacities; Irresistible; Psychology; Symptoms; Moral; Scientific; Agency; Conversation; Therapeutic; Abstain; Addict identity; Medication; Community; Opioids; Voluntary; Active blame; Significant; Volitional; Anger; Cravings drugs; Heterogeneity; Sake; Food; Attributions; Diagnosis; Punish; Habit; Cues; Morally wrong

Audience(s) for this book

For an expert adult audience, including professional development and academic research

Princeton University Press

What Would You Do Alone in a Cage with Nothing but Cocaine?

Overview

About this book

Reviews

Topics

Table of contents

Frontmatter

Contents

Note to Readers

Map of the Book

Introduction

Part I. Explicating addiction

Part II. Shifting the paradigm

Part III. Solving the puzzle

Part IV. Ethics and relationships

Conclusion

List of Acronyms

Acknowledgments

Notes

Bibliography

Index

Bibliographic data